God In Remix

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Recently I wrote a post called God On Trial. I’m glad I wrote it, but the more I think about it, it’s not enough. Yes, it addresses the ‘Is there a God?’ question, in its own way, but if we’re going to ‘concede’ that there is, indeed, a God (or god, or all-encompassing-Is-ness, or any other omnipresent providential Dude you can dream up), it still leaves us with a bigger problem: dang, if there is a God, why the effin’ bleep is the world so effin’ bleeped up?

Or, put another way: is God also in the shite, and if so, how can I find Him there?

If God is love, how can we ‘God’ (i.e. love) a world that prominently features ugliness, sadism, oppression, the triumph of evil, and good people going down in flames?

Sure, God is clearly ‘there’ in the smell of rain, or the changing of the seasons, or the glint in a child’s eye, but where is the God in child abuse, or the torture of prisoners, or religion-based genocide? Let’s say a woman is born, lives, and dies doing unending menial work under a regime that is hideously restrictive of women’s rights, and condones mass murder: was her life ‘touched by God’ in the same way as that of a woman who was privileged to have the support to discover her innermost dreams, and then fulfill them?

At first blush, it seems impossible to believe that such an unfair, chaotic and dangerous world was created (or is inhabited) by any but the most capriciously-whimful, crazy-ass being imaginable.

Yes, I understand, it’s possible to embrace a belief system that preaches,

Look, guys, just because we don’t understand the Ways of God, that doesn’t mean They’re not there.

Fair enough – and maybe it’s true: after all, what Is . . . Is, right? So, if we’re going to go on the assumption that a God made (and inhabits) this whole mess (sorry, Dude), and we cannot for the life of us understand how or why He could have included the evil parts, then it must be that we just can’t understand God, right? Kind of like how a child looks at the behavior of his parents, even if said behavior is abusive or mean or crazy: they’re the parents, ergo they Must know what they’re doing. (And, sadly, this often necessitates the child then ‘making it alright’ by assuming he must be ‘worthy’ of the abuse.)

Well, I understand, and even respect such a point of view: Since it (i.e. the world, in all its inglory) is there, then God, in His infinite wisdom, must have a reason for it all.

Cool – knock yourself out, but I just can’t buy it. Yes, I understand that we can hypothesize that the ‘bad parts’ are put there (by God, presumably) in order for us to learn the lessons of love – and yes, that gets me a little closer to acceptance of the God concept; after all, a therapist is always a sucker for almost anything that involves the holy grail: Personal Growth (Sing Hallelujah!).

So there I was, stuck with this:

Yes, there is a God – but only in the ‘Good Stuff.’

Then there’s all that Bad Stuff floating around: Godless and unaccounted-for.

Hmm, what’s a fella to do?

The first part of the answer came when sitting with a patient recently. She said, “I want to be closer to you – I want to be merged with you. I want you to just understand what I’m thinking, without my having to say anything.” This is a pretty frequent phenomenon in therapy, especially with someone who feels validated and ‘held’ by a strong connection with the other person.

I was quiet, sitting in silent understanding, and witnessing, of her wish.

Then she said, “I feel like I’m going into a space.” Patients will often shift ground in this way – transcending, for a moment or more, their own personal identity and entering a more expansive area, what would be called ‘oneness’ in meditation practice – boundarylessness.

I waited quietly.

I noticed a beatific glow on her face, and she said, “You’re in the space, too – everyone is.”

I waited quietly.

Then she paused, almost laughing, and added, “We’re together, after all.”

Patients often go into these expanded-identity ‘spaces’ during session, because therapy can be a spiritual practice, a form of assisted meditation. And once you leave your small, personal identity, you see that we are all, indeed, ‘together,’ as beings sharing existence, and even beyond that, we are all ‘star-dust,’ in unity with all that is.

So, I had all this roiling around in my mind, as I looked out my window at the clouds, after her session ended: the yearning for Connection, the search for Unity, the need for shelter from the storm. I thought about how lost we feel in such an enormous world, yet how at home we could be, if we could live from a ‘space’ such as my patient had entered – all One, all In It Together. But I also thought about the pain, the hurt, the meanness, the seeming unfairness, of the world. I thought about how we don’t treat each other ‘right’ – heck, we don’t even treat the Earth right, pillaging her treasures, paving her soil over with concrete and asphalt, mowing down entire forests like we cut the lawn.

For a sad moment, I felt protective of the Earth – almost like it was . . .

And then it came over me: an answer, a way, maybe. Yes, I understand, and accept, that God is love. Yes, I see God in the wonderful things of the world, but can’t accept, can’t love, the Bad things, too – at least not in the same way.

But wait: what if I thought about the world as my child? It occurred to me that I have no problem loving my children, even though there are ‘bad’, disappointing, and frustrating things about them. Even though they have hurt me, thwarted my plans for them, and let me down at times. Sure, I’m mad, hurt, even hateful at times, but it always comes back to love. I see that they are imperfect, that they hurt others, too, not just me – but always, always, it comes back to love and acceptance. Why – just because they’re ‘mine’? No, I don’t think so – it’s not, “Since they’re mine, they’re perfect,” it’s more like, “I am committed to being big enough to love them through it all,” which means through the hurts and disappointments, as well as the joys and the triumphs. My love doesn’t ‘go away’ just because I’m mad. Sure, I might feel rejecting, or need to take some space and time to recuperate from an incident, but I come back – I make sure I come back, not matter what it takes.

Hmmm – so if I “have it in me” to do this with my children, and other loved ones, why can’t I do the same thing with the whole world? Hey – this could work!

I looked out the window at the same clouds I had been watching before, and said, “God damn it – I love you guys.” I’m not sure, but I might have seen them give a little squiggle in return.

I looked at a winter-bare tree I had seen a hundred times before, and said, “Hey kiddo – welcome to the family!”

I watched a single bird flying by, and called out, “Keep truckin’, little buddy!”

It felt good – like my patient said, we’re all in the same space now.

I realized that I’m a ‘better’ person when I’m a parent than I am as the man in the street: aren’t we all?

Now came the hard part: I picked up the newspaper and forced my eyes to a story about Muslim terrorists – stuff I would normally avoid like the plague. I took a deep breath and pictured talking to them:

“You know, I don’t like what you did, but . . .”

