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Californication, or things I say to clients


“Sarah Nevin once told me I could ask to see my guardian angels in dreams. I asked and I’ve never had worse nightmares in my life. ‘Ask them not to scare you,’ she says. Since then they’ve always shown up to deliver messages in disguises that make me laugh – because my GAs are smart asses. Last night they were the Red Hot Chili Peppers. Very funny, silly angels… But seriously, I didn’t believe her and then I tried it. Now…there they are.”*

Yes, this sounds like something I would say. No, I don’t remember this moment, not at all actually. It’s always fascinating to discover what clients retain from our sessions. The words, “And then I remembered what you said… blah blah blah” always fill me with a mix of anticipation and dread, because even though it’s exciting the client remembered something, I have NO IDEA what is going to be attributed to the therapy and to me.

Often what clients remember has to do with emotional memory. A phrase or story sticks with them because they either really liked it or sort of hated it. Sometimes what comes back to me doesn’t sound like myself, at least not to me. But I don’t think this means that one of us is wrong in our memory. Rather I prefer to look at it as symbolic content. Why is this memory/phrase important? What made this comment stick over the hundred other comments from that session, or the 1000s of comments from the previous months? Even if that’s not how I believe I might phrase a statement or a question, why would it be important to this client that it be remembered in this form?

One therapy school of thought is to treat ALL content in a session as symbolic. Which means even though you’re telling me about an encounter you had at the grocery store, and then an argument you had with your mother on the phone, followed with, say, a childhood memory—one of my jobs is to wonder how do all these seemingly disparate items fit together. What is in common? What might the client really be telling me? As if the session itself is like a dream. (Of course, I’m going to also pay attention to the reality of what you’re truly saying simultaneously so that the session does not get lost in la-la-land.)

But. And. What if it’s true that life is but a dream? Something fun to think about…

*printed with permission from a former client
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Better than sunshine


I may be the only person I know who didn’t enjoy “Little Miss Sunshine.” The same movie studio produced a new film this summer, “The Way Way Back.” Naturally the film is being compared to LMS, but I like the characters in WWB much better. In LMS every character had some kind of goofy personality defect, but in WWB there were some characters whom are just believably struggling—and those are the ones who carry the story. Some reasons this film is worth seeing:

1. Don’t believe the people who try to convince you that you’re lesser than you think, even if couched as constructive criticism. Also, that the best revenge for these types of negative, critical people is to succeed despite them. Don’t cave in on yourself and let their judgements contribute to one’s low self-esteem.  What happens when one can fuel frustration into action as opposed to self-defeating behavior?

2. No matter how dismaying or confusing your personal situation is, you can still contribute positively to another person’s life. Often times having a disappointing outcome in one’s own life opens a door into being able to feel empathy with others. Not that misery loves company, but because difficult life experiences allow us to authentically relate to and recognize another person’s struggles. And sometimes being there for another person can put our own troubles in perspective, or bring an unexpected joy to one’s life.

3. Being afraid that you can’t succeed on your own merits can trap a person in an untenable situation. Fear of being unlovable is one of the most common human fears. Fear of not being able to financially support one’s self is another. People often compromise their beliefs and/or values in order to stay in the “safe zone.” While it’s fully understandable why people do this, it often comes at a great cost to the individual. It take much bravery to risk facing these kinds of fears.

SPOILER ALERT: I’m guessing most people will leave this movie cheering for the kid. However, I’m cheering for the adults. Specifically the fun park manager and the mom. Both of these character exemplified the above points in different ways. The kid was great, don’t get me wrong. But as kids it’s part of the job to push the limits and explore new territory, but for adults to realize their issues and to take risks and grow in spite of that—that behavior deserves extra commendation.

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More and more people have met their current partner online. And even if not successful, many people have participated in some form of online dating. In today’s modern world of adult relationships, if you’re seriously looking to meet someone, chances are that a dating Web site is somewhere in your future.

This is a terrifying prospect to most.

“What do I say, what kind of photo do I post? How do I screen other profiles? What if I meet him/her and they are not like their photo? What if I don’t like their personality?” To which, of course, the answer is always (infuriatingly) “Be Yourself.” Another sage piece of wisdom, “If it’s not a match, don’t take it personally and move on without emotional drama. Thank you, but no thank you.”

Easier said then done.

In therapy, we often talk about discovering people’s attachment styles and try to help them pick a better match. Often I try to help people go against pattern or type, especially if the normal pattern is the same mis-match over and over again. Sometimes in dating one can discover a mis-match over coffee, most of the time it requires a greater investment of time. And bravery.

