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.

The Diary Of Anne Candid









Once, years ago, I was talking with Sarah, a young woman patient, about how to deal with narcissists and other people who are self-referent and blaming of others, and end up making you feel ‘wrong’ for any of your behaviors or personality characteristics that upset them. This led us into reflecting on single-minded family systems (like hers) that offer you two choices: either join us in thinking, feeling and acting ‘our way,’ and thereby be a part of something (ostensibly) wonderful, or have your own (wrong!) attitudes and be all alone.

What a godawful Sophie’s choice, especially for a child, and most especially for a sweet, sincere child who wants and needs connection, and needs to feel a part of things.

Such a connection-oriented child, brought up in such a my-way-or-the-highway family, is at a terrible disadvantage. Desperate to fit in and not be an outsider in her own family, the child naturally (and unconsciously) learns to disregard and disbelieve her own perceptions. As my patient and I continued talking, we realized that, eventually, she was going to have to come up with a strategy for dealing with these types of monolithic people, and systems.

But wait: though Sarah understood all this, on an intellectual level, a strong part of her resisted it. That resistant part of her (the innocent child) still wanted to believe that everybody is basically honest, basically sincere, and wants authenticity and connection as much as she does. Unfortunately, in our culture, that’s called “leading with your chin,” because believing, unquestioningly, in the “good of all mankind,” means that sooner or later, and probably sooner, you’re going to get beat up and dumped in an (emotional) alley somewhere.

Again and again.

Her continuing belief in the ‘goodness of all beings’ led her to believe self-referent people when they said she had upset them (i.e. by disagreeing with them and their ways, or by being herself). Therefore, she ended up in situations repeatedly where, in order to maintain the illusion of a connection, or a working relationship with others, she had to doubt herself and her perceptions.


Feeling bad about herself, and disbelieving herself, to the point where she sometimes thought she must be crazy. Oh, and did I mention suicidal thoughts and no self-confidence?

I tried again, mentioning gently, once more, that she was going to have to come up with a strategy that allowed her to maintain her own reality with these people; that when other people are lying, or insincere, or totally unable to perceive or value her reality, there had to be a way to detach from their demands, and stop giving them the power to define her.

Well, my pushing finally led to this outburst:

But that’s elitist and snobbish. Who am I to judge them? Besides, that implies that I think I’m better than them.

I tried to explain that, whether she knew it or not, this ‘detachment’ is a function that “normal” people perform, internally, all the time. Let’s say you’re in a transaction with someone and it becomes clear that they’re blaming you for something that’s actually their own doing. You say to yourself, “Hmm, I guess they’re too limited for me to pursue this with them now.” That is, you disengage to some degree, and give up the hope of carrying on a sincere, open transaction with them any further. No, it doesn’t mean you write them off, or that you think you’re ‘better’ than they are – but it does mean that you decide, independently and unilaterally, that they are not able to continue things in a manner that honors your reality.

Once again Sarah said, “But I don’t like that!”

Hmmm. And I responded, “Well, I don’t like it either, but then, do you ‘like’ thinking that you’re a loser, crazy, or wrong all the time? Are you willing to sacrifice yourself, in order to maintain the illusion that you and this person are ‘close,’ or ‘on the same page’? And remember, it is an illusion.”

She looked agitated, and truly dismayed. I could see the wrestling match going on in her mind:

In this corner, representing all that crap Dr. Bernstein is telling me about self-preservation by selective detachment: Kid Change!

And in that corner, representing the innocent child’s belief in the Goodness of All Mankind, and the desperate need to stay connected with others At All Costs: The Denier!

At this point, I could have pressed her to continue processing her feelings about all this, no matter how rational or irrational they might be, but instead I obeyed Bernstein’s First Law of Psychotherapy:

Shut Up And Listen!

And, as so often happens when you shut up and listen, something creative and ‘self-y’ happened. She finally looked up at me, a steely resolve in her blue eyes, and said, “But, what about Anne Frank?”

