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.

Pop Psychology












Pop Psychology: The study of fatherhood.

That’s a joke, but then as far as I can tell, fatherhood is kind of a joke, in our society.

Each child is biologically required to have a mother. Fatherhood is a well-regarded theory, but motherhood is a fact.

—- P.J. O’Rourke

You hear people talking about ‘mothering,’ but seriously, does anyone ever really say, ‘fathering’? Fathers are the distant stepchildren of parenting, the ‘other guys,’ the second bananas. Whereas a new Mom is ‘in her glory,’ Pop is more like, ‘along for the ride.’ While motherhood is seen as a sacred commitment, a holy blessing and a joy forever, fathering is more like, “Hey, buddy – yeah you, the one who’s trying to lam out that back door: get back in here and do your duty!”

While many (maybe most?) young women dream at some point, or at least fantasize, about becoming a mother, I don’t think many young men would describe having a child as a life goal, or a major fulfillment (though it may become that, later). Women frequently come into therapy to deal with their unfulfilled desperation to have a child, or their guilt, loss and even shame about not having had one, but men most often seek help to talk about their ambivalence about having a child, or their fears that they won’t be able to ‘get into’ the whole parenting thing, if they do have one. While women tend to see babies as adorable and endearing, men frequently see them as, well . . . boring.

So then, what exactly is fathering, anyway, other than evidence of (uh oh!) unprotected sex?

I take parenting very seriously. When my wife’s out with her friends, I always try and check on the kid before my second gin and tonic.

— A former patient

Well, the good news for prospective fathers is that the bar has not been set very high. If you can bring in a few bucks pretty steadily, avoid hitting anyone, show up for parent-teacher nights, recitals and graduations, take a few ‘shifts’ at night, drive little people around town every so often, and remember birthdays, you’re probably in good shape. And if you’re actually willing to put in the time to form any sort of real relationship with your kids, well you’re a champ. Don’t panic: I don’t mean drop everything and give up your whole life to ‘bond’ with anyone – just be nice, try to show interest in things, teach people to shave, tell people they’re beautiful.

See – that isn’t so hard, is it?

Oh, and if, like me, you do actually find yourself getting involved ‘for real’ and thinking your kids are wonderful, don’t fight it:  you’re in for the ride of a lifetime! No, it’s not the same as winning your fantasy football league, or getting that big promotion, or making partner, or sinking that two-footer to take twenty-five bucks off that insufferable, gloating neighbor of yours: it’s better.

Look, when most men have a kid, they want to go around passing out cigars, proud that they continued the ‘line’ of Smiths, or Johnsons, or Abromowitzes. It’s like, “Look at me – the stud,” akin to strutting out of a board meeting and announcing to all and sundry, “Dude – I killed in there!”

And then, for the next eighteen years, comes the actual raising of the ‘line,’ and dude, that’s not quite so sexy and studly. You don’t swagger into the office and say, “Whoa, I rock! Three diaper changes last night, and I didn’t smear shit all over myself even once!” And you don’t get high-fives all-around for spending the day driving a station wagon full of writhing little people to a soccer game, a t-ball practice and Gymboree, without losing anyone.

But you do get something else – something that sinks in deeper, and lasts longer, than a momentary flush of manly pride. It’s the realization that, much to your surprise, you actually have the chance to influence an actual person’s actual life. No, not just mindlessly spreading your seed and ‘continuing your line,’ but maybe helping create a better ‘line’ for your kids, and doing a good job, not at work, but at home – the job of giving a little person a decent start in life, and taking pride in them, not yourself.

Now I don’t mean to imply that you’ll become a saint, or that you’ll take boundless joy in missing that Giants game on TV, in order to cart Junior around the world all weekend. No, you’ll still want to do your own stuff, and maybe sometimes resent the hell out of your rug rats for stealing what’s left of your youth, but for every withdrawal of time and energy, there’s a deposit made, that’s even bigger: the knowledge, and satisfaction, that you’re participating in something that’s bigger than yourself, something that’s even (gasp!) more important than the Giants game, that somebody needs you, and that, dammit, you’re coming through for them. And all this is something that’s really hard to explain to a guy who hasn’t had children, or is terrified by the thought of what having children will ‘do’ to his life.

Because you can’t put into words what it’s like to sit there in the stands when your son comes up to bat in a Little League game, and, with tears in your eyes, say to yourself, “That’s my boy!” Or to sit there and watch your daughter, who was scared out of her wits the night before, stand up there and belt out her lines in the school play, and think, “You go, girl!’ Is it too crazy to say it’s almost a religious experience, a spiritual one? I don’t know – maybe. But it’s not far off. Because isn’t religion all about seeing that we’re bigger than just individual blobs of protoplasm, that there are things beyond us, that we’re a part of something much bigger than being John Doe? Well, having kids takes you to those places, those spiritual spaces, beyond yourself.

Yes, I know that most men (including myself) don’t ‘get it’ until they have their own kids: before that, you hear guys talking about their children, and you nod at all the right times, but honestly, it’s like, “Yeah, whatever.” You watch your girlfriend get all excited about her best friend’s baby shower, and honestly, all you’re thinking is, “Please, god, don’t let her come home in a lather about having a baby.” It’s not that you don’t understand, in some abstract mental universe in the back of your mind, what all the hullabaloo is about – it’s just that it doesn’t really hit home.

And then your wife or girlfriend gets pregnant (planned, or not) and you decide to have the baby. And you think, “Yeah, cool – I can handle this,” but it’s still just an abstraction. And you deal with her food cravings, and it’s cute that she wants lobster bisque in the middle of the night, and gets sick to her stomach when there’s a Frito in the room – but it’s all an abstraction. And you feel her stomach when the baby’s kicking, but honest to god, you’re really just kind of humoring her, because it’s not ‘real’ to you, other than the late-night dread about your lost life, which of course you can’t share with that lady with the big belly lying next to you, that brave girl who’s willing to go through all this to bring a new life into the world – a life that is connected to her, not you.

And then the big day arrives. She says, “This is it,” and you race her to the hospital, more worried, in the back of your mind, about something ‘happening’ to her, than the baby itself. And you stand there, dutifully, in your mask and gown, or you sit there in the waiting room, and you act like you’re participating, thinking, this is it – the end of the pickles and the lobster, the end of the  backaches and the swollen feet, the end of the emotional jags and the guilt-trips about not letting her have a baby – but it’s still not about the kid, not really. And if you’re thinking anything, you’re thinking, “Oh god – just let her live! I don’t want to lose her!” and you’re so darn proud of her, for going through all of this for you, for us.

And then it happens: the baby pops out, or is cut out, or is pulled out, but somehow, it gets out of there – that zone that, a long time ago, used to be yours – and you’re so relieved, and proud, that she made it through – that your girl made it through all the way. And it’s still about her, that brave lady who has done this amazing thing, for you, for us.

And then your attention finally shifts to ‘it’ – a baby girl. And that’s when it hits you: Oh My God, it’s a baby! It’s our baby! It’s my baby! I’m a father, and I have a baby! An honest-to-god, real-life baby of our own!

And in that instant, your life is changed, forever.

How? Well, it’s hard to explain, if you haven’t ‘been there,’ but I’ll try. In that instant, you find, or rather you experience, bodily, that you are connected – to all of humanity since time immemorial, to the history of life, to everyone before you. And you are now part of the great ‘fraternity’ of life, too – the club of people who have had children. You are now an initiate into the great mystery of life: like a retired attorney is ‘of counsel,’ you are now ‘of humanity,’ a member in full standing of the chain of human events. You find your eyes filling with tears, and all you can think is, “Oh my god, oh my god, oh my god.”

In the movie Resurrection, Ellen Burstyn plays a woman who, as a result of a near-fatal accident, develops spiritual powers. At one point, she goes ‘back to the farm’ where her father – a hard, flinty man – is dying. He doesn’t give an inch, emotionally, until just as he is dying, when he begins to experience his ‘passing,’ and he suddenly breaks down and sobs, “The light . . . oh, my.” Well, a baby is like that. I have friends who say their first acid trip was like that, back in the Sixties – that it changed everything, from then on. I wouldn’t know – my only ‘trip’ ended with a desperation to come back to normal life, and a bad neck-ache for the next week.

