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.

A new beginning

"In the Midst of winter
I finally found there was within me
An invincible summer"

Albert Camus



Some days we wake up with a newfound sense of understanding. In these moments we are granted a short time to glimpse deeply into the machinery of the universe and nod our heads at the poetry and synchronicity of what it is we are doing here. Today for me was one of those days. These kinds of days can never be planned or deliberately discovered, but instead stumbled upon humbly and almost entirely by accident.

One thing I do know, is that for me this feeling nearly always comes from giving some part of myself to someone else. Today I ran a grief counseling group for people who had recently suffered the death of a someone close to them. Normally these groups are quite intense, and today was no exception. About 30 minutes in today we began a discussion of how our time here on Earth echoes much longer than the duration of our physical bodies. This I believe very deeply. All of our human connections have deep meaning, and we affect each other in a million little ways we rarely take the time to truly consider or comprehend. Today, for one hour, myself and 6 other human beings took the time to tell each other a little bit of how much we have affected each other. I precipitated this display of emotional honesty as a result of all of the things I have been through in recent months since I have been sober. It was a big step.

The power and energy in that room were tremendous. All of this was precipitated on the idea that we weren't going to leave things unsaid. Much of the grieving process is about this very thing. We not only miss the person who is gone but we miss the things we didn't say to them. We find we would give nearly anything for one more day to tell someone all of the things they meant to us.

So.... The lesson is, although we don't get that day with that particular person, we can apply this lesson to the people who are still here. We can tell people each and every day how much we appreciate all of the little ways they have touched our lives. We can't just assume people know. We need to say the words. To look into someone's eyes and make this connection.

So I've been doing this for the last week. In many ways I feel like my life is starting over and it's a wonderfully scary feeling. I feel like I have emerged from an emotionally closed cocoon. It is new. Wonderfully new.