Oh The Chords, They Are A-Changin’!








When I was a teenager, a friend and I took beginning guitar lessons at a local community center. I remember it was the Friday after Thanksgiving, because I thought it rather odd that the place would be open that day. We took our seats in a nondescript room full of gray folding chairs. Finally the teacher showed up – a tall, gangly lady who looked like a road show Olive Oyl. Oh well – we were still ready to become stars!

After a few introductory remarks, she took her guitar out of its case with a flourish and said, “And now, C major!”

She said it like Carl Denham, on opening night: “And now, ladies and gentlemen, the Eighth Wonder of the World: Kong!” She had managed to track down the elusive C chord in its lair, and now, out of the kindness of her heart, she was willing to share it with us.

On her command, we all jammed our recalcitrant fingers in place on the fretboard and strummed: poor old C major – he had come all this way for this? We did it over and over again, probably clearing out the neighborhood of anyone within hearing distance.

Finally, she rapped her stick on the back of her chair, calling a halt to the wholesale slaughter. Then, once again with all due pomp and circumstance, she drew herself up and announced, “And now: G Seven!”

It was hard not to break out into applause, hoots and whistles. I mean, heck, we already had King Kong. And now, she had brought along Godzilla, too? Talk about an embarrassment of riches!

For the next fifteen minutes, we perpetrated the same crimes on G-7 as we had on Mr. C. I heard a rich and varied assortment of under-the-breath curse words used, too. Some of ’em, in Spanish and Chinese I think, sounded like real beauts, but of course, I can’t verify that, being a lowly monolingual curser.

Once again, Olive tapped her stick on the chair.

“Alright, class, time’s up.”

Then, wagging a long, bony finger at us, she added, “Now learn those two by heart: we’re going to be using them next time.”

Wow, that meant a song was in the offing: an honest-to-god song! Oh my god, what would it be: Love Me Tender? Poor Little Fool? Party Doll? The mind boggled.

Well, we went home and practiced those chords all week, until our fingers were mincemeat. We ate, slept and dreamt C major and G-7. We were ready to take on anything she could throw at us – as long as it involved only those two chords!

The next Friday, we showed up bright-eyed and bushy-tailed, lugging our dime-store, nylon-string guitars to our assigned seats, giddy with expectation about the hot songs we’d be learning: heck, by Christmas we’d be wowing the girls!

Suddenly, Ms. Oyl tapped her baton smartly on the chair back, bringing us to order. There was a reverent hush throughout the room.

Then she sat down and said, “Guitars at the ready, everyone!”

My breath caught in my throat. This was it: the beginning of our meteoric rise to stardom!

“Now, we’ll start with C. Strum downward once on every beat. Then when I say, ‘Change,’ we’ll all change to G-7. Everyone understand?”

It sounded easy enough: we nodded in unison.

I hauled my fingers into place for C major, making sure every one was placed just so. Look out, world, here I come!

Then she tapped her stick briskly again, like a real conductor, and began:

“Hang down your head, Tom Dooley

Hang down your head and . . .”

                                                 . . . suddenly, she shrieked, “CHANGE!

It was the funniest thing I’d ever heard in my life. I turned to my friend, and we both got the giggles so bad we could barely breathe.

Ms. Oyl gave us a glare, but soldiered on, undaunted:

“Hang down your head, Tom Dooley,

Poor boy, you’re bound to . . .” 

                                        . . . she bellowed, “CHANGE!!!

We were helpless, doubled over – howling, baying, with laughter. And the severe, reproving look Ms. Oyl shot us only made us laugh even harder. There was nothing to do but to pack up our guitars and run off into the night.

We sprinted through the gathering darkness to the parking lot, like kids expelled from school, projectile-laughing until our stomachs hurt. Then, when we reached my friend’s beat-up old ’57 Ford, we looked at each other and without a word, knew what we were going to do.

As he pulled the Ford out into traffic, we rolled the windows down and cruised the night-lit boulevard. First we would parrot Ms. Oyl’s shrill, “Poor boy, you’re bound to . . .”, then scream, “CHANGE!” at pedestrians all the way home, weak with insane laughter at their stunned reactions.

I really don’t know what set off the whole crazy outburst: was it the shock of seeing the priggish, controlled Ms. Oyl yelling, CHANGE!! at the top of her lungs that did it, or the goofiness of the class, which suddenly made our dreams of stardom seem pitifully ludicrous, or simply that once you lose control like that, all is lost anyway, so you might as well go ahead and make a total fool of yourself?

Whatever it was, the whole episode was enough to make me put down the guitar for years – until I got to grad school, in fact. Playing the guitar had become ‘tainted’ by the experience, forever associated with ridiculousness. It doesn’t really make any sense in retrospect, but sometimes, things go that way: something gets associated with a particular context, giving it a ‘coloring’ that stays with you, and even trumps reality, in some cases.

It’s like a young woman patient of mine, years ago. We were talking about the movie Thelma and Louise, in which Brad Pitt had a small but striking part – one of his first in a big movie.

As we discussed the movie, my patient made a point of saying about Pitt, “Aw, that guy’s nothing.”

Hmm. That was interesting, because a number of female patients had specifically mentioned noticing him in that movie, and I don’t think I’m breaching any confidences by breaking the news that they certainly did NOT think he was “nothing.”

