Psychotherapy Blog

My mom died recently after struggling with dementia and severe rheumatoid arthritis for many, many years. I moved to the Bay Area from the East Coast in the year 2000 to be closer to her, as I thought she might not have much time left, and 17 years later, on a sunny spring morning shortly after my 43rd birthday, she died as I lay in a liminal half-sleep between the 3rd and 4th round of my snooze alarm. I woke...

Everybody knows: therapists are all crazy. Right? Where did this idea come from? For some of us, perhaps it’s our social skills. Some therapists can come off a bit . . . well . . . awkward in social situations. Perhaps you know a Socially Awkward Therapist (SAT)? SATs even find each other off-putting. I had a SAT friend who was talking about another therapist friend. “She’s unsettling.” He shrugs. His eyes drift down and to the right. I catch the glance. I automatically...

Clair* walks into my office this morning as she does every week. She sits downs and looks up. “I’ve got nothing to say today,” she tells me. Sometimes, I say nothing. I just sit and wait. Something will come. The unconscious mind can often be counted on to send something forward into the silence. But sometimes I feel the need to help things along. “Well,” I say, “What’s most on your mind?” Clair has been with me for a little over...

"Smile, breathe, and go slowly." — Thich Nhat Hahn   I got doored on Saturday night. I was riding my bike out to dinner with my husband and a guy in a big SUV opened his car door into the bike lane without looking and knocked me over. My face hit the pavement, I still don’t really know how my teeth weren’t knocked out, but my lips were cut and bleeding and my forehead was gashed and scraped. It happened so quickly...

The late 1960s and 1970s were exciting times for the fields of psychology and psychotherapy. Much of the enthusiasm was spawned by a body of landmark research. At the time experts postulated that humans had two distinct nervous systems: the voluntary and the involuntary. The voluntary nervous system allows you to brew your morning cup of Joe or take out the trash before you leave for work. The involuntary or autonomic nervous system controls your heart rate, blood pressure and...

It's getting colder in the Northeast. I love it—mostly I do—except that I am colder than cold, colder than most folks. I feel it in my bones. My husband and I are Florida bound for vacation soon, and then, we think, to live. Not just yet. The kids need a bit more raising first. So with the cold coming and the time being ripe, we take the kids (the same ones who still need a bit more raising, and two that...

Sometimes my days bring to mind a funhouse mirror. I stretch, collapse, widen, or shrink depending on the clinical demands of the moment, fundamentally changing and fundamentally remaining the same, moment to moment and hour to hour. Yesterday in my first session of the evening I was speaking with a young woman about the reasons for her recent spotty attendance. I fielded an interpretation that I know in every molecule of my being is correct, that she is trying to convince...

A few days ago, I read yet another article comparing the costs and effectiveness of psychotherapy and medication. While both have benefits, the article stated, medication is cheaper. Hmm. I wondered. My insurance company has a handy calculator that allows me to estimate the costs of various types of care, so I figured I’d check it out. Well, as it turns out, generic antidepressants are pretty inexpensive—definitely cheaper than psychotherapy for insured and insurer. But let’s consider my modal client. You’ve...

It’s the kind of telephone call that every therapist gets and every therapist hates to get. “I’m sorry to disappoint you on such short notice, but I can’t come in today.” It was a patient who had come only once before, the week prior, and though he was articulate about what troubled him, one could discern that he was deeply conflicted about who he wanted help from or whether he even wanted help at all to solve his problems or even ease...

It was not one of my better moments. It was a very busy time of year, getting ready for Passover, juggling my schedule with patients and the kids' spring break. It was one of those times where I stood at the intersection of my mothering and my profession and my head was spinning. On the top of the TTD list (things to do) was getting my five year old daughter a haircut. Routine errand as it seems, it did require a...