Awakenings

“All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another.”

Anatole France

Most of my life I have felt like I have been poking around in a dark room. Much of the time I have been able to make extremely thoughtful assessments of why I do the things I do, but almost always after the fact, and often when it was just a little too late.

In the grand accounting of difficult conversations I have had in my life, today was absolutely at the top of the list. I heard and confronted some things about myself today that cut very deep into the core of my deeply-flawed self.

The crux of what I discussed today in therapy was about Tommy, my actions with his father, and my subsequent actions arising from his case. After all my protests, all my rationalizations, and all my anger, the session reached its climax when I was asked by my therapist, point blank, just which little boy I was trying to save, Tommy or myself.

This question found its mark. I sat in stunned silence for what seemed like several minutes and truly contemplated everything I had done over the last couple days regarding this case. To react with the level of anger that I did was indicative of a far greater reaction than simply protecting a child, I knew this. Somehow Tommy’s father, in one moment became for me a representation of all of the powerful objects I have been unconsciously fighting with for my entire life.

Facing this was important. When one accepts the responsibility of becoming a psychologist, it is a virtual certainty that we will hear stories of some of the darkest and most sinister actions people are capable of. Our job is to listen with empathy and compassion and build affective relationships with the people who put their trust in us. This demonstrates the power that can occur when two people truly and honestly connect. We are not avenging angels and it is not our duty to set things and people right.

And yes, this even means not striking child-molesting monsters despite the fact that our every instinct tells us to do so. This is a fantasy most people would love to indulge, but by the very nature of my position I am not entitled to do so. It’s not what I’ve signed on for.

As to my desire to save Tommy, I clearly see a number of parallels between his life and mine. He is angry and he is confused and he has a terrible secret, and life has brought the two of us together to deal with these problems. Ultimately a psychologist has only one thing to use in therapy and that is himself. This is only entirely possible if we have really examined our own issues and learned how to put them to rest. Those of us who have not done this allow our emotional difficulties to seep into our work, and when this happens therapy is just not that effective.

I go home totally drained. One thing I don’t seem to want anymore is a drink. I’ve been through to much to surrender to such a petty and temporary solution to my problems. No the real battle is now with myself, and deep down I know it always has been.

In this battle honesty is my best ally. With the help of my therapist I am learning to truly examine how, in my case the child has truly been the father of the man. I’d like to learn to examine my own behavior in the moment. My whole life I’ve always been a half step behind, and this one half step has dramatically affected my ability to find happiness.

Sychronicity

“We plan our lives according to a dream that came to us in our childhood, and we find that life alters our plans. And yet, at the end, from a rare height, we also see that our dream was our fate. It's just that providence had other ideas as to how we would get there. Destiny plans a different route, or turns the dream around, as if it were a riddle, and fulfills the dream in ways we couldn't have expected.”

Ben Okri

I saw Tommy again today and am continually amazed at how well he seems to be holding up. I realize that a great deal of the damage that has been done to his psyche is still buried deep inside of him, but he has begun to talk about it, and if we can talk about it I can reinforce in him that it wasn’t his fault. If he can begin to internalize this, the intense guilt and shame most victims of sexual abuse feel may be at least partially neutralized. Much good came of his talking about what happened so soon after it happened, as now we can process this “secret” and not allow it to become buried deep in his unconscious and destroy his life.

There is much work still to do, perhaps a lifetime’s worth but we have started, and he is incredibly resilient. His strength has made me strong, and I hope he has also drawn something from me. I am beginning to feel responsible for him, and he is pulling a very strong paternal, nurturing feeling from me. This is dangerous. Although he absolutely needs a strong, familiar presence in his life right now, I have to be careful not to create a relationship based on dependence, for him or for me.

Later that night I go and see Darren, my patient who is a musician play a big show he has been looking forward to for quite some time. He told me it would mean a lot if I came to his show and so I came, but this too is problematic. Perhaps I am becoming to attached to my patients in the absence of any significant substance in my own life. This is something I want to think over and consider.

The issue here is one of boundaries. In a therapist’s office two people discuss some of the most intimate moments in a person’s life. The job of the therapist is to first build a powerful relationship with this person, and model, through this relationship, skills that the person can then take back to their lives. The therapist is not supposed to literally return with the person to his life.

Attending a concert of a patient certainly walks this line. Although we have a very easy-going therapeutic relationship, it is still ethically questionable. I went to this show with the intent of showing support and seeing someone I believe in realize a dream. I have always thought some of the ethical rules concerning this kind of thing were a little rigid and even silly, but at this point in my career I am in no position to be playing cowboy with the rules. I have to make a real examination if I am using my patients to fulfill some of my own needs related to loneliness and a need for companionship. I will give this some serious thought.

But sometimes you also have to throw the book out the window. In the case of Tommy, he needs an advocate, a friend, a surrogate parent, as well as a therapist. I am well aware that I am perhaps over stepping my bounds by trying to be all of these things for him, but I want to at least see him through a few weeks before I start thinking about the implications of this. I know all too well how children can get lost in the system. I myself was lost in the system. The sychronicity of this does not escape me. Tomorrow I will make another appointment to see my therapist.

A day of reckoning

During the twenty months in which I experienced psychotherapy, perhaps one of the major constants was surprise……..This voyage of discovery was the most incredible I’ve ever known.