And the willingness to learn about one’s self.

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Dog Attachment

The researchers concluded that dogs were only motivated to play because they were more secure when their owner was present. “One of the things that really surprised us is, that adult dogs behave towards their caregivers like human children do.”

Without recapping the entire article—the full article link is below, when a dog loves it’s owner and feels safe, then it wants to play in the presence of the owner/parent. And that a playful dog will play less when the owner isn’t present. (Maybe this explains why  my puppy goes crazy, or super-playful, inside with me after an extended period in the yard. You’d think she would be tired, but no, she wants to play more!)

Many years ago I adopted the best-dog-ever, Taft. He was a 10-month old stray who had clearly been over-disciplined and then abandoned in a local park. When I first got Taft he was so well-behaved that he would voluntarily leave the room when you put food on the table. However, he didn’t know how to play with toys, people or other dogs. I had to teach him how to have fun. Which  makes me wonder, most likely Taft was loyal to his former owner, but what if he didn’t feel safe and loved? And clearly those feelings were confirmed when that person left him in the park.

Sometimes I see similar traits in people. They don’t know how to play, they can’t have fun with others because they’re so anxious. They don’t feel safe in their environment and/or they don’t have a secure home base from which they launch out and explore the world. Sometimes these people have trouble picking out a good partner because they don’t know what’s safe or not safe. Or they have trouble trusting their current partner for similar kinds of reasons. I view these kinds of bonding troubles as attachment issues.

Attachment theory informs a large percentage of how I view what patients bring up during sessions. In a nutshell people classify as anxious, avoidant, or securely attached. Much of this stems from our childhoods, other parts of it come from our adolescent and adult experiences. It’s always wonderful to sit with patients as they learn about attachment styles and use this knowledge to help unravel questions and problems in their life.

Haven’t most of us had people in our lives that we don’t feel safe  to “play” in their presence? What questions come up when one thinks about with whom and how do we choose our adult friends and family outings?

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Goodbye, Tony

“This psychiatry shit. Apparently what you’re feelin’ is not what you’re feelin’ and what you’re not feelin’ is your real agenda.” – Tony Soprano. RIP

I feel that I owe a small debt to the Sopranos for career marketing, because a common question strangers ask each other is, “What do you do?” When I respond, “I’m a therapist.” The next question is usually, “What kind?” To which I often find myself saying, “A talk therapist, you know, like on the Sopranos.” And, almost everyone I meet has watched the Sopranos and knows that Tony went to therapy.

Television mimics real life, making some things appear easier or harder than most of our actual experiences. Tony’s television therapy experience was polished to include brilliant interpretations in every session, which actually doesn’t always happen. But Tony’s resistance to therapy: his disagreements with Dr. Melfi, his anger at her interpretations, his threatening to leave therapy, and his unwillingness to give credit to the therapy vs the medications—those are all normal challenges people can have in response to therapy.

The remarkable, laudable trait about Tony is that he stayed in therapy, even when he was unhappy with it. Or, at least he returned to Dr. Melfi during his difficult periods to try and understand himself and his confusing world. Perhaps it’s the fact that he tried to wrestle some with his interior life that allowed me to have a soft spot for Tony, who otherwise would be just another sociopathic, power-hungry mafia boss/murderer.

As far as the above quote, and what’s obvious or not in therapy, part of the therapists job is to track content, patterns and signs/symbols. Often times all the content in the therapy session is related, even if it feels like it’s not. At the end of a session, perhaps the patient disagrees with the therapist’s interpretations. But also, perhaps it will register in the patient’s subconscious, spawning later discussion or different thinking. Therapy is generally not an immediate gratification process, another concept with which Tony struggled.

The world will miss James Gandolfini, by all accounts an intense, multi-faceted, challenging, surprising human being.

* I am not a psychiatrist—I am a psychotherapist.

** One of my former neighbors claims Gandolfini rushed him and his dog to the ER after witnessing a doggie hit and run. Animal lovers get lots of credit at our house.

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Each time you meet an old emotional pattern with presence, your awakening to truth can deepen. There’s less identification with the self in the story and more ability to rest in the awareness that is witnessing what’s happening. You become more able to abide in compassion, to remember and trust your true home. Rather than cycling repetitively through old conditioning, you are actually spiraling toward freedom.  – from Tara Brach, “Finding True Refuge”

This quote is referring to meditation practice, but it can also apply to therapy. “Each time you meet an old emotional pattern with presence” could also be interpreted as “every time you notice your self repeating an unwanted behavior.” This behavior could be anything from having road rage on a regular basis to finding yourself dating the same type of undesirable personality multiple times. The key is to finally recognize the pattern, to learn to witness one’s own  behavior.

