NEW LOW PRICING!
Video Memberships for personal viewing.
Access to over 300 of the best psychotherapy
training videos starting at $29/month.
Our first dive was beautiful but exhausting. The surf was rough, and we had to swim a couple hundred yards in choppy seas before our descent and after resurfacing. Because of exhaustion and cold, three from our group opted to stop after one dive. The fourth participant said he was "50/50" about doing a second dive. I knew I was tired, and that it would be a challenge to complete another dive. But I also realized that we had a rare opportunity, because we had two highly skilled dive masters who would accompany us (in attachment terms: a very secure base). I let them know I was 60/40 in favor of going, which tipped the scales and off we went.
We navigated through gorgeous kelp beds, dropped down to about 70 feet, saw stunning marine life—and then I got slightly entangled in kelp. After one of the dive masters helped disentangle me, he and I realized we were separated from the other two divers.
After a brief underwater search, we followed protocol and surfaced to look for the others. Then things got hairy. Ironically, diving can be more dangerous at the surface of the water than below it, because it is difficult to stay afloat and breathe in heavy, choppy swells. I switched my breathing source from the regulator to the snorkel, to conserve air in the tank and keep from taking in mouthfuls of seawater amidst the choppy surf.
Unfortunately, it is hard to breathe through a snorkel while dog-paddling in a nearly vertical position. Waves splashed into the snorkel, mixing water into the air I was breathing. I began taking short, quick breaths—which is the opposite of what is desired while diving. The surf and currents were stronger than earlier, and I quickly became exhausted... and cold... and scared.
Then something happened that I've never experienced before: I began to hyperventilate, which made everything worse. The more frightened I felt, the more frantic my breathing became, and the less air I was receiving.
Fortunately, scuba diving has many safety procedures built into it, including considerable dependence upon one's diving partner. In this case, I knew my partner was a highly trained expert. By verbally assuring me, coaching me to relax and breathe deeply, and assisting me in the long swim back, the instructor helped me get ashore.
![]() |
I vividly recall a key statement from my diving instructor when I first became certified. Within the first five minutes, he told us, "If anyone is taking this certification course to please a spouse, parent, child, friend or anyone else, you should leave now. Diving skills can be learned, but only if your heart is in it."
Therapy is an organic process that must be fundamentally linked to our clients' deepest wishes, feelings, and needs. As psychotherapists, connecting with our clients' hearts and wishes is equally critical.Even with a structured buddy system and safety carefully built into the equipment, scuba divers face many dangers. Overreacting in a crisis can be disastrous, for example if someone abruptly drops their weight belt and shoots to the surface without stopping to decompress.
I often explore the manner in which a man relates to the myth of Icarus, the Greek boy whose father, Daedalus, hastily attached wings to their bodies so they could fly away and escape the labyrinth in which they were imprisoned. Icarus, in his excitement and wonder, ignored his father's warnings not to fly too close to the sun, with disastrous results: the wax melted, his wings fell off, and he crashed to his death into the sea below.![]() |
My experiences diving help me appreciate that masks and armor serve essential functions, yet they can easily be abused. One's protective gear, such as gloves, fins or diving knife, might be helpful, yet at the same time make one insensitive to one's environment. Consequently, knives and even gloves are sometimes outlawed, such as near some coral reefs that are easily damaged by being touched. At times I use these analogies with men regarding dealing with highly sensitive friends or family members. The roughness, even callousness, that men need to survive in some environments can be quite destructive in other contexts.
Boys and young men learn endless ways to armor and defend themselves; as adults, they need to see the psychological cost of wearing armor that no longer serves its intended function. I often borrow a potent analogy from Jim Bugental wherein he described the life-saving function of a spacesuit for an astronaut—and the reality that the very thing that saved his life must be shed when he returns to earth.Carlos, a 45-year-old refugee from an oppressive Latin American dictatorship, entered my office with a pronounced limp and an enormous chip on his shoulder. The limp resulted from medical neglect during his childhood, and the chip on his shoulder from years of defending himself from hostile putdowns. After initially conveying considerable anger and bluster, Carlos described a series of disappointing relationships with women and a desire to "learn some tips to keep a woman interested in me." He clearly felt humiliation and shame about his physical impairment, as well as self-loathing about his cultural background and lack of formal education.