Roger Walsh

When you’ve worked as a therapist long enough you become a master debater. The process of challenging illogical thinking, offering counterpoints, issuing challenges, and when necessary outright confronting people all make a therapist a verbally agile craftsman in the use of language. I’ve talked my way out of many tight situations over the years, averted crisis after crisis, and untangled myself from more potential messes than I’d care to remember.

All of that ended today. My new therapist saw right through all my cleverness, diversions, and subterfuges, and made me face some hard truths about why I do the things I do. I was amazed at his gall, incredibly irritated, and appreciative that this might be the first person in my entire life who truly holds a mirror up to me in a brutally honest way.

Today we got into the twin demons of my defense structure, humor and intellectualization. I have become highly adept at shifting in and out of these two modes of communication throughout my entire life, and in doing so have managed to wind up exactly where I sit today. In other words they have allowed me to reach a position of some degree of success and even prestige, while also helping walk me right to the brink of the cliff of self-destruction.

The nature of defenses is they protect us from pain. Most people have several, and many of these are adaptive responses to stress and anxiety. Denial is a very common defense, as is rationalization, and I am more than familiar with both in my own life. Defenses become important when they begin to strongly interfere with our everyday functioning.

As was pointed out to me today, I have learned to talk circles around my own drinking problem and explain, rationalize, and expound on it in a myriad of different ways. What I haven’t done is take a long look into the mirror, and admit that what I am doing is utterly destroying me physically, mentally, and spiritually.

As was also pointed out to me today, I constantly deflect problems by telling little jokes, which creates a temporary subterfuge to avoid talking about my own problems. Hard to argue with this one. But hearing it so directly and so bluntly was still aggravating, which was of course because it struck directly on top of a nerve.

When I left today I felt stripped naked. The cardinal rule of stripping people of their defenses is you don’t engage in this process unless you have something else to offer in its place. No such offer was tended to me today. Perhaps he wanted me to experience what is known as “optimal frustration.” Which, according to constructivist therapy is necessary for fostering independence

optimal frustration has these main points:

• “Children, especially young ones, have fundamental tendencies toward being dependent, selfish, and irrational.
• The child must be forced through frustration to develop: a sense of self separate from caregivers; control of emotions and impulses; respect for others; adaptation to reality; and the skills of independent living.
• While caregivers should be sensitive and nurturing (that's the "optimal" part), frustration is the necessary and primary pathway through which children build the cognitive and affective structures of the self.”
• 
  

The difficulty with understanding this, is that, despite the fact that I am in my thirties, I am the child in this scenario. This is known as “reparenting” and today I got some tough love. I’m trying deep down to shake off my anger and fully engage in this process.

Because…..Somewhere there is a real child who is depending on me, and I owe it to him to give him every bit of what I have to give without my personal baggage getting in the way. This is keeping me going right now. So yes, I will be “the child” in therapy if it means I am better able to help a real child who is teetering on the verge of the abyss. I am collecting and integrating myself and gathering strength for him, and for me. This time the stakes are much higher.

A nagging question

If you have made mistakes, even serious ones, there is always another chance for you. What we call failure is not the falling down but the staying down

Mary Pickford

I met today with my local review board of the American Psychological Association. While in front of them I faced a very serious decision. I could tell them that I felt I was in physical danger from Tommy’s father and acted in self-defense, or I could tell them what really happened. In thinking about this decision I wanted to factor in what the best decision would be for Tommy in this case, and I decided to tell a lie. I realized the seriousness of this decision, and what I would have to live with as a result of it.

With the receptionist corroborating my story, the review board agreed to let me retain my license and practice if I agreed to enter into counseling of my own to discuss any possible issues I may have with excessive anger. I agreed to this stipulation and stepped out into the afternoon sun, basically free to return to my livelihood, which had taken on newfound significance given the seriousness of what had happened with Tommy over the last week.

And the fact is I do have some serious issues to address. This is obvious. The credo “first do no harm” is as relevant to psychology as it is to medicine, and I had nearly killed a man. Whatever this man was, I’m quite sure I could have easily beaten him to death if other people weren’t around.

In the back of my head a sinister and daunting question has been forming that I have been afraid to let crystallize. This question thumps in my mind like a tell-tale heart beating louder and louder until finally I have to stand and face it. The question is “whose father was I beating up, in that moment, Tommy’s or my own?” The question sickens me but I know I have to answer it. There may not be an answer to this question. Perhaps my past and present selves are so intertwined that I’ll never completely untangle them. I know this is likely true. But if I am violent I have to face that. I have responsibilities and people counting on me.

Later that day I make an appointment to see a prominent yet eccentric therapist, who has the reputation as being extremely tough, yet also very kind. Therapy is going to be quite difficult this time around, and I am looking forward to it while also being a little apprehensive. A part of me thinks this might be the last shot to get it right, but I don’t want to get down on myself.

For once in my life

“For once in my life I have someone who needs me
Someone I’ve needed so long
For once, unafraid, I can go where life leads me
And somehow I know Ill be strong

Stevie Wonder “For once in my life”

I saw my friend Tommy today. He is staying with a foster family who seems very nice, and because I am his therapist of record I was allowed to take him out to lunch. He does not know what I did to his father and I’m not sure I want him to know, not yet anyway. For now I want to act entirely in his best interests, and that means not adding any more stress or worry to his life right now.