In meditation one can learn to witness one’s thoughts as they go by, without getting caught up in all the different stories that run through our heads when we are doing so-called nothing. In a similar vein, with therapy it is possible to begin to see how one might be choosing unwisely and acting accordingly, again and again. (You don’t have to learn meditation unless you want to…) Therapy can help to slow things down, to begin to examine behaviors in a different way, to attribute a new meaning to old habits, and to help one find love toward the self despite the same missteps taken (again.)

Re-patterning one’s habits/known choices can be a long spiraling journey. But every time one can face the same negative behavior and know it, then each encounter can begin to be from different parts of the path instead of the same spot. Hopefully, eventually, the demon might even become your familiar friend—a part of self that is recognizable, understandable, know-able— and life can become more about choices/freedom, and less about reactions.

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Two Views of Notre Dame

by Henri Matisse, 1914 -- Paris

by Henri Matisse, 1914 — Paris

In 1914 Henri Matisse had a Paris studio overlooking Notre Dame cathedral. He painted the scene above left from his window view. Later in the year he painted the blue painting to the right. Can you tell they are both paintings of the same scene? If you look carefully you can see the two bell towers, prominently shaded in the blue painting. Then, look below the towers and  notice the heavy black lines. It is there you can see the arch of the bridge, mirroring the same degree of curvature as the first painting — and also the street that runs above the bridge, as well as the outline of the street and walkway that run along the river.

Remarkable that two paintings can look so different, yet be of the same scene and by the same artist? These paintings remind me of the therapeutic theory of object relations. Object relations is when a person relates to others and situations in his/her adult life based in many ways, unconsciously, by their own infant/childhood family experiences.

It is not unusual to discover that one’s life has patterns. Some patterns repeat and we don’t know how to change them. We don’t know how we got stuck choosing the same  job, or the same date, or having the same  fight with our friend / family. In therapy there are opportunities to examine these patterns, to notice when the hidden structure becomes more obvious, to begin to relate what might have been disparate patterns into one larger cohesive structure.

Matisse was working on the nature of perception with these two paintings — also something we do in therapy, albeit differently. How do we perceive our own lives, what would we like to change? how would we like to move our lives forward to begin to resemble the vision we can see for ourselves in our minds eye? While we cannot alter the basic foundational structure of our early experiences, one does have choices in how to move forward with the overlaying art(work) that becomes one’s adult life.

These paintings are currently on view together at the Metropolitan Museum of Art in NYC until March 17, 2013. http://www.metmuseum.org/exhibitions/listings/2012/matisse/introduction


Why Sadness?

Friday night I saw Zero Dark Thirty. Warning: spoiler alert–I am going to talk about end the film. The last scene is Maya boarding an empty hanger plane as the only passenger—the pilot even comments that she must be an important person because she has the whole plane to herself. He then asks her where does she want to go (leaving Afghanistan)? The scene cuts to a closer view, and there are tears streaming down her face. The film ends with her crying in the plane. We don’t know where she is going.

I found myself wondering why might she be crying? Mostly I assumed it was because she had just completed an insurmountable task that had consumed her entire being and was horrifically difficult. Along the way to achieving her goal she appeared to have sacrificed any kind of normal civilian life, put herself in unimaginable inhumane situations, worked 100 hours a week for the majority of 12 years, and lost some of the few friends she had to terrorism. And then at the end of it, she had to identify a bloody corpse that had died a violent death. Who wouldn’t cry?

After the movie, at dinner I was eavesdropping (a horrible habit most of us who study humans and behavior can’t seem to stop ourselves from doing) on the table behind us. They had also been at the same movie. The woman of the couple was saying that Maya was crying because she had no where to go.

The narrative of the character implies Maya had no intimate relationship, in fact she barely had interpersonal relating of any sort. Her personality was on the crispier side of intense. She was even referred to within her agency as “a killer.”

Being single definitely has it’s pluses and minuses. It would have been much harder to be laser-focused on her career had she been maintaining outside relationships. Maya achieved massive professional success. There are definitely periods in life where it’s a bonus to be able to be selfish with one’s time. However, the woman at the other dinner table seemingly thought the cost was too high, because she had no “nest” to welcome her home at the end of a (metaphorical) long day.

Of course balance is generally the desired solution, but sometimes there are periods in life where it’s impossible—whether we’re in too much relationship(s) or not enough—how can we know we’re making conscious choices? Or at least the right choices for ourselves? One person’s right choice often looks different than someone else’s. And sometimes we need help to regain one’s footing.