Fuel For The Heart










Today, while the blossoms still cling to the vine,

I’ll taste your strawberries, I’ll drink your sweet wine.

A million tomorrows will all pass away,

Ere I forget all the joy that is mine, today.


Many years ago, probably 1966 or ‘7, when I was a student at UCLA, my girlfriend, who was outgoing and socially at ease, and therefore the polar opposite of me, was on The Colloquium, I think it was called: some kind of Student Council, or Guidance Committee, or Student Council Guidance Committee, or – well, you get the idea. She was “in leadership,” as chambers of commerce like to say, whilst I, her eyes-downcast, shy, unsure consort, could barely get it together to be in followership. Anyway, the Colloquium had a yearly “retreat”, undoubtedly for the members to get together and Colloquy up a storm. I, as the consort, was invited along for the ride – a bus ride, as I remember, sports-team-style, with everyone crammed together for optimal bondage and fermentation.

Where did we go? I have no idea. What did we (or rather, they) talk about? I have no idea. Were there breakthroughs, grand hatchings of world-changing ideas, comings-up-with of new dimensions in human colloqui-izing? No idea, for in that era of my life, I was mostly on the Bernstein Plan: fade into the woodwork and hope nobody notices you, or far worse, calls on you, causing potential shame and humiliation, beyond that which was already in place, aplenty.

So, what do I remember?

Only this: on the way back home (yep, my memory skips the entire Colloquipalooza itself, though I’m sure it was groundbreaking and historic), music was playing on the bus, or wait, maybe we were all ‘group-singing’ (bondage and fermentation – remember?) the song, Today, by John Denver. It’s actually rather a nice song, and if you click on the link (go on, you scallywag, you!), you can watch the New Christy Minstrels performing it, and see and hear for yourself the Anita-Bryant-hair’ed, hands-prettily-clasped-in-lap’ed, Sunday-frocked girls, and the suit-and-tied, Ivy-League-hair’ed, pink-cheeked boys harmonizing it, altogether a pre-Hippie folkie vision of Purity, Goodness and Earnestness.

Anyway, you can imagine sitting there in the bus, having spent the weekend Doing Good, as we sang our little hearts out together like Methodists or something: sure, I’m mocking it a bit, but the fact that I still remember the goose-bumpy feeling of it forty-eight years later says something.

After the singing, I remember I sat there on the bus talking to a much older, white-haired couple, about “the state of the world”. We talked for quite a while, which was unusual for me with older people at the time, and, as I recall, we touched on most of the standard (but important) issues of the time: proto-environmentalism (“conservation”, in those days), why do there have to be wars, what’s happening to the world anyway, can non-violent resistance work – or will it take revolution, the military-industrial complex, commercialism, and all the rest.

As we pulled in to the UCLA parking lot, and wrapped up the conversation, the old guy extended his hand to me and said,

You’re a very mature young man.

I remember I wondered at the time, ‘Does he mean it?’ Or was he just trying to offer a little encouragement to a young, kind of lost kid who was basically an okay guy and in political agreement with him? Now I realize that it doesn’t matter, because I ‘registered’ his remark forever: here I am, almost a half century later, repeating it. Looking back on that young man who was me, I see that, to ‘him’, it meant, “Maybe I’m not that bad,” so whether the old man ‘meant’ it or not is irrelevant: it had found its mark, and I would always have it in the woodpile of emotional encouragments stacked deep in my soul, to draw on, during the freezing weather of my future. Fuel for the heart.

1973: I was a psychology grad student at the University of Tennessee, Knoxville. I was a bit more self-possessed than in my teens, but not much: each year there was a make-or-break test we had to pass, or be asked to leave the program. I had friends who had washed out, or been in the process of washing out, for years. It wasn’t pretty, and it ruined a couple of friendships, when I ‘made it’ and they didn’t. I’m not blaming the school: that’s probably the way it was everywhere at that time. Kind of like the Marines: they used the emotional pressure partly as a weeding-out tool. If you couldn’t ‘cut it’, you didn’t have it in you to function professionally as a psychologist: if you did – well, you were part of The Few, The Proud.

I didn’t doubt my ability to become a good therapist, eventually, with the right help, but the program wasn’t particularly geared to people like me: the ‘good ones’ were supposed to go on to become academics, researchers, ‘scientists’. As we went on, and my classmates seemed (at least, to me) to become more involved in their research, to spout more jargon, and to talk of finding positions in academia, I felt more and more like a fish out of water. I didn’t give a hoot about my dissertation, statistics, or reading deadly dull journal articles and books that seemed designed to impress colleagues, rather than shed light on human life. I didn’t want to know about “learned helplessness”, “cognitive dissonance”, or the primacy effect: I wanted to know what to do when someone feels their life is meaningless, why some people grow from grief while others collapse under it, and how to connect with people who were different from me.

I felt my adviser was disappointed in me for not being enthusiastic about behavior therapy, and sometimes it seemed like the professors were more involved in their internal squabbling with each other (“When he first came here, he never approached me for guidance, not once, so the hell with him!”), and their own personal problems, than they were in producing the next generation of decent, human psychologists. Again, I don’t blame the school – I was an idealistic, romantic kid who was probably slated for a lot of disillusionment, no matter where I went to school.

Then, a ray of light came into my life: it turns out there was a ‘breadth requirement’, which decreed that you had to take at least a few classes out of your ‘field’ of concentration, in order to ensure that you were, if not a Renaissance Man, at least not a Dark Ages Man, oblivious to anything not in front of your nose.

Joy! I took the first film appreciation class of my life, and I’m pretty sure I was probably not very rewarding to the poor teacher. A sample of one of my ‘critiques’ of an artsy art film: “This film was a one-hour exercise in mental masturbation: I could have gotten much more out of an hour spent in actual masturbation!” – to which the response was a very great many savage red pencil marks. But that class was my first realization that film could be treated as a legitimate art form (kind of like what Freud and Jung did for people), and the beginning of a lifetime of appreciation and enjoyment.

And the other ‘field’ I gamboled in for a semester? Poetry. Well, actually I don’t remember a lot about it, other than the fact that the other students (grad students in poetry, I suppose) seemed to be operating on a different level than I – a much higher level. Specifically, I remember sitting in class trying to puzzle out The Emperor of Ice Cream, by Wallace Stevens: While the other students seemed to be spooning it up like a big sundae, I’m afraid I sat there with brain freeze.

But this I do remember: I was talking to the professor, a remarkable and highly-honored man (I believe he won the Professor of the Year award at U.T. several times running), during his office hours, about this or that, and he suddenly started out to say something, then stopped, abruptly.

Somehow, I had a feeling it was important. “What did you start to say?”

“Oh – nothing.”

Despite my shyness and lack of confidence, I had an intuitive feeling about this, and pressed him. “Please – tell me.”

He blinked a few times, in indecision, then seemed to make up his mind. He cleared his throat. “I honestly don’t know if it’ll be helpful or not . . . but, well, it’s just that, uh, I think you’re the brightest student I’ve ever had.”

I stopped breathing. For one thing, I had been a total boob in his class, contributing nothing to the conversation: if I was the emperor of anything, it was melted orange sherbet. I tried to discredit the statement: after all, this was Tennessee, not Harvard. And besides, what would he know about me, or anything else, anyway? But, much as I tried to negate him, that dog didn’t hunt: this guy was special – he didn’t get that Professor of the Year thing for nothing. He could hold his own at Harvard or anywhere. I knew my major professor was a friend of his: maybe they had talked? But my major prof didn’t think I was all that big a deal, anyway, so that didn’t make any sense.

My mind continued on though, trying to discredit, negate, and nullify:

Oh, I get it: he knows I need a little shot in the arm, and this is his way of administering it. That’s why he hesitated so much: he’s a decent fellow, and so it took him a while to make up his mind whether a lie for a good purpose was justified.  That’s why he’s such a good teacher: he knows how to motivate people, how to inspire them, and this is what he decided I needed.

We didn’t mention it again, then or ever. He seemed uncomfortable with having said it to me, like something you do that’s out of character, and then have to live with. I guessed it was possible he might have meant it, that his hesitation might have been because he was afraid it would ‘go to my head’, but I would never know.

What I do know is that that one little sentence has stayed with me for the rest of my life. It has buoyed me through some very hard times, when I thought I was stupid, a loser, a lightweight, a dope. When I’ve been put down by people who thought they were superior. When my ability, my talents, my credentials have been questioned.

Two little statements, from decades ago:

You’re a very mature young man.

You’re the brightest student I’ve ever had.

True? False? Well-intended ‘manipulations’, or sincere statements of truth? It doesn’t matter. I took them and ran with them. And I don’t mind saying that there were times when I clung to those statements, and others like them that I have filed away, deep inside, like a drowning man to a life ring.

And now that I’m the ‘elder’, and in a position to do this for others, I never hesitate to bestow laurels of encouragement, in my professional life or otherwise. I doesn’t cost you anything to compliment someone on something that’s true, or acknowledge them, whether it’s minor or deeply meaningful:

You have the most interesting sense of humor.

You have a real soul.

It’s so unusual to find someone with a sense of personal ethics.

To have gotten as far as you have, coming from your background, is remarkable.

So, if you’re an elder, or in a position of authority, or just realize that someone looks up to you, don’t waste the opportunity to say something positive, something for that person’s ‘woodpile’ against the winter winds. Don’t assume “it’s obvious,” because it isn’t.