Well, I remembered that Anne Frank was one of her idols, someone she looked up to as a role model for innocence, authenticity, and a belief in human nature. I wasn’t positive where she was going with this, but I had a pretty good idea that what it meant, roughly, was, “If I accept your proposition that I have to decide, on a case-by-case basis, whether people are sincere and safe for me, or narcissistic and toxic to me, that would mean losing my charter membership in the Anne Frank Pure and Innocent Society.”

Looking at Sarah’s sad-shading-into-angry face, I also understood that, even beyond Anne Frank, she felt that accepting my ‘proposition’ would, in some sense, mean losing her charter membership in her own family. And the universally sad part is that growing up ALWAYS means, in some sense, losing your charter membership in your own family – and absolutely so when your family is a monolithic ‘cult,’ that requires unquestioning agreement with what has been laid down by the elders.

As a child develops, and his or her uniqueness starts to become evident, a normal family says,

“That’s interesting – you’ve brought some healthy diversity to our ‘stock’.”

Whereas a monolithic family says,

“Kid, you’d better drop those new thoughts and feelings, and quick, or you’re out of here.”

Unfortunately, Sarah’s family was the “drop it, quick” kind, though she had never really ‘claimed’ her knowledge of that fact. Not surprisingly, she had discovered, and clung to, Anne Frank as a symbol of openness and honesty, without fully realizing why Anne Frank meant so much to her.

Anne Frank is, deservedly, a symbol the world over, of how the voice of life continues, even under the most severe repression and ugliness. But she is more than that, as well: her diary is not only the record of a family forced into hiding by the insanity of Nazi repression, but a testament to the struggles of a young girl to say, “I exist!” to the world at large, i.e. a universal teenage girl’s shout-out of existence, of mattering, of uniqueness. Because the whole world had gone crazy, her story is not just the “usual” teenage (or ‘tweenage’) angst played out against her parents, but against society as a whole.

The challenge of a young girl entering her teens is to grow, to expand, to lay the emotional groundwork to eventually push her way out of her family system, and take her place in the big, scary world beyond – and that, as we all know, is hard enough. But in the case of Anne Frank, here is a girl who, at the very developmental moment of gathering herself and all her courage for the Big Push, up and out of her childhood cocoon, was forced Down and In, literally into hiding and secrecy, into an even smaller, quieter, more constricted world, than her normal childhood life.

And so her diary is not just the tenuous confessions and gropings-toward-adulthood of a normal preteen girl, but actually a piercing, heroic, countercoup scream to the world:

I’m alive, damn you!

I’m still here!

I exist! 

You can’t stop me from growing up!

And the ultimate irony is that, if this type of diary had been written by, say, an ordinary Dutch girl of the same era, living out in the open, in a non-persecuted group, it wouldn’t have nearly the same power.


Because you have to get MAD (even if unconsciously) to force these things out of yourself, to fling the words out there like spears, with abandon and full honesty. You have to be pushed to an emotional place where it almost doesn’t MATTER what you write, or do, or feel. Almost like, “I’m lost anyway – so I’m going to go for it!” My guess, also, is that with the Nazis as a shared family enemy, it probably forced the developing Anne into a more appreciative stance towards her family than she would have had otherwise. There wasn’t the LUXURY of standard rebellion towards family authority!

The diary was not a careful record, or a childish outburst; it was more of a, “Please, Lord, hear my cry!” Not that Anne recognized this, by any means – but the power of the diary is that it is the document of a girl in circumstances that stripped her of all pretense, of posturing, of both preening and self-pity, a girl reduced, like a fine roux, down to her basic essence, and in the case of Anne Frank, that essence carried a magnificent humanness and universality.

And this courage, this magnificence, is what Sarah responded to in the writing of Anne Frank. In lobbing the hand grenade of Anne Frank at me, in the session, she was saying, “I don’t have to face all this!”

She got MAD.

I didn’t say anything, waiting for her to make the next move: after all, it was her ‘show.’ It was up to her to mobilize all that energy and pressure we had uncorked, like drilling down to a gusher.

Suddenly, she stood up, saying, “You can’t take Anne Frank away from me: I won’t stand for it!” and stormed out of the room.

I could have stopped her in a million different ways, but I wanted to give her her head, to let her loose in the world not being scared, not being careful, not caring anymore – like Anne Frank.