We had pizza and talked sparingly. It was clear he is incredibly scared and confused, and I realize it may have been better to do this in my office. I know he is still in a great deal of shock, and I don’t want to push him to talk if he isn’t ready. On the other hand I know it is important he does talk about it and for me to let him know that whatever it is he is feeling it is ok for him to feel like that. He is, quite literally, being attacked by guilt and shame right now, and I want to let him know that he can tell me anything and have it be OK.

Halfway through our meal he says he likes it with his new family and how nice they have been to him. I am again amazed at his strength and resilience and tell him how proud I am of how strong he has been which makes him smile. We switch into a conversation about the Chicago Bears, and I am perfectly OK with this. Although I have been ostensibly trained to deal with these situations, I am terrified of saying the wrong thing. In this moment, I am trying to operate simply out of human kindness, and be there for him if and when he is ready to talk.

As I dropped him off, he looked up at me with sad eyes, and asked when we’ll see each other again. The truth is I don't know. Although I haven’t officially been suspended or reprimanded, I know that there will be some serious questions I have to answer before I go back to work. I explain to him that I’ll see him as soon as possible, but this doesn’t seem to satisfy him. It is an evasive answer and for someone who has been lied to as much as he has it’s a poor choice of words. Still, I really don’t know.

“I love you,” he says as he opened the car door, anxiously looking at me to see what my response would be.

And in this moment I am truly at a loss about what to say. Clearly the response he craves very badly is, “I love you too”, but this may be a dangerous thing to say. I’m not sure what his definition of love is given his history, and am afraid of evoking any confusing feelings. On the other hand, this is a human being badly in need of reassurance. His pain is likely of a magnitude I haven’t even come close to experiencing. I look down and he was still looking at me with expectant eyes.

“I love you too kiddo” I said, “And I want you to know that you can count on me to stand by your side, whenever and whatever you need, okay?” I ask.

“Okay”, he says and heads to the house with a faint smile. As I pull away I see him turn his head back towards the car and wave, and I wave back as I pull away. I look in my rearview mirror and see that I have begun to cry again, and I pull over and try and make a fair assessment of my feelings. The universe has thrown me a very difficult challenge, and I need to reach deep inside myself and rise to this extremely difficult task. For the first time, perhaps ever, I’ve come to understand what it is to be truly needed by another human being.

Lost innocence continued

“But man is not made for defeat. A man can be destroyed but not defeated.”

Ernest Hemingway

When the dust settled, the parents of the boy I was seeing were both arrested. The boy had bruises all over his legs and private parts, and he was convincing enough for the district attorney to press charges. Should this case go to trial, I may have lost my chance to testify given the magnitude of the violence I inflicted on the boy’s father. The DA was very disappointed in me, lectured me sternly, but in the end pressed no charges. I had dodged that bullet.

But…. My partners felt it would be best if I took a couple of weeks off while the American Psychological Association sorted out what to do with me. I didn’t object.

Although my professional life literally hangs in the balance, something inside of me has changed. I feel powerful and I feel strong. I have conquered some kind of demon that has been dormant inside of me and become a man of action. For the first time in quite some time, I have no urge to have a drink. It would be an insult and a dishonor to a little boy who proved to me what real courage really means.

Philosophically I have to come to terms with what I’ve done. As a psychologist I have been deeply habituated to believe that problems have non-violent solutions, and that violence is the very antithesis of what we do. I have always subscribed to Edmund Burke’s idea that “All that is necessary for the triumph of evil is that good men do nothing.” For me this fight has thus far consisted of summoning all of my reason and compassion to help people along the way. Until yesterday. Yesterday, sensing that I was in the presence of pure evil, I returned to the most primal method of conflict resolution known to man.

Which brings us to the question of evil. Is there such a thing? A great debate between Rollo May and Carl Rogers took place on this issue, and I’ve always leaned towards Dostoyevsky’s view that “If the devil does not exist, and man has therefore created him, he has created him in his own image and likeness.”

Gilbert Ryle thought of evil as the “ghost in the machine.” Basically he suggested that as man has evolved, he has retained some of his primal urges which can override the higher brain and lead people to do hateful and evil things.

Over the last couple of days I have searched my mind for possible alternative explanations as to how someone can molest their own child for years in conjunction with their spouse. I have worked with sex offenders, have heard their stories, and tried to understand how their twisted logic develops. I understand that many of these people were themselves molested and the developed a very maladaptive view of human sexuality. I’ve seen it and I’ve tried to help these people.

But….. to take a child who came out of your womb and to hurt and destroy him sexually, and for the father to respond by molesting him as well? There is no explanation for this except pure unadulterated evil that makes any kind of sense to me. Perhaps this is still my anger talking. But truly, beyond whatever forces twist and distort a person’s sexuality, there is a moment when they look into the eyes of a crying and terrified child and have a choice, and when they make the choice to satisfy their own needs at the sake of this terrified child, that is evil…….

Can evil therefore be learned? I guess it can. Perhaps this is even predominantly the source of evil in the world. Perhaps children who are neglected, abused, scorned, and ridiculed by those who they are supposed to trust the most learn to simply act on all of the anger that is inside of them. Freud said “I cannot think of any need in childhood as strong as the need for a father’s protection.” Maybe betrayals of this magnitude are what gives birth to evil, I’ve certainly seen it happen.

Which brings us to the real point of what it is I’ve done. Somewhere there is a little boy sleeping in a strange home who is terrified to death. Without the right assistance this little boy may very well turn into an evil person. He has been betrayed very badly, been used for others pleasure, and has likely got some very confused ideas about what love might mean between a parent and a child.