So often I’ve had couples come to me for help and one person says, “I need to hear some words of love or appreciation sometimes,” and the other person says, “Well, I’m sitting here, right? That should be enough!” No, it’s not enough! Patients have often told me about kind words, encouraging words, personal words, that a teacher, or a neighbor, or a friend, said to them many years before, that have sustained them in the face of despair or loss or failure. Despair, loss and failure: those are obvious. Love is not obvious. It’s fragile – it needs to be expressed, manifested, and nurtured like a hothouse flower.

So, today, while the blossoms still cling to the vine, open your mouth and let out some of that love you’ve been hiding inside. Just look around you: someone you know is dying for someone to believe in him or her, dying for a little encouragement.

Don’t wait.

Today is the day.

Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

Man Meets Oven

ding dongs







Some years ago, my daughter moved away – from the Bay Area down south to Los Angeles – voluntarily! Yep, she wanted to make it in the music biz, and on the West Coast, the music biz is in Los Angeles. And, as if that weren’t bad enough, she actually LOVES it down there! The nerve of that girl: here, I was born in L.A. and fled to civilization (i.e. the Bay Area) as soon as humanly possible, and now she, having been given a ‘head start’ by being born in Oakland, turns her back on civilization and becomes a heathen – by choice, yet!

Kids: what are you gonna do?

Well, for years I did nothing, other than mope privately and hope she didn’t catch on (yeah, right!). But lately, I got the idea that, dammit, if the mountain (she) wouldn’t come to Mohammad (me!), well, then, Mohammad (me, again) could go to the mountain (I think you know the dramatis personae by now). To wit, I got the idea that by baking her treats, and mailing them to her, I could keep the contact I wanted, and express my love, without being a pill about it (sorry, hon, for De Daumier-Smith’s Blue Period, or The Moping Years, as I now refer to them).

And, as it turns out, I’m pretty glad I waited so long: years ago, I would’ve had to actually buy (or actually check out from the library) actual cook books, then actually read them, then actually make the stuff: too many actual steps! Now, all I have to do is subscribe to innumerable baking blogs, check my email once in a while, spot a fantastic recipe, and make it. Easy, peasy, culineezy! Of course, I’m actually not much good, having come to the baking game more than a little late, but then how hard is it to buy a few ingredients, dump ’em in a bowl together, set the oven to 350, shove it all in, and wait?

And the love part? Well, as the Pillsbury Doughboy once said, “Nothin’ says lovin’ like somethin’ from the oven!” And, though she and I have had our ups and downs on her (and my) road to growing up, it’s pretty hard to misinterpret, deny, or distort a pecan pie bar, pistachio-coconut bark, or a Maraschino-cherry truffle, right? Woo hoo!

So what’s my point? Adaptation – that’s what. How did De Daumier-Smith’s Blue Period morph into all this? Acceptance, facing facts, and willingness, that’s how. As a friend of mine always says (and, major confession: I hate him for it, each and every time),

It is what it is.

Translation?: Reality will trump that pathetic, distorted little ‘personal vision’ of  the world you’re holding onto for dear life, 99.99 percent of the time. And that remaining .01 percent of the time it seems to be working out the way you ‘dreamed’ it?  A fluke, dude: like winning the state lottery – it isn’t a ‘trend’ or ‘magic’ or ‘now my luck has really turned’, or anything of the kind – it’s a fluke, something you should never have counted on in the first place, and never should count on again.

So what are we left with? Reality. I know – you don’t like it. I don’t like it, either – it bites, it blows, it sucks, but, as the newscasters say: This just in: the tail doesn’t wag the dog. You don’t count on Life conforming to your personal ‘vision’; You adjust to Life.

Sorry to break the news to you like this – I wish I could have baked it into a gooshy, homemade, marzipan-creme-filled Hostess Ding Dong and served it to you on a fancy silver tray, but, like a good break-up, it’s easier in the long run just to take the hit all at once.

So, Reality: there it sits, like a big ol’ Great Dane in your living room, drooling all over the carpet and pooping in the hall. What are you going to do with it? Well, once upon a time, Freud had this idea, and he called it Sublimation (or technically, Sublimierung, in German – maybe on the assumption that a spoonful of letters makes the medicine go down?). Well anyway, it basically means this: that a mature (pronounced: mah-tew-ah) person, in the face of frustration (hello, Reality!) does not murder, rape, pillage, pout, moan, fling objects, or guilt-trip others (maybe it was a hint to his Jewish mother?) – rather, he or she “makes the best of a bad situation”, by throwing Reality a bone, rather than kicking it in the slats (then Reality bites, see?). By incorporating Reality into the solution, you can maybe meet some of your own needs, and at the same time allow Reality to gnaw on its soup bone. Result: everybody’s (at least sort of) happy.*

{*Yeah, yeah, I know – sublimation actually has to do with channeling primitive drives into higher-level functions, but listen up: My Blog, My Rules! Now, that’s sublimation!}

Examples, you say? Sure, we got examples:

A couple I was working with (Clive and Vera) came to me on the verge of breaking up. Why? Well, Vera was jealous, insecure, and “possessive” (hey – she said it, not me!), and Clive was handsome, outgoing and friendly. Oh yeah – he appreciated ‘the ladies’ quite a lot, and they certainly returned the favor. Result: when they were out in public or with friends, and especially when they’d both taken on quite a bit of ballast, Clive would be his ‘friendly’ self with all comers, while Vera steamed and fumed from the sidelines, feeling ignored and devalued.

Later on, when they were alone, she would unload on him, both barrels. He, in turn, would fire back, saying that there was nothing wrong with his being friendly, that he had no intention of ‘starting’ anything, or even flirting, with the women he was talking to, that she could damn well take him as he was, and that furthermore, she was an insecure, jealous b-word, who had better get herself together quick, or else. Add booze, stir, and baby, it was, “Fire in the hole!” And that’s the nice version of it, because, of course, I wouldn’t want to upset the delicate sensibilities of anyone out there who still thinks life is a marzipan Ding Dong.

So, what happened, you say? Oh, yeah, I almost forgot (Sorry, I was dreaming about that Ding Dong – talk about primitive urges!). Well, here’s what happened:

First, I looked at him. “You get to be who you are.” He looked happy.

Then, I looked at her. “You get to be who you are.” Now she looked happy, too.

Finally, I looked at both of them. “But if you want to stay together, you have to work together.” Now nobody looked happy, except me, of course. (Trade secret: it’s a lot better being the one without the problems than the one(s) with the problems – but don’t tell, it would just hurt people’s feelings.)

So now what? You see, the real trick of doing therapy with couples is in understanding that most couples approach it as a kind of court of last resort, or to be more precise, the therapist as Final Arbiter. In each person’s eyes, the therapist’s ‘job’ is to tell him (or her) that he is right, right, right, and that the other person is wrong, wrong, wrong: that’s why they’re really here, here, here – to see the Final Arbiter. Of course, you also have to understand that, impressive as your new title may sound, you only have power in somebody’s mind as Final Arbiter if you agree with him (or her): if you don’t, well you’re soon stripped of your title and cast out among the bulrushes to eat hyacinths.

But enough inside information – let’s get back to Vera and Clive. So, sitting there glaring at me, they had crossed the first Rubicon of couples’ therapy: giving up on the Final Arbiter. Their plan having failed (thanks to me), I was now On My Own, in the Slough of Unfairness – for, you see, a human being in couples therapy who has given up on the Final Arbiter now shifts desperately to the Fairness Doctrine, that is, that while the therapist may not agree with him (or her), the therapist at least does not blame him (or her) for ‘Everything‘. (Note – it’s always Everything: there is no ‘some part of it’ at this stage; if you’re ‘bad’, you’re all the way bad; if you’ve caused something, you’ve caused Everything. Why? Don’t ask me – ask Freud, if he’s not too busy sublimating.)

At this point, Clive says, “I’m not changing – I am who I am.”

I say, “No problem.”

Vera, somewhat alarmed that I’m not going to make Clive change (damn, I must have left the Change Button at home) says, “Okay, so I’m jealous, sometimes, a little bit. But, I can’t change either – and if he doesn’t change, well . . .”

I smile, confidently. “No problem.”

What the f___?  If the Final Arbiter bit is out, and the Fairness Doctrine has been sent to the bulrushes, what’s left? As it happens, the last resort is What Works.

“Guys – here’s how I see it: Clive, you’re a gregarious guy (proud smile), and it’d be a shame to make you change that (besides, I’ve left the Change Button at home, but they don’t know that), and Vera, you want, and deserve, to feel Special (proud smile – that sounds a lot better than Out-of-control, jealous b-word), so here’s what I propose: Clive, when you’re, shall we say, mingling – and as we know, you’re not flirting (head nod) – why don’t you make it a point to include Vera in some way? You know, just put your arm around her, or nod to her, or make a reference to her while you’re talking, so she knows, and everyone else knows, you’re with her? Is that too much to ask?

Clive: I don’t have to stop being outgoing?

Me: Nope – not a drop.

Vera: See ! I told you . . .

Me: Nope – not a drop. Let it go: nobody’s wrong here, nobody has to change who they are. Clive gets to be exactly who he is, but, since you’re together, he has to work with you on your jealousy issue, instead of resenting you for it. You see, he’s operating on the assumption that if you trusted him, you wouldn’t be jealous (Clive nods), but that’s not true: your jealousy is there whether you trust him or not. You just want to be included, and acknowledged, in his socializing with other people (Vera nods).