But your concept of being a father, at the moment you see that baby girl, changes forever. It’s not what you thought, anymore: not just a series of obligations, or that you have to share your wife, or getting no sleep for the next two years, or giving up your basketball games on Saturday. Sure, it might ‘mean’ those things, technically, but it’s suddenly so much more: it’s that the baby is part of YOU, part of US, that you WANT to do things for her, that you identify with her. It’s that what happens to her, happens to YOU. It’s that how you act, now affects HER.

I didn’t have to go to Vietnam –  my bad back spared me that particular honor. So I’ll never know how I would have acted ‘under fire.’ But I wondered about it. And I think most boys think about that at some point in their lives, seeing war movies, playing video games, listening to older guys talk about their time in the ‘service.’

But I do know this: when I caught sight of my son Brett, at age three, just as he ran headlong into the surf at Sea Ranch, on a stretch of beach that was marked, “Dangerous riptides,” I ran for all I was worth and jumped in. Now mind you, I don’t know how to swim, don’t like the water, don’t even like hot tubs. But all that didn’t matter: I ran like a man possessed, jumped in the water and paddled and kicked for dear life. I could see him up ahead of me, tumbling around and around in the undertow, tossed up and then sucked down, again and again. I prayed, “Please, God, if you’re there: please help me – not for me, but for him!” It didn’t matter that I didn’t know how to swim, that I was half-drowning, myself. I was like a crazy man. All I could think was, “My boy is in trouble! I’ve got to save him – got to!” Finally, I reached him, and slung him on my back, trying to keep his head above the surging waters. I staggered, gasping for air, pushing for all I was worth against the weight of the surge that was trying to pull us backwards toward the open sea.

Finally, I was able to drop down on all fours, and with him on my back, crawl laboriously forward towards the shore, rocks and sand grinding into my knees with every move.

At last, we made it, me and my boy, my Brett who was part of me – the best part. We lay there panting for a few minutes, then he, being Brett, got up and dashed off to his next adventure, with a little glance backward that said, “My Daddy!” And in that moment, I knew I would have done just fine in Vietnam, and much more than that, that in saving my boy, I had become more of a man. I was part of the earth in a different way, part of the human race in a deeper way.

I don’t know if there’s such a thing as a God who listens to the prayers of desperate fathers, but in that moment, as I watched my boy race away, I felt that if there is a God, it’s somehow all tied up with love and devotion – because being a father forces you to get your mind off of yourself and look beyond you, beyond all of us, and be a part of something big, something that has no end.

I stood up and brushed myself off. I saw the boys up on the bluff, kicking a sparkly soccer ball back and forth, and set off to join them – so thankful, in a new and deeper way, for the grace of being a father.

And then, suddenly, like one of those big breakers, it hit me: all along, they were raising me!

I couldn’t get the smile off my face all afternoon.

Fatherhood: it’s no joke.









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

How Psychotherapy Ruined America









See? I am capable of writing, catchy, ‘marketing’ titles, as all the “How To Grow Your Blog” people keep telling me to do! Next time, I may write about Ancient Secrets Of Reverse-Aging, followed by Losing Weight Without Diet Or Exercise, and maybe How To Date Without Leaving Your Mother’s Basement – am I on the right track here?

Well, all marketing aside, the truth is, the title of today’s blog is unfortunately not just a come-on. I’ve wanted to write about this for a long time, but hesitated because, let’s face it, therapy has been under attack for a long time now, both from within and from without the profession, and I didn’t want to be the one to put yet another spear in its side. So permit me to just pen a quick anticipatory defense of therapy, then we’ll move on to our target for tonight:

Therapy is the reason I’m even alive and writing this. Without years of at least halfway-decent therapy, I’d either be living under a bridge somewhere, or long gone from this mortal coil. And practicing psychotherapy has also enabled me to have a functional role in society, doing what I’m most suited for, and I think I can say without undue horn-blowing that I have been responsible for saving, or improving, many, many lives over the years I have been in practice. I write about therapy, I love being a therapist, and I’d like to say a public and deeply-felt thank you to Sigmund, Carl and all the rest of the gang who made the whole thing possible. Okay, all together now:

Every session’s sacred, every session’s great – if a session’s wasted, Freud gets quite irate. 

Alright, now that that’s out of the way, I do have a few items on the negative side of the ledger. Psychotherapy is ultimately about the Self: claiming the Self, reclaiming the Self, rehabilitating the Self, finding the Self, enabling the Self. And that’s fine – the ‘standard’ therapy patient is someone who, for whatever reason, has not had the opportunity to establish a strong, secure, delineated sense of Self, the lack of which results in low self-esteem, confusion, insecurities, vagueness about life purpose, unacknowledged feelings, difficulty with boundaries and limit-setting, and a host of other problems. And psychotherapy is tailor-made for those people: that type of person, in the hands of a competent, dedicated therapist, stands a very good chance of finding their way to a life with more meaning, satisfaction and purpose.

And in doing therapy with this kind of person, there are certain basic principles that inform and guide the work, either explicitly or tacitly. These have never been stated openly, at least in lay terms, but I think this would be a fair listing of some of them:

Getting in touch with your OWN feelings is a good thing, and letting your feelings be your guide in life is an even better thing.

If something doesn’t work for you, you should probably not do it.

Your tendency to subsume your own experiences and needs to those of others has caused you problems: we are working to bring your experience to the fore and to help you feel that your perceptions and needs are at least the equal of everyone else’s.

If and when you stop ‘taking care’ of other people and start getting your own needs met, you will not only feel more fulfilled, but ultimately be more available, in a more real way, to attend to the needs of others without sacrificing yourself emotionally.

Okay, I could go on and on, but I think you get the basic idea: for people who have been minimized, marginalized and squashed (by others, and ultimately, by themselves), it is necessary (as an emotional ‘corrective’) to bring their own experience to the forefront, and to honor it above all.

In a crude form, you could express the task thusly:

First YOU – then everyone else.

As I said above, this goal is only an emotional corrective to having stifled their own experience before this, much the same way that Affirmative Action is a (hopefully temporary) societal corrective that exists in order to try and counterbalance forces that were out of balance before. A pendulum that is ‘out of whack’ needs to swing back ‘too far’ the other way before it can gradually swing back to the mid-point. For example, we all recognize and accept that a teenager has to ‘over-correct’ in the direction of rebellion, in order to throw off the strictures of childhood, until ultimately coming back to the center-point of normal adulthood (we hope!).

So far so good. But here’s the thing: these corrective principles, which were developed in a particular context (psychotherapy) to help a particular kind of person, don’t stay put. They leak out into the mainstream willy-nilly, out of context, and get appropriated wholesale, and applied across-the-board, by all.

And in my generation, that admittedly did sometimes take the form of “Turn on, tune in, and drop out,” or “Do your own thing.” The older generation saw this as an abnegation of responsibility to others, a rejection of what they had worked (and fought) so hard to preserve, and a justification of self-absorbed ‘navel-gazing.’

Here’s one small instance of what I’m saying: I started my career in the Seventies, working in alcoholism rehab. I worked with people struggling with substance abuse, but naturally my help was also needed by the ‘significant others’ of these addicts and alcoholics. You’ve probably wondered to yourself at times – why would someone stay with an abusive alcoholic or addict? Who are these people who would sign up for continued pain, disappointment and suffering that is virtually guaranteed? Well, the answer is complicated, but many of these people are the kind I was describing earlier: people who have a hard time knowing what they want, have a hard time asking for what they need, and on some level, for them it’s more comfortable, and more familiar, to focus on the needs of someone else, to continually ‘monitor’ someone else, even if it means living on a roller coaster of fear and dread.

For these people, the Al Anon program was developed. With group support and a spiritual program, it helps people focus on (and meet) their own needs, and learn to balance themselves inside, rather than looking to the addict for a stability that is not there, and therefore focusing on and resenting the addict. And a few years later, along came Melody Beattie and others, who developed the concept of Codependence (see Codependent No More, for example). This gave a name (yay: we all love a name!) to this phenomenon I described earlier, i.e. that of being a ‘good person’ by orbiting around another person’s life and (seemingly) not having many needs oneself. I won’t go into the concept any further, because I’m just using it as an example, but like I say, this concept ‘leaked’ out into mainstream society and has been picked up by anyone and everyone.

So now, I frequently hear extremely self-centered people, when asked to do something for a friend, a partner, or even a dying parent, say,

“The hell with that: I’m not going to ‘co’ her anymore! What about me?”