And he trusts me. If I can’t be a psychologist anymore, then perhaps I too have betrayed him. I couldn’t live with this. I am the only adult that he trusts right now and it is of vital important that I stay in his life right now. For the first time I’ve truly come to understand the magnitude of what it is I’ve been called to do. I must stay in this boy’s life, and to do this I have to get back to work. The existential shock of these events has brought me back to life, A drink is truly the last thing on my mind right now. Someone needs me very badly and I need to keep a clear head.

The ceremony of innocence is drowned

“Turning and turning in the widening gyre The falcon cannot hear the falconer; Things fall apart; the centre cannot hold; Mere anarchy is loosed upon the world, The blood-dimmed tide is loosed, and everywhere The ceremony of innocence is drowned; The best lack all conviction, while the worst Are full of passionate intensity.”

William Butler Yeats

There’s nothing quite like the tears of a child to take an icepick to even the most frozen of hearts, and today I heard a story that put mine over the edge. It was from a little boy I have been seeing who came in because his parents felt he had “emotional problems”, and yes he certainly does. We have been meeting for several weeks now, and finally, after weeks and weeks of compassionate struggle, he said the words every therapist dreads hearing the most, “my mommy hurt me.”

Those words opened a floodgate of emotion in this child, and between his tears, he told me his dark and horrible secret. His mother had been coming into his room at night for several years and molesting him.

This alone would be cause for powerful shock and sorrow, but indeed the story had gotten even worse. When the child had gone to his father and told him about this, he had molested him as well. He had also told him that if he told anyone about this then he would have to kill him. This was his secret, his guilt, and his shame, and the roots of his “emotional problems.”

How he was able to tell me this story I have no idea. I have seen some tremendous acts of courage in my life, but never, in all my years, have I seen someone summon the amount of bravery that this child did during this one terrible hour. I wanted to hug him and hold him and protect him, but I realized being touched by another adult would send confusing signals. In that moment, all I could do was assure him that he was safe and his parents weren’t going to be doing that to him anymore.

When you hear these stories, your first obligation is to the child. Despite the fact that I was filled with both murderous rage and penetrating sorrow, I had to summon my rationale powers and follow protocol. I called DCFS who sent someone to my office to pick up the child. I cancelled the rest of my appointments for the day and accompanied him to their office so he could be with a familiar face for the rest of the day. I knew he would have to tell his story at least one more time, and when he did I wanted him to know I would be with him.

He was terrified and he was in shock, but the composure that little boy showed over the next several hours was truly astounding. It made me ashamed to think that my little problems kept me running towards the bottle when an 8 year old boy could show this kind of courage and resilience. At then end of the day as we parted company he hugged me. It was perhaps the most incredible act of trust I had ever witnessed from another human being considering where this little boy had been. I assured him I would do everything in my power to be with him in every way I could as we sorted out how we were going to keep him safe.

When I stepped out of the office I began to cry, softly at first, and then an open and torrential cascade of tears. I wept as strongly and as powerfully as I ever had in my life in that moment, and literally sobbed until I had no more tears left to give to this shitty fucking world we live in.

I went back to my office, utterly drained and as discouraged with the human condition as I had ever been in my twisted and pathetic life. As I entered my office I felt a hand come down on my shoulder and I slowly looked up, not fully understanding what was about to happen. And then, the realization of what stood in front of me slowly began to crystallize. Before me was the father of this boy, and he had just put his hands roughly on my shoulders.

In retrospect I don’t fully know what happened next, but I do know that in that moment, every part of my rationale brain had utterly and totally disappeared.

The next thing I remember there were several more hands on my shoulders, but none of them were powerful enough to stop me. I was striking a bloody and mangled man who I now lay on top of over and over and over again. Finally as I began to tire I took stock of my surroundings and began to get some comprehension of what it is I had just done. I had nearly killed a man. Not really a man, but a pathetic excuse for a human being. In that moment, had there not been security guards present, I truly believe I would have taken this man’s life.

When the police eventually came there was a lot of sorting out to do. The receptionist explained to the officer that the man had violently put his hands on me and that I had acted in self-defense, but I knew that this was a lie. I had utterly surrendered to every savage impulse I had inside of me, and given the chance, I would do it again.

So we all went down to the police station, and when they heard the story several cops came and congratulated me. But deep down, somewhere inside of me, I know that much of what I did was for me and not that little boy whose interests I am supposed to be protecting. I am racked with guilt, shame, pride, and intense confusion. It remains to be seen if I am still a psychologist. Time will tell.

Story of my life

The greater the feeling of inferiority that has been experienced, the more powerful is the urge to conquest and the more violent the emotional agitation.

Alfred Adler

For most of my life I’ve thought reading books was the answer to my problems, and for the most part I have solved a number of problems from the wisdom I’ve gained from others. Joseph Campbell has been my constant companion for many years, as have Dostoyevsky, Vonnegut, Hemmingway, Steinbeck, John Irving, and many, many others.

As a lonely child who had suffered the loss of his mother, I found a wonderful escape from pain through reading, and it is not a stretch to say that reading has both figuratively, and even literally saved my life.

So slowly I progressed from a broken, wounded, scared, angry child to one filled with intense intellectual curiosity. It was the way I learned to defend myself from the world. By becoming an expert. By becoming even more of an expert than teachers, relatives, foster parents, and many others I spent my childhood with as I learned to make my way in the world.