(Insider information: at this point the Final Arbiter and the Fairness Doctrine have both been sent to the showers, and What Works has come in to pinch hit. They’re still a little uneasy about it all, waiting for the other shoe to drop, for me to say someone’s ‘wrong’, but I don’t, and I won’t: it’s about What Works, not Who’s Wrong, and What Works has just hit a ringing double to the gap.)

Vera: (Suspiciously) And what do I have to do?

Me: What you have to do is not hang back and pout while he’s talking to other people. You have to stay around, instead of ‘testing’ him by withdrawing, so that, when he does his homework, you’re there to receive it.

Vera: Hmm – okay, sounds reasonable.

Over the next few sessions, Clive and Vera gradually shift from suspiciousness to relief: imagine that – this son of a bitch (Me), who couldn’t even play Arbiter properly, has come up with a Plan – a plan that doesn’t require confession, degradation or groveling, but merely Cooperation toward a common goal – a decent, functioning relationship. Our subsequent sessions are mostly about monitoring The Plan, modifying it as needed, answering questions about specific instances as they arise, and most fun of all, incorporating variations THEY come up with, as they get into the spirit of it.

In a later session, Clive says, “I’ll tell you one thing: it’s good to feel, for once, that I can do something right.”

Nodding, Vera responds, “And it’s good to feel like I’m not always the crazy lady.”

And I add: “There was never anything ‘wrong’ with either one of you: you just needed to work together instead of blaming each other.”

Granted, this was a situation that turned out to be relatively non-toxic, though keep in mind, when they started therapy, they were one step away from some serious violence. What if Clive actually had been coming on to other women, had been having affairs? What if Vera actually had slashed the tires of a woman he was talking to innocently, put sugar in her gas tank, and sent her a death threat? (I’ve dealt with all of the above.)

Sure, there are much more extreme, and uglier, situations a therapist has to deal with, all the time, but the principle’s still the same: you can’t just “have what you want” in life, regardless of consequences, and expect things to work out. You can’t just say, “I am what I am, take it or leave it,” and not eventually run into the buzz saw of Reality, whether as a parent, a spouse, a Little League coach, an employee, or President of the United States.

But if you learn to adapt, to let the little things go, to change your tack when the wind blows from the northeast, you can have a pretty good life, without giving up who you are.

And if you get really hard up, you can always come over to my house:

Line forms on the left for marzipan Ding Dongs!







Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

A Journey To Forgiveness, Part III: The Crossroads












(Note: please read Part I and Part II first, especially if you’re interested in being able to follow anything written below – but then, it’s your call.)

Grace left the office. She didn’t glare, she didn’t slam the door, she just threw me a lightning-fast eye-lock, and then she was gone. I knew she didn’t hold anything against me – it wasn’t anything like that. It was just that her head was exploding from so many forces coming together at the same time: her anger at her mother; feeling like a bad daughter; embarrassment and shame at the fact that her mother still held such sway over her; guilt over seeing me, given what her mother had said and done when she ‘found out’ about me; and last but not least, her strong desire to get better, to find herself, to claim a life of her own.

And sometimes, it’s just . . .

Too many teardrops
For one heart to be crying.
Too many teardrops
For one heart to carry on.

(As Question Mark and the Mysterians put it)

After she closed the door, I sat there in the office, staring straight ahead, but only seeing what was inside me. I felt pain for her. There was nothing I could ‘do’ right now, at least nothing dramatic: I certainly wasn’t going to engage in a world war with Momma over the rights to Grace’s mind. For one thing, I didn’t want the rights to Grace’s mind – I just wanted Grace to have those rights.

And I knew something else: human growth swings like a pendulum; a patient has an ‘amazing’ session one week, with breakthroughs and insights galore, and the next week it’s like the slate has been wiped clean, and it’s back to Square One. With experience, you learn that the patient isn’t really back to Square One, nor have you suddenly, and unaccountably, become a terrible therapist, because the pendulum will swing back toward growth again, if you ‘allow’ the swing to occur, and hold the therapeutic space for the patient. Just as a plant will seek light, a patient, if at all possible, will seek growth, if you provide conditions for growth, which don’t include forcing the issue, or expecting things to go in a linear manner. If you force the issue, all you do is alienate the person and let them know that you don’t understand, or respect, the forces they are dealing with.

No, it wasn’t time for theatrics – but it was important to let Grace know I was still there for her, when and if she was ready. I would send her an email to that effect, but not now, not today. Today was a day of turmoil for her, and I had to respect that. Tomorrow would be soon enough.

And besides, I had things to do. At times like this, a therapist needs perspective, and friends.

In baseball, they say the double-play is a pitcher’s best friend.

And at times like this, you know what a therapist’s best friend is?

The next patient.


It was the following day. I hadn’t heard a word from Grace, but that didn’t concern me too much: she needed some time, and space, to process all that had happened. I remembered when she banged her arm down on the chair and said, “I’m so sick of lying!” I had to trust that, sooner or later, she would come back to that truth: she had come too far to go back now. You can’t “unring the bell” of knowledge and insight that you have fought so hard for. It doesn’t just vanish that easily, even in the face of terror, guilt and ‘old ways’.

I sat down to my computer. I felt that an email might be easier, and less pressured, than a phone call. An email you can read at your own pace, revisit whenever you want, and respond to when, and if, you are ready. It doesn’t get distorted by the vagaries of fickle memory: it says what it says. And by the same token, I needed to choose my words carefully, because they would be there, and unalterable, once written.

5:00 P.M.

Grace – I know that yesterday, when you left, you must have felt like you were in a waking nightmare:

What’s real?

What’s true?

Who are my real enemies?

My real allies?

How can I be a good daughter and still live my own life?

How can I stay in therapy when it means losing everything I have known?

We both know there are no easy answers to any of these questions, but I do know this: you’re worth fighting for, and if you stay with it, there will be answers – answers you probably can’t even imagine right now. You are a young woman, and there are countless experiences waiting for you, some of them wonderful.

Sure, your mother is angry right now, and threatened, terribly, by your being in therapy, but in time I feel she can come to accept your need for a more authentic life, and realize that you are not trying to lose her, just find yourself.

I also know that I am here to help you take whatever next step is necessary, whether it involves continuing with me in therapy or not.

I hope to hear from you sometime. Whether you leave therapy or not, please don’t leave you.

All the best – Dr. Bernstein.

That was it – now the waiting.


At 11:28 that night, this appeared in my email queue:

Dr. Bernstein – Thank you so much for your email. I thought you were mad, or at least disappointed in me. I was so upset, I didn’t know what else to do but leave. I’m lying here in bed, with the covers pulled up over my head, just like in your office. Not much more to say right now.

I felt many things upon reading Grace’s message that night, but mostly relief: I didn’t pick up any hints about despair, or about “nothing mattering anymore” – not that she might not have been feeling those things, of course, but at least it didn’t sound like they were crowding out all else in her emotional field. Of course, it was also possible that she was so regressed she was omitting them so as not to ‘burden’ or upset me, but from the tone, that seemed unlikely.

No, it sounded like she was doing what I thought she was doing: holing up and saying, “Stop the world, I want to get off,” for now, buying time so that she could process all that had happened. It reminded me of how a friend’s mother had once described childbirth:

Trying to shit a watermelon.

Right now, she was seeing the emotional task before her in basic, extreme terms: I can have Momma, and be miserable the rest of my life, or I can have myself, and be alone and ‘bad’ the rest of my life. The missing ingredients in that formulation are Time, and Help: Time, to let her sense of self expand (remember that pesky watermelon?) to accommodate the complexities of the task (and to let Momma accommodate to the new realities, as well), and Help, to add another person’s wisdom, and support, to the solution, and to demonstrate that it doesn’t always have to be like it is with Momma.

It was late, and I didn’t want to disturb Grace’s process at this point (remember, I want her process to be Hers – to have and to hold), so for now, I merely emailed back,

I have every confidence in you. Stay with it.


Two (long!) days went by before I communicated with Grace again. Yes, I could have called or emailed again, but it didn’t feel right. Besides, it occurred to me that maybe I was being the dramatic one: how did I know that she hadn’t intended, all along, to keep her next session? Oops: busted! Her sessions were on Tuesday – it was Friday now. She had never ‘officially’ said she wasn’t continuing her therapy – so why not just assume normality? What a concept!

I emailed her,

Feel free to update me or check in anytime. See you Tuesday.

And back came the immediate response:


Whew! And to think, I was the one who wouldn’t have been there on Tuesday, because I had ‘jumped the tracks’ and made a dramatic assumption! Little did I know what was to come on Tuesday.

I didn’t hear from Grace any further. On Tuesday afternoon, her regular time, she appeared, once again in Living Goth: short black skirt, torn fishnets, boots. This time, I was going to play it ‘smart’: I wasn’t going to make any Pollyanna assumptions about her state of mind, based on her clothing. And once again, I was wrong.

She sat on the chair, as usual: no couch, no blanket.

Grace: You know – I wasn’t going to come.

Me: Oh, really?

Grace: Yeah – I thought you knew.

Me: (Wisely silent)

Grace: But then, when you sent me that email, saying you would see me at our regular time, in that instant I made up my mind to come.

Me: I’m so glad you did.

Somehow, she was more cheerful than I expected. Sometimes it’s good to be wrong. I didn’t want to pry, but I had to know ‘what happened’.

Me: So, what happened with . . . you know . . . your mother and all?

Grace: (Gaily) Oh, that? She asked my cousin to sit with the animals, and I went with Kim for the spa days we planned. (Pause) It was so fun!