But what? Where do I go from here? I forced my mind back – and I do mean forced:

” . . . but you’re still my children, and I have to find a way to love you through it. It doesn’t make it right – you did wrong and I have to hold you responsible for that – but . . .”

Whoo – this was hard! I took a breather. Okay, back to the salt mines:

” . . . but it doesn’t mean I stop caring about you, or seeing you as fellow beings. After all, if I was you, with the whole package deal of your DNA, your cultural experiences, and your upbringing, I’d be you. I don’t have to like you at this moment- just like I wouldn’t like my child if he committed a murder – but I wouldn’t abandon him, and I won’t abandon you, either, at least in spirit.”

Whew – that was rough. It felt a little weird trying this new ‘suit’ on for size, and I felt a little like I was abandoning myself, and my values, but in another sense, I knew I was being more true to my larger values, than I had ever been, pushing myself to a larger place than I had ever been – kind of like a snake, moulting out of an old skin and into a larger one.

I know that it’s going to be hard – new ways always are. And I know it’s going to keep feeling weird to not ‘take sides’ the way I always have – but then I still have the right to my beliefs. I haven’t abandoned them – just found a higher-level way to exercise them. I’ve always envied people who can have spirited debates with others about deeply-held beliefs – like about right and wrong – and emerge from the debate laughing and still friends – maybe even better friends. Isn’t that what I’m doing with the whole world now?

Now I understand, a little better, the meaning of Robert Frost’s famous quote:

And were an epitaph to be my story I’d have a short one ready for my own. I would have written of me on my stone: I had a lover’s quarrel with the world.

Now I see the crux of that quote more clearly: “lover’s” and “quarrel,” both together, in the same space. We disagree – maybe strongly – but I still love you.

And that’s exactly my challenge, now: to do that with the whole world. To love ‘my’ world – my beloved world: the clouds outside my window, my friend the tree, that bird flying solo, and also the Muslim terrorists.

Not agree – just love.

Not like – just love.

Not side with – just love.

Not side against – just love.

Not tough love – just loving tough, loving hard, loving like a crazy-ass son of a bitch.

Loving like God.

 

 

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

Mysteries

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      She’s hanging in the Louvre                    She’s sitting in your office chair       

 

 

 

Out past the cornfields where the woods got heavy,
Out in the back seat of my ’60 Chevy,
Workin’ on mysteries without any clues,
Workin’ on our night moves.
Trying’ to make some front page drive-in news,
Workin’ on our night moves in the summertime,
In the sweet summertime.

I woke last night to the sound of thunder,
How far off I sat and wondered.
Started humming a song from 1962.
Ain’t it funny how the night moves?
When you just don’t seem to have as much to lose.
Strange how the night moves,
With autumn closin’ in.

Night Moves, Bob Seger

That about sums it up, doesn’t it? We’re all “workin’ on mysteries, without any clues.” You never know what kind of mysteries someone is working on, until you listen, very, very closely. People come to therapy for many reasons, and with amazingly varied expectations. What do I mean by ‘amazingly varied’? Well, try this on for size:

I once saw Jimmie, a guy in his late Thirties, who said, and I quote:

“We just found out my wife is sick. She might have cancer, but they’re not sure yet. Well, the thing is, I’ve never had a problem before in my whole life. Everything’s been easy and just gone great. My family is wonderful, my marriage is perfect, and my career has been a dream. So now, I don’t know what to do. Can you help me?”

Wow. I felt like saying, “Dude – can I touch you? Maybe some of that will rub off on me!”

What actually happened? I explained to him that, while feelings have their own ‘reality’, and are important, they are not ‘actual’ reality, and that you can allow the feelings (e.g. panic) to be there, while still having a larger part of you that is going ahead and functioning in the real world at the same time. A feeling (e.g. panic that his wife might be very ill) is not a true representation of outer reality, but is only what happens when outside information ‘bounces’ off your insides. Therefore, you can say, “Wow, I feel panicky,” at the same time as having a more accurate, ‘larger,’ realistic assessment of the situation (“My wife might be ill – we’ll see”), and these can coexist without the feeling overwhelming the overall picture, or your functionality in life.

He nodded, thoughtfully. “Thanks – I think I’ve got it now.” He paused. “Can I call you if it doesn’t work?”

I said, “Uh, off course – anytime.”

He shook my hand, left, and that was it.

Oh, I did get a brief phone message about a month later:

“This is Jimmie. It worked. By the way, my wife is fine. Thanks.”

Once again: Wow! Maybe I should have touched the hem of his garment! Well, needless to say, Jimmie is not representative of most people’s lives and emotional issues, or else I’d be out of a job today – or maybe a film professor, explaining how Orson Welles revolutionized deep focus, or something. But I really love being a therapist, so thanks for having problems, everyone! (Just kidding.)

But most people’s ‘mysteries’ are a lot more daunting than Jimmie’s. To wit:

How could the father who loved me so much, who was, by far, my best parent, who was the only person who understood me and made me feel loved and seen – also have molested me?

How can it be that so many people who only want power, or to be admired, or money, have contributed so many amazing things to our culture?

Why is it that the only women I’m attracted to are the ones who hurt me?

How come, so often, after I have accomplished something good, I feel like killing myself?

Why does my husband keep having affairs, even though I know he loves me?

Now, these are mysteries – serious ones, the answers to which can really alter lives.

So, what do I ‘do’ when someone comes in with these kinds of tormenting questions? Do I cite chapter and verse of some heavy psychology book I read that says,

“Every time someone says ____________, it means ___________”?

I could: people LOVE this – and that’s why so many therapists can get away with being authoritarian (as opposed to authoritative), prescriptive, and definitive. Many, many times patients have told me that a previous therapist told them stuff like, “When a tree appears in a dream, it signifies the flowering of the unconscious,” or “Yawning a lot is a sign that your creative element is blocked.” Like I said, people LOVE definitive statements like this; one’s psychological life is so difficult to get a ‘fix’ on, that anything specific and definite you can (supposedly!) find out feels like getting a piece of the jigsaw puzzle.

Not to mention, people are paying you to be an expert, to answer the question: What does ____________ mean?” – not to jack around asking them,

“Hmmm – what do you think it means?”

So what do I do? I listen to them, and I listen to myself, over time. And then I share (selectively) what I hear inside, and I ask them to share what they hear inside, over time.

Sounds easy, huh?

Not.