The concept of codependence, a perfectly useful one in the context in which it was developed, has been lifted, stolen and appropriated for constant misuse by narcissistic, self-absorbed people in all manner of situations.

Likewise, the whole idea of Self (as developed in, yes, psychotherapy), and the need for under-Selfed people to ‘correct’ by putting themselves first sometimes, has been swallowed whole by a society that is increasingly self-absorbed. I am not proud to acknowledge that it was my ‘generation’ that was first called the Me Generation – and with some justification.

But you have to understand, at that point (say, the Sixties), it was a necessary corrective to the so-called Greatest Generation before us, who, by necessity in most cases, navigated the Depression and the World War II era by emphasizing self-sacrifice, non-expression of feelings, self-sufficiency, and modesty in all areas of life. Ask a World War II Medal of Honor winner about his feats, and he will invariably say,

“I just did my job. The real heroes are buried in Normandy (or Iwo Jima).”

And that modesty, that self-deprecation, is a very special quality – one I admire with all my heart. But, ‘we’ – i.e. my generation, and all the people who entered psychotherapy beginning in the Sixties – felt we needed something more than being the father who worked his ass off, then looked down at his shoes and refused to talk about anything real, or the mother who tirelessly slaved for her family, without an expressed life of her own.

We needed more out of our parents than that, and more to look forward to than a life of duty and self-sacrifice, and this is where therapy was of tremendous help – in claiming these needs without guilt or shame, and in providing a safe framework for finding a more meaningful, richer life for ourselves.

But as helpful and as transformative as therapy was, it was inevitably hijacked by society. By the Sixties and Seventies, you started hearing therapy talk everywhere, like “guilt trip,” “ahh – she’s got a complex about it,” “that’s just your family shit,” and “you’re so paranoid.” And today, people throw around terms like bipolar, transference, regression, personality disorder and borderline, without a thought. They use them for name-calling, for labeling people, and for excusing all kinds of inexcusable behavior.

So, I wanted to write this, in public, as a therapist, to say in all honesty that sometimes, when someone says, “Therapy just teaches people to be selfish,” or “Since you got into therapy, it’s all about you,” well, sometimes they’re right.

And sometimes, when people misuse therapy talk and therapy concepts to justify meanness or obliviousness to the needs of others, well, it makes me feel bad, and I do feel that therapists have had some part in creating a country of self-absorbed people.

But you have to understand that therapy, and therapy concepts, were necessary as a corrective to a generation that was silent, undemonstrative and sometimes too self-sacrificing. And therapy was – and is – necessary, now, for people who feel disenfranchised, lost or unheard. It’s a damn shame that the therapy world was hijacked, distorted, oversimplified and misused for the wrong purposes, but I’m afraid that that’s the fate of every philosophy or practice that comes down the pike, from democracy to existentialism to Christianity.

All we, as therapists, can do is honor the guts and vision of those who developed these amazing concepts, and try to stay true to their use in the right context and for the right people, because self-absorption and the justification of selfishness is never the ultimate outcome of appropriate psychotherapy.

My experience with people has been that, though their ‘pendulum’ might swing towards selfishness as they work through their problems, it always swings back as they consolidate a true sense of themselves, and ultimately leads to a generosity of spirit and a sharing of the human experience that would have been impossible without the crucible of psychotherapy.



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

The Marquis de Carolina










“They say Caesar was born in a caul. Well, I was born in a Chevy, but it don’t seem like that count for nothin’. He get ‘Hail, Caesar!’ and all I ever get is ‘Hail no!'”

Thus began my association with Curtiss M. Jones, the self-styled Marquis de Carolina, drug dealer, man about town, “love machine,” and pimp extraordinaire. He once described himself to me as “da pimp de la pimp,” and while his “wordiage” (another of his terms) may have run slightly afoul of the style guide, he got full marks for originality, and his meaning, as always, was crystal clear.

Curtiss (“don’t forget that last S!”) was a sometime outpatient in the North Carolina V.A. Hospital I worked at one summer during my training days. He was a Vietnam vet who had suffered a ‘service-connected disability’ during his tour of duty. I still don’t really know whether his manic-depression (now gussied up as ‘bipolar disorder’) was really brought on by what he went through in Nam – he used to say it was, or it wasn’t, depending on his mood and how he felt about me at the moment – but the fact is, when he went away to serve his country, he had a 3.75 grade point average at his inner-city school (he once showed me the report cards, which he’d preserved carefully, like holy relics, in a sealed plastic bag), and was aiming for college, and when he came back, he was a changed man.

This may sound like a crackpot theory, so feel free to toss it out if it doesn’t make sense to you, but oftentimes, when people suffer from psychiatric conditions (bipolar, oppositional-defiant, Tourette’s, even ADHD) that temporarily hijack their ‘regular’ mind or behavior to a raw and more coarsened place, their day-to-day personalities eventually start drifting in the direction of their ‘altered’ states.

Maybe I can explain it this way: let’s say you’re an actor, a person who is normally quiet and unassuming, even reserved, and you win a role in a play, as a rowdy, roistering truck driver. You play this role over and over again, until finally, you find yourself beginning to incorporate aspects of this truck driver into your ‘civilian’ behavior. Your girlfriend says, “Did you just call me ‘Babe’?” Your friends say, “What’s with the Brooklyn accent?” You’re calling AT&T to discuss your bill, and you hear yourself shouting, “I wanna talk to your boss’ boss – now!” It’s not that you’re becoming someone else, really, it’s more that playing that role has pulled out of you parts of yourself that might otherwise have remained relatively dormant.

Well, I think this happens with state-shifting emotional conditions, too. Even if you’re normally a quiet guy, once you’ve stayed up all night long three days in a row, in a hypomanic state, calling everyone you know, yelling at them for hours on end about your plans to save the world – well, it changes you. Once you’ve ‘gone off’ and shouted at the school principal that she’s a “crazy, stupid bitch,” you change. Once you’ve punched out a co-worker because you thought he was listening to your thoughts – you change.

Yes, you revert to your regular self between episodes, but it’s never the same: there’s something lost, some innocence or inhibition, some buy-in to society’s norms, that can never be completely restored to mint condition – a certain figurative loss of virginity, that can never be put to rights again.

And this is what I think happened to Curtiss, during and then after Vietnam. In his hypomanic states, he ‘became’ a certain kind of character – loud, brash, flamboyant, maybe a caricature of people he had known and seen in the ghetto where he was raised – and he gradually became that persona, even in his normal state.

And once he became the Love Machine, The Marquis de Carolina, I think he stayed there because it gave him a kind of shield to put up against the pain of what he had lost: the bright young man on the way up and out of the ghetto, the sensitive, unsure man who had no concept of how to carry off who he really was, into adult life.

And beyond a certain point, it was too late to go back, too late to be that kid anymore, too late to do anything but go forward as the ‘new’ Curtiss, the pimp de la pimp.

We would talk in the little, threadbare office that I – as the punk kid trainee – was allowed to use. He would give me that pimp-ass jive, and I would try to turn things around in a more therapeutic direction. I usually failed. But I always liked him, and I think he at least got a kick out of me.

Well, one day, during free time in the big day room, while the other guys were watching TV, Curtiss grabbed a cup of coffee and came over to knock on my door while I was doing paperwork in my cubbyhole.

“Hey, little chief – what’s the haps?”

“Hey, Curtiss – nothin’ much. Pull up a chair.”

He folded his big, lanky frame down into one of the straight-back, utilitarian chairs that were ubiquitous at V.A. hospitals, and scooted it over to me. “Whatcha scrabblin’ down there, little chief?”

“Oh, just notes. Ideas.”

He cracked open his Zippo and fired up a Parliament. Being a Southern gentleman, of course he offered me one, too, knowing I’d refuse it – then took a deep drag on it and arranged his coffee and beanbag ashtray just so. (God, I miss people smoking, even though I never had the habit myself: there was a certain gentility, a languorous ritual to it all, a kind of ‘styling’ to how you lit up, how you held it, how – and when – you knocked off the ash, even how you stubbed it out, that we don’t have anymore, to our great loss, in my opinion.)

Well, anyway, as I say, once Curtiss ‘set up shop,’ we began. “So, exactly what’s the deal with y’all’s bein’ here, anyways?” (The “y’all” referring to me and my fellow trainee.)