Me: (Feeling left at the post) But, she was so mad . . . and you were so . . .

Grace: (Nodding, jauntily) Guilty? Scared? Hopeless? Yeah, I was, for a day or two, but then it just seemed like . . . you know, like something snapped, and I realized I’m not a bad person, whether Mom thinks I am or not. And, it’s really none of her business, anyway, whether I’m seeing you or not; in fact, if I wasn’t seeing you, she and I would probably be doing a lot worse. (Shrugs) In fact, I think she understands now, that you’re trying to help me deal with her, not ditch her. (Pause) We had a talk: as usual, she didn’t really listen, but I think some of it got through.

Wow – this whole conversation reminded me of my oldest son’s fear of ghosts. In elementary school, he had a teacher who, for some misguided reason, brought in an article that discussed the possibility that ghosts may be real. Ever since that time, he had been afraid of ghosts, especially at bedtime (Thanks, teach!). When I went in to tell him his bedtime story, I would frequently have to reassure him that ghosts weren’t real, and weren’t going to come and get him in the night.

One night I went in and ‘proactively’ began to ask him about his ghost ‘thing’: how was he doing with his fears, if there was anything I could do to help, etc.

He promptly said, with an almost disgusted, eye-rolling tone,

Daaaad – I’m not afraid of ghosts anymore.

Uh – yeah. Well, that’s how I felt with Grace: she had shit the watermelon, and, suddenly, what I was talking about was ‘so yesterday’. Of course, it was not ‘over’ – far from it, but this phase of it was over: she would never again feel so desperately torn in half by her mother’s demands, or agree so passively with her mother’s (mercurial) ‘assessments’ of her personality. She had come through the ‘fire’ stronger for it, and she never walked out of therapy again.

She could damn me, or damn her mother, but she didn’t have to damn herself anymore – at least not full-bore.

How far had she come? As she walked out of the session, she said,

By the way, Doc, that ‘naturopath’ crack was pretty good!  It  gave me some perspective on things: if you could sit there and have some humor about the whole thing, well, maybe I could, too. It kind of made Mom’s accusations seem silly, and my taking them so seriously, silly, too. So, thanks.

Maybe you’re saying, “Hey, wait a minute: what does all this have to do with forgiveness?” Well, all of the above is how ‘forgiveness’ usually looks, in real life: Grace and I never even mentioned the word ‘forgiveness’, and yet she was moving towards it all the while. By ‘demoting’ her mother’s opinions of her to the level of, “Oh yeah – well, that’s just what you think”, Grace stopped having her self-image, and her whole life, controlled by her mother. (And, note: she was now calling her mother “Mom”, not “Momma”. Was she even conscious of it? It didn’t matter.)

And once her mother didn’t control her life, Grace could step back and take control of it herself. And once she could run her own life, she didn’t have to hate her mother anymore, or wish her dead. In seeing her mother as “just a person”, Grace could have empathy for how limited and fragile her mother’s self-image was, and how needy her mother was. In effect, Grace had been giving her mother more power than her mother could handle: after all, you don’t base your self-image on what a four year-old, in the midst of a tantrum, thinks of you!

In the future, when her mother would start to rant and rail at her, Grace didn’t have to collapse into being crushed or enraged: she could reassure her. When “Mom” said, “You’re an ungrateful brat,” Grace could say, “Mom, we don’t need to go there right now. I’m sorry it hurts you that I can’t talk to you right now, but I’ll call you later, when I’m off work, okay?”

So, it turns out that forgiveness is not something you can just make happen by wishing for it, or focusing on it, or repeating some magic mantra. It comes when what the person has ‘done’ no longer is actively destroying your life, and you can see it as their problem, not something that defines you in the present.

It takes hard work, and usually, teamwork, to break the iron grip of resentment and get to forgiveness, but, just as being in the thrall of someone’s abuse is hellish, to release that grip is a heavenly blessing.

So I guess Alexander Pope was right at that: To forgive is divine!



















Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

A Journey to Forgiveness, Part II: Grace Under Fire









(Note: please read A Journey to Forgiveness, Part I: First Steps, first)

During the next few sessions, Grace continued to get more comfortable talking to me about herself, getting more used to being the ‘main attraction’, as opposed to talking about the other person (i.e. me), pleasing me, or taking care of my feelings There was less knee-jerk fear about my reaction, whenever she said something that might not be ‘acceptable’, and she talked less and less about her mother, and more about her own interests and dreams.

She was working as an ‘admin’ in a law office, and was highly valued by the firm, but she dreamed of becoming a paralegal, and maybe, someday, even a lawyer, though her mother had told her repeatedly, since childhood, “You’re not very smart, and you’re not very pretty – your only hope is to be a hard worker.”

Although her growing comfortableness in talking about herself might seem at first blush to be great progress, I knew it was just the calm before the storm, because there was still a white elephant in the room, spelled M-o-m-m-a.

One day, I came out to the waiting room and saw that, for the first time, Grace was not wearing the hoodie over her head. I could see purple and red streaks in her hair. She had on a shorter skirt, black tights and her engineer boots, along with heavy mascara and eyeliner.

Oho, maybe a Goth not too depressed to claim her Gothnicity?

Alas, that was wishful thinking.

As before, she sat down hesitantly and looked around the office like a trapped animal, twisting her fingers together.

I waited for her to start.

Grace: So, Momma called again.

Me: Oh? What did she have to say?

Grace: Oh, the usual: “Why didn’t you ever apply to Stanford, like I told you to?” and “You know, I had high hopes for you,” and “Why are you always trying to hurt me?” (Looking down, dejectedly)

Me: And what did you say?

Grace: Nothing: I mean, what is there to say? I am a failure, I didn’t have the guts to apply to Stanford, I am a disappointment, and I am always hurting her: four for four. (Tearing up)

Me: Well then, just for my information – why didn’t you apply to Stanford? (Pause)You’re certainly smart enough.

Grace: (Her eyes flipped up to mine instantly, when I said “certainly smart enough” – maybe to check out my sincerity?) Because I had, like, a 3.2 in high school – that’s why.

Me: So it would have been unrealistic to apply, in your opinion?

Grace: (Angrily) Dude – in anybody’s opinion! Let’s face it.

Me: (Smiling) Wow – thanks for the “Dude”!

Grace: (Looking down, biting her lip and smiling in embarrassment) Sorry – I guess I . . .

Me: Forgot yourself for a minute, and were real with me? (Pause) I just said “Thank you” – did you get that?

Grace: Yeah, but . . . it was disrespectful.

Me: Was it really?

Grace: (Immediately) No! (Pauses, surprised at the heat she gave the word). I mean, I didn’t mean it disrespectfully, but, you know, you might have . . .

Me: Been wounded – in my feelie-weelies?

Grace: (Smiling) You’re weird, Dr. B.

Me: Well, what do you expect: I didn’t go to Stanford, either. (Pause) So . . . I guess that just makes us a couple of gutter rats, right?

Grace: (In a high, silly squeak) Pass the cheese!

We laugh hollowly, both knowing we were just sparring before the main event.

Grace: (Turning more serious) Then, why do I let her talk to me like that?

Me: I don’t know – why do you? (I know what’s coming, and keep my mouth shut to let this crucial piece develop)

Grace: (In a questioning tone) I don’t know . . .

(I keep quiet.)

Grace: . . . because part of me believes her?

Me: (I just raise my eyebrows in acknowledgment – that’s enough, and besides, she’s not done)

Grace: So – what do I do with the part that believes her?

Me:You mean, you’re more than just that one part?

Grace: (Looking down) I guess – I mean . . . I don’t know . . . I’m so confused . . . it’s like . . .

Me: A civil war, inside?

Grace: Yes – but how do I know which side is the good guys?

Me: Maybe ‘good’ isn’t the right word.

Grace: What do you mean?

Me: Maybe you need to start thinking about which side actually works for you, and which side cripples you.

Grace: (Thinking) But, that’s not fair: I want to be good, and functional!

Me: Then maybe you need to take charge of what’s considered ‘good’.

Grace: I mean, what’s my goal in life, anyway – to be a good person, or to be . . .

Me: Yourself?

Grace: (Twisting her fingers) It’s so confusing. (Pause) How do you figure it out?

Me: You mean, for myself?

Grace: Yeah.

Me: Well, number one, I figure it out – not someone else. And number two, it’s about my Self, not someone else’s idea of who I should be.

Grace: But that seems so . . . you know . . .

Me: Selfish?

Grace: Yes!

Me: You mean, instead of Other-ish?  (Pause) Or Mother-ish?

Grace: (Smiling) You’re weird!

Me: Guilty as charged. (Pause) But then, it takes one to know one.

Grace: (Thoughtful, big breath) Somehow, that’s a relief.

Me: What – being weird?

Grace: Yeah – like I can finally say, “Momma – I admit it, I’m weird, so just leave me alone.” Like I can finally throw off her expectations, and still not . . . (Pause)

Me: (Pause) Be a failure? Be all alone in the world?

Grace: (Nodding) Yeah – I think so. (Pause) I think being ‘different’ from what she wanted, always meant that I would be alone the rest of my life – like, you know . . .

Me: Cut out from the herd?

Grace: (Nodding) But now I see that (Pause) . . . well, there might be another herd right over the next hill – even though I don’t know them, yet. (Pause, looking up) Does that sound stupid?

Me: No – not to me, it doesn’t.

Grace: (Crying) It’s . . . scary . . . to be, you know . . . Free . . . (Looks up) . . . isn’t it?