I was deeply moved by his physical and psychological journey, his resilience, and his determination to provide better opportunities for his children than he had. Over a two-year period, Carlos gradually let go of his shame about his physical impairments and cultural background, developed a sense of pride in his accomplishments, and became an informal historian in his neighborhood regarding oppressive Latin American regimes. As he put aside his armor, he became a warmer and less hostile man. He came to understand the universal aspects of his individual struggles, which helped him take pride in his own psychological growth. When he ended his therapy he had not yet developed an ongoing relationship with a woman, but he had developed a healthier sense of self-esteem and a positive place for himself within his community.
The danger inherent in diving means that the activity often evokes a range of intense emotion, from awe to fear to anger (e.g., when another diver does something irresponsible that jeopardizes others), so I have frequent opportunities to work with these intense emotions.
I directly and explicitly educate men about feelings, particularly in relation to anger, anxiety, guilt, and shame.Richard, a partner in a prestigious law firm, entered therapy with only one goal: to reunite with his wife and three children. He had "accidentally" shoved his wife during an argument at home, badly bruising her. She obtained a restraining order and he had to move out of their home. Richard excelled at work, where he could be totally in charge. But he had no close friends, and no one, including family members, sought his company outside of work.
When Richard was angry, he was intimidating. At times in our sessions, I feared that he might become violent. I shared these concerns with him, and he was ultimately pleased to hear them; while I would not tolerate abusive or threatening behavior, it was okay with me if he was pissed off. He had never thought about the distinction between anger and hostility, or about the difference between feelings and behavior. Once we established a mutually safe therapeutic environment, we focused on what precipitated his anger. After many months of hard work, he slowly became aware of a pervasive, previously unconscious fear of abandonment that provoked his rage. He gradually realized that he had never felt safe revealing vulnerability to anyone, particularly his father. He also realized that, although his love for his wife had died, he desperately wanted to nurture his relationships with his children. During a lengthy course of therapy, he went through a divorce, re-established and strengthened ties with his children, and began to have far more fulfilling and respectful relationships with women.
![]() |
When I go diving, I occasionally feel competitive with others. But I'm far more interested in collaborating than in competing. Since scuba diving entails potentially life-threatening situations, it highlights the importance of cooperation. Diving demonstrates that "survival of the fittest" has a collective meaning ("The better we function as a team, the safer we are") and not just an individual meaning ("To hell with everyone else, I just have to look out for my self"). The older I get, the more I appreciate this shift in consciousness in many aspects of my life—and the more determined I am to help other men make this shift.
As my clients begin to develop psychological-mindedness or convey a desire to hasten change, I encourage them to join support groups, such as a 12-step group, a men's group, or a process-oriented therapy group. Twelve-step groups and men's groups can serve as powerful antidotes to the isolation and shame that many men experience, yet may not put into words. I find that particularly helpful are groups with the commitment and expertise to address here-and-now dynamics, which is arguably the most critical therapeutic aspect of an ongoing group.A very successful executive I worked with individually and in group therapy suffered from a crippling addiction to pornography. After he gained control of the addictive behavior, it was clear that he continued to feel shame about his sexuality. In his individual sessions, he occasionally informed me of sexual fantasies he experienced about women in the therapy group. We worked on helping him talk about these fantasies in the group, while being sensitive both to his vulnerability and to the feelings of others. His sensitivity and courageous disclosures helped him develop transferable skills for his other relationships, and enriched the therapeutic experiences of the other group members.