“Oh, it’s just a chance to make a little money, and get some experience over the summer, between classes.”

(Flick of ash, another long draw) “So, what kind of classes you talkin’ ’bout? Figurin’-people-out classes, or how-to-talk-to-people classes, how-to-tell-people-they’re-crazy classes, or what?” He gave one of those wonderful Bill Russell cackles, if you happen to know who Bill Russell is, and if you don’t, you’ll just have to make do with Samuel L. Jackson.

“Well, so far there’s mostly a lot of learning about the history of psychology, a lot of memorizing old guys who were important, a lot of terminology, famous experiments – that kind of thing.”

“What for you need to know all that shit, little chief? That’s not even about crazy people.”

I nodded wearily. “You got that right. But you see, we’re trying to get Ph.D.’s, and a Ph.D. is a research degree: that means you got to know the history of psychology as the science of human behavior – not just all about crazy people.”

He nodded back, skeptically. “So when do the crazy folk come in?”

“Later – next year, after we pass this big test about all the stuff I just told you about.”

“Sh-ee-it, boss.” (Understand – in the South, ‘shit’ is a three-syllable word.) “You got to be kiddin’ me: you mean they put you through all that, before you can even get to the crazy people?” He coolly got a new Parliament going from the glowing end of the old one – like I say, a lost and most wonderful art.

“Yep, that’s what I’m saying.”

Curtiss shook his Afro back and forth sadly. “You got it baaaad, brother.” He thought for a moment. “So, y’all ain’t yet even learned how to be with crazy folk, have you?”

I smiled. “Well, technically, I guess you could say that – yeah. Officially, I’m just sort of faking it until I learn the real deal.” I took a swig of my Coke, and lowered my voice, confidentially. “Now, I’m counting on you to tell me when I fake bad, okay?”

He gave one of his rich, raspy, Parliament laughing-coughs. “Sh-ee-it, little chief – you fake good, for a white boy! Now, you take some of them staffs been around here for years, supposed to know all they is to know about crazy folks: god damn it to hell, they talk to you, it sound like a robot:

‘Hell-lo, Mis-ter Jones. Would you like to share with the group how you’re feel-ling to-day?’ 

We both laughed out loud at his spot-on impression of one of the very uptight staff psychologists.

Then he went on. “And here, you never even studied crazies, and you talk like a human bein’, and like I’m a human bein’.” He paused, thoughtfully. “Shit, little chief, all you been doing is studying, and after this, y’all just goin’ back for more studying.” He rubbed his chin. “You know what, I should set you up with one of my girls – show you some fun, show you what life really about. My treat – what you say?”

I could see he meant it – and meant it as a genuine gift. I was flattered. “No, Curtiss – that wouldn’t work. I’m married, you know.”

He cocked his head, frowning protectively. “She cute?”

I nodded, “Yeah – she cute, she real cute.”

He cocked his head again. “She white?”

I laughed, “Yeah – she’s Hungarian.”

His mouth flew open. “Son of a bee-yitch! I was with a Hungarian gal one night. Heard her on the phone with her Mama once: they talk crazy talk! Couldn’t make out a word of what she sayin’, and I know some Spanish, some Gook, even a little Frenchie.”

“Did you take French in school?” (Yes, my clumsy attempt to shift to a ‘therapy’ mode, but don’t judge me: I hadn’t studied crazies yet, you know!)

His eyes softened and turned thoughtful, as he fired up another Parly and toyed with his lighter. “Long time ago, chief. That was a looong time ago.”

“Like another lifetime, you mean?”

“Like another person’s lifetime, I mean.”

“It must be weird to feel that disconnected from your old life, and your old identity.”

He took another deep drag, contemplating the holes in the acoustic ceiling tiles like a sailor searching the stars for his bearings. “It used to. Now – I just . . .”

“Just what?”

“I stay away.”

“You mean, from the memories? The way things used to be?”

“From the whole thing.” His right foot started beating fast time. “I got my girls, I got my V.A. check, I got this place, I got a place to live, I got every fuckin’ thing I need.” His voice was suddenly defiant, steely.

He was smoking fast now – hard, his zippered Italian boot pounding time on the dingy linoleum of my cubbyhole. I could feel his anger flare, and I knew he’d hit a wall – we’d hit a wall. I scrambled for a way to ‘reserve’ the emotional space we’d just shared, keep it safe and available for future reference, like those report cards in their plastic bag.

I watched him for signs, but his face was a mask now. And a shield like that can’t just be peeled back like Caesar’s caul.

He suddenly turned to me, that big, jive “Marquis de Carolina” smile pasted back on the mask, and said, “That’s it, alright, boy – we gotta get you laid, before you go on back to where you came from, and all that studyin’.” He pulled out his “little black book” and read, as he flipped the pages, licking his fingers studiously between flips. “Sophia? Naw – too black. Maria? No – too ugly. Carrie? Yeah – she the one for you, little chief. Smart, and pretty – and she likes to talk a lot, like you.”

He looked up at me. What we did before, what he let me see, was gone baby, gone. “What do you say to Carrie, boy?” My lack of enthusiasm pained him. “I am doo-in’ you a favor here, boy! You need some action, before they turn you into a sci-en-tiste, little chief.”

I felt sad. I felt like crying. I was only beginning to learn myself as an ‘instrument,’ learn myself as a young therapist: I had the capacity to feel other people’s feelings directly, especially if they didn’t want them. My body collected unwanted feelings like some people collect stray cats. Of course I didn’t know this then – I just felt sad, guessing that maybe it was because I had failed in helping him. He was right: I hadn’t yet studied being with ‘crazy folk,’ and had no idea, really, what to do even with my own ‘stuff.’ I was awash in his rejected emotions, and in my own confusion about what had just happened, with no way to right the foundering ship.

I must have been staring straight ahead like a dope as I felt all this, because suddenly I heard his voice saying, “Don’t feel bad, little chief. For a guy who ain’t studied crazy folks, you do good – real good. I just know, some day, you’re gonna be a big chief.” His eyes went to the ceiling again, his hands fishing his shirt pocket for his Parlies. He paused, licking his lips, then cleared his throat. “See – it’s, uh, it’s just that, for me, it’s too late, little chief. You got here too late, is all.”

I’m pretty sure I had tears in my eyes, and I think I heaved one of those stifled sighing-sob things, the kind that’s not crying, but not not, either. His eyes were glistening, too as he flicked them at me. And in that moment, we knew each other. I saw things in him that he didn’t want to know, and he saw things in me that I didn’t even know I had, yet. It was deep – something beyond patient-therapist, beyond black and white, beyond V.A. hospitals. An instant in time, but forever.

He turned to leave, the big smile back, and gave me a little half-salute. “Later, big chief; the Marquis, he got to go.”

I lifted my Coke in his direction. “Hail to the Marquis!”

I thought about the Marquis and me all the rest of that afternoon – the magic of it, the specialness of that one moment we’d had – and I wanted more. I knew I was gifted – to feel things, to know people, to see who they really were, but I also knew that my gifts were raw and undeveloped. I had a lot more work to do, to make that magic happen again and again, but moments like this made me want to hurry up so that I wouldn’t be “too late” the next time.

After work, I locked up and walked to the parking lot slowly, through the heat and humidity of the North Carolina summer. I got into my car and headed for the tunnel and home. On the way, I watched the people in the cars around me, looking ordinary and normal. But I knew better now. What were their secrets? What were their shields? Was I ever really going to be good enough to be a big chief?

As the rush-hour traffic came to a halt, my eyes fastened on the old, beat-up green car in front of me. It had that familiar ‘bow-tie’ logo on it, the letters spelling out ‘Chevrolet.’

I smiled, remembering the Marquis’ story about his birth, and thought to myself, sometimes even a beat-up old Chevy can be a pretty classy ride.















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

Light Unto My Lamp










The Lamplighter is one of Robert Louis Stevenson’s most famous, and most endearing, poems, from his classic, A Child’s Garden of Verses. Stevenson was a sickly child, ‘banished’ to his room, alone, for long stretches of time, away from the society of his peers.

But, here – read it first, and then we’ll talk some more:

                         The Lamplighter

My tea is nearly ready and the sun has left the sky;

It’s time to take the window to see Leerie going by;

For every night at teatime and before you take your seat,

With lantern and with ladder he comes posting up the street.