Me: It sure is – at first. But you get used to it, after awhile. And, besides, you get to hang out with a whole different class of people: honest ones.

Grace (Crying again, angry, slamming fist down again) I’m so sick of lying! I’m so sick of feeling like a failure! I’m so sick of wanting to die! I’m so sick of hating everything: myself, Momma . . .


Grace: (Sobs dying out) (Pause)


Grace: You . . . you think I can really pull it off?

Me: You mean, being yourself?

Grace: Yeah – being a weirdo.

Me: Well, you’ve made a pretty good start: (Looking at watch) You’ve already been one for at least forty-five minutes, and you haven’t been arrested yet.

Grace: Yeah, but that’s in here.

Me: Well, maybe you can take some of here with you. Besides, you can always connect with me between sessions, if you want. (Note: she never did this before, feeling it was ‘dependent’, ‘weak’ and a ‘burden’)

Grace: (Shaking her head) You really are a weirdo.

Me: Welcome to the club.


After that, she began to email me occasionally, between sessions. She was learning how to ‘use’ me for support, and validation of her experiences, especially with her mother. She would regularly say, “You sure I’m not burdening you?” and seemed surprised when I said I wanted to know what was going on with her.

But I also felt that, in establishing regular communication with me, she was just ‘battening down the hatches’ in anticipation of the coming storm, and I was proven right in the next session.


When I greeted Grace in the waiting room, she looked like she had come directly from bed: her hair was held up by a pencil stuck through it, she was wearing what likely were actual pajama tops and bottoms, and she had flip-flops on her feet, with no socks, though it was actually rather cold. Her eyes looked wild – haunted.

As she entered the room, she went directly to a blanket I keep underneath an end table, pulled it out and, in one motion, flung herself on the couch, and threw the blanket over herself, pulling it up over her head. She had never used the blanket before, or lay on the couch. Something big had obviously happened. I was guessing it started with an M . . .

Silence. (I was letting her take it at her own pace)

Grace: Well, I did it.

Me: You did what?

Grace: No – that’s wrong: not “I did it,” but, “Now I’ve done it.”

Me: Sounds scary.

Grace: It is: I just want to cover myself up and hide from the world, forever.

Me: Must have been pretty bad.

Grace: It was – the worst.

Me: I’m interested.

Grace: That doesn’t matter – anymore.

Silence. She was ‘baiting’ me with negativity again: would I give up, get mad, be impatient?

Me: Why don’t you just tell me what happened?

Grace: I just feel numb. (Pause) Okay, then – just for the record: I had a fight with Momma, and . . . and, I lost it.

Me: How do you mean?

Grace: (Pulling the cover up higher, talking from underneath it) I mean I’m an idiot – that’s what I mean!

I could hear anger in her voice, probably at me, but I didn’t want to ‘go there’ yet, as I felt it was probably still unconscious, and there was important ‘Mom work’ to do first. We could always do me later.

Me: Was it a conversation you had with her?

Grace: Ha! I’d say more of a “versation” than a conversation, since there was no place in it for me!

Me: So, what did she say?

Grace: (Sighing) Okay – so she called me because she’s going out of town for a week on a business trip, to Denver, and she wanted me to pet-sit at her house for the week.

Me: Oh? I didn’t know she had pets.

Grace: (Ironic smile)Oh, just four cats and a huge German shepherd! She calls them her “good children”, as opposed to her ‘bad’ one, which of course is me.

Me: So, what did you say?

Grace: I said ‘No’, because I’m going out of town for three days with my friend Kim. (Pause) I haven’t had a vacation in years, and it’s important to me!

Me: Sounds reasonable. And what did she say to that?

Grace: She went off! She said I was a bad daughter, that I didn’t care about her at all, that I was disloyal, and that I had never once put her needs before mine! That it was all about me, that no matter how much love she’s poured into me, all I ever thought of was myself. She said she thinks I’m a psychopath . . .(crying) . . . Dr. B., am I a psychopath?

Me: You? Hardly. You’re not even a naturopath.

Grace: (Pulls blanket down to glare at me, then blanket goes back up) Don’t kid! This is serious!

Me: Okay, I’m sorry – but it’s hard to take seriously that anyone could call you a psychopath: you’re such a sweet, caring person, and daughter: she’s lucky to have a daughter like you. 

Grace: (Pulls down blanket) You have to say that!

Me: I do not. Okay, put it this way: would you call someone just before going out of town for a week, and ask them to pet-sit your four cats and a dog, and then blow up if they said No, because they already had other plans?


Me: I’m waiting.

Grace: Well – that’s different.

Me: Why – because different rules apply to you, than the rest of the world?

Silence. She’s still undercover.

Me: I ask you again: would you ask your daughter to do that on such short notice, then blow up if she had other plans?

I can see squirming under the blanket.

Grace: Well, I guess not.

Me: You guess not? C’mon – get real.

Grace: Okay, then – I wouldn’t. I mean, of course not: especially my daughter.

Me: So?

Grace: But she expects it of me! To her, it’s what a good daughter would do! And I’m not a good daughter! (Pause) And there’s something else, too.

Me: And what is that?

Grace: I told her about you. I mean – she got it out of me.

Me: You make it sound like a police confession.

Grace: Well, it is, kind of. (Pause) She . . . kind of . . . figured it out.

Me: What do you mean, figured it out?

Grace: When I said No to the pet-sitting, she said, “Something’s wrong here: what’s going on in your life, that you would talk to me like this?” (Pause) So – I told her. (Pulls covers back over head)

Me: You mean, she didn’t know all along that you were seeing a therapist?

Grace: No – how could I tell her? She would just think I was talking trash about her. (Pause) And, besides, then she would grill me about it every week. (Pause) And – I kind of am.

Me: Am what?

Grace: Talking trash about her.

Me: That’s unfair to yourself – you’re just trying to find yourself, and if that sometimes involves facing the truth about her, well, what else can you do? The truth is the truth.

Grace: But she doesn’t believe in the truth: she just believes in her truth. (Throws blanket off – picks up purse and stands up) I . . . I can’t do this anymore . . . I can’t take it anymore . . . I have to . . . get things back to normal! (Begins to walk out)

Note: It’s different this time than the last time she started to walk out. This time, I feel she may need to go through with it, at least for the moment. I want it to be her choice to continue, if she does. But I also want her to know I still care.

Me: Grace – are you sure you want to do this?

Grace: I’m not sure of anything – that’s why I have to get out of this and just let everything just go back the way it was. (On the way out, she makes almost desperate eye contact with me for an instant, then walks out, closing the door)

At this point, my biggest concern is that she might do something impulsive, to harm herself. It is not like before, when she would have been walking out before even starting therapy: by this point, I know she knows the ‘truth’, and knows I am on her side. I’m frustrated, but at the same time, I understand: to go towards the truth, when it seems to be bringing disaster with it, is a hard, hard thing, and sometimes people can’t do it in a linear way.

Sometimes, they have to go (what looks like) two steps back. I know that, by now, even if Grace stops therapy, she has come too far to ever go back completely to ‘the way it was’ – she has an inner strength that is impressive, and even though she doesn’t know it’s there, it’s there.

I am not going to ‘force the issue’ at this point, but that doesn’t mean I don’t have a plan: I’m going to give her some space, and make sure she knows I am still available, am not ‘mad’ at her for leaving, and am still in her corner. It’s important that she know she has not “disappointed” me, as she always feels with her mother: I am proud of her for coming as far as she has, and I stand ready to help her puzzle this thing out, even if it means talking ‘outside of therapy’ in some way, without a commitment to therapy.

As I said earlier, the most important thing is that our interaction be for her benefit, not to please me or to avoid alienating me (i.e. an echo of what happens with her mother): if therapy is defined as my ‘thing’, not hers, then I will have failed, even if she comes back to therapy.

Did I make a mistake by not being more forceful in influencing her to stay? Will her mother’s pull be more powerful than the working relationship we have established so far? And what does all this have to do with forgiveness?

For now, it’s a waiting game, while “ignorant armies clash by night” inside of her. This ‘clash’ of primitive forces, this squirming under the blanket of emotional imperatives, is what therapy is all about. This is the cutting edge of change, and it’s never easy, or predictable.

A patient once yelled at me, in anger,

You dragged me out into the middle of a race track, with cars whizzing past me at 200 miles an hour. How am I supposed to survive out here, alone? Damn you!

And two days later, the same patient said,

If it wasn’t for your faith in me, I’d still be a little girl, afraid of my own shadow. Thanks to you, I’m becoming a grown woman: for the first time in my life, I feel proud of myself.

Which of these two statements was true?

Both of them.

Grace was at a fork in the road. Which path would she take? And what would the rest of her journey look like?

I didn’t know. I just knew that if I continued to believe in her, and demonstrate that belief to her, she had a chance to become herself, someday.

Continued in: A Journey to Forgiveness, Part III: Crossroads.





















Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

A Journey To Forgiveness, Part I: First Steps










To err is human – to forgive divine…

Alexander Pope

Well, Al, I know you were a Pope, but for most of us, the closest we’ll ever get to divinity is corn syrup, eggs and sugar. So let’s take a whack at what forgiveness actually is, and what attaining it is all about,  for real people in real life. We’ll use the topic of parents today, because parents are a common target of resentment and suppressed rage, and therefore a common subject for forgiveness. We could use bosses, landlords, ex-spouses, abusers, or anyone a patient (or other human) might hate or hold a grudge against, but resentment against parents is so universal, it’s a handy set of ‘training wheels’, for starters.