Believe me, I want to know the answers to their mysteries, and wish I could just ‘lay it on ’em’ and have their questions resolved immediately (although, yep, maybe then I’d be out of customers and back to being a film professor!), but it most certainly (how’s that for definitive?) does not work that way. By the way, I’m not just goofing around with that whole film professor thing: doing therapy is a lot like art appreciation. You wouldn’t just tear through War and Peace, or The Searchers, or The Naked Maja, and start spouting instant, ‘definitive’ opinions. If you’re a serious art, film, or literature student, scholar, or even critic, you return to the art again and again, over time, going back and forth between the work of art (what is really being presented here, anyway?) and yourself (what does it evoke in me?) – sensing carefully, then comparing, sifting, re-thinking, shifting focus, maybe doing some research, maybe comparing to other works of art: in other words, it takes work, experience, talent, and time, to do a work of art justice.

Sure, maybe you see a movie, or read a book, and all you think is, “I hated it.” Well, that’s fine, for amateurs: nothing depends on it, except maybe your friends not cuing up to see it after they’ve talked to you. But if you’re an art critic, a scholar, a commentator, or a professor, we expect a lot more out of you than, “I hated it.” We want you to dig deep, to tell us things we wouldn’t have thought of on our own, to show us things we wouldn’t have seen if not for you, to put it in a historical context, to compare it to its contemporaries, to work at it. When I read, or listen to, something a professional has said or written about a movie, a book, a piece of music, or even a performance, I want to feel, “Wow – I couldn’t have thought of that; it expanded my vision, my capacity to appreciate, and my artistic sensibilities – in some way.”

Even in sports, we expect our commentators to go beyond what is immediately apparent. When I read Baseball America, or watch MLB Now, I don’t expect to hear, “He can flat rake” (translation: he is a really good hitter), I want to hear, “With runners in scoring position, he has the highest OPB in Cardinals’ history.” You’ve got to tell me something I don’t know!

And for a therapist? Same thing: you’ve got to be a jeweler with a loupe, looking at a stone, not the guy on the street saying, “Nice rock!” Every human being is a truly amazing ‘work of art,’ and it is your job to be a professional-level appreciator, evaluater, and if necessary, restorer, of that work of art. Just like our hypothetical professional art critic, you are not there to spout definitive statements about what is before you, to point out the obvious, or to prate, “You need to change X, Y and Z,” as if the person him/herself hasn’t thought of that already. To do so would be to vastly underrate (and insult) the complexity, the ingeniousness, and yes, even the beauty, of the person before you. That is why, just as in approaching a work of art, the first (and constant) thing you do is, “Shut up and listen.”

You wouldn’t speed-read Dickens’ A Christmas Carol, and then say, “Duh – it’s about an old guy who’s a miser, and then he changes. Period,” would you? Well, maybe if you were a teenager who had to read it for a class, you might (and plenty of kids I work with have), but even that teenager ‘knows’ that what he did was an insult to a great classic (and yes, those kids do know that).

What you do is this: you ASSUME that there is a richness, a complexity, and much to learn, from the person you’re working with. You ASSUME they can’t just be skimmed and summarized, like a D student does at the last minute with A Christmas Carol. And, like a good work of art carefully studied, you assume that it will reveal its secrets in time, and that there will be worthwhile secrets to be revealed (there always are). You assume that, like Ebeneezer Scrooge, for some reason they have become emotionally constricted, and that, with enough safety, encouragement and ‘fellow-traveling,’ they will open up (like Scrooge) to the joy and meaningfulness of sharing and connection – and by sharing and connection, I mean within as well as without.

Oh, and you don’t look for an ‘answer,’ because there is no answer: what there is, is a process. Yes, in hindsight, you can see that it was a logical, step-wise progression that took you across that wide river, but at the time, it’s just feeling your way along, following the hunches and responses that are the stones you step on, one after the other, until you’re ‘there.’

So, how does someone go from suddenly ‘recovering’ memories of her beloved father molesting her, to rage and disillusionment, to seeking help from others in the same boat, to acceptance, to helping others in the same boat, to being a therapist specializing in child abuse? I don’t know – even though I was ‘there.’ I can tell you that, when treated with the reverence, genuine inquiry and respect you would accord a work of art, my patient went from being relatively unformed clay, to a far more realized work of art. Yes, I could tell you the ‘steps’ we took together, but it would be a meaningless extraction, like trying to tell someone about the thrill of a horse race by showing them a series of photos of the race.

The mysteries therapy patients hold inside resist easy solutions and formulaic approaches: they demand you to be more than you are, so that your patients may become more than they are.

Like reading a good book, the mysteries hidden inside human beings require full engagement and involvement – of the intellect, the heart, the senses, the intuition and more.

So no, I didn’t become a film professor, but I feel like I got something far richer: whenever someone asks me, “Seen any good films lately?” I can smile to myself and think, “Yes – about thirty of ’em.”

 

 

 

 

 

 

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

God On Trial

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Recently a friend told me about a blog by a Methodist pastor, called Unfolding Light. I read it, and loved it. Here is an example:

 

Coin

You are not some little cent
that God has buried in the earth
to save in fear or greed.
You are a coin of greatest worth
that God has spent in joy
for those in need,
that God, delighted, gave
to someone dear,
or lent and lends again
at no interest, freely,
sent into the great economy of love.

I wonder now:

how will God

spend you

today?

 

It’s great – but, ya know . . .

So what is the ‘but, ya know,’ you say? Well, er . . . if you, ya know – must know, it’s The God Thing.

Yeah, I know – this comes up all the time with people I send to A.A., or N.A., or M.A., or O.A, or Any A. They go to a meeting, and seem to like it. And then here it comes:

Patient: Well, there was just that one thing.

Me: And what was that one thing?

Patient: Well . . . The God Thing.

Of course, I know what to answer. I say, “You don’t have to believe in God, per se, to use the Anonymous programs – they just mean ‘God, as you experience Him, Her, or It.'”

And this seems to work for most people – that is. If they’re actually ready to do something about their drinking, or smoking, or drugging, or eating, they get over ‘The God Thing’ and use the program, meet the people, and eventually realize that their Higher Power can be whatever they want it to be, or whatever comes to them, or even their own ‘higher self’ – it all works just fine. And most of those who quit because of ‘The God Thing’ are using it as an excuse to cut and run instead of digging in and using the program and the people who, after all, are there to help them, not proselytize them.