Now Tom would be a driver and Maria go to sea,

And my papa’s a banker and as rich as he can be;

But I, when I am stronger and can choose what I’m to do,

O Leerie, I’ll go round at night and light the lamps with you!

For we are very lucky, with a lamp before the door,

And Leerie stops to light it as he lights so many more;

And O! before you hurry by with ladder and with light;

O Leerie, see a little child and nod to him to-night!

Lovely, isn’t it? And haunting. You can just picture the young Stevenson, poet and literateur-to-be, the scope of his world reduced to his bedroom and the street outside his window, the endless hours marked by the regular cadence of activity on the street, the coming of darkness, and then, finally, Leerie’s nightly rounds.

Mary Shelley gave her famous novel, Frankenstein, the subtitle A Modern Prometheus, in honor of the godlike miracle of vivification that Dr. Frankenstein performed with lightning. But for the small Stevenson, Leerie must have seemed a modern Prometheus as well, bringing flame, as he did, to the darkened streets of Edinburgh on a nightly basis, magically replacing the foggy murk outside his bedroom window with the warm glow of the flickering streetlight.

And little Robert lay there wondering, probably, if he would ever again leave his room, and maybe, too, about those things a child should never have to wonder about: permanent infirmity, continued isolation, and possibly, death.

What do you do in that kind of situation? You make, by necessity, a ‘world’ of your small world. You watch, and wait, for the rhythmic, the predictable happenings that mark the tedious hours, happenings that assume enormous importance. So much importance that even a (hoped-for) momentary nod from a lamplighter becomes a signal daily event, a blessed pinprick of light in the vast darkness of a child’s loneliness.

Stevenson even immortalized his sickroom ‘world’ in this poem:

When I was sick and lay a-bed,

I had two pillows at my head,

And all my toys beside me lay,

To keep me happy all the day.

And sometimes for an hour or so

I watched my leaden soldiers go,

With different uniforms and drills,

Among the bed-clothes, through the hills;

And sometimes sent my ships in fleets

All up and down among the sheets;

Or brought my trees and houses out,

And planted cities all about.

I was the giant great and still

That sits upon the pillow-hill,

And sees before him, dale and plain,

The pleasant land of counterpane.

Is this a boy who is content to lie in bed, a passive observer of life? Is it even possible to read this verse and miss the longing embodied in the references to the active, daring life of soldiers and sailors, or the poignant irony of Stevenson, in enforced bed rest, calling himself “the giant”?

Growing up, attending various schools, he was eager, desperate, to push his way out of the narrow confines of not only the sickbed, but the boy’s world of Edinburgh that circumscribed his life. He wanted ‘out,’ but then again, he also still prized, and needed, the “pleasant land of counterpane” where he had once lived. Like a prisoner of war who, once released, finds the ‘real world’ too fast, too loud, too demanding, too changed, Robert still clung to the old, the small, the familiar.

But is it possible to hold on to the old, when the world is changing so fast?

Stevenson certainly hoped to: here is an excerpt from his essay, A Plea For Gas Lamps, which he wrote years later, clearly influenced by his continued affection for the fast-fading age of gas lamps. In this passage, he compares the ‘new’ electric lights with his beloved gas:

The word ELECTRICITY now sounds the note of danger. Such a light as this should shine only on murders and public crime, or along the corridors of lunatic asylums, a horror to heighten horror. To look at it only once is to fall in love with gas, which gives a warm domestic radiance fit to eat by. Mankind, you might have thought, might have remained content with what Prometheus stole for them and not gone fishing the profound heaven with kites to catch and domesticate the wildfire of the storm . . . but where soft joys prevail, where people are convoked to pleasure and the philosopher looks on smiling and silent, where love and laughter and deifying wine abound, there, at least, let the old, mild lustre shine upon the ways of man.

So young Robert found ways to prize and treasure his ‘small world,’ but at the same time, I think The Lamplighter shows you that, for Stevenson, watching wasn’t enough: He wanted the power of the lamplighter, too! He wanted to make a difference. He, too, wanted to ‘bring the light.’

But how was he supposed to bridge the huge gap between being a sickly child, confined to his bed, and becoming a force in the adult world, like Leerie?

He wanted to be somebody!

And not just any somebody: his own somebody!

He didn’t ‘just’ want to go into the family business, as he was expected to, although, ironically enough, the family business was ‘bringing the light’: Robert’s father, and other close relatives, were noted lighthouse designers. No, Robert, though limited and betrayed by his frail body, imagined something grander than designing lighthouses. He imagined himself bestriding the ‘big world’ in seven-league boots, running away from his real life as a frail boy in his cloistered bedroom.

It seems clear that young Robert felt the soul of an adventurer stirring within himself, but also that he knew, from early on, that he didn’t have the body of one: an identity out of sync with itself, two warring camps, each insisting on its own way.

But how does one resolve this internal tug of war – something that is far more common than you might imagine? Well, I could give lots of examples from my practice, but let’s use Stevenson as an example. For Robert, an artistic type with a literary bent, one of the ways is to work on the issues by using fantasy.

Is this the internal tug of war that haunted Stevenson? Forced into a small world by childhood illness, trying to make something worthwhile, something memorable, something meaningful, out of his limited resources? Then, as an adult, expanding his world hugely, almost ‘counter-phobically,’ by taking trips – no, not trips: voyages, that were certainly uncharacteristic of people of his time, traveling the biggest of the Big World, with seven-league boots. But was this far-flung travel, this enormous striding of the bigness of the world, the ‘corrective’ that he sought, to his childhood confinement? And finally, in writing of his travels, did he become a symbolic Leerie, bringing that larger, far-flung world to ‘light’ for his readers, illuminating them with tales of his voyages and adventures?

Hear his ‘protest’ of following in the family footsteps, in this poem:

Say not of me that weakly I declined
The labours of my sires, and fled the sea,
The towers we founded and the lamps we lit,
To play at home with paper like a child.

Does the phrase, “like a child” jump out at you, like it does me?

I hear, in this poem,

“I’m no f________child! I’m not weak!”

He wants us to know that, although he didn’t do the ‘right thing’ and follow his father in the lighthouse business, he is not a nothing, not a failure.

There was an enormous displacement, and discontinuity, in scope, that his life spanned: shut-in, to world-wide traveler. Was this the split, the disjunction, that so haunted him, the basis of Dr. Jekyll and Mr. Hyde? That enormous gap between the small world and the big world, that lay inside him, yawning and unbridgeable? Did he wish that it were possible to bridge that gap by taking a magic potion?

Did he say to himself, as many, many of my patients have said to me,

Can’t you just knock me out and give me something, so I wake up changed?

Well, that is what Dr. Jekyll did, isn’t it? The fantasy of getting to the ‘other side’ just by taking something – kind of an alchemy by ingestion. Well, what were Stevenson’s alternatives? There was no psychotherapy, no real way that personal help from another person could bridge that gap. So what could he do? The well-known ‘Geographic Cure’ was an obvious attempt to get there. This tremendous yearning is even on display, very clearly, in his most famous writings: what is the plot of Treasure Island, after all? A young boy is basically ‘transported,’ willy-nilly, into a pirate’s life! He (as the character Jack Hawkins) goes from the Small World of an ordinary boy of those times, into the Big World of swashbuckling adventurers, from the ‘good boy’ world of young Robert Stevenson, to the ‘bad boy’ realm of a buccaneer!

But let’s go back to The Lamplighter for a moment, to the time before this child, Stevenson, lost his innocence, and when those yearnings were right out in the open, for us to see. What is he really saying in this poem? That he is lonely, clearly. That the nightly coming of the lamplighter is a boon to him, and something to hold on to, to look forward to, clearly. But there is more here: he is saying to the lamplighter, isn’t he:

Please be with me.

Please notice me.

Let me ‘apprentice’ with you, the art of lamplighting (and therefore, be my bridge to the big world)

Take me with you!

And, maybe even,

Get me out of here!

And that’s what we all want, isn’t it? A way to magically be transported (with care) to the adult world? The irony of psychotherapy is that, while most psychologically ‘healthy’ people already know, and assume, that they have to make use of other people in order to “get there from here,” most psychotherapy patients have learned, somewhere along the line, that it is THEY who are ‘deficient,’ that somehow, they just have to get it together, try harder, snap out of it, concentrate, stop fooling around, face facts, stop dreaming, get with the program, and BUCK UP!