To begin with, most patients come into therapy with an attitude something like this:

I know my parents did some things wrong, but we all, do, right? Besides, they tried their best. So how do I stop holding all that stuff against them and just let it go, already?

Easy there, Pilgrim: I can see that you want me to just hand you a card that reads, “Go Directly to Forgiveness – Do Not Pass Go, do not collect $200.” I wish it were that easy, but unfortunately you do have to pass Go to get there. Religious wishful thinking to the contrary, you can’t just go straight from the thought to the done deal.

Penance won’t do it.

Brow-beating won’t do it.

Primal screams won’t do it.

Prayer won’t do it – not prayer alone, not in any real, meaningful way.

You have to earn it, by traveling each step on the emotional road, from the original injury to the present day effects of it – and by ‘traveling each step’, I mean going a step at a time, and traveling it consciously. And what does ‘consciously’ mean? It means feeling your way through it, ideally with a witness (Good Therapist, Good Therapist, to the orange courtesy phone, please!) helping you make sense of it all. It means Claiming what happened, fully and freely.

But enough talk – let’s dive in and actually go through the whole process of how Grace, a patient of mine many years ago, got to forgiveness. And although we all have different journeys, Grace’s ‘stations of the cross’ (i.e. the steps of her journey) are representative of what it’s like for almost anyone to take the journey to forgiveness, a journey that, as we’ll see, is part of the journey to self.

My first contact with Grace (though I didn’t know it, initially) came via checking my voicemail.

Please enter your PIN, followed by the pound key.

I did so.

You have five new messages. To get your messages, press 1.

Being no dummy, I pressed 1.

First new voice message, received today at 5:52 P.M. :


Hmmm – must’ve been a wrong number.

Second new voice message, received today at 5:53 P.M.:


Hmmm, they must have thought they mis-dialed.

Third new voice message, received today at 5:54 P.M.:


Hmm – my my, what have we here? Hesitancy? Shame? Fear? Well, maybe the fourth time’ll be a  charm:

Fourth new voice message, received today at 5:55 P.M. :

Uh, Doctor . . . .Click.

Hmmm: Dr. Click, Dr. Click – paging Dr. Click!

Well, I crossed my fingers that on the next call, she would give me enough contact information so that I could at least talk her through her initial hesitation, whatever it was. By now, I was rooting for her: making that first call is one of the hardest things in the world for someone to do; I already respected her for making it, and I didn’t want to miss the precious opportunity that it represented – for her.

Fifth new voice message, received today at 5:56 P.M. :

Uh, Doctor . . . . Doctor Bernstein? Could you call me, please? Grace, at (She gave her phone number) . . . . I, uh, I, uh, . . .oh well . . . .Click.

Go, Gracie! We were in business! At this point, in my mind, I’m the Coast Guard: I’ve received an SOS, and it’s my job to see to it that the caller gets headed towards help, as soon as possible, whether it’s going to be with me or not. Like I said before, that first call is tenuous, tentative, and very, very precious. From the perspective of having been a therapist for decades, I know all too well that how I handle it now can make the difference not just between life and death, but between life and a death in life. To reach that crisis point, finally ask for help, and then get no response, or an uninterested response (Sorry, my practice is full – Click), or to hook up with a dud therapist, literally can make all the difference between going on indefinitely in misery, or a life that was meaningful and well-lived.

I dialed the number she gave.

Grace: Hello?

Me: Hello – this is Dr. Bernstein.

Grace: Oh, uh, Hi, Doctor. I’m not really, uh, that is . . .

Me:That’s okay – I know it’s hard to call, and hard to talk, right now. How about you just tell me what’s going on today, that brought you to ask for help?

Grace: Oh – oh, okay, then: I had this fight with my mother, well, Momma, that’s what I call her – this, uh, big fight.

Me: When you say ‘big’, do you . . .

Grace: Oh no, no – nothing like that. But it was bad, you know – pretty bad. And it’s been bad for a long, long time. . . .

Me: And you thought it might make sense to talk to somebody about why it all happens, and what it all means?

Grace: Something like that . . . yeah, well actually – that’s it, exactly.

Me: So, would you be willing to come in and see me, so we can actually meet, and then I can see what you need, and help you find what you need?

Grace: Oh, well sure, I guess so. (Pause) But, do you think I really need . . .

Me: Well, I really don’t know anything right now – that’s why I’d like to have a chance to sit down with you and see and hear it all from you in person. Then I’ll have a better idea what’s going on, and what you need. Okay?

Grace: Okay.

We made an appointment for an afternoon the following week. Would she keep it, given her hesitation? I didn’t know, but I knew one thing: I was going to be there.


Next week:

I walked into the waiting room to find an attractive woman (girl?) in her mid-twenties, looking distracted and preoccupied, twisting her fingers together and staring at the floor. She had on a dark green hoodie with the hood up over black hair, big sunglasses, no makeup and a long, dark skirt that came down to her black, engineer-type boots. She had a tattoo of Snow White on one arm, and a grinning skull on the other one: hmmm. If you made me call it something, I would call the look Depressed Half-Goth.

Me: Hello there – c’mon in. I’m really glad you were able to make it. (That tells her, hopefully, two things: that I know it was hard, and that, for me, it’s not just, “Next!”. But I could see she was too preoccupied to pick up on anything at the moment.)

Grace: (Taking a seat, looking around the office dubiously, scared – no eye contact) . . . (sighs) . . . So, yeah, well . . .

Me: When we talked, it sounded like there was a lot going on . . . (I deliberately drift off, leaving the thought for her to complete, if she will, and knowing that she probably has already down-shifted, emotionally, from the ‘crisis point’ when she got up the nerve to call; now, in the ‘cold light of day’, when she’s actually facing the help she asked for, will she still have enough oomph to carry through with it?)

Grace: Yeah, well (still looking around the office, clearly hesitant and conflicted, twisting her fingers again) . . . Things were really bad last week.

Me: (Nodding) Yes – I could hear that.

Grace: But, you know, I think we cleared it all up. Momma . . .well, she apologized (looks down),  well, not really apologized, but . . .

Me: You mean, like, it blew over, and now you’re supposed to let it all go and act normal again?

Grace: (Smiling ruefully, in recognition) So – I guess you’ve heard all this before, huh?

Me: Well, I’ve heard things like it, but never from you – and I’m interested in you. (N.B.: the patient wants to know you’ve ‘heard it all before’, but also wants to know it’s not routine for you.)

Grace: Well, things aren’t really ‘back to normal’ inside me, to tell you the truth. Something’s changed, and I can’t . . . can’t . . .

Me: Just flip a switch and be a good girl again?

Grace: (Nods, closing her eyes tightly, starting to cry, but trying to stop it)

Me: (I wait quietly – I know what’s coming.)

Grace: Dr. B, do you think I’m – I mean, is it bad for someone, you know, to . . .


Me:To what, Grace?


Grace: (Slumping in the chair, looking down, defeated) Nothing.

Me: To feel hurt, and angry, when you’ve been hurt? No, it’s not bad – it’s just human.

Grace: (Still looking down) But she says (swallows, hard) . . .

Me: (Gentle, now – this is brain surgery) She says what?

Grace: Well, she says . . . that I’m over-dramatizing everything, that I’m oversensitive. (Looks up, hopefully) You know?

Me: (Nodding) Yeah – I think I know. You’re supposed to ‘understand’, and not be hurt, and get back to normal, like it never happened. (Pause) Something like that?

Grace: (Nods, dejectedly) Yeah – that’s about right. (Pause) So then, why do I always feel . . . (trails off) . . .

Me: Guilty? Bad?

Grace: (Nodding, looking down with eyes closed) Yes, but it’s more than that. I’m almost scared to say what I really feel. (Pause) As far as me, yeah, I feel bad and guilty, but as far as her, well . . .(face gets red) . . .

Me: As far as her – what?

Grace: Well, that’s what I came in about. I’m starting to wish . . .you know . . .

Me: (Waiting – allowing her to get it out in her own time)

Grace: Well, it sounds horrible to say it. (Pause) Even to think it. (Looks at me)

Me: Go on. (I can’t rush her here – this is important. Sure, I could try to complete her sentence, but then it’s me saying it, not her.)

Grace: Okay, I’ll just blurt it out: Sometimes I wish she was dead, and I was rid of her, for once and for all! (Holds head in hands) Isn’t that terrible? My own mother! (Pause) I’ve even prayed for it! (Pause) I mean, here, she gave me life, and here I am wishing her dead. (Rocking in the chair, head down) Sometimes, it seems like the only way out is to either kill myself, or kill her. (Pause) Am I sick? Am I crazy? Or just an ugly person?

Me: Well, this may not answer your questions, but this is what I’m thinking as you talk: It sounds like there’s something your mother’s doing that makes it feel like it’s either her reality, or yours. So, in order for you to be a good daughter, you have to deny your own reality, and in order for you to believe in your own reality, you would have to cut her off and be a bad daughter. (Pause) Not much of a choice. It reminds me of the old Westerns, where someone says, “This town’s not big enough for the two of us.” Like, one of you has to go: you can’t claim your own life without being considered a bad person, and you can’t be a good person without denying yourself – at least in her view of things, which you seem to have accepted.

Grace: Yes – I’m trapped no matter which way I turn, and I end up just one big blob.

Me: Blob?

Grace: Yes, a blob – and more. I feel like a jellyfish, Doctor – like a big blob that just. . .you know, blobs around . . .