As a result of this I built a fortress built of knowledge around myself that became impossible for others to penetrate. If someone knew more than me about something, I went to the library and read everything there was to know on that subject. No One was going to tell me how life was supposed to work again, not after my life had crumbled so badly.

And so it went. Despite some fairly normal adolescent stumbles I became an expert at succeeding in academic environments. Somewhere along the way I realized I had become a know-it-all. I was always the kid who answered the questions before the others, and soon found this was not the best way to succeed.

So I developed some charm. From my father I had learned how to tell a story, make people laugh, and tell people what they wanted to hear. All of these things served me well, and soon I developed a kind of duel persona. I could be “the expert” when I had to, but could also downshift into glib and superficial charm when it served my purposes. Soon a schism between these polarities developed, and I became a kind of Jekyll and Hyde character, full of vigorous intellectual energy on one side and smarmy and superficial charm on the other.

Nathaniel Hawthorne said “No man for any considerable period can wear one face to himself and another to the multitude, without finally getting bewildered as to which may be the true.” This was me. This is me. Vacillating between these two extremes.

So, I kind of learned to adopt whatever persona people needed from me. If someone needed to laugh I made them laugh. If they wanted a rigorous intellectual discussion I could put on that face. Somewhere in the midst of this confusion I began to drink, a lot. It was the only way I ever felt at peace. This then became a deeply habituated pattern of behavior which became my strongest and most indelible coping style.

This set me on a crash course towards alcoholic oblivion. In my early twenties I was drinking so much it was a wonder I survived. Still, I managed to maintain a straight A grade point average. Along the way I also became an actor, performing in plays and using what I had learned from my father to entertain. On paper I was an eclectic, successful man of many interests and passions, in reality I had become a very severe alcoholic.

Sometimes the most unlikely people come into your life at exactly the right time and through you a rope. For me this happened when I wandered into a nursing home and worked as a volunteer. Although I did this as kind of a lark, I soon found I had discovered, in the most unlikely of places, the meaning of how powerful it is to give a part of yourself to others. In this nursing home I discovered most of what I know about serving others, and, although I only intended to stay for a couple weeks, I soon quit my job and began working there full time. I stayed for two years. While there I learned about the power of empathy. It changed, saved, and launched the life I would come to inhabit.

So I became a psychologist, and for years did this with a fair degree of competency. But still I had secrets. I would close bars down by night and then get up and go to work. I was young, I had company, and my life didn’t seem that much different than anyone else of my age and station in life.

As I got older I started to realize something was wrong. I began drinking during the week, alone when at home, and sometimes even in the morning when the discomfort became to severe. So I learned to wear the mask. To smile and laugh and pretend when inside I was dying.

Along the way I did a great deal of self-analysis. I learned to recognize my triggers for drinking and this was an important realization.

I discovered that I was a victim of emotional highjacking. I would become overwhelmed by the unresolved emotions from my youth, and all of a sudden my rationale brain would shut down. Adrenaline would overwhelm my body and I would become emotionally agitated. I solved this by drinking. I still solve this by drinking.

So that, in a nutshell is a large part of how I came to drink. There are other genetic and situational forces that are relevant, but basically that is it.

I tell this story because it speaks directly to the idea that a person can know virtually every reason that they drink, all the consequences, and still not be able to stop. I can’t stop. Not yet, I’m still not emotionally balanced. Years of both giving and receiving therapy has not restored this balance.

So here I sit. Alone. Unable to form a real relationship with someone else, and watching TV. I want a drink. After purging all of this from my mind I still want a drink. How? Why? Who can help? What can help?

The powerful play goes on

O me! O life!... of the questions of these recurring;
Of the endless trains of the faithless--of cities fill'd with the foolish;
Of myself forever reproaching myself, (for who more foolish than I, and who more faithless?)
Of eyes that vainly crave the light--of the objects mean--of the struggle ever renew'd;
Of the poor results of all--of the plodding and sordid crowds I see around me;
Of the empty and useless years of the rest--with the rest me intertwined;
The question, O me! so sad, recurring--What good amid these, O me, O life?

Answer.

That you are here--that life exists, and identity;
That the powerful play goes on, and you will contribute a verse.

Walt Whitman

An old professor of mine use to like to espouse the idea that he had touched millions of lives in his life working as a psychologist. His reasoning was that when he touched one life, than that person what go on to touch other lives, and on and on it went. This is the “power of one” idea and it’s a lovely thought such as it is, but it never really sat right with me.

Why????? In reasoning this out, it’s important to examine what it is we’re helping people get back to. The credo “first do no harm” applies in Mental Health, and is an important idea to remember. The field is full of people who have sexual relations with clients, exploit them for financial gain, and use them to confirm their own high opinions of themselves, all of these people violate this first cardinal rule.

So the goal broadly speaking is then to ease people’s pain. This is where the truly difficult, soul-draining, incredibly gratifying work takes place. Within the realm of this one powerful idea.

On the other hand, many people come to psychologists and other Mental Health professionals because they have been deemed by society to be “unwell”. They don’t conform to the standards of society and they are sent to Mental Health professionals who are the high priests of wellness to make them better and send them back into the world ready to be productive.

But what if it is the society itself that is maladaptive? Certainly there is a great deal of evidence to suggest that this is the case. How did it come to pass that people such as psychologists and psychiatrists, who are a group of people that are statistically very unwell, get to make these judgments?