What they don’t know is that it takes HELP from other people, to do this. That’s why they come in (reluctantly) to therapy and say, “Tell me what to do,” not “Help me.” They want explanations, shortcuts, techniques, or maybe at worst, pills, to ‘get there.’

What they don’t want is an actual relationship (ick!) with another person (eeewww!).


Because, as we all know (All together now, big breath – now hit it):

That’s WEAK!!

There now, don’t you feel better, getting it all out?

Cue the marching girls! Cue the brass band! Cue Stars and Stripes Forever! Because independence is the American Way! Not needing is the American Way! Flying solo is the American Way! Doing it on your own, by your lonesome!

And needing? Shoot – that’s just .  . . just . . . well, it’s just plain Communism! Weak-kneed, bleeding heart, sob sister, boo hoo, poor me, pity party, oh-dearie-me-I’ve-got-the-vapors Communism!

And here’s the ultimate irony: for all our jingoistic, teeth-gnashing, fire-breathing, gun-toting, saber-rattling defiance of England, the ‘Mother Country’ we broke away from; for all our proclamations, declarations and disputations, we (like all rebellious children) ended up a hell of a lot like our ‘parent’ after all, in the things that matter.

We just didn’t notice.


What is it you see all day long, from therapy patients who have ‘sworn’ to be totally different from their parents, and from patients who divorce one person, and swear they’ll never, ever, hook up with anyone ‘like that’ again?

Exactly: the rebellious son of a cantankerous, controlling father takes up a defiantly ‘alternative’ way of life, grows his hair long, wears outlandish clothes, and then proceeds to become a cantankerous, controlling ‘alternative’ man.

And the woman who will never, ever, marry a man like her short, long-haired, uninvolved alcoholic plumber ex-husband, ends up marrying a tall, short-haired, uninvolved alcoholic stock broker.

And America, the country that shouted long and loud that it wanting to be nothing – nothing at all – like its stiff-upper-lip, don’t-talk-about-your-problems, keep-it-private, act-like-everything-is-okay-even-if-it-kills-you, look-fate-in-the-eye-and-spit, don’t-let-’em-see-you-sweat ‘Mother’ England, ended up . . .

Need I go on?


So, what can we learn from the life and works of Robert Louis Stevenson, that we can put to use here, on ‘our side of the pond’? Well, it’s not very sexy, but is it too much to suggest that running away (i.e from the ‘Hyde’ parts of ourselves, and from our lives) doesn’t work? That, while we are fascinated (understandably) by Treasure Island as an adventure story, it’s not really much of a model for life? After all, we Americans have our own Treasure Island, don’t we? I mean, isn’t ‘our’ own American archetype, Huckleberry Finn, really just Treasure Island on the Mississippi?

Running away makes a compelling story line for a book, but it’s the relationships, not the geography, that make these books, and our lives, truly memorable and rewarding.

Because it’s not running away that really lights our lamps – it’s running TO.

And, when Stevenson died, in far off Samoa (“I’m NOT home in bed!”) he requested his poem, Requiem, to be engraved on his tombstone:

Under the wide and starry sky,

Dig the grave and let me lie.

Glad did I live and gladly die,

And I laid me down with a will.

This be the verse you grave for me:

Here he lies where he longed to be;

Home is the sailor, home from sea,

And the hunter home from the hill.

And what does this scream? “I’m a hunter; I’m a sailor; I traveled far and wide. I’m not a little boy, lying in bed at home: I’m a man!” It not only sounds more like an epitaph for John Wayne, it actually was recited by John Wayne in a war film, in an impromptu memorial for a lost Navy comrade. But it’s clearly what Stevenson wished for himself –  the more empowered, more uninhibited man he felt stirring inside himself, and that he wished he could embody, or at least unleash at will (paging Mr. Hyde!).

But you can’t just jump out and ‘be somebody else’ – it takes a foundation, a continuity of self, to actually be the man Stevenson envisioned himself to be. Fortunately, these days we have psychotherapy and other means of obtaining help from others, to assist us along that trail from child to adult, and from chronological adult to true adulthood. So let’s really rebel from England, and be a people that embrace not only independence but all parts of ourselves, and our fellow human beings as well.

Because while in books you can be transformed magically from a child in a sickbed to a cabin boy on a pirate ship, in real life it takes hard work and help to manifest your inner buccaneer.

So set sail on your own bold voyage, get all the help you need from the wise and the adventurous, and raise high your own Jolly Roger. Yo ho!







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

Where Are They Now?










When you’ve been a therapist as long as I have, you have legions of former patients. And you wonder about them, these people who once looked to you, to help them transit the dark night of the soul.

Patients often ask me,“What’s the hardest part of your job?” And I just know they’re thinking that the hardest part is sitting there, listening to people’s problems all day long.

Or else being ‘responsible’ for solving my patients’ problems.

Well, it’s not.

People bringing me their problems is an honor and a privilege, and I’ve always felt that way. No, the hard part isn’t listening to people’s problems, or being responsible for them: that’s just my job!

Actually, there are two ‘hardest’ parts:

One is when I’m much more ‘into’ their therapy than they are! It kind of sucks to be thinking about them all week between sessions, imagining what they’re going through, trying to make psychological connections that might help them, worrying about them, and wondering how they’re doing, and then they cancel a session, or forget, or seem totally uninterested, like they’re just going through the motions. Yes, I understand that it’s all par for the course, that their lack of interest in their own life and growth is a symptom of “what they’ve got,” and just more grist for the (therapy) mill, and that’s why I don’t resent it or feel cheated.

But is it hard?

Yes – it’s hard.

And the other ‘hardest thing’ is when patients leave. I mean, sure, I’m proud as heck when someone finishes their therapy and is launched out into the great unknown, or even when someone isn’t really finished ‘cooking’, but decides they’ve done enough ‘for now,’ and wants to try it on their own a while. But like a parent whose child leaves home, it also feels bittersweet.

In the movie Dark Passage, Humphrey Bogart plays a man who is wrongly imprisoned for life in San Quentin, for murdering his wife. He escapes and is hiding out in San Francisco, in the apartment of Lauren Bacall, a woman who is sympathetic to his situation. Finally, he decides he has to take off on his own to try and prove his innocence. But his face has been on the front page of all the newspapers.

He is riding in a cab, trying to figure out where to go to next, when the cabbie recognizes his face. When the cabbie asks him where he wants to be taken, Bogie, feeling defeated, sighs, “Might as well make it the police station.”

The kind-hearted cabbie says, “Don’t be like that – you’re doin’ alright.” Then he goes on to say he has a friend who is a plastic surgeon, who could change Bogart’s face. Bogart is skeptical, fearing that it will not only cost a fortune, but that the surgeon would then “keep after me for the rest of my life,” i.e. blackmail him.

The cabbie says, “Nah – he’s a friend of mine.”

Still skeptical, Bogart finally agrees to be taken to the back-alley office of the plastic surgeon, who, though he turns out to have been “kicked out of the medical association,” and is kind of a scary-looking old geezer, is actually a fine person, and a fine doctor, just as the cabbie had said.

He operates on Bogart, and finally, early the next morning, it’s time for Bogart to leave, his face swathed in bandages. The surgeon shakes Bogart’s hand and says, wistfully,

 The artist in me wishes I could see what a nice job I’ve done, but I never will. Goodbye, and good luck.

Bogart agrees, pays him, and leaves, forever.

Well, that’s the way it feels, most often, when a patient leaves, quits, or even just drops out of sight: the artist in me wishes I could see the results of my work, both now and in the future. But more than that, I care about them, and just want to know how things ‘turned out’. And some patients do check in occasionally and give me an update, so I’ll know how it went.

But, mostly, I never will.

And that’s hard.

Do other therapists feel this way? I don’t know – I’ve never heard another therapist talk about this, though I imagine they must wonder, too, about the lives of the many people that they were so intimately involved with, for a while.

But, me – I wonder: where are they now?

The woman whose boyfriend got her involved in a dope-smuggling ring, who had to leave him, quietly, in the middle of the night, before she got busted, but was always afraid of him tracking her down and hurting her.

The married doctor who fell in love with a Venezuelan nurse when he was in Doctors Without Borders in South America.

The race car driver who injured both knees so badly in a skiing accident, that he couldn’t even work the accelerator or brake pedals on his family car anymore.