Me: (Smiling sympathetically) Yeah, I can see that. I may just have to have you arrested for having no visible means of support.

Grace: (Smiling, a tiny bit, clearly surprised, and unsure, at the humor) Well, you’d be within your rights. (Pause) Am I hopeless?

Me: (Smiling) Ohhh, I think we might be able to salvage a tiny bit of spine from all that jelly, if we look hard enough. (Pause) Don’t you?

Grace: I used to think I had a personality, and even some talent, but now . . .

Me: It’s like it all got pounded out of you? (Pause)

Grace: (Nods)

Me: (Smiling) Or maybe it just leaked out through the jelly?

Grace: (Smiles, biting her lip, then giggles) Yeah – like, maybe they should stamp ‘Smuckers’ on my forehead, so people will know what to expect.

Me: You mean, like truth in advertising?

Grace: (Laughing, with obvious relief, while covering her mouth in conflict about laughing) Yes, exactly.


In the following sessions, Grace began to explain to me “How it works” in her family:

Me: So, you live alone?

Grace: I do now.

Me: What do you mean, ‘now’?

Grace: I mean Momma threw me out.

Me: Of her . . .

Grace: Apartment – yeah, in the City (i.e. San Francisco).

Me: Go on.

Grace: She said I was being ‘disrespectful’ because I . . .(drops her head down)

Me: It’s okay – I really want to hear.

Grace: (Shaking her head ‘No’) It’s too embarrassing.

Me: It’s okay.

Grace: (Angry) No, it’s not okay! (Pounds her fist down on the chair, starts crying, gathers her things and rises to leave)

Me: Please – don’t do that.

Grace: (Still getting up, but slowly) There’s no point – can’t you see there’s no point? There’s no point in anything!

Me: (Standing up halfway) Please – please don’t leave, Grace . . . we can work on this. (Note: this is a crucial move – I had to decide between, reluctantly, letting her leave for the moment, which could have been her first act of ‘defiance’ of me, which could have been interpreted as a healthy show of spirit, or ‘begging’ her to stay, which could be an exact (and healing) contradiction of her mother’s insisting that she leave: it’s important that she see I am willing to fight for her, and that it’s not about ‘being a good patient’ i.e. staying in therapy, but rather our being a team, on her behalf.)

Grace: (Vacillates, then sits down again, looking defeated). See – I just do what everyone tells me to do. (Wan smile) A human jellyfish.

Does this mean I ‘blew it’? I don’t think so, though it’s possible: I think she’s testing me by guilt-tripping me about ‘making her stay’, to see what I do with it (i.e. do I pout or get defensive?) – I don’t think she really believes what she just said – she’s seeing whether I’ll stay in team with her when she takes a shot at me, or show my ‘true colors’ by flashing some ego.

Me: I think you decided to stay. (Pause) I think you had the guts to stay. (Pause) And I admire you for it, because it was your decision, not mine.

Grace: (Skeptically – looking at me slantwise, head down, eyes up) Do you mean that?

Me: You mean, did I say it because I ‘have to’ say stuff like that to my patients?

Grace: (Unsure) Well, it is possible, you know.

Me: (Shrugging) Sure, it’s possible, but it’s not true: if I’m not honest with you, you’ll never know when I’m telling you the truth and when I’m full of shit. (Pause – looking her in the eye) As it happens, everything I just said was true.

Grace: (Big sigh) And everything I said was true, too.

Me: You mean, like how it feels like there’s no point to anything?

Grace: I mean, like how there is no point to anything!

(Note: The fact that she’s now ready and willing to move on the ‘main event’, i.e. her hopelessness about her life, tells me I did the right thing by making her stay, and that I ‘passed the test’ by how I handled the phony guilt-trip, too: if my ‘forcing her to stay’ was really an issue, she would be shut down now instead of ready to move on to deeper water, like this. Remember, there are always at least two threads going on: what she is telling me, per se, and what is happening between us, in real time, and they are both crucial.)

So here it is – since I passed the last test, I get another one: what am I going to do with her aggressive statement that there is no point to anything, and the implied undertext of suicide? Do I show panic by immediately starting to ask her the ‘correct’ clinical questions of a suicide assessment?:

Do you think about suicide?

Do you have a plan?

If I do this, it will telegraph to her that her statement scared me, and that I feel I need to ‘cover my ass’ by getting my legal ducks in a row: this is not to say that there aren’t times for this, and these questions could be coming from genuine concern, but not at this point, not with this woman. She is testing me by throwing a scary, intense statement out there.

Remember, her mother is always telling her she is overdramatic, and oversensitive: therefore, it is critical that I ‘roll with the punches’ when she gets more dramatic like this – I have to show that, while I do care, it also doesn’t scare me, and that she is not ‘too much’ for me. I need to take it seriously, but not too seriously, and also remain calm and level in my response, so that it is still ‘about’ her, not me.

I have to track all of this, in real time, and I have to get it right: this is the real ‘therapy’ – not the words she is saying.

So, back to our session . . .

Grace: I mean, like how there is no point to anything!

Me: You sound angry.

Grace: (Angrily) Angry!? When I just said there’s no point to anything?

Note: She is mad that I didn’t ‘take the bait’ she threw out there, by either panicking or accusing her of being overdramatic, in response to her intensity. People are used to what they’re used to: when you don’t do what they’re used to, they get mad and confused, even if they hate what they’re used to, and even if what you did is the ‘right thing’.

What she knows about ‘caring’ is this: when she’s intense, the other person is overwhelmed, or mad, or turns the focus back on themselves. Since I didn’t do any of these, it feels like I “don’t care”. She is used to getting the ‘big response’ from Mom, and there is a form of power, and predictability, in that: even though she hates that pattern, she is unable to recognize, or ‘take in’, that she did get a response from me, because my response was about her, not me.

At this point, she doesn’t have a ‘place’ (inside her) for it to be about her – my job is to create that psychological ‘place’ (like planting a seed) and then to fill it in with repeated experiences of it being about her (watering the seed).

Me; Yes, when you just said there’s no point to anything.

Grace: (Still frustrated) Aren’t you going to do anything?

Me: If you want to talk about how your life feels pointless, I’m definitely interested in hearing all about it. But if you want me to try and dismiss what you’re saying, or get all upset about it, I can’t help you there.

Grace: (Staring at me, shaking her head slowly) I don’t get you. (Pause) You call this caring?

Me: Yes – I call this caring. (Pause) Why – does it seem weird?

Grace: Weird? Definitely. (Long pause) Did you mean what you said?

Me: About what?

Grace: About wanting to hear about my life feeling pointless?

Me: Absolutely.

Grace: But, what good will that do?

Me: I don’t know – let’s try it and see.

There wasn’t much time left in the session, but she did talk to me about how empty she felt, how she felt like she was watching her own life ‘from the outside’, about how she sometimes used alcohol, or marijuana, to get through time and “make the bad things go away”.

I listened intently, giving her the experience I mentioned earlier, of it being about her, not me, and though she still couldn’t really ‘take it in’, she talked to me about herself, freely and spontaneously, for the first time – not as a ‘good patient’, or waiting for me to give the answers, but just to share and feel understood – brand new experiences for her.

She did not recognize this, and I didn’t mention it, but this is what creates ‘the place’ inside.

We were getting somewhere.

Next: A Journey To Forgiveness, Part II: Grace Under Fire.



























Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

The Lady in the Leopard-Skin Suit









I was four years old, walking down the beach, feeling my feet sink into the soft sand with every step. I had never heard of ‘walking meditation’, and wouldn’t for many years, but that’s what I was doing. It was a typical Los Angeles beach day: hot, hot, hot, and crowded, crowded, crowded. My family – my parents, sister and I, had come here for the day.

Mind you, I hate water, always did – hate its unpredictability, its danger. I hate to swim – still do – and can’t, really, despite lessons as a kid, lessons as an adult. It’s pretty simple, really: I sink. I mean, when one of Nature’s Major Elements tries to warn you repeatedly like that, you should listen, right? Case closed.

My father was a whole different story. As soon as we got there, he did what he always did at the beach: put on his brown and yellow trunks with the sailfish on them, and run straight for the water, diving in with total abandon and swimming straight out to sea with strong, confident strokes. I wished, at four years old, that I could be the way I saw him then: strong, brave, at home in the world. I still do, sometimes, but now I realize there are different kinds of strength, different kinds of bravery. But that’s a story for another time.

My mother, also, did what she always did: set out the blankets and the food, and looked askance at the ‘neighbors’. She had a thing about ‘the great unwashed’ being in proximity to her, especially when in public. At the movies, she always said it was guaranteed that the guy who plopped down next to her reeked of garlic, or had a smoker’s hack, or mumbled inanities to his wife, loudly, throughout the show. So, having set up our temporary beach bivouac, she did the Proximity Scan: all clear, for now. Being an observant fellow, I of course had learned my lessons well: the world was unsafe, overwhelming, untrustworthy and coarse.

What do I mean by ‘coarse’? I mean Mark Halpern’s mother driving me and the guys down to the Channel 5 studios to watch Zebra Man annihilate The Hypnotizer, until the Hypnotizer finally maneuvered into position to ‘hypnotize’ Zebra Man’s hand to the ropes, leaving him free to pummel the beejeezus out of Zebra Man, while grown men on all sides screamed their lungs out in crazed bloodlust. Now that was ‘the world’. We didn’t do things like that.