The anti-psychiatry movement was concerned with this and other important questions. The fact is that psychology has been wrong about almost everything at one time or another. For instance, consider this word that was once a part of psychology’s lexicon- Drapetomania. Drapetomania refers to a supposed mental illness that caused black people to run away from their white masters in the 1800’s. This was an accepted medical diagnosis. Seriously.

How about homosexuality? This was considered a mental illness until 1973, just one short generation ago. But even in 1973 they weren’t quite finished. They changed the definition to ego-dystonic homosexuality. This basically said homosexuality was a disease when there was a, (1) a persistent lack of heterosexual arousal, which the patient experienced as interfering with initiation or maintenance of wanted heterosexual relationships, and (2) persistent distress from a sustained pattern of unwanted homosexual arousal. This despite the fact that homosexuality occurs in roughly the same percentages everywhere around the world, and there are hundreds of species in the animal kingdom who engage in this practice.

But I digress. The point is that who the hell are we to pass judgment on who is well and who is not? Especially when we ourselves are so unwell?

I rail like this because I already know the answer to my own question. Beyond the pretentions, the titles, the licenses, and all the other trappings, the only thing we really know definitively about psychology is that it is the quality of the relationship between the therapist and the client that is ultimately predictive of its success.

Which brings us back full circle to the wounded healer idea. Perhaps only those that have known deep suffering can truly assist others with it. As Elie Wiesel said “I have learned two lessons in my life: first, there are no sufficient literary, psychological, or historical answers to human tragedy, only moral ones. Second, just as despair can come to one another only from other human beings, hope, too, can be given to one only by other human beings.

So there it is, the curse of other people. We want so much to be close to others, yet we hurt each other so much. We are desperately lonely but on the other hand also unbearably cruel. This is the paradox of coexistence.

So meanwhile as therapists we can, for one hour a week, build a relationship based on trust, warmth can compassion with people who have to this point not found these things from others. On our best days we also get some of this in return. On our worst days we become overwhelmed by the cruelty of others. I never know on any give day which way the coin will land. But I will continue because it is meaningful and it is important, and perhaps, as my professor suggested, it does set a chain of goodwill in motion. I’d like to believe that.

A good day

“Run your fingers through my soul. For once, just once, feel exactly what I feel, believe what I believe, perceive as I perceive, look, experience, examine, and for once; just once, understand.”

Sara Ohotto

One of my favorite patients came to see me today. He is a 25- year old musician who is struggling with pursuing a career in music and taking a job that would be more fitting with his parent’s expectations.

I have seen him play. He is extremely talented and likely has a bright future as a musician if he can make the transition from playing covers songs (which he does wonderfully) to making a connection with his audience through the passion and creative power of the music he has written himself.

So he came to me. Working with him reminds me of how much fun it can be to help put someone in touch with the creative life force we all have inside of us. This young man has a tremendous amount of this life force, but, like all of us vacillates between periods of confidence in himself and intense feelings of self-doubt.

Today we had a wonderful conversation about how one of the most powerful forces inside of people is the desire to be truly known by someone else. For creative people this is not always done verbally, but often through paining, dancing, and in my client’s case writing and performing music. I encouraged him to, with all of this passion inside of him, perform with this idea in mind. To really let his audience feel what it is he feels, and to channel all of the power and energy he has to truly connect with the people who have come to see him. This really seemed to resonate with him.

So today reminded me that sometimes, beyond the tears, the anguish, and the hopelessness that are the meat and potatoes of a psychologist’s daily routine, sometimes someone comes to us ready to truly seize the magical and mysterious assistance the universe has to offer us.

Again today I feel good. Truly rooting for someone else has made me feel better about the world. This is how it is supposed to work. Again today the universe had something powerful to remind me. Helping others is not an answer to life’s puzzles, but is in fact, for me, the only answer that has ever brought my life into balance.

And yet……There must be a way to do this without it ripping pieces of you away. I have not yet found out how. I truly experience a thrill from helping others. But change is insidious, and the slow crawl through people’s private infernos of the mind is horrifically draining, for them and for me. Undoubtedly it has a purpose, and human change is often very slow and requires mining through various levels and stages of human suffering. Along the way the therapist often gives away his emotional well-being at the expense of helping those in pain navigate their way back to their own emotional freedom.

And when we’ve given it all away, we return to our lives still holding the baggage of the horrors of what is we’ve heard. A responsible therapist will recognize this and seek therapy of his own, but even this has its limitations. Therapy with another therapist can be like two magicians doing tricks for each other. We know how our own minds can go on autopilot during therapy, and therapy in these circumstances can therefore become nothing more than an expensive poker game.

So what do we do? We drink. Many of us drink. I drink. This is a break from our thoughts, a short cessation of active consciousness. A freedom from other people’s ghosts which have now become our ghosts.

So here I am, a guy with all kinds of answers for others and a guy with no real answers for himself. But today was good, and despite my aversion to A.A, getting through each day intact is a pleasure. Today I will sleep peacefully, reminded by an aspiring musician, that, despite all of our endless stumbling, sometimes life can go the other way to.

Dancing inside the fire

"It is not the critic who counts, not the man who points out how the strong man stumbled, or where the doer of deeds could have done them better.