The traveling salesman who had a normal life in the Bay Area, but was a secret cross-dresser on his frequent trips to the Midwest.

The teenage boy whom – in a secret, two-hour emergency session in the middle of the night – I talked out of killing his father.

The girl who, late at night, compulsively ate bowls and bowls of cake batter, cut her own wrists up terribly, and stole Demerol from her mother’s medicine cabinet, who went on to become a Nobel Prize-candidate professor.

The little, abused, ‘poor white trash’ girl in Tennessee who, on the Information subsection of the WISC children’s intelligence test, successfully gave all the correct answers: but they were the correct answers to the FOLLOWING questions – questions I hadn’t asked yet, questions she couldn’t possibly have seen before, or known about.

The teenage girl at a group home I once ran, whose mother had ‘pimped her out’ to her men friends, for a price.

Sure, I wonder, sometimes, about high school friends, or people I worked with at various places along the way, or old girlfriends. I wonder, but it’s not the same. You see, I wasn’t privy to their most intimate private lives, wasn’t responsible for their emotional well-being, wasn’t in charge of their ‘recovery’.

No – wondering about former acquaintances is a different kind of curiosity, more of an, “I wonder what happened to old what’s-his-name?” rather than the deep, committed feelings I have toward my former patients. No, the closest I can come to describing it is that it’s more of a parental concern: like the plastic surgeon who operated on Bogie, I not only feel a continuing sense of responsibility, but a personal ‘stake’ in the outcome – whether it’s a testament to, or a sad commentary on, my work.

But is this a sad thing? A negative thing? No – not at all: I WANT to feel I had an effect, that I made a difference, and most of all, that I tried my best, in life. That I didn’t just ‘mail it in,’ squandering my skills and just getting through time without putting the precious gifts of life and talent that I have been given, to good use.

And I feel strongly that the best way I can put my gifts to use, is to help other people learn to use, and appreciate, theirs.

There is an old song with the words,

Why was I born?

Why am I living?

What do I get?

What am I giving?

These are the questions we all should be trying to answer. Sure, maybe in the final analysis they’re “unanswerable” questions, but we must TRY. Because life shouldn’t be for just ‘getting through’ – it should be treated like a two year-old treats a Christmas present: the process of unwrapping it is just as important as what’s inside. The two year-old revels in trying to undo the ribbon, in tearing the wrapping paper apart, in opening the box. He is present with his presents, noticing the colors, the textures, the faces of his parents, the smell of the Christmas tree, the whole ‘gestalt’ of Christmas morning. Christmas should never get ‘old,’ whether you’re a parent or a child: like in the song lyrics above, it is about “What do I get?” and “What am I giving?” And those questions are about a lot more than gifts and presents; they’re about the purpose of life itself: getting and giving.

And a therapist should treat each patient like that two year-old treats a present: really ‘being there’ for the unwrapping, with senses at the ready to take in the (emotional) colors and textures. Making space for each person, each session, to be ‘new’, not standardized, not ho-hum, not predictable. If you’re sitting with your patients and feeling bored, feeling that it’s all predictable, that you’ve seen it all before, feeling unchallenged, then it’s ON YOU to shake things up, to dig deeper and find what’s new, what you didn’t know, what you haven’t seen before.

Because, if you’re really paying close attention, there’s no such thing as a predictable person, a boring person, a ho-hum person: it’s YOU who has become predictable, boring and ho-hum! Sure, you could be FEELING bored or ho-hum with someone, but then it’s up to you to use this information for the patient’s benefit, not as a way to excuse yourself from full participation, or to check out. You must ask, WHY is this boring? WHY is it ho-hum? What is ‘dead’ about this patient, that you are allowing to go unchallenged, unquestioned? What are they telling you, here and now, that you are failing to register, or respond to?

Is it because they were treated in a ho-hum manner, and they’re unconsciously ‘pulling’ to recreate this same relationship dynamic with you, in the here-and-now of the therapy session? Are you just going to ‘go along for the ride,’ checking out and participating in a re-enactment of the old damage, without bringing it to everyone’s attention?

Is it a way to (unconsciously) ‘tip you off’ as to how they feel in life? Bored, ho-hum, uninspired? Here, they’re giving you a ‘front-row seat’ to their insides, and are you just going to let it pass by without comment, without saying, “Wow, you must feel so dead inside.”

To which they most likely will say, “How did you know?”

And the answer should be, “Because I’m paying close attention to what you’re telling me. Because you matter.”

Once upon a time, a young executive, who was ‘dead inside,’ asked me, cynically, about the session, “What are we actually doing here, anyway?”

And I responded, “Buddy, I don’t know about you, but I’m fighting for your life!”

It shocked him – that I wasn’t ‘playing the game’ of ho-hum, a game that he was used to, in his personal life and at work – a very common game, unfortunately, in our society. No, in therapy, I don’t allow ‘ho-hum’ to be the mantra, or if it is, I challenge it. We don’t ‘mail it in’ in therapy – we WORK, even if the work is to sit with ho-hum, and explore the hell out of it, until ‘something happens’ – something REAL and alive, even though the ‘something’ is often unwelcome or scary feelings: ‘unwelcome,’ ‘scary,’ and ‘out of control’ are fine – we can get through them together, like slogging through a muddy bog, on our way to where we’re going.

But ho-hum is not fine: it is saying ‘No’ to the life you’ve been given, like being handed a treasure chest and saying, “Not interested: cart it off to the City Dump.”

Yes, I understand, sometimes ‘ho-hum’ is all a person can do, their only possible response to how they’ve been treated, or the hand that life’s dealt them. I get it, I understand, but I can’t join them in ho-hum. Sometimes, on our journey together, I have to ‘carry’ the caring, for both of us, until they can catch up.

You, the patient, can afford to not care (temporarily, I hope) but I can’t: it’s my business to care, to have you matter, to make you matter, even over your own objections.

And I do – and caring has its consequences. When things, and people, matter – when you care about them, you can be enriched by them, you can feel the joy of connection, you can both ‘give’ and ‘get’ in equal measure. But you can also be disappointed, you can be hurt, and you can feel loss when you lose that connection.

Just as it’s wonderful to have a patient dare to do new things, to finally be herself, and to feel, at last, truly alive, it’s also hard to care deeply and have a patient leave therapy, without a word, or cancel five sessions in a row without responding to your calls, or start seeing another therapist without even telling you about it.

It’s hard, but it’s worth it.

Because caring means being alive, just like in the lyrics of that song, that end,

Why was I born to love you?

But see, that was a ‘torch song,’ where the singer was lamenting how she was, unfortunately, fated to love this guy who would always hurt her. So, I’m hereby taking it on myself to change those lyrics, just a little, for my own purposes. They are now:

Why was I born? 

To love you.

And that’s it exactly: that’s why I was born, that’s why we were all born:

To love you – whoever ‘you’ are.

To love and be loved – that’s about what it amounts to. That’s why we’re here. It feels wonderful, it feels crummy, it’s the highest high, and the lowest low. But it’s alive.


Try it sometime.

And, oh yeah, I almost forgot. Where are all those patients – the ones I wonder about?

Not really as far as you might think.

They’re right here, in my heart.





































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

And Now, For Someone Completely Different











I love “characters” – always have. I think that’s one of the reasons I love movies so much, because you get to see people who stand out from the crowd, people who surprise you.

I remember years ago, when I used to work at an alcohol rehab facility, there was this guy, Augie, in the program, from “back East,” who could have been straight out of the cast of Guys and Dolls. He used to talk about “hangin’ out on the stoop,” being a numbers runner out of a candy store, and collectin’ for loan sharks. Well, as he got older, all his children moved out West to a ‘better life,’ and they finally convinced him to make the move, too, because his health was failing. The ‘kids’ found a “wonderful, clean, safe” place for him –  a small trailer park in Rohnert Park, outside of the Bay Area.

It seemed ideal.

On paper.

Well, Augie was lonely, out of his element, and bored stiff. When he tried to talk to the ‘squares’ in the trailer park, they didn’t get him at all, nor he them. Finally, to obliterate the endless days, he started drinking, and didn’t stop until he was picked up one Sunday at two A.M. by the cops, comatose, in the middle of a busy street.

One day, and I’ll never forget it, in the group I ran at the rehab facility, Augie, who hadn’t said a word until then, suddenly broke down in tears and said, “Back East, I was a character. Here, I’m just a freak.”