So, out of curiosity, I followed up on her comment, and she eventually acknowledged that she’d gone to the film with an older woman friend of hers, someone she looked up to, who had made some disparaging comments about Pitt after the movie – stuff like, “What a dork,” or “He looked like the Mama’s boy type to me.”

And that had ‘set’ my patient’s opinion of him.

But as a result of our conversation, she went to see the film again, “as an experiment.” This time, her opinion of Brad Pitt took a one-eighty. As I recall, her revised assessment went something like this:

“He may be a dork, but oh man, what a dork!”

Well, much of doing therapy is about noticing, pointing out, and challenging these unconscious contextual ‘taintings’ of things – ways in which a patient’s opinion or take on something has been set in concrete because of the (sometimes gratuitous and unintentional) influence of previous people or circumstances.

Here is another example, from my ‘case files’: one day, Mary Beth, a woman of about thirty, came in, ostensibly to work on her “intimacy issues.” Great, I thought – let’s go: intimacy issues are like catnip to a therapist. She was attractive and, as my mother would have said, “well turned out,” meaning that her ‘ensemble’ was not only pleasing to the eye, but kind of unique in a way that was hard to describe: I suppose that overused word ‘style’ would convey it best.

We started to talk about her background. Turns out her mother was a nationally-recognized artist – the kind who’d had one-woman gallery shows in New York, the kind who had paintings commissioned by the rich and famous. Her father was dead, but he’d been an architect and engineer. She had an older sister, who was also an artist.

Before she said it, I knew what was coming next: that only ‘left’ the role of Architect or Engineer for Mary Beth; her sister had already ‘taken’ Artist.

After we finished a cursory overview of her background, I asked her why she had come to see me. She said, “Well, my life is fine, I guess, but, somehow, I don’t seem to think so. I have a nice husband, a good job, and two great kids.” She looked down in guilt, “But, I don’t know . . .”

“So what’s the part about ‘intimacy problems’?”

She nodded. “Oh, Burt – that’s my husband – says I must have intimacy problems, because I’m unhappy with our life, when we have, you know, a good life.”

Well, I already had my own ideas about what her ‘intimacy problems’ might be. Something about the way she was dressed, and the fact that she’d said of her sister, “She’s the artistic one,” were ringing a bell in my head. I decided to follow up a bit.

“So – tell me about your job.”

She gave a little start. “Uh, what about my job?”

“Well, just, you know, what it’s like, how you feel about it – that sort of thing.”

She shrugged, doubtless surprised that we weren’t delving into her ‘intimacy issues’ first. “Well, I’d guess you’d have to say it’s . . . fine. They need something done, and I do it.” She paused, searching for anything further to say about it, and came up empty. “That about sums it up.”

I laughed. “So, your job is as follows: they need something done, and you do it.” I paused. “And that about sums it up.” I paused again. “‘Next topic,’ huh?”

She had to smile. “Well, there’s a little more to it than that.”

“Yes, I’m sure there is, but that’s what you said: it’s fine, and that’s about it.”

Mary Beth licked her lips and looked at me with narrowed eyes, clearly thrown off balance by my focusing on the ‘wrong thing.’ Then she gathered herself. “Just what is it you’re trying to say – uh, Doctor.”

“Gregg – please.”

She gave a deliberately fake smile. “Okay, then, Gregg Please.”

I smiled – good, she had a sense of humor: we could use that. “I’m trying to say that when you tell me about your job, it’s colorless, drab – like it’s in black and white.” I waited a moment. “Is that how you see it?”

She sighed impatiently. “Look, I said it’s fine, didn’t I? I mean, what more is there to say?”

I nodded. “Okay, I’ll tell you what: ask me about my job.”

She shook her head, confused. “What do you mean?”

I repeated. “Ask me about my job.” I gestured with my hand. “Go ahead.”

She looked at me in disgust. Then, in a condescending, sing-song voice, she said, “Okay then, tell me about your job.”

I shrugged, disinterestedly. “People come in to ask for help, and I help them.”

A small smile played around her mouth.

I continued. “Now say, ‘Is that all?'”

She rolled her eyes. Clearly she was in the presence of a true idiot. She said, “Is that all?”

I shrugged again. “Yep – it’s fine.”

She nodded thoughtfully, beginning to ‘get it.’ “So, you’re saying that I’m not enthusiastic enough about my job?”

“No, only that people aren’t enthusiastic about jobs that don’t do them justice.”

“What do you mean, justice?”

I pointed to her outfit. “Where did you get that dress?”

She looked down at it, then at me, clearly ‘off her feed’ again. “Why are you asking that?”

“Please, just humor me.”

She smoothed the fabric lovingly. “Well, as a matter of fact, I got it at a thrift store near here – over on College Avenue, a long time ago.”

I smiled. “You love it, don’t you?”

Her eyes brightened, and her mouth turned up. “Yes, as a matter of fact.” She paused, confused. “But, how did you know that?”

“Well, the way you caressed it, and the fact that it would take love to put together an outfit like that – love, and talent.”

She smoothed the skirt again. “Oh – you like it?”

“Yes. I bet you could tell me where you got every single thing you have on.”

She laughed. “Yes, as a matter of fact, I could.” Her eyes were shiny-bright now.