The credit belongs to the man who is actually in the arena; whose face is marred by dust and sweat and blood; who strives valiantly; who errs and comes short again and again; who knows the great enthusiasms, the great devotions, and spends himself in a worthy cause; who, at the best, knows in the end the triumph of high achievement; and who, at worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat."
Theodore Roosevelt

My good feelings from the therapy session the other day continue. Part of this was my own catharsis and part of this was easing someone else’s pain.

What’s more interesting is how these two things mesh together. This is the essence of the wounded healer idea. It’s not just that the therapist has felt pain, or just that the people come to see us are in pain, but the magnetism that draws this shared pain together. This is the art, the dance, and the substance of why therapy can be a life-altering catalyst for change.

Irvin Yalom, who has perhaps contributed more to the discussion of how to do therapy than anyone else since Carl Rogers, talked a great deal about this very thing. He even went so far as to suggest that in some cases the power differential in therapy can shift so it is in fact the therapist getting assistance from the patient. I’ve certainly experienced this. Jung felt that therapy was not in fact effective unless the therapist changed along with the people that he was treating.

This is a powerful idea and one that has been very much on my mind recently. I’ve had more than one dark night of the soul where I’ve seriously questioned if I should be doing what I’m doing given the consistent state of my life over the last several years.

And yet….. I know I’ve done some good and touched a great many lives. Although I’ve made a horrible mess of my own life, I’ve always been able to make a fair assessment of my work with others. I say this not to excuse myself from my own occasional unethical behavior, but simply as a fact. Much of my own suffering has been a useful conduit for others change. This I know. And they have changed me!!

Heraclitus said “You can’t step into the same river twice” with the idea being that life is constantly in a state of flux and change. Human interactions are like this is well. For a truly sensitive person, each significant conversation with another person slightly, (and sometimes not so slightly) alters the way we move in the world. We are always consciously and unconsciously recalibrating our perceptions of the world based on what we learn from others. This speaks to the importance and power of truly listening to others as opposed to constantly waiting for our turns to talk. This is a lesson most people unfortunately have never taken the time to learn.
Can this be taught? I don’t really know. Most of us have so much we want to say that we forget that the people across from us have these very same feelings.

This is where the therapist comes in. We are there to listen. For one hour a frustrated human being gets to say all of those things they can’t seem to get others to understand. Sometimes, after emptying their pent-up trash in the therapist’s office, they feel better, but alas this is a temporary fix. What they haven’t done is address the emotional component of their frustrations. This is the difference between venting and healing.

The Power of Human Connection

“Feelings are not supposed to be logical. Dangerous is the man who has rationalized his emotions.”

David Borenstein

My time with my female patient yesterday truly provided a moment of existential shock for me. Sitting with someone and sharing their emotional pain is the essence of what it is we do as psychologists, and at the core of what we can do to facilitate human change. But… It was only possible because of the pain I was in. Why? In theory a psychologist should be able to meet someone in their emotional space and truly feel what they feel and then go back to their normal lives unscathed.

This is of course bullshit. No one that I know of can truly feel someone’s intense pain without it taking something out of them. This is why people who work in Mental Health are often so troubled. Wallowing in a sea of pain, loneliness, fear, anxiety, depression, day after day after day takes a horrible toll. Alcoholism is rampant in our field, as are broken marriages.

Role call, therapists who have committed suicide include Bruno Bettelheim, Paul Federn, Wilhelm Stekel, Victor Tausk, Lawrence Kohlberg, Michael Mahoney, and perhaps most significantly Sigmund Freud himself.

So why do it? What leads a person to want to subject themselves to intense negative emotions and story after story containing tragic life scripts? The fact is many people with intense mental health problems of their own drift into the field because it offers a refuge from the storm that is their life. This was certainly true of me. I rationalized that while I was getting help with my own life, I could do the same for others. This is a very common script for a Mental Health professional, and one that can lead to some degree of success in the field if one learns to regulate their own emotional response.

Than there are those with more sinister motivations for entering the field. These are the people that seek a narcissistic mirror for their own high opinions of themselves. By assuming the role of “The Great Healer” they get to trade on people’s pain to continue to aggrandize themselves. The field is full of such people and it is an especially rampant trend in the field of education.

But there are those of us who truly want to ease people pain because of the amount of the pain we have experienced ourselves. We have been in the fire, suffered greatly, and found that the only road out of this suffering is the service of other people.

But meanwhile we’re never quite healed from our own scars, and these ghosts may come back to haunt us when we least expect it. Although we have been trained to make “choices” about emotional response, this is never entirely possible, not really.

So meanwhile we trudge on. I didn’t drink today because I felt something very deeply yesterday with that woman, and that feeling was enough to sustain me. It was a moment of true and real human connection, and this is the gift she gave to me. Perhaps I to am selfish, and use my patients to share my own feelings of sadness and loneliness. This is real food for thought and has kept me reading and writing and thinking for the last several hours. In the meantime I look forward to going to work tomorrow. I have been touched very deeply by another person, and for today this is enough to keep me going.

Down the rabbit hole

“For a person to build a rich and rewarding life for himself, there are certain qualities and bits of knowledge that he needs to acquire. There are also things, harmful attitudes, superstitions, and emotions that he needs to chip away. A person needs to chip away everything that doesn't look like the person he or she most wants to become.”

Earl Nightingale

So today I got a call I from the lady I have been seeing telling me it was over. This did not surprise me. Once again, I have pushed someone away that I was close to, and I went this afternoon and drowned my sorrows in the nearest bar.