I’m glad to say that, with help, Augie did stop drinking, and eventually moved to North Beach, where he could put his ‘character’ to better (and more appreciated) use among a slightly more bohemian crowd than the Rohnert Park trailer set. He became a bartender – and a sort of unofficial greeter and drawing card – at a local old-time watering hole, and stayed sober for the rest of his life.

The thing is, you meet characters when you do therapy too; like with movies, it’s one of the reasons I love this work – and once in a great while, you meet someone who’s a character and a therapist all at the same time. Someone like Nelly.

But first let me give you a little background. When you’re a therapist, you see a lot of therapists as clients. For one thing, they’re interested in therapy, for another, most of them need it (sorry, my esteemed but problematic colleagues!), and for yet another, they can sometimes come at the times you have available, the times other people cannot. And since patients talk about their work lives, and therapists’ work lives are about doing therapy, well . . . you hear a lot of funny, crazy, heartwarming, odd and puzzling stories – well, no, not all of those qualities in one story, of course.

But then, on second thought . . .

I had been seeing Nelly, a psychologist beginning a private practice in Oakland, for about a year. Sometime in the late Eighties, she had come to me to help her get through her last year at a local psychology doctoral program. Therapy supervision is a required part of becoming a therapist, and doing therapy and being supervised both tend to bring up ‘issues’ for candidates. In the case of Nelly, her supervisor, an older woman whom I knew of from my years in the therapy community, had “strongly recommended” that Nelly get some therapy herself, to help her iron out a few psychological wrinkles that had come up in her supervision.

Ah, Nelly, Nelly, Nelly –  I could go on and on with psychological jargon, to explain her ins and outs, but I’ll spare you all that and just speak in good old American:

Nelly was a real trip.

And I mean that in the fondest way. She was South American, and anything you can imagine about American stereotypes of South American women, well, Nelly was it. She was flashy, extroverted, ‘out there,’ funny, charming and at times overwhelming.

Think Evita Peron.

You’re getting warm.

Now think Charo.

You’re getting warmer.

Now think Carmen Miranda.

You’re hot!

Nope, Nelly was certainly not the traditional ‘therapist type,’ but she had some wonderful things going for her, too: a warm heart, a high, lively intelligence, and most delightfully, a great sense of humor, including about herself. Sometimes, during her therapy sessions, when she was proclaiming things, throwing herself around and ‘on a roll,’ I’d give her a certain look, and she’d throw up her hands dramatically and laugh, in her thick accent,

Jes, jes, I know dees: I am in Diva Mode, no? Bueno!

Well, jes, jes, she was in Diva Mode much of the time, but no one else could make Diva Mode as charming, or as fun, as Nelly; it wasn’t posturing, it wasn’t a put-on, or a pose, it was her. Most women therapists dress modestly, neutrally, even – well let’s face it, dowdily, only pepping things up with the occasional hoop earring, paisley scarf or long, flowing skirt – a friend of mine once called it, “the half-Gypsy look.” But Nelly – to her, skimpy was the norm, tight the standard, and short the rule. She wore high heels, low-cut tops, and things that dangled and clacked all over the place. Not to allure, or provoke – it was just Nelly being Nelly.

Well, you can imagine how her ‘personal style’ went over at the Elite Institute For Impressive Studies, as I’ll call the training program she was in. The Elite was “juuuuust a bit self-important,” to paraphrase Bob Uecker in Major League. They fancied themselves direct descendants of Sigmund Freud, even though the only thing they really had in common with Freud was a smelly couch.

The accepted ‘mode’ around EIFIS was low-key, inhibited, and intellectual, what some (not I, of course) might call “having a stick up your butt.” At EIFIS, it was always important to use jargon instead of plain English: you didn’t say, “The patient made me feel nervous,” you said, “There was a great deal of attributive projective identification going on in the transaction.” And as for expressing your own, measly feelings? Why do that when you could dress them up in fancy words and ten-dollar concepts, and put them in the mouths of Bion, Melanie Klein or Winnicott?

But, that wasn’t Nelly’s way – not by a long shot. She once scandalized her supervisor by reporting that, in the presence of a very virile young male client, she fanned herself and said, “Whew – you are one hot potato!” (Actually, Nelly thought the supervisor would be impressed by her knowledge of American slang!) Another time, she was working with a very repressed young woman, and when the woman asked Nelly, “What’s wrong with me anyway?” Nelly stood up, did a bump-and-grind on the office rug, and said, “Nothing – you just need a leetle more of theese!

Every practitioner needs to find his or her own way of doing psychotherapy – because at its best, psychotherapy is the most personal of art forms. But most people struggle to find their voice, that perfect amalgam of what everybody else is doing, and what they and they alone can do, the ‘way’ that they can claim as their own, signature style. And it’s best when they can use all the theory, tradition and lore – the stuff you learn in grad school – as a sort of armature on which to hang their own personal strengths, quirks and novel approaches.

However, in the case of Nelly, I’d say her only ‘struggle’ was in even allowing psychological tradition to find a seat at the party. She came to the profession with her own fully-formed ‘approach,’ which I always called psychoaNellysis – a mixture of Catholic philosophy taught her by the nuns, folk wisdom from her mother and aunts, reading (she claimed that if you just paid close enough attention, Jane Eyre would teach you everything you needed to know about life – oh, and that it was a much better book in Spanish), and life experience she had picked up along the way.

And by life experience, I do mean Life Experience: she had been married twice, once to a deadbeat sometime drug dealer, and once to a professor. When she was with the drug dealer, she had worked as a, how-you-say, call girl/masseuse/sex worker in Buenos Aires for a number of years, where she learned, and I quote, “many, many especial things about the mens,” and also an awful lot about what men think about women, from her customers talking about their wives and girlfriends.

Actually, there is a rather long tradition of women sex workers becoming therapists – I’ve worked with a number of them (as patients, that is) – although that fact might come as a surprise to their colleagues and patients. The truth is, many of the same skills are required in both professions: in fact, a young woman patient of mine recently laughed, “You listen, you understand, you make me feel more powerful, and I pay you – in some ways, you’re nothing more than a prostitute.”

To which I replied, “Then I’m going to be a damn good one.”

I’m quite sure Nelly was a ‘damn good one,’ in her day, and in fact it was one of her customers, a university professor, who told her that she was too smart to be making a living in bed, that she should, and could, return to school and finish her education, which she did, taking top honors in her university before coming to America for graduate school in the Bay Area.

I loved to tease her, saying, “You mean they have higher education in Argentina?” upon which she would launch on a rant about how superior Latin culture is to ours, saying about America, “Jew don’t even talk to each other! Jew don’t even look at each other! Jew don’t even touch each other!”

To which I would say, much to her consternation, “Yeah – and the Gentiles are even worse!”

Well, Nelly barely squeaked through her supervision at EIFIS, and once I even had to talk to the supervisor I mentioned before (at her request), to explain that when she was lively, extroverted and sassy with her clients, she wasn’t “acting out,” but just being herself, and that it wasn’t for lack of self-control that she did so, but rather that it was an integrated, grounded way of being that worked for her – and for her clients. And I might add that, somehow, clients almost always managed to get better under her care. The supervisor said, “But we wouldn’t let anyone else get away with this – it’s not consistent policy,” to which I replied, “Well, if anyone else did it, it would mean they were out of control, provocative and lacked boundaries, but with Nelly, it’s just her way. She’s coming from the right place, and her clients know it, so it works.”

To her credit, the supervisor, a diametrically opposite personality (someone who some, not I, might say had a stick up her posterior, too), did eventually agree that Nelly’s ‘way’ worked for her, even though if therapy students were to see one of Nelly’s sessions, it would have to be accompanied by a banner saying, “Kids, don’t try this at home!”

Nelly did graduate, and started a thriving and effective private practice – specializing in Latin women – and eventually even became a supervisor at the EIFIS, and I think everyone who met Nelly or worked with her was the better for having been exposed to her own special brand of flightiness, charm, warmth and wisdom.

We talk a lot about “diversity” nowadays – and by this we mean the inclusion of differing races, nationalities, creeds and genders. But we also need to treasure and protect the ‘characters’ in our society – people like Augie and Nelly – for they are a national resource that has much to teach us, especially in this homogenizing age of ours.

So, to all the characters out there, I say, on behalf of Nelly, “Jew can do it!”













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