I waited, letting her make the connection herself.

She scooted forward in her chair, licking her lips again. “Are you trying to tell me . . . that . . . my reaction to my job and to my outfit are . . .”

“Like night and day? Yes, ma’am.”

Ten seconds went by, before I continued. “Were you artistic – as a kid, I mean?”

She shook her head slowly. “No – not really. I mean, I did fine, I guess, but my sister . . .”

“She’s the artist – like your Mom?”

She bristled. “Yeah – that’s right. What about it?”

“And what did your Mom say about your artwork?” (I was looking for a ‘keyword’ here, and seconds later, it came.)

“She said it was, you know, fine.”

I repeated, “Fine,” then waited. “Uh huh – same thing you said about your job: it’s ‘fine,’ too.”

She cleared her throat and rubbed her nose thoughtfully. “So, ‘fine’ means mediocre – is that it?”

I nodded. “Apparently – in your family, yes.”

She started to protest. “But my mother was a famous artist, so if she thought my stuff was . . .”

“What: ‘fine’?”

“Yeah – mediocre, well then that’s that, isn’t it?”

“And besides, your sister was the artistic one, right? And there’s only room for one, right?”

Mary Beth twisted her fingers together, pursing her lips tightly. The words came out slowly, one at a time. “Are . . . you . . . saying . . .”

I gestured to her outfit. “I’m saying that you clearly have a gift, and that your eyes sparkle when you talk about the lovely clothes you put together.” I paused. “You can take it from there.”

Time was up. I only hoped I hadn’t gone ‘too far’ for a first session.

The next week she walked in, barely able to contain herself. She handed me a sheaf of papers, saying, “I hope you like it.” She covered her mouth with both hands.

I leafed through her ‘portfolio’ – beautifully-wrought fashion drawings of amazing ‘outfits.’ I smiled at her. “Now, I think this shows you what you can do, when you follow your passions.”

She laughed with relief. “You mean it’s better than ‘fine’?”

“Way better than fine! I’m no fashion expert, but it’s obvious that you’re very, very gifted.”

Her eyes danced.

“And what’s more, I think we may have solved your ‘intimacy issues,’ too.”

She blushed and looked down. “I’m pretty sure Burt would agree with that.”

“Woo Woo!”

She waved her hand to shush me, grinning from ear to ear.

It took a lot of work together, and weathering some hard times, but once she’d freed herself from the ‘tainting’ of her family mythology, Mary Beth eventually went on to have a ‘fine’ career in the fashion industry.

And me? Well, sometimes, when I’m sitting with a patient, and we’re working on some kind of conditioning from the past, and close to a breakthrough, I still smile and think to myself,

Poor boy, you’re bound to, CHANGE!!!

















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

Lewis and Clark at Griffith Park








By all rights, I should be a full-blooded, pure-bred narcissist – and by that I mean, I come from narcissists on both sides. You know, like a dog with champion bloodlines and everything – I have ‘papers.’ Kind of like being a Plantaganet, or a Tudor – you are one simply because you’re, well, “to the manner born,” as they say.

Except, in my case, it didn’t really ‘take’ properly, so I ended up with low self-esteem instead. Maybe my parents both carried recessive genes for low self-esteem and I lost the reproduction lottery.


Because from the outside looking in, it seems kind of fun to think you’re the greatest thing since sliced bread: everything you do is great, simply because YOU did it, and everything you are, and have, is the BEST. Not a bad gig, eh?

Sure, it’s kind of hard on your kids – I think that’s been pretty well documented, here and elsewhere – but then again, if you’re a narcissist, it’s all about what YOU think, and since YOU think you’re just peachy-awesome, they can just take all their theories and put ’em where the sun don’t shine.

So, I’m not here today to talk about emotional child abuse, creating poor self-images, or virtual neglect (heh heh, managed to get all those in there, didn’t I?) – nope, I’m here to talk about the advantages of having narcissistic parents.

What ho – you say I don’t have a leg to stand on?

Well, gather round and give a listen, ye of little faith.

So here’s the deal: when you have two narcissistic parents, who, moreover, agree with each other about such things, this is what a young child learns:

1. Everything we do is FABULOUS.

2. Everything we have is FABULOUS.

3. Everything we are is FABULOUS.

4. Though you don’t understand precisely how all this works, YOU, by association, are FABULOUS as well. You are ‘of’ THEM, and therefore under the aegis of THEM, so ergo you partake of their fabulosity as well.

And because Numbers 1 through 4 are true, therefore:

5. All experience is AUGMENTED.

What do I mean by augmented? Well, we’ll get to Number 5, but first, let’s see how Numbers 1 through 4 work, in a ‘special’ family.

We lived in the San Fernando Valley, a relatively uncelebrated suburb of L.A. If it was recognizable for anything nationally, it was for its vast, undeveloped tracts of chaparral and scrub lands, shown in virtually every cheap Western ever produced. The developed portions were mostly row upon row of tract houses, the glory of which was made possible because ‘they’ (have you ever seen Chinatown?) made a desert into a semi-desert, by stealing water from Colorado.

Hooray – sort of.