So, I’m no virgin at the God game, is what I’m saying. I get it: God can be anything, from a belief in yourself, to Nature, to a stuffed Teddy bear you call Uncle Amos, to J.D. Salinger, I guess, if he rings your chimes.

That’s the fun part of a Customized Life, as I call it with my patients:

You Get To Make It Up!

It’s kind of like a psychology continuing education course I once took, where the guy said it is crucially important to keep ‘progress notes’ on all your sessions, and to designate a proper diagnosis – meaning, that is, from the DSM (all hail!).

But then he added something, sotto voce, that I never forgot. He said, “Well, I suppose it doesn’t have to be the DSM: technically, you could make up your own diagnostic system, as long as you defined your terms, and used them consistently.” I think it was kind of a throwaway line for him, but of course, for me it became the most memorable thing he said that day. I went home and thought about it – a lot. And I thought, talking to myself (as is my wont), “Okay, Self, so you dislike the DSM and the whole diagnostic system. So noted, hotshot. So, if you don’t use that, what would you suggest in its place?”

The disavowal part (that is, disavowing the DSM) is easy. The replacement part – not so much. Hell, what would I say, in a progress note, to designate “what is wrong” with the people I see, that would have any descriptive value to anyone reading my notes, say a thousand years from now, when a future psycho-archaeologist might spend years deciphering them (my handwriting, you understand), in order to publish his masterpiece:

Great Psychotherapy Progress Notes of the Twentieth and Twenty-First Centuries

Well, that’s as far as I got with my own diagnostic system, but it’s still good to know I could make it up, if I really wanted to – my teacher said so!

But back to God. How do we resolve The God Thing? Is there a God, or isn’t there a God, for God’s sake?  How do we answer this? Well, even though I failed at the New Diagnostic System, I think I’ve succeeded at this. I thought and thought, and here’s what I finally came up with – exclusive to my readers, I might add.

Perhaps we could put God to the ultimate test:

The Courtroom.

Just for you, Constant Reader, I pulled some strings and got the State of California to let us use a spare courtroom that was lying around, and even loan us a State’s Attorney! (A good one, too – I checked).

So now, to set the stage, let’s imagine that God has come under fire from a legal entity – say, oh, The People of the State of California. The charges are grave. He stands accused of running a hustle, being a fraud, soul-molestation, and impersonating a Being, while not actually being a Being (though, of course, to his believers, he is Being itself, but if he’s declared Null and Void in a court of law, they may have to get along on their own, or get a writ of Habeas Deus, or something.

The scene:

A Fall day like today, blustery, windy and cool. One might almost say ‘foreboding,’ if one had a dark, romantic turn of mind.

It was foreboding.

The immediate setting:

A huge, impressive State of California courtroom, in Sacramento, maybe. No, make that Oakland – I don’t want to have to drive that far. We enter the room and gasp as we take in the impressiveness, the gravity of it all: the high ceilings, framed in rich, old woodwork, the plush drapes covering high, deep-set windows, that might even be mullioned, if I knew what mullioned meant: ah hell, let’s go ahead and make ’em mullioned.

We take our seats, quietly – in the back, of course, with the other commoners. The rich, the powerful, and the working press take up the front three-quarters of the public space. This is big stuff, and everyone knows it. Entire ways of life depend on the outcome of this thing, and everyone wants in on it. Tomorrow, they will be calling it History.

Quiet! It’s starting:

All rise for the Honorable Wisdom Elbert Smith!

We rise as one, and see the Judge stride in, his robes flowing: tall and stalwart he is, maybe a shade over seventy, with the wavy, white hair of experience and a deeply-lined face that is not so much handsome, as . . . Eternal.

To one side sit the twelve ladies and gentlemen in whose judgment the fate of the universe is entrusted this day: The Jury. They are mostly well-dressed, though the random tattoo does peek through here and there. But all in all, a straightforward-enough-looking lot.

Suddenly, The Bailiff intones, in a voice as frighteningly devoid of emotion as a death knell:

Case of The People of California versus the Alleged God.

There is an audible gasp at the one word, ‘alleged’: a civilization on trial!

Formalities are attended to, the introduction of the ‘sides’:

For the People of the State of California – The Prosecution: Filbrick C. Filbrick, State’s Attorney.

For the Defense: Liam X. O’Flaherty.

O’Flaherty, you say? Whew, and a good Catholic lad he is, as is only right. They say as a young man he struck for the priesthood, but Harvard lured him and his brilliance away with promises of a free ride and a top o’ the line education – doing God’s own work in the lay world, don’tcha know?

Ready on the left, ready on the right, ready on the firing line! The crowd buzzes expectantly. We’re to witness history today, and no mistake. Shhhh! The Judge is speaking!

Judge Smith: Mr. O’Flaherty, are you ready for the Defense?

Mr. O’Flaherty: I am, Your Honor.

Judge: You may begin.

Mr. O’Flaherty: I would like to begin by introducing into evidence Defense Exhibit One, otherwise known as Avalon, by Jim Hession.

Judge: (Cupping an ear – rather endearingly, I might add) What – Avalon, you say?

Mr. O’Flaherty: That is correct, Your Honor. (Motions grandly to the back) If the Sergeant At Arms will dim the lights, I believe we are ready to present our first exhibit.

The lights dim. No one drops a pin, but if they had . . .

Mr. O’Flaherty: Roll ’em!

 

The lights go back up. Appreciative murmurs roll through the audience. Several jurors are seen to nod enthusiastically, but with a warning glare from the Judge, they belay that jazz, but quick.

Fillbrick (For the Prosecution): But surely, it must be obvious to all that this only proves that the gentleman is a fine piano player.

O’Flaherty (For the Defense): Tut tut – come now, sir! Surely, it must be apparent even to you that his powers are something more than human!

(Enthusiastic murmuring from the crowd.)

Filbrick: Objection! Calls for speculation on the part of the State – which is me. I stipulate to no such thing.

Judge: Overruled! In the considered opinion of this Court, it is not speculation that his playing is more than human – it is an observed fact.

Filbrick: But, Your Honor…

Judge: (Banging gavel) I said Overruled, Mr Prosecutor! Any more outbursts like that and I’ll have you up for contempt of court.

Filbrick: Yes, Your Honor.

Judge: Now, Mr. Defender, do you have any other exihibits you wish to put into evidence?

O’Flaherty: Yes, Your Honor. Take a gander at this . . .