This was her break-out moment: hers alone, not to be carefulized, or diluted, by me.

I waited.

The next night, I got a message on my voice mail from her:

Dr. Bernstein, I’m going to leave a message here, but don’t call me back. I need some time to deal with all this – on my own. (Pause) Okay, I think I’m getting it: you’re not trying to take Anne Frank away from me, are you? You’re trying to get me to join her. (Pause) It’s just so . . . so sad, to have to leave my family like this – to, you know, outgrow them, I guess. I thought you were trying to get me to hate them, to reject them, but now I see that . . . that it’s not like that, is it? It’s just sad, but kind of sad-proud, if you know what I mean. (Pause) Okay, that’s all I can say, for now. I guess I’ll see you next week . . . since you’re not a monster, after all (small laugh). Goodbye.

The next week, I could feel, the moment she walked into my office, that something was different. Her posture was more erect, her bearing almost regal: she had always been a pretty girl, but now she was close to beautiful. I knew, without her saying a word, that she had crossed her own personal Rubicon; she would never be the same. You know, it’s funny, being a therapist, because at times like this, part of you thinks, “Hey, what happened to my little girl? I’m not ready to lose her!” Loss and growth is hard for therapists, too! But you never say it – you just live with it, and smile.

Well, the first thing she said was, “Dr. B, I never realized that one of the things about Anne Frank that is so perfect is her last name: you know, like Frank means honest? And, in the last week or so, even though it’s taken me a long time to get there, I’ve started to be honest with myself. Well, actually, I’ve always been honest with myself: what’s different is that I’m starting to be more honest with other people, and about other people. So I promoted myself.”

I angled my head at her, confused. “What do you mean, promoted?”

She laughed. “Well, you know how I always felt like Anne Frank was a sister – the sister I never had? But before, I never felt worthy of really being related to her. Well, now I’ve promoted myself to being her sister . . . and, you’re going to think this is crazy, but, secretly, I’ve started a diary, an honest diary – and I’m calling it The Diary of Anne Candid – because that’s my new nom de plume. And that’s what I mean by ‘promoted.'”

Well, Sarah left a short time later to go to college. Her struggles weren’t over, by any means, but they were different. Now, instead of drowning in her troubles, she was swimming through them: I hadn’t made her problems disappear, but I had taught her the Australian crawl.

Sarah got her degree, eventually got married, had kids, and lives a nice life in a Midwestern town.

And every holiday season, she sends me a card, and it’s always signed, ‘Anne Candid.’

And every time I see that name I smile, and feel like I’ve been promoted.

















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

Sleepy Town Awakening








So here I am in Cazenovia, New York. Things are old here. Real old. I mean, San Francisco barely existed before the Gold Rush, and L.A., where I’m from – well, anything more than fifty years old, they either tear it down or slap a plaque on it. But here – there are lots of buildings still standing from the 1700’s, and there are no plaques, shrines, or ceremonies associated with them: they’re not ‘marketed’, they’re just, well, there.

As you may remember from my old blogs, I like old things. I like old things a lot. But I’m getting ahead of myself, so let me take a minute here and go in my favorite direction: backwards.

A long time ago (well, an L.A. long time – say ten or twelve years), I somehow got involved with a real estate investment outfit that said they would help you find the ‘hot spots’ in the country, places where big things were happening, or were just about to happen.

For a fee, of course.

Major hot spots. For a fee. What could be bad about that, right?

Well, it turns out that, according to these heavy hitters, Upstate New York, and particularly the Syracuse area, was going to go nuts, I mean just explode, in a supernova of development. Big stuff. I’m talking major malls, big stores: Wal-Marts, Schmall-Marts, Tall-Marts, hell, All-Marts, if you catch my drift. So, being the kind of prescient investor who has his ear to the ground for big doin’s like this, I ponied up the dough and jumped right in.

You know, kind of like the Gold Rush: you can’t lose.

Well, somehow, and I don’t even remember anymore how, I ended up buying a small apartment building in Cazenovia, New York. I mean, it’s kind of near Syracuse, right? Well, what I mean is, if you look closely at a map, with a magnifying glass, you’ll see that it’s in the Greater Syracuse Sphere of Influence. Or something. I mean, I promise you, it is there. There’s even a college there, called (wait for it) Cazenovia College. Actual people actually go there and everything.