Okie dokie, I think we can all agree on all of the above, but wait: WE lived there! So therefore, in the stroke of an ego, the semi-desert was transformed into the Crossroads of the World, the most desirable place on earth, where every man (i.e. my Dad) was a King, and every woman (i.e. my Mom) was a Duchess. After all, WE had a double-depth backyard. Well, we and everyone else on our side of the block, but only WE, by the precise choice of that exact combination of plants, trees and flowers, had transformed our yard into the Hanging Gardens of Babylon, putting all others to shame.

And yes, it was true that we didn’t get a clothes dryer until after everyone else in the world had one, but see, hanging the clothes on the line outside was BETTER!

How do I know that?

Because we did it that way, you big dummy!

Are you catching on?

Now let me see if I can explain what I mean by Number 5, ‘augmented experience.’ Let’s take a typical Sunday afternoon outing for our family of four, circa the mid-Fifties. We all piled into my Dad’s pride and joy, the brand-new yellow ’54 Mercury Monterey sedan (not a measly Ford – a Mercury, mind you!) – the greatest car in the world. We’re on our way to Griffith Park – the L.A. equivalent of Central Park, or San Francisco’s Golden Gate Park, or the big park in the city of your choice. But see – ours is better! It’s the best park in the best city in the world – and WE get to go there!

How do I know all this?

Well, didn’t you just read Numbers 1 through 4, a few minutes ago? Seriously, I’m beginning to have doubts about your reading comprehension.

Okay, we drove to Griffith Park (which, though you are rather slow on the uptake, we all now agree is the greatest park in the world, correct?), going there, of course, by the best possible route.

First stop: the Los Angeles Zoo. Now, I loved going to the zoo. I loved all of it. The small cages where the big cats were kept, pacing back and forth – cages that would be considered the worst sort of animal abuse nowadays, but which gave kids a guaranteed close-up view of the magnificent lions, tigers and leopards, as they paced their cages endlessly. I loved the landscaping – tall, old eucalyptus and pepper trees everywhere, like they were standing guard over the grounds. I tried to imagine the drama of a famous trapper like Frank Buck ‘bringing ’em back alive’ – to picture what was involved in the taking of such enormous and dangerous beasts without damaging them, how they were transported across entire oceans, and then across the entire U.S. or around the tip of South America to the Wild West. I even loved the smell of the animals. I loved the popcorn, always in those red-and-white striped cardboard boxes, and peanuts in the shell, that you could throw to the monkeys. I could go on, but most all kids feel these same things about the zoo, don’t they?

But all kids weren’t our family! Because although we were with the other people at the zoo, we were not of the other people at the zoo. It was as if we were some kind of visiting royalty, hobnobbing graciously with the hoi polloi because we were good-natured, but not actually of the same ‘stock’ as they, the huddled masses, the great unwashed. They slumped along, the ignorant armies of the night, while we strode along magnificently to the unheard (by them!) strains of the promenade theme from Pictures At An Exhibition. The only reason we didn’t blow kisses to the toiling masses, or give them benevolent Papal waves, was because it would only make them feel bad.

See what I mean by Augmented?

And now on to the true highlight of any trip to the Zoo, at least for me: the great, the magnificent, Bee’s Rock. What the heck is Bee’s Rock, you say? Well, in NPR (Normal People’s Reality) it was this place near the Zoo where you drove uphill until you parked your car, then hiked up to a relatively modest outcropping of stone, which overlooked, well, chaparral and scrub lands down below, and then, beyond that, a view of the city.

But in Augmented Reality? Ah, it was a magical, mystical place – think of a combination of the Blarney Stone, Mount Everest, and Livingstone when first he beheld the splendor of Victoria Falls.

The only possible vocalization from its summit was, “Eureka: I have found it!”

Think Lewis and Clark, putting their hands dramatically up to shade their vision as they peered out into the enormity of a vast and blessed new land, tears of awe spilling from their eyes. It was a summit, and a view, to transport even the lowliest of mortals, but for those of us who truly understood, who were capable of appreciating its true glory, well, words just fail, and since no adjective could do the experience justice, I won’t even try.

Tearing ourselves away from heights that would make the word rapture seem puny, we now approached yet another shining star: The Griffith Park Observatory. Oh, the huge, retractable dome of it! Oh, the science of it! Oh the arcanity of it! Oh the shiny red plastic buttons-that-you-could-push-and-make-things-happen of it! There was a huge pendulum there, recessed in a huge pit, that demonstrated things as it swung. Exactly what it demonstrated I was never exactly sure, but I knew it definitely demonstrated things, and I knew it was gasp-worthy.

And after you saw all the exhibits, and pressed all the buttons, there was the maxi-gasp of all time: The Planetarium! You sat there and the lights went down, revealing a back-lit silhouette of the cityscape all around you. And then a smart guy came on and talked you through The August Sky, or Tales Of Orion, or The Gotterdammerung – it doesn’t matter what they called it, as long as there were millions of stars up there, and the Ride of the Valkyries playing real loud, giving you chills and bumps.

I mean, what more do you want?

How about a gorgeous water fountain, lit up at night with ever-changing colors? You got it: The William Mulholland (yep, the Colorado water thief) Memorial Fountain, on our way down the hill and toward Los Feliz Boulevard and home. We parked at the fountain for a few minutes, to take it all in. Then Mom and Dad turned to me in the back seat, not “as if to say it was the greatest thing in the world,” but to ACTUALLY say, “This is the greatest thing in the world: right?”