Judge: Mr. O’Flaherty, you will watch your language in this honored chamber!

O’Flaherty: Sorry, Your honor. If you will be so kind as to watch the following, I think it will lay to rest all possible objections to the Higher Power argument.

Filbrick: Objection! Leading the courtroom!

Judge: Sustained. Mr. O’Flaherty, you will confine yourself to legalistic jargon, and desist from the use of all leading commentary. (Whispered aside) And I hope this next one’s as good as Avalon.

Filbrick: Objection! The Judge has clearly been swayed by Avalon, and is now openly siding with the Defense!

Judge: (Visibly upset) Objection overruled! How dare you imply that I am anything less than utterly objective, Mr. Filbrick! I warn you, sir, you are treading on thin ice!

Filbrick: Sorry, Your Honor – I’ll try to skate next time.

Judge: (Banging gavel) Bailiff – remove Mr. Filbrick from the courtroom, if you please!

Filbrick: But Your Honor, I beseech you . . .

Judge Smith: Alright, Mr. Prosecutor, you may stay, but I warn you – any further exclamations directed at The Bench will be dealt with harshly. The jury is directed to disregard that outburst against Your Honor – oh, that’s me.

Jury: (Rising as one) That’s You!!

Judge: (Beaming) Mr. O’Flaherty, next exhibit, if you please.

O’Flaherty: Your Honor, we have found an exhibit that goes beyond . . . well, beyond exhibition. This one will knock your socks off.

Filbrick: Objection! That requires supposition as to Your Honor’s state of sockery!

Judge: Objection sustained. There will be no more mention of said sockery in this chamber. The jury will disregard socks of any stripe.

Jury: (Rising as one) So disregarded!

Judge: Mr. Defender, you may proceed

O’Flaherty: The Defense wishes to present Exhibit Two: Rhapsody in Blue.

Court Reporter: Excuse me – was that ‘blue’, or ‘bloom’?

O’Flaherty: Blue, as in Rhapsody in . . .

Judge: The Court Reporter will refrain from needless interjections.

Court Reporter: Making it so, Your Honor.

O’Flaherty: (Gesturing to the rear) May we have the house lights dimmed, Sergeant At Arms?

Sergeant At Arms: Dimming!

O’Flaherty: Aaaaand – Action!

 

 

 

 

The entire courtroom, and the Jury, rise in a deafening and prolonged standing ovation.

Judge Smith: (Banging gavel repeatedly) The onlookers will cease and desist from this outrageous behavior! And if there are any more such demonstrations, the courtroom will be cleared.

Onlookers: (Rising as one) Sorry, Smitty!

Judge Smith: As well you should be. And Jury, you will be seated, and stay that way!

Jury: (Sitting as one) Indeed!

Judge: (Turning to O’Flaherty) You may proceed with the Defense.

O’Flaherty: (To Jury, enthusiastically) So, how did Rhapsody In Blue strike ya, boys and girls?!!

Filbrick: Objection!! I call Jury Inflammation!

Judge: Sustained! The Jury will resist inflammation, and strike, ‘How does that strike you’!

Jury: (Rising as one) So stricken!

Judge: I told you to remain seated!

Jury: (Sitting as one) Remaining seated!

Filbrick: (Emboldened by his minor victory) Furthermore, I want it on the record that there is some question as to the divinity of this piece as well. And to this end, the prosecution calls Dr. Rudenheimer Schtrechenbaugh to the stand.

Bailiff: Call Dr. Rudenheimer Schtrechenbaugh!!!

Dr. Schtrechenbaugh: (Rushes up the aisle, looking suspiciously like Groucho Marx, in academic cap and robes) I’m here! I’m here, already!

The witness is sworn in.

Judge: Dr. Schtrechenbaugh, I am going to have to ask you to divest yourself of your cap and robes at once. Only I am permitted to wear impressive robes in this courtroom!

Dr. Schtechenbaugh: But they are my academic regalia! What is an academic without his regalia?

Judge: Bailiff, divest the doctor at once!

Dr. Schtrechenbaugh: Okay, okay – I’ll divest myself forthwith (taking off his robes, revealing a camouflage t-shirt and holey jeans underneath). I only wanted to make a good impression.

Judge: Let your testimony be your impression. (Pause) Hey, I like that one: Court Reporter, make sure that one gets in there! Read back the record, please, so we can all hear it.

Court Reporter: (Paging back hurriedly) Hmm, let’s see: “Let your testimony be your impression.”

Onlookers: General applause.

Judge: (Nodding to crowd) Excellent, excellent. Your witness, Mr. Prosecutor.

Filbrick: Now, doctor – would you please inform the Judge and Jury what you are a doctor of – even without your regalia, that is?

Dr. Schtrechenbaugh: Well, my regalia covers a number of fields . . .

Judge: You will confine yourself to the field at hand.

Dr. Schtrechenbaugh: Oh well, then, I have a doctorship in Music Criticism.

Filbrick: For the benefit of the Jury, would you please tell us – in lay language, that is – what that entitles you to do?

Dr. Schtrechenbaugh: It entitles me to say bad things about almost any piece of music.

O’Flaherty: Objection!

Judge: And what is the basis of your objection?

O’Flaherty: I don’t know – it just seems pretty negative to me.

Judge: (Sighs) As I’m sure you know, Mr. O’Flaherty, your personal feelings are not admissible here. If you would put your objection in the form of a question to Dr. Schtrechenbaugh, perhaps you might get somewhere with it.

O’Flaherty: Dr. Schtrechenbaugh, you have stated that you have the right, and training, to say bad things about any piece of music. But what about saying good things about a piece of music?

Dr. Schtrechenbaugh: Oh, that would be a doctorship in Music Praise: I never got that one.

O’Flaherty: And why is that?

Dr. Schtrechenbaugh: It wasn’t offered in the Fall term. Besides, I was working full-time at Macy’s by then.

O’Flaherty: With a doctorate?

Dr. Schtrechenbaugh: No, Macy’s doesn’t require a doctorate to sell appliances – or at least they did not at that time.

O’Flaherty: But why were you working at Macy’s when you had a doctorate?

Dr Schtrechenbaugh: I didn’t say I had a job as a doctor: only that I had a doctorate.

Filbrick: Objection! This is making me look bad!

Judge: Sustained – it certainly is doing that. (Pause) You may continue.