Of course some people (mostly relatives) other than us were okay in my mother’s ‘book’, but then their okayness floated in and out like the tide: sometimes they were ‘in’, sometimes ‘out’, and as it was hard to keep up with her social tide tables, I think I just played it safe and decided that all ‘outsiders’ were not to be trusted – that way, I didn’t have to keep readjusting to their fluctuating status. If I just held everyone at arm’s length, I was safe.

But back to the beach. As much as I hated the water, water took second place to my worst fear: Getting Lost. Getting lost meant being separated from the herd, and when you’re a prey animal, in a predator’s world, that’s a bad thing. Well, things were going alright: my Dad had returned from his swim (Catalina and back?), Mom was pretty well settled – so, finally, sequestered on Bernstein Island, temporarily safe from all possible danger, I could finally relax on the blanket and watch the waves go in and out. God, there were a lot of people! God it was hot! I eyeballed the shoreline: gee, it looked kind of fun to be down there, at least getting your feet wet. No harm in that, eh?

I scanned the distance from my parents to the shore: not that far, as the crow flies, and I definitely was going to be the crow on this run. Maybe a hundred feet there, a hundred feet back:. Sure, I could do it, easy. Besides, they’d be right here watching me, though at the moment Mom was absorbed in a book and Dad was – well, Dad wasn’t responsible for ‘the kids’. Once, years later, when I was in the initial righteous flush of therapy and confronted him about not being available or ever doing much with me, he said, in all earnestness: “Well, your Mom had been a teacher: I figured she should take care of all that.” Hmm, nice to be relegated to ‘all that’, but back to the beach.

I mentally measured off the distance again: if I went straight there, didn’t move, and came straight back, I should be okay. After all, the shore wasn’t going to move in relation to my parents, and the same went vice versa (yep, I actually thought that), and if there wasn’t a massive act of god (I had seen hurricanes on TV, and heard about earthquakes) I should be alright.

I stood up and started walking. The sand seemed to pull me down with every step. Uh oh. Of course, I had seen Ramar of the Jungle and knew what quicksand could do (“Help – give me your hand!” “No, it’ll pull me down, too!”), unless you were a gorgeous jungle girl or Ramar himself.  But, as I went on, I  started to relax and enjoy the way the sand gave with my every step. It was like walking on the moon, or Mars, maybe: this was kinda fun, like being an explorer. I made it down to the beach. The waves weren’t bad, kind of unpredictable how high they were going to come in, but what’s the worst that could happen? Getting my legs wet, but that’s no big deal. Granted, it felt a little weird to have the sand give way under me even more now, when the water came in, but what’s that, to an explorer? Ramar had nothing on me.

The gulls wheeled overhead, a friendly escort. Hmm, what if I just walked along the shore for a while? What if I just looked down and followed my feet, like I used to do on the way to school? I could try to stay in a straight line, even though the undertow was always trying to pull me down and toward the water. Heck, I’m strong, I can do it: one, two, one, two . . .wow, this is amazing: I feel free, almost hypnotized, like the Zebra Man’s hand. One, two, one, two . . .I’m doing it, I can stay in a straight line if I keep concentrating . . .shutting out everything but my feet . . .wow, I wonder if the Zebra Man even felt The Hypnotizer hitting him when he was ‘under’? One, two, one, two . . .I’m free, free, free . . .

A cloud passed over the sun, breaking my trance. Gee, how long have I walked? I turned to the shore, looking behind me hopefully – nope, nothing was familiar. Deep breath. Okay, I’ll just turn around and retrace my steps – I should be able to see where I . . .nope, all washed away. I swallowed my panic. Well, all I did was walk along the shoreline, right? I’ll just do the same thing in reverse. Eventually, I should see them on my left. What if I don’t? I pushed that away. All I have to do is turn around and march. I was tired by now, but that didn’t matter: I had to get back, somehow. Seaweed swirled around my feet, tripping me up, but I kicked it away, angrily, and plodded on. Take a few steps, look to my left. Take a few steps, look to my left. Nothing, no one I knew, just hordes of strangers, laughing, shoving, having a great time. It was like Laughing Sal, the maniacal funhouse woman that populated so many scary old movies I stayed up too late to watch on the sleazy local channels: she laughs and laughs, oblivious, while desperate things – murders, betrayals, beatings – are going on.

Gotta keep walking. No, don’t watch your feet this time. Gotta stay alert, gotta keep going, gotta keep watching. Don’t cry, don’t panic – none of that baby shit, you got too much to do, boy. Walk, walk, walk . . .

“Are you okay?”

What? What’s that? I looked up, unsure who had spoken. I scanned the faces: all strangers – and everybody knows, “Don’t talk to strangers.”

“Little boy – are you okay?”

There she was: a lady. Kind of fat, kind of old, but she looked pretty nice. She had on a funny swim suit – a, what-do-you-call-it, from the zoo, a leopard-skin suit. What was I supposed to say? I froze.

“Come here – I won’t hurt you.”

I remembered the witch in Hansel and Gretel. No – somehow, the leopard-skin suit cancelled that out. No, this was a ‘regular’ lady, and she was holding her hand out. Hmm, when does “Don’t talk to strangers” not apply? There was nowhere to appeal for a ruling.

Then, like a flash, the thought came, “I wish she was my mother.” Even in my panicky state, I felt guilty toward my mother. How could I think a thing like that? I pushed it away, along with the panic, and waited, a rabbit in the high beams.

She walked over to me, clearly seeing the panic in my eyes, panic that, somehow, I could now afford to feel. I started shaking, and realized for the first time that I was cold.

She pointed up, toward the shore, to a funny little house of some kind, and beckoned me to follow her.

Oh my god – the witch’s house in Hansel and Gretel! I can’t go up there, I’ll get trapped and god knows what she’ll do to me! I looked around in panic.

Suddenly, something in me snapped. Wait a minute, I had a whole new slant on this thing: I was lost, right? On my own, right? Well, godammit (thanks, Dad!), that made me an orphan, a hobo, a wanderer, and a tough guy, didn’t it? Hell, I’m free, ain’t I? I can make it! I can live off seaweed, garbage, little things in shells, right? I mean, the whole beach is lousy with people loading up on all kinds of food, isn’t it? They can’t eat all of it, can they? A guy could live pretty good at the beach – tons of people come here every day, don’t they, and all of ’em bring food, don’t they? Hell, a guy could live off the land! I mean, Jungle Girl did it, didn’t she? Even Hansel and Gretel were doin’ okay, until they met the witch.

She came closer and took my hand. I froze, half-expecting her to cackle, “Come with me, Deareeee.” But she just winked at me, pointed up toward land and said something about a ‘lifeguard’, whatever that was. Lifeguard? Did that mean my life was in danger? I mean, as far as I knew, I wasn’t actually sick or anything – why did I need a lifeguard? Besides, I was a hobo now, a man of the road. She can take her ‘lifeguard’ and . . .

“Sweetie, there’s a man up there who will help you.” I let her lead me up the dune. Having accepted the touch of her hand, I was a scared little boy again. I actually remember thinking, “Well, there goes my life on the road.” I fixated on the leopard-skin suit all the way up the hill, and followed her up the steps to the funny house.

Inside the little shack was not a gingerbread nightmare at all, but just a young, tall blond guy named Norm. I mean, Norm? He couldn’t be that bad! The lady handed me off, smiled at me kindly, then started down the steps. Suddenly I wanted to stop her, to hold onto her for dear life – she was my lifeline, after all, my ‘panic-mother’, and in those few minutes since our meeting I had somehow formed a whole new idea of what ‘outsiders’ could be: kind, nice, helpful, with a warm smile and a leopard-skin suit. Suddenly, “different” was okay. But she was gone, for good.

Later, when I watched episodes of The Lone Ranger, and the recipients of his good deeds said at the end, “Who was that masked man, anyway?” I knew exactly how they felt.

And when Jimmy Durante ended his act with the famous sign-off, “Good night, Mrs. Calabash, wherever you are,” I got tears in my eyes, for the same reason.

“What’s your name, sonny?”

Norm’s steady, not-overly-concerned tone brought me back from wherever I had been.


“Where do you live?”

“Norf Hollywood.”

What’s your religion?

“Uh – Christif?” (I knew about the Holocaust: better to play it safe. I mean, Norm was a blond. And besides, I had a right, being only half Jewish.)

Well, my parents did come, eventually (I guess they had heard about lifeguards, too, from somewhere), and eventually, the whole episode kind of devolved into a family joke, featuring The Lady, my near-miss stab at religious affiliation, and, more seriously, the answer to the question: “Why doesn’t Gregg like the beach?”

But for me, it was much more, and this I didn’t talk about with my parents, or anyone else, ever. Walking along that beach, following my feet, and then later that day, in my short-lived career as a ‘hobo’, I’d had a glimpse of freedom: I realized that, at least theoretically, if I could find a way to survive on my own, which could include help from other people, I didn’t have to worry anymore about getting ‘lost’, or of losing my parents. I could make it in the world, and stop worrying all the time. True, it was just a glimpse, but sometimes a glimpse is all you need, to tell you there’s something out there to shoot for.

And I also learned how powerful it is, in this life, for one person to help another. I knew what the kindness of one Lady did for me, and how it felt, and I wanted to do that for other people who were ‘lost on the beach’. I’m not afraid of their lostness – I know all about it – and I’m willing to wade in and do something about it, unafraid that they’re going to “pull me in, too”, because I know  a secret: helping them pulls me up, too.

I know what it is to care for people, and if someone cares for you, you’re never really lost.

So good night, Lady in the Leopard-Skin Suit, wherever you are.



















Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.