“Uh, right.”

And as you say, “Right,” you come to believe it!

See what I mean about Augmentation?

Well, that only left one item of business. To put a nightcap on a perfect day, we stopped in at Currie’s Mile-High Ice Cream, the (surprise!) apotheosis of the ice cream maker’s art. Need I point out that they had the BEST black walnut (Dad) and the BEST black cherry (Mom). And, as for the Pistachio (Me), well, ooh lah lah, say no more. Gee whiz, what were the chances of that: the greatest ice cream in the entire world, and lo, it just happened to be in our town, on our way home.

And finally, home again, home again, jiggity jig. I slumped back dreamily in the back seat of the Merc, in my post-pistachio torpor, the passing scenery washing over me, swaddled in the warm cocoon of protective specialness that came from being part of a perfect family. Let others worry about bad decisions, mistakes and fatal weaknesses – none of that stuff for us, because we existed atop the Bee’s Rock of society, looking down benignly at the human chaparral below, secure in the knowledge that whatever we did would be fine, because we had done it.

Riding for a fall? Sure, sure, but all that would come later. For now, we were in our heaven, and all was right with the world. As my eyes fluttered closed, I pictured myself up on Bee’s Rock again, looking out over the city from on high, master of all I surveyed.

Well, there you have it: an outing in the Augmented Universe. Sounds good, huh? Well, it is, until you hit the real world, and that’s . . . well, not quite so good. But I only promised you a rose garden, not the thorns, so we’ll leave the “come-down” for some other time. In the meantime, I hope you enjoyed the vicarious thrill of a trip down Narcissism Lane.

And now, as the lights come up, and your eyes get adjusted to NPR once again, we will play you a selection from The Ride of the Valkyries, so that you might return to your drab, quotidian existence trailing at least a few clouds of glory:

Good night, and please come again!






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

That’s The Way, Uh Huh, Uh Huh, I Like It








So many people come in with complaints about depression, sleeplessness, resentment, bitterness, apathy. They blame it on money problems, drug and alcohol problems, marriage problems, job problems, marriage and job problems.

But here’s the thing: much of the time it’s really about ‘I’ problems. As in, they don’t really know who they are, or what their proper place even is, in this big, wide world.

Of course, they don’t usually realize this. What they do know (or think they know) sounds more like this:

1. What’s wrong with me, that I’m always dissatisfied with my life?

2. I have no reason to be depressed.

3. If I could just get that new job, for more money, I’d be fine.

4. If I could just get that new wife/husband, who treats me better, I’d be fine.

So sure, it would be easy to say to them, “It’s all in your attitude.” Then I could give them ‘attitude-adjustment’ exercises – you know, like homework:

List ten things you’re grateful for.

When you start to think negative thoughts, practice mentally ‘changing the subject.’ 

Update your resume, and start to network more.

Sounds good, huh? And that’s exactly what most people think therapy is: basically really expensive good advice, with a side of cheerleading.

Well, they couldn’t be more wrong.

Not to mention, it’s a set-up for yet one more failure. Because you give them their ‘assignment,’ and they either don’t do it (i.e. they’re a ‘failure’), or they do it and it “doesn’t make any difference,” (i.e. they’re a ‘failure’).

After all, they already knew what they ‘needed to do,’ before they ever came in to see you, didn’t they? I mean, any friend, spouse, or sidewalk superintendent could have told them to improve their attitude, get a new job, and learn to be grateful for what they have, right? If they could do those things, they would have already done them. And if all they needed was a little cheerleading, well, they could have gotten that from the afore-mentioned friends, spouses or sidewalk superintendents, couldn’t they?

So then what the heck are they paying a therapist for? Well, it’s not advice (though it includes advice), it’s not cheerleading (though it includes cheerleading), and it’s not assignments (though it often might include those, too).

So now maybe you’re saying to  yourself,

“Ohhh, I get it: all that Freudian hocus-pocus: talking forever about my crummy Dad and my crummy Mom, going over all my dreams in minute detail, reviewing the time the neighborhood boys called me a sissy, and dwelling endlessly on the fact that, since I was the oldest, they expected too much of me, or since I was the youngest, nobody took me seriously.”

Well, yes, while therapy may even include some of that ‘Freudian hocus-pocus,’ too, it’s a lot more than that. Because all of the hocus-pocus, all of the advice, all of the cheerleading and all of the assignments are taking place in the context of a (don’t faint!) Relationship.

Here, I’ll share with you a session with my patient, Paul.

Shh, let’s listen in:

Paul: Sure, it’s a ‘Relationship’: the relationship between my paying you money, and your showing up every week.

Me: Well, that’s true, too, but that’s not the relationship I was talking about.

Paul: Oh, you mean, like, the relationship between your pocketing the money and your acting like you care about me?

Me: Thanks for sharing, but no, that’s not really what I meant, either.

Paul: In that case, I’m fresh out.

Me: How about, the gradual evolution of your sense of yourself, in the context of our developing connection with each other?

Paul: (Mentally backing away slowly) Okay, now I’m going to call the men in the white coats, for you!

Me: But,what if it’s true?

Paul: Well then, I’d say that’s a tall order.