Filbrick: Who – me?

Judge: (Sighs) Yes, you, Mr. Prosecutor: You’re the one who called this refrigerator salesman, are you not?

Filbrick: Um, yes, well, Dr. Schtrechenbaugh, please tell us, in your own words, why you feel Rhapsody in Blue is not proof of divinity?

Dr. Schtrechenbaugh: You mean God?

Filbrick: Uh, yes, Doctor – that means God.

Dr. Schtrechenbaugh: Well, there are a number of items in this composition that point to a consistent pattern of humanness. For one, there is that first part – you know, where the clarinet player goes waaaay, waaay up . . .

Judge: You refer to the opening glissando?

Dr. Schtrechenbaugh: Glissando, schmissando – I’m talking about the part where he goes way the hell up, like he’s completely out of control. You don’t start a song like that: everyone knows you start quiet, and then you build up as you go along. You don’t start way high; you start way low, and build up to way high at the end. God would never do it like that. God’s smart: the guy who wrote this shit is dumb – see?

Onlookers: “Fraud!” “Idiot!” “Give ‘im the hook!”

Judge: (Banging gavel, repeatedly) Order in the court!

O’Flaherty: Your Honor, I move that the witness be stricken, and then removed.

Judge: Bailiff, strike the witness!

Bailiff: (Delivering a couple of good whacks around the face area) So stricken!

Judge: Now grab those ridiculous robes and get this man out of here!

Dr. Schtrechenbaugh: It’s okay – I was on my lunch break anyway.

(Bailiff grabs the robes and hustles the witness down the aisle and out of the courtroom.)

O’Flaherty: In the light of the witness’s utter disregard for reality, I move that Rhapsody in Blue be declared a work of divinity by acclamation!

Jury (Rising as one): So acclaimed!

Judge: (To Jury) You take that back! You have no right to stand, or go around acclaiming anything without my permission!

Jury (Sitting as one) Taking back acclamation, Your Honor!

Judge: Okay, you may now rise and acclaim.

Jury (Rising as one) So acclaimed!

Courtroom explodes in spontaneous cheering.

Judge: (Banging gavel) What did I just tell you people?

Crowd (Sitting down and shutting up, as one): To sit down and shut up!

Judge: Thank you. Are there any further exhibits at this time?

Def: There is one final exhibit for the defense, if it please the Court.

Judge: It do – er, it does.

Def: Then, I introduce Defense Exhibit Three: Nessun Dorma.

Judge: Court reporter, as you getting this?

Court Reporter: I got it phonetically, Your Honor, but it might be a foreign language. And you can’t expect me to . . .

Judge: That’s alright, Court Reporter – I am willing to stipulate that you can’t be expected to know a bunch of foreign crap. If you’ve got it phonetically, we can go back later and get the correct spelling from the counsel for the Defense – if he knows it, that is.

Court Reporter: Thank you: that helps.

Judge: And now, counsel for the Defense, are you prepared with the exhibit?

O’Flaherty: I am, Your Honor. (Gestures to Sergeant At Arms) Sarge, let ‘er rip!

 

Spontaneous, thunderous cheering throughout the courtroom.

Judge: (Smiling, while banging gavel down repeatedly) Now see here, people. We still have a case to try!

Bailiff: Order in the court! Order in the court!

The bedlam continues unabated: “Bravo!” “Bravissimo!” “Bravioli!!”

O’Flaherty: (Shouting above the crowd) I hereby move that the case against God be dismissed, forthwith!

Crowd: Forthwith! Forthwith!

Judge: (Banging gavel) Mr. Prosecutor, what say you?

Filbrick: (Shrugging helplessly in the face of the continuing clamor) So stipulated.

Crowd: So stipulated! So stipulated!

Jury: (Rising as one) Amen!

Judge: (To Jury) Get back down there!

Jury: (Sitting as one) Getting back down there!

Judge: Okay – you may now rise.

Judge, Jury and Crowd: (Rising as one)

Amen!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Do You Believe In Magic?

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One’s destination is never a place, but rather a new way of looking at things.

— Henry Miller

Everyone in therapy wants to change. We hear it every day, from new patients and old. They come in with a problem, that frequently sounds like this:

“I’m ________________ (fill in a way of being), but I want to be __________________ (fill in ‘better’ version of way of being). Where do we start?”

It reminds me of an old comic strip I used to read (maybe Dixie Dugan?), in which there was a character that obtained plastic surgery. I can’t remember whether the person wanted to hide, or just look better, but I do remember the premise was this: plastic surgery can make you look ANY WAY YOU WANT – all you have to do is point to the right picture, and let’s go!

Otherwise known as magic. People love magic. Another favorite magic fantasy is hypnosis. I can’t tell you how many people have said to me, “Can’t you just hypnotize me and make me different?” Magic lurks everywhere in our society, but we don’t always call it magic.

How about,

“Lose ten pounds from your thighs in two days, without having to diet!”

“Send $29.99 for step-by-step instructions on how to have power over women!”

“Make up to $5999 per month, from home: no sales, no calls, no products!”

“Take my weekend seminar, and never be shy again!”

I love magic, too – hell, most of art is based on magic, on teleportation: it ‘transports’ you. For two hours, I can watch a movie and be somewhere else; for days I can read a book and be someone else; I can watch a music video and be swept up in the energy, or sadness, or joy, or wildness, of a song. We all want to be somewhere else, someone else, and we want life to be ‘different’ than it is – better. We want all things to be possible, and in art, in fantasy, all things are possible.

We don’t want to have to work for it: we want it good, and we want it now.

Sounds like a child, doesn’t it?

Mommy – I want a pony!

In a movie or a book, as soon as little Johnny says, “I want a pony,” we know that somehow, some way, he’s gettin’ a pony. In real life – not so much. One of the things we like about movies, about books, is that the story makes sense, it ‘goes’ somewhere: almost like there’s a ‘God’ watching over the whole story – because there is: the director, and the writer! We want there to be a God, a Higher Power, watching over us, too, but all too often, when a child in real life says, “I want a pony,” the response is:

“Do you realize we live in a city?”

or

“Do you think we’re made of money?”

or

“Get real, dodo!”  (Sadly, the ‘signature’ rant of the parent of a patient of mine.)