Treating someone in individual and group therapy raises many complicated and challenging issues for a therapist. I've made mistakes, such as nudging an individual to join the group when he wasn't ready or motivated on his own; it became apparent, once this man was in group, that he was there to please me rather than to pursue goals of his own, and that guaranteed failure. I've been fortunate to have trained with two individuals—Jim Bugental and Irv Yalom—who are masters at utilizing this powerful combination of therapeutic approaches, and who have helped me on numerous occasions convert what I initially perceived as disasters into growth opportunities. I strongly encourage those therapists who are considering adopting this dual format strategy to get consultation from someone experienced in this approach.Diving with my family has not only allowed us to share exciting and amazing experiences, but also to deepen our relationships by taking on new roles. This role shift occurred, for example, when my family and I went diving for the first time, before any of us were certified. I was surprised, when I cautiously reached the ocean floor, to see my son Cody, then 21, doing flips underwater less than five minutes into our dive. He gestured for me to do the same—but I let him know that his old man was content to simply observe his surroundings and keep an eye on his wife and two kids (all of us were closely supervised by an accompanying dive master). In this way I conveyed respect for his autonomy and appreciation for his sense of adventure, while simultaneously asserting my own wishes. Ten minutes later, after Cody took on a less active and more inquisitive role, he encountered a small octopus and his own sense of awe. I doubt that either one of us will ever forget that shared half-hour experience.
![]() |
Luke, a 35-year-old physician, carried himself with an air of invincibility. I had a difficult time understanding what he wanted from our sessions beyond his occasional statements that his fiancé thought it would be good for him to see a therapist and that he liked having a place to discuss random events in his life. Whenever I tried to get clarity about his concerns, he became evasive. Something, though, kept him coming; he attended sessions regularly and paid his bill promptly.
After a couple of months I raised the possibility of doing a conjoint session with him and his fiancé, in order for me to better understand Luke’s social life and to hear her perspective on their relationship. Luke was quite open to this, and we talked about what he might hope to get from such a meeting. During the conjoint session his fiancé conveyed great love and admiration for Luke, and excitement about them getting married. She let it be known that she had but one complaint, which was what initially led her to encourage Luke to seek therapy: their sex life had greatly diminished during the previous year. (Luke had not previously acknowledged this, despite my specific inquiries about his sexual life.)
Her comments opened up an immensely important aspect of Luke’s therapy. He refused, initially, to participate in couples therapy. However, in his ensuing individual sessions he began to talk candidly about his history of intermittent sexual difficulties, which seemed interwoven with his professional success. We spent considerable time helping him overcome the humiliation and shame which initially prevented him from addressing these issues with me, and which fueled his resistance to couple’s therapy. After several months of exploring his perfectionism and unrealistic expectations of himself, he became more comfortable addressing his sexual difficulties. Eventually he asked for a referral for a couples therapist who dealt with sexual issues. Within a year Luke reported that their sex life had regained its lost glory and he decided to terminate his therapy.
Last summer, while snorkeling with friends in the Sea of Cortez, an older friend hollered and let me know he needed help. We were only 200 yards from shore, in very calm water that was only slightly over our heads. Nonetheless, he panicked, because he had taken a good deal of water into his mask and was having trouble breathing. I grabbed him by the arm and pulled him to shore, similar to the way someone had helped me about a year before. I felt no competitiveness or bravado during or after this experience, but rather a heightened awareness of the risks inherent in the ocean and an appreciation for the caution we had exercised as we snorkeled together. I'm not a foolish daredevil. But I'm determined to sustain a sense of vitality by taking measured risks with cooperative friends.
Note: This article is an expanded version of pieces that were previously published in the May/June 2008 issue of Viewpoint, the newsletter of The Psychotherapy Institute, Berkeley.CE points are a great way to save if you need multiple CEUs. Get up to 45% discount when you buy packages of 10, 20 or 40 points. Your CE points will be redeemed automatically at checkout. Get CE packages here.
*Not approved for CE by Association of Social Work Boards (ASWB)
CE credits: 1
Learning Objectives:
Articles are not approved by Association of Social Work Boards (ASWB) for CE. See complete list of CE approvals here