Me: That’s right, it is. Now maybe you can see why I might make a little more than a man-on-the-street advice-giver, and might even be worth it.

Paul: Hmm, can’t you just tell me what it’s going to look like after all this evolving takes place, and I could just act like that right now, and then we could be done with all this?

Me: I wish I could, but the fact is that it takes a human being a certain amount of time to do the things I mentioned – even if I’m really good at my job.

Paul: So you admit it’s a job!

Me: Well, yes, it is a job, but the ‘job’ part is not that I’m getting paid to fake caring, but to actually care, and not just to go through pre-ordained ‘steps,’ but to actually help you find your way to a relationship with yourself.

Paul: Hey, before, you said the relationship was between me and you!

Me: I did, but we’re ultimately concerned with your relationship with yourself – that is, being able to see who you are, to accept who you are, and to embody who you are, in the world.

Paul: Embody? Alright, now we’re back to mumbo-jumbo.

Me: Hey, before, you said it was hocus-pocus.

Paul: Smart-ass. There’s nothing worse than a smart-ass therapist.

Me: Except maybe a dumb-ass therapist.

Paul: You may have something there. (Pause) So, when do we start building all these relationships: with you, with me, with the man in the moon?

Me: We already started: this whole conversation has been part of it.

Paul: Damn, why am I always the last to know?

Me: That’s what we’re here to find out.

Paul: There you go again.

Me: I wasn’t being a smart-ass.

Paul: I’ll have to take your word for that. (Pause) So what do I do now?

Me: Just sit there and tell me what you’re feeling and thinking.

Paul: Like, dreams and stuff?

Me: Like real life and stuff.

Paul: You mean, like, now?

Me: Can you name any other time that it is, at this very moment?

Paul: Okay, okay, don’t rush me.

Me: I didn’t say we were in a hurry.

Paul: Well, you make it sound like I’m supposed to start spouting all this deep stuff, immediately.

Me: Is that how it sounds, to you?

Paul: That sounds like a therapist question.

Me: Would you prefer a train engineer’s question? Toot! Toot!

Paul: (Sighs) Well, this is all pretty confusing.

Me: You mean, understanding what we just talked about?

Paul: (Sighs) No, no: knowing what I’m thinking and feeling, right now.


Paul: This is hard.

Me: (Nodding)

Paul: I mean, what do you want out of me?

Me: So, it feels like a performance demand?

Paul: Yeah – exactly. Like I’m a kid at a piano recital, and I haven’t practiced my piece.

Me: And if you don’t play it well, you’ll be a disappointment?

Paul: (Ironic laugh) More like a failure.


Paul: In fact, my whole life feels like that.

Me: Like a failure?

Paul: Like I’m supposed to know how to do it, but I don’t, because I . . .

Me: Didn’t practice? (Note: I say this, not because I think it’s correct, but to act as a ‘foil’ that nudges him toward the real answer.)

Paul: (Shaking head) No – it’s more like . . .

Me: Like . . .?

Paul: Like no one ever showed me how, in the first place. (Two fingers going up to mouth, eyes blinking fast) Are you, uh . . . you know . . . allowed to say that?

Me: You mean, is it an excuse – a cop-out?

Paul: (Nodding) Yeah – I mean, it’s my failure, right? Not anybody. . .

Me: Else’s?

Paul: Because, they, you know . . . they . . .

Me: Were nice people, who took care of you?

Paul: Well, yeah . . . I mean, all the work they put into me .  . .

Me: You know, sometimes even nice people can screw up. I mean, you’re a father, I’m a father: have you ever screwed up, as a father?

Paul: (Laughing) Sure, I guess so. (Looking up) Why – have you?

Me: (Shaking my head) Oh no – never: I was always perfect.

Paul: (Laughing) You know what I mean.

Me: Yes, I know what you mean, and the answer is yes: I’ve screwed up a lot, and so does everybody. (Pause) Everybody. (Pause) You know, all parents do their best – but sometimes their best doesn’t work right, for a particular situation, for a particular kid. So, getting back to your question, yes, you are ‘allowed to say that,’ at least in here. And when you say something about your parents, or your childhood, we’ll both keep in mind that we’re not saying anyone is a monster, or evil, or a bad person. We’re saying that, in certain ways, you might not have gotten what you needed – not in all ways, but in particular ways – and that, yes, that might have caused you some problems.

Paul: (Nodding, slowly)

Me: So, can we agree to that – in here?

Paul: You mean, that when I say something, or remember something . . . that it’s not . . .

Me: Not a wholesale condemnation of anyone.

Paul: Or, saying they’re bad, or anything.

Me: Yes – but you’re still allowed to have your feelings about it, knowing that a feeling has its own validity, which can be separate from whether it’s right or wrong, factually. So, we can have the feeling world, and also the factual world, and we allow them both in here: they both have their own importance, and purpose.

Paul: Okay, so hmm, right now, I feel like your chair is too close to me.

Me: Do you want me to move it?

Paul: Umm, is that okay?

Me: With whom?

Patient: I don’t know – the gods of therapy?

Me: In here, we’re the gods of therapy. (Moving chair further away.)

Paul: So, you’re saying it can actually be the way I want it?

Me: Yes, it goes by you.

Paul: Is that what you mean by a relationship?

Me: It’s a start – yes.