And this is assuming that there is even anyone there to listen. More often than not, and so very unlike ‘the movies’, our wishes are met by the other person’s being preoccupied with their own issues, or distracted, or even cynical. We express a wish, and are told, as in the old English nursery rhyme:

If wishes were horses, beggars would ride.

So we learn that to wish for something unrealistic leads to being mocked, put down, or ignored. We learn that this is for ‘babies’ (though for many of us, it wasn’t even okay as babies!).

Why are people so ‘mean’ about irrational wishes? There are several reasons:

For one, most likely they never had anyone to treat their ‘irrational’ wishes with respect, either, so there is no role model for this; also, if you don’t get something yourself, you have no way of accepting others needing it.

For another, people feel that to ‘encourage’ irrational wishes is to lead the child (or person) down the wrong path: i.e. our job as parents is to teach the child about real life.

Further, it makes parents (especially those who actually care) feel inadequate:

Jeez, now what – how am I supposed to get this kid a pony?

And inadequacy feelings lead to anger:

You made me feel inadequate, so to show that I’m not inadequate, now I have to make your wish seem ridiculous, and paint you as a spoiled baby.

In fact, the skillful handling of irrational wishes is one of the most important jobs of a parent. Unfortunately, most parents are unprepared for the task. So the child learns to ditch all of the elements of ‘wishful thinking’, and it’s a case of throwing out the baby with the bathwater, because in wishing lies great power.

Almost all meaningful change starts with a wish:

Why can’t I be taller?

I want to be rich and famous.

I want to be young again.

I want to love my life.

Yes, these are all either irrational, or certainly not reachable by mere wishing (i.e. magic), but is the recognition of irrationality the ‘end of the line’ for a wish? It doesn’t have to be, and much, much, is lost if it is. For a wish – even if it’s a wish for ‘magic’ – can be just the beginning of the ‘line’, not the end, as most therapists can attest to. Wishing, hoping, dreaming, are direct pipelines to what’s inside of us, and fantasy is one of the most profound (and useful) of the signal qualities that sets us apart from the rest of the animal kingdom.

But how do we use it?

As I mentioned earlier, parents spend an inordinate amount of time “drumming into” their kids that you have to be realistic in life. So it’s safe to assume that most people, by the time they’re even young children, actually “know” the score:

You can’t attain anything without work.

Money doesn’t grow on trees.

Don’t wish your life away.

Wanting something, or even deserving it, doesn’t mean you’re going to get it.

Okay, so they know these things, on some level, but what does that actually mean? Well, in most cases, what it means is that, while they’ve learned these (admittedly) valuable lessons about reality, they may also have learned to suppress their irrational wishes, maybe even lose touch with them.

Then what?

Well, to most people, having ditched everything irrational, all that’s left is the humdrum, the ordinary, the boring – that is, going ‘straight’. But somehow, a lifetime of being good, of being realistic, of not wanting more than you can have, of settling for the regular stuff, doesn’t seem that thrilling, that exciting, or worth fighting for.

And there’s something else, too: living life that way doesn’t seem to fit with your insides. You hear a great song, see a great movie, read a great book, and you feel something inside you – something above and beyond the normal, the safe, the regular. It makes you want more out of life than just playing it safe and being good, and it makes you want more out of yourself than just falling into that long, grey line behind everyone else.

And what about those ‘weird’ feelings that come up inside, especially when you’re young – the ones that no one really talks about? Wanting to hurt yourself, or other people? Sexual feelings, or desires, that aren’t the ‘norm’? Crazy thoughts, about all kinds of stuff: running away, experimenting with drugs and alcohol, living an ‘alternative’ life, being different? You’ve been taught that these things are ridiculous, wrong, bad: yes, you understand all that, but the thoughts, the wishes, are still there. Are you supposed to just squash them, push them away, and march along with the crowd, acting normal, keeping your secrets inside?

Whom do you talk to about it? Your school guidance counselor – the nice one, who’s  trying to get you ‘on track’ for college and a ‘good future’?

Nope.

Your parents, who would just be worried – and mad, that you’re going against everything they’ve tried to drum into you all these years?

Nope.

You keep it to yourself. Maybe smoke dope alone in your room, late at night, trying to get away from all the pressures to conform.

And if you’re already an ‘adult’, already grooved into regular life, what do you do? Well, variations on the same theme: maybe drink alone in the living room, late at night. Maybe have an affair, then feel crummy about it. Maybe try to lose yourself in sports, activities, interests, raising kids, work.

And maybe, just maybe, see a therapist, to figure out:

What’s wrong with me?

Well, very often what’s ‘wrong’ with you is that your dreams are under lock and key, exiled deep in a bunker inside of you. And even if you somehow got access to them, you wouldn’t know what to do with them anyway. You’re not really going to run off and join the French Foreign Legion, or become a hobo, or immediately act on any of your dreams, anyway, so being in touch with them just hurts, right?

But a therapist knows what to do with your dreams. When we can haul them out, together, and take a look at them, in a safe and accepting environment, they can work for you, in ways that might surprise you. It is possible to lead a life that doesn’t feel staid, constricted and boring – and sometimes it isn’t that different from your current life, but it requires the therapist doing what your parents couldn’t: letting your dreams ‘breathe,’ so that they can interact with, and be affected by, reality, without being mocked or squashed. They need to evolve, and, like growing a plant, this involves water (attention), good soil (a safe environment), and time.

How does this work? Well, it could look like this:

Sometime in the mid-Eighties, Harry, a big, burly guy in his early forties, came in to see me. At first glance, he looked like he should be the owner of a bustling Italian restaurant, or maybe a ‘mad’ sculptor (a lovable mad sculptor, that is). But what was he?

Yep – an accountant.

He told me that he came from a very difficult family background, in which his father was an alcoholic, his mother (“She was wonderful”) died when he was seven, and his ‘mean stepmother’ (yes, they really exist!) was always yelling at his father for being a weakling and a failure.

So where did this leave Harry? Well, on his own, mainly, unless his father wanted someone to make a ‘milk run’ to the liquor store for him, when his stepmother wasn’t looking. Not only did procuring a bottle of whiskey for Dad bring him a “Thanks, old boy,” but even a pat on the head and sometimes a quarter: “Here ya go kid – stuff yourself with Snickers.” When you’re starving for attention, even a pat on the head and a couple of Snickers can be a big deal.

There was no planning for Harry’s future, no encouragement, nothing but staying out of range of his stepmother. One day in high school, Harry was called in to the office of the school guidance counselor: the infamous Miss Magreblian. Apparently it was a requirement that every student had to see her once a year.