This is a serious violation of ethics. Especially when you continue to see patients which I did. Two days ago I quit therapy. I am cracking up.

Going home after a long night of drinking I thought about the implications of what I had done. The seriousness of this professionally is a major concern, but selfishly, I am also worried about myself. Where the hell am I going and why do I keep making the same mistakes over and over again? Am I a prison to my own negative patterns? Am I caught in a matrix of self-replicating defeat?

I take a long look into the mirror and see the scars of what I have done. Although my skin is pretty clear, what I see beneath the surface is a man with secrets full of guilt and shame. I know this is not entirely rationale. I have after all confessed my secrets. I have laid myself bare, screamed, cried, and emerged stronger for the experience.

Or have I? Perhaps there is still more I haven’t explored. Or perhaps I am simply defective packaging, damaged beyond repair. Even as I write this I recognize this kind of self-talk as the hallmark of depression, but yet it is a question I still need answered.

What happens to me in relationships? Why do I allow my defensive emotions to highjack my personality, and why do I always hurt people so much? I am a helper, and on my best day even a healer, yet I continue to sabotage my own happiness.

I wake up with one of the most piercing hangovers I have ever experienced. Alcohol has cleared my body over the last few weeks, and this morning it has returned with an awful vengeance. I am absolutely overwhelmed with an urge to crawl out of my own skin. I know this feeling well. I crave the wellness I had been recently feeling. How the hell did I wind up back here again?

I go to work with the familiar sagging eyes and rumpled clothing which have been my trademark for so long. My first patient discusses her intense feelings of loneliness, and as she is talking I begin to cry. Seeing me cry moves her to tears and soon the two of us are plumbing the depths of our intense feelings of grief. She believes my tears are out of sympathy, and in many ways they are.

Is this ethical????? To totally break down in front of a patient? I don’t know, but what I do know is that in that moment we are truly fellow travelers, both utterly lost on our short journeys on this earth.

Eventually the session ends, and on the way out my patient gives me a huge hug, telling me this is “the best session she has ever had.” I am moved, and I am guilty, as my tears were as much about me as they were about her. Still there was a powerful lesson here. I had met her emotionally and truly felt what it is she was feeling. This is the essence of the corrective emotional experience. The lesson is powerful. It reminds me that people are not healed by words. Not very often. True healing comes from sharing emotions. This is what happened today for her and for me. We began to heal each other.

A Hard Fall

There are things which a man is afraid to tell even to himself, and every decent man has a number of such things stored away in his mind.
Fyodor Dostoevsky

Self-deception is possibly the most insidious force in the universe. And yet…it is also a wonderful way of protecting ourselves. We constantly rationalize the things we do in defense of our fragile egos, not realizing that we are in effect building Castles on top of sand. Eventually these castles collapse however, and we are left wondering how we keep ending up back where we started.

This happened to me today involving a relationship I had recently become involved in. Although I have thoroughly threshed the fields of much of my intrapersonal baggage, what I hadn’t considered was how little work I’ve done on assessing how where I’ve been affects the way I interact with others outside of a therapy session.

So I became involved with a woman. A beautiful, intelligent, thoughtful woman, who pushed some buttons in me that I hadn’t realized were still there.

Throughout my life I’ve been highly successful at sabotaging interpersonal relationships. Although my whole career such as it is has been based on building these relationships in a therapeutic setting, this has not been a skill that readily translates.

The funny thing is that many prominent Psychologists and in particular relationship experts, have a history of unstable interpersonal relationships including at least one divorce. Hmmm.. Why? Perhaps because we are so adept at identifying weakness in other people, as this is what we have been trained to do. Verbally we can quickly put together convincing arguments about someone’s “defensiveness”, or “projection” when in fact we are merely using our own significant training in defense of our own egos. Ultimately this is a doomed strategy and people who rely on it may finding themselves winning little battles while losing the much more important war of intimacy and emotional connection.

Why? When people are hurt they say things that they normally wouldn’t say. The result is often a destructive reaction formation where we mask our hurt by developing an emotionally hurtful persona of our own, and personally I have let my own hurt speak for me on way too many occasions.

Which brings me to the point of this diatribe. Yesterday I fell back into this destructive pattern so easily and so readily that I was actually startled at my own degree of verbal abusiveness. Were those really my vile words coming out of my mouth? Yes in fact they were, and although I quickly realized the error of my ways, it was too late, the damage had been done.

You can’t always put the genie back into the bottle when it comes to a well-placed verbal attack. These are the kinds of words that leave psychic holes in people’s sense of self, and these holes then become incredibly difficult to repair. I have spent a lifetime discussing these wounds with my patients and trying to provide a “corrective emotional experience.” Meanwhile I’ve inflicted plenty of my own.

So today I ask myself, just who the hell am I so mad at? What are the roots of this anger and how can I get it out in the open, deal with it and then finally put it to rest. Patterns, even for the most thoughtful of people are still very deeply entrenched, and mine are as much so as anyone's.

I go to bed today tossing and turning. Craving a drink and needing one to help me sleep. I realize I am in a highly dangerous emotional state. I do a number of mindfulness exercises to calm myself down. I am an expert in these techniques and often teach them to others, but unfortunately this doctor cannot heal thyself. I drive to the 7-11 and buy a quart of cheap vodka. In the parking lot I take a deep swig and feel the rush of healing emotion wash over me. I am in trouble. Deep trouble.