So, I bought this place and waited – you know, for the supernova.

And waited.

Well, it should have been a tip-off to me that I’m the kind of person who, if I get in a supermarket line, I actually curse the people ahead of me, because as soon as I get in the line, someone at the head of the line is guaranteed to forget their credit card, or decide they don’t want half of what they brought up there, or need a price check on some recondite item that simply cannot be found anywhere in the store, after ten or fifteen minutes of intense checking. I am actually called Price Check Bernstein in certain quarters, because where I go, Price Checks follow. But I don’t usually talk about it openly. Anyway, the point being, it should have been a tip-off.

I’m not actually sure, but I think that after I bought this place, Syracuse not only didn’t grow spectacularly, but had the city equivalent of a price check. I mean, it did nothing. Somehow, Sam Walton must have heard that I was involved, and passed the word on to all his big-store buddies, to drop all their major plans for the area, and leave it flat.

So, I’m using this space to issue a blanket apology to the entire Greater Syracuse Area: it was me, guys, that popped your balloon – it was me, all along.

Yes, I ruined Syracuse.

Whew, it always feels better to make a clean breast of things – you know, like an amends.

Man, I can breathe again.

Okay, so the point being that I ended up with this little apartment building in Cazenovia, New York. That I’ve never seen. And eventually, I got this nice couple, who live in town, to manage it for me. And eventually I sort of got over my disappointment about the whole thing, and settled down to accept reality for what it is, which is that I am Price Check Bernstein, who owns a sort of cute little apartment building in Cazenovia, New York.

And when people ask, “What the hell – why Cazenovia, New York?” all I have to do is say, “Aw, it’s a long story,” and they give up, right away.

See, it’s not that hard, once you get used to it.

So, there it is. It’s over and done, and I own it. End of story.

Except for one thing: I’d still never seen it. So, I got this idea: how about going to see it? You know, Autumn in Upstate New York, plus I could see stuff like Niagara Falls, and maybe sneak over to the Baseball Hall of Fame in Cooperstown, another nice little town not far from Caz (that’s what we insiders call it, you know).

You know, like visiting a nice old uncle you have somewhere, except that it’s a nice old apartment building.

So, I made my plans to fly to Syracuse. Whoops, two plane changes. Well, that’ll be no problem, right? I mean, what could go wrong?

So, I don’t have to go through the whole Price Check thing again, do I? I mean, by now, we all understand the immutable rules of the universe, and that one of them is that, if I’m involved, things MUST go wrong. If you read my last blog posting, you know most of the details anyway, so either go read it now, or just move on to the rest of the story, like those people who say, “Just tell me the good stuff,” which I’m not one of, but I do understand, especially in this case.

Though I can’t promise that it’s ‘good stuff’. You’ll just have to take your chances. I waive all responsibility: your results may vary.

So, a lot of bad airplane stuff happened, but that’s over now, and I have now seen Niagara Falls, too (and no, they didn’t stop falling when I got there, thank you!), and then I was on my way to Cazenovia (that’s in New York, in case you’re the type that skipped the whole first part of this).

And shoot, Cazenovia turns out to be Gorgeous. I mean, everywhere you look there’s leaves (the good, deciduous kind, not the blah evergreen needles we have in the Bay Area), and lakes, and beautiful rivers, and old things. Yeah – old things, which I happen to like, in case you skipped everything above, like the disrespectful skimmer that you are (but I’m not judging you, you understand – we can’t help our disabilities).

So I met the nice couple that manages my place, and the nice couple took me to the nice place – and it was really, you know, nice. And I’m even gladder that I own it, now, even though Syracusapalooza didn’t happen and Sam Walton shot me down like that.

It doesn’t matter, anymore: I’m happy with what I have.


So, having some time, they took me on a short tour of the Village (Caz is a village, not a city or town – in fact, there’s a little place just up the road that actually officially calls itself a Hamlet, imagine that!), and the whole place is gorgeous, though they kept saying, “There’s