Harry dreaded it.

She was a tall, reedy ‘spinster’ lady in her fifties, with “not an ounce of fat on her, and a face that would stop a clock” (Harry’s exact words), and she had a reputation for being mean and scary. But she wasn’t mean or scary to Harry. He thought maybe she felt sorry for him – Harry remembered she once came up to him in the hallway and said, “Do you even have parents?” telling him that she had tried to contact them, repeatedly, for some reason, and struck out. His Dad had never been to any of his schools, not once, and his stepmother – well, it was best to keep her away from any part of his life.

He sat there quietly at Miss Magreblian’s desk, while she leafed slowly through his records and his test results, until she finally put the paperwork down and looked at him, with a small, pitying expression. Then, she sighed heavily, and said,

Harry – here’s the deal. You come from nothing and you’re probably on your way to nothing, but I’m going to say this anyway, because I’m supposed to offer you guidance, whether you use it or not. You’re not a bad kid – not a particularly bright kid, either – but all in all, you might make something of yourself, because you’re mostly quiet and get your work done. And I’m guessing you get it done with no help from anyone, either.

Harry squirmed in his seat, unused as he was to being talked about at all. Even though her words kind of hurt and made him uncomfortable, he also liked it, a lot, that she was acknowledging his existence. He nodded, “Yes, Ma’am.”

She sighed again, and went on, chewing her pencil thoughtfully between words.

So, here’s what I think: as I’m sure you’ve figured out by now, the world revolves around money. Now, there are two ways to get it, legally. First, come the people who are smart enough to make a lot of it. Then, come the people who help the smart people take care of what they’ve made.

She paused, chewing thoughtfully again.

I’m thinking you’re the second kind – the helpers.

Harry wasn’t sure if he should be insulted or grateful. They sat there in silence for a moment, until he managed to sputter, “So, what does that mean – you know, about me?”

She waved her hand at him. “Quiet – I’m thinking.”

Wow, imagine that: someone was actually taking time to think about him. He knew, somehow, that her next words would shape his whole life. He noticed he was holding his breath.

Finally, she tapped the pencil on her desk, decisively, three times. “An accountant, I think.” She paused, chewing the pencil again, and looking at the ceiling. “Yes, that’s it.” She carefully placed the pencil back in her desk tray, with finality. “Harry, I don’t know if you have it in you, but that’s what you should shoot for. If you don’t make it – well, you’ll still have a college education to fall back on. And a quiet kid like you, who does his work, can always manage to scrape by.”

She looked at him with a not-unkind expression. “I think we’re done here.”

So that was it: the gods had spoken. He was supposed to be an accountant, if he was smart enough, and hard-working enough, to make it. If it wasn’t exactly thrilling, at least he knew she was right about that money stuff: anyone who could help the smart people who made lots of money, take care of it, would always have a job, somewhere.

Well, Harry rode that interview for the rest of his life. He did attend a local community college, then transferred to a state college, majoring in accounting. He graduated – not with honors, maybe, but he’d had to wait tables practically full-time – and eventually, went all the way through and became a CPA. He got married, had three children, owned his own home, and had a German shepherd he called Miss M, in honor of you-know-who.

All in all, a “nice life.”

So what did it mean, that one day he walked into my office for the first time and said, “My life isn’t enough”?

That his whole life was a sham, or a mistake, or a mess?

No – to me, it just meant that he had reached the next stage: the stage where he could take all that he’d worked for thus far (successfully), and add to it. He had enough experience now, enough self-esteem, to recognize that fifteen minutes of guidance, given him twenty-five years before, was not enough to carry him through the rest of his life.

Sadly, I find that many therapists are too eager to ‘rip into’ their patients’ lives, to dismantle them (“How could you stay with him after that?”), to tear them down, like malfunctioning engines. Instead of helping to build on what is already there, they assist people in creating major, unnecessary drama and pain. So often, the ‘problem’ is not the existing family relationships, or the existing job, but an inability to access what is inside, and put it to good use, in a way that also preserves what the person has already built up over so many years.

The Wizard of Oz is a classic example of what I’m trying to say: Dorothy leads a (purportedly) ‘drab’ life on a drab farm with drab people, until she has a kind of spiritual awakening, that enables her to ‘see’ her life in a new, colorful, richer way than before. The real problem, ultimately, was her inability to appreciate what she already had, rather than the seeming drabness of her surroundings and people.

And yet, if Dorothy had come to therapy at the beginning, many therapists would have in effect agreed with her initial ‘take’ on the situation, and recommended leaving the farm as the solution, i.e. that she “had a lot more ‘going on’ than the other people on the farm, greater dreams, and more potential” – needs that (supposedly) couldn’t have been met on the farm.

But what was the actual solution? It was Dorothy’s ‘stepping up’ to take a more empowered view of the people on the farm – her own view: instead of being the little, passive girl who lived amongst all these ‘big’ people, who were beyond her ken, she (or at least her unconscious) stepped up to see each of them as they actually were – flawed beings, each of them needing something specific to be complete. In seeing these ‘adults’ as merely human beings, like herself, she was able to join them in the human race, to feel like we are all in the same boat. And ironically, in seeing all of their flaws, she was able to see them (and herself) in all of their beauty, as well.

And so, in the end, she didn’t have to leave the farm after all, in order to be her real self: she merely had to step up (where she was) to a more empowered self, and a richer, fuller, inner and interactional life.

So, the therapist’s job is to help people find, and follow, their own ‘yellow brick road’ to inner consciousness and empowerment – not help them run away to what A. A. calls a ‘geographic cure.’ Someone once said, “Wherever you go, there you are,” and that’s true, as far as it goes. What’s more true is this: “If you’re not ‘there’ here, you’re not ‘there’ anywhere.” Movement in space isn’t the answer – movement inside is the answer.

So, the next time you “wish for a pony,” take a closer look (maybe, with some help): you might already have one!

And Harry? Well, in therapy, he ‘remembered’ that he’d always wanted to sing in a barbershop quartet. These days, you might see Harry on the weekends, in a church, or a retirement home, or even on a stage, singing Sweet Adeline, with three of his closest friends. I went to see them once, and they won a local barbershop contest.

Harry came up to me later, with a big smile on his face, and said, “It’s like magic!”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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