Paul: Okay. (Pause) Now, what were we talking about?

Me: We’re talking about it right now.

Paul: Smart-ass!


Paul: Thanks for not being a dumb-ass.

Me: You’re welcome.


So, does that give you a little better idea what I mean when I say change happens “in the context of a relationship”? Now that Paul and I have begun to create that context, at some point it might feel right to ‘assign’ him homework, or be a cheerleader (say, connect with him between sessions), or talk about the ‘mental management’ of his worry, or his negative self-talk.

But if he doesn’t feel free to tell me why he’s not doing the assignment, or if he doesn’t even recognize, within himself, why he’s not doing the assignment, well, the whole enterprise will eventually collapse of its own weight.

That’s why I always make it a point to draw my patients out about what they need, and what they want, both in the therapy and in life. If I need to move my chair farther away, or closer, I do it. If I need to set up the therapy room the way they like it, I do it: some people like blankets and pillows; one woman wanted me to turn around the figure of the Maltese Falcon that sits on my bookcase, because it scared her. No problem. And, if, in walking from the waiting room to my office, they feel uncomfortable going first, well, I go first.

Does that mean I do everything they want? Of course not – if it’s a way to avoid the work, or run away from important issues, I challenge them. And if it feels like a ‘power struggle,’ then I’ll point that out, and we will work with it as such. But on the other hand, I don’t label every preference, or request, as a ‘demand,’ either: after all, it is their time, and their opportunity (maybe their only chance in life) to have it their way.

That reminds me of that particularly nasty psychological approach that views all problem behaviors as “manipulations,” forever asking the patient with back pain, or fibromyalgia, “So, what are you getting out of it?”

Or saying, of a child who is misbehaving, “He’s only doing it for attention.”

I always feel like saying back, “So why don’t you give him some attention, then?”

So no, I tend to see requests as needs, not manipulations; I think that, overall, most people are doing the best they can with what they’ve got. If we don’t understand why they do what they do, it’s not because they’re ‘just evil,’ or manipulative, but because our capacity to understand is limited.

In therapy, you’re asking people to do perhaps the hardest thing they’ve ever done: look at themselves honestly, without turning their glance aside, and in the presence of another person who is being ‘paid to care.’ The least I can do is actually care, and make them as comfortable as I can.

Therefore, if I can move around a few pillows, or give them a blanket, or turn around the Maltese Falcon, well, that’s a small price to pay, for what I’m asking them to do. If they’re willing to tell me what they need, I’m willing to do it.

Oh, and by the way, the Maltese Falcon didn’t mind a bit that I had to turn him around like that.

He likes being seen as big and scary.

He told me so.












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

Oddball In the Corner Pocket










The first course: two poems by Alice Walker, to serve as antipasti for the soul (note: if you have the attention span of a hummingbird, I hereby give you permission to skip ahead to the entree without incurring my wrath):

Be Nobody’s Darling

Be nobody’s 

Be an outcast.

Take the contradictions

Of your life

And wrap around

You like a shawl,

To parry stones

To keep you warm.

Watch the people succumb

To madness

With ample cheer;

Let them look askance at you

And you askance reply.

Be an outcast;

Be pleased to walk alone


Or line the crowded

River beds

With other impetuous


Make a merry gathering

On the bank

Where thousands perished

For brave hurt words

They said.

But be nobody’s darling;

Be an outcast.

Qualified to live

Among your dead.


I Will Keep Broken Things

I will keep



The big clay


With raised





Of their





I will keep



The old





To my


By Mississippi

A jagged



In its sturdy




I will keep



The memory









I will keep



In my house






On which

I will




Their beauty








I will keep






It is now







I will keep



Thank you

So much!

I will keep



I will keep





I will keep



The other day, at the Chinese restaurant, I asked a good friend: “Am I an oddball?”

For a bare instant she contemplated her plate, then nodded, “Yes,” and popped an egg roll into her mouth.

Whew: I haven’t lost my mojo yet.

To really “be somebody,” you can’t be everybody, you can’t be a stereotype, you can’t be society’s personality du jour, you can’t be totally predictable, you can’t get along with everybody, you can’t be universally admired, and you can’t be all things to all people.

Being a person is hard.

In Finger Man, Frank Lovejoy’s (Casey’s) sister Lucille is in a ‘dry-out’ facility for alcoholics. This was the mid-Fifties, and dry-out meant cold turkey, complete with the DT’s or whatever other devils, terrors and hells came along for the ride. She is suffering – in pain and desperate, looking at the world cold sober for the first time in years; looking not only at what she has done to herself and her young daughter with her years of drunkenness, but at a future without booze, facing life straight, with nothing to soften it, nothing to blur it.

Lying there in bed, writhing in agony, Lucille says to him, “Casey, is there room in the world for people like us?”

Good question.

And here’s the weird answer, the secret ‘they’ never, never tell you:

There is room in the world for you, but ONLY if you’re being yourself!

And why don’t ‘they’ ever you this? Easy:

There’s no money in it.

It reminds me of a big oil company executive I used to see in therapy. Once, during a lull in the conversation, I asked him to be honest with me about why the big energy companies don’t pursue the development of more ‘sustainable’ sources of energy more vigorously. He laughed and said, “What – you think I’m a greedy captain of industry who doesn’t give a damn about raping and despoiling the earth? Look – I’ve got to answer to shareholders, and the truth about solar, wind, geothermal and all the rest of that shit is: there’s no money in it!”

And that applies to any field: look at psychotherapy, for example. Which would you rather market: something that is highly individual, quirky, takes years to learn, is deeply complex, and really more of an art form (i.e. traditional psychotherapy), or something that you can ‘package’ into one-size-fits-all modules that can be taught in a series of weekend workshops (i.e. behavioral therapies, EMDR, and the like)?

The same is even true for spiritual and religious practices. There are some things you just can’t ‘sell’. How would you like to attend a seminar where the leader says,

“Look, there’s this guy, Jesus, who had some truly amazing, transformational spiritual experiences. We have some information in this book, The Bible, which admittedly is speculative, about how he did it, and you’re welcome to delve into it all, but what you really need to do is to have your OWN transformative spiritual experiences. Of course we have no idea what that would look like for you, but, using Jesus’ experience for inspiration, please go out into the world and seek your soul. We’ll be right here to support you with soup, sandwiches and hugs, if need be. You may begin.”

The truth is that anything that is individual, quirky, unpredictable, spontaneous, intuitive and creative can’t be packaged or sold, and if something can’t be packaged or sold, there’s no money in it. Of course, the flip side of all this is that, when there’s no money in something, the nabobs and poobahs aren’t much interested in it, so it’s left pretty much unregulated, unsupervised, wild and free.

Which is to say that in the field of self-development, the bad news is, you’re on your own, and the good news is, you’re on your own.

When I was an intern at the UCLA Neuropsychiatric Institute, we each shared an office with another trainee. My fellow boarder was the kind of fussily self-important guy whom you just knew would go on to become a psychoanalyst (he did). Somehow, I always felt that, in striving so mightily to prove himself as a serious dude, he was acting ‘on top’ of a part of him that was, well, kind of goofy.

But it gets better:

Now, mind you, we’re talking the Dark Ages here – no computers, no Internet, no nothing. After we saw patients, we dictated our notes, which were then typed up mysteriously by the Typing Pool (a phantom room full of unseen women, somewhere in the bowels of the building), who, after a reasonable period of time, returned to us our notes made visible, corrected for spelling and punctuation, as need be, and suitable for presentation to the Panels of the Gods (the supervising faculty members, whose intellect and all-around majesty we could never hope to approach).

But to get back to the Typing Pool: understand, they were there not to interpret, but to take down ‘the record’ accurately. Theirs not to reason why, theirs but to type or die, and all that sort of thing.

Well, one day my office mate, I’ll call him Percy, dictated his final termination notes on a particular patient whom he had seen for some time, then sent them off to the Ladies of the Keyboard. Apparently, he was nodding off while he was dictating, because, to his shock and chagrin, when the copy came back, the last sentence of it read, and I quote:

I had high hopes for you, boy, but you were just a fucking oddball.

Well, it was funny – at first. And it was funny for the same reason it’s funny when Groucho Marx puts a whoopee cushion under Margaret Dumont: because of the comical juxtaposition of Percy’s officiousness with the bald primitiveness of his ‘real’ feelings about this patient.

But here’s the thing: I still think about it all these years later, and it’s not that funny, because it has all the earmarks of bad therapy: blaming the patient; an inability to respect the other person’s ‘otherness’; an assumption that the therapist’s ‘way’ would have worked if the patient had been what the therapist thought he was. I’m not saying Percy was a bad guy, or a bad therapist, only using this incident to point to a phenomenon that could — and does — happen to anyone, therapist or not, where ‘different’ equates to ‘weird.’

And the scary part is that, for so many therapists, this kind of thinking doesn’t go away with training and experience: it just goes underground and unconscious. If it were always this blatant and obvious, it would be less insidious, but it almost never is: therapists tell themselves they accept people for who they are, that they’re not ‘triggered’ by their patients, that it’s an even playing field for all.

But in reality, it’s like parents telling themselves (and their children) that they love all their children exactly the same: bullshit! That’s ridiculous and impossible – not to mention the reason for a great deal of psychotherapy, as people deal with the huge unspoken undercurrents of family life. Therapy is not just about ‘making the unconscious conscious,’ but making the unspoken spoken. To say something out loud, to claim it and admit it, is the beginning of all growth and change for the better. It’s what we’re helping our patients do – why shouldn’t it apply to us as therapists, too? It never really ‘hurts’ a patient for the therapist to admit to negative, judgmental or even hateful feelings about the patient, as long as the therapist uses reasonable clinical judgment about how to use the realization – whether to say it or not, and if so, how, etc.

But first, and most importantly, comes saying it to oneself. Without that, there is nothing – with it, the rest is just following your intuition and judgment.

And most of all, therapists need to know this: EVERYONE is an ‘oddball’ – and especially when they’re allowed to play out their individuality without fear, which is what should be happening in any good therapy. If you don’t get to their ‘oddball’ places, you’re not done, because the oddball in someone is the “there there.”

So, like Lucille in Finger Man, I have always hoped that Percy’s oddball did find ‘room in the world’ for someone like him.

To become a person, you must have the courage to stray from any path that can be sold, packaged and marketed.

Embrace your inner oddball, because without it, you’re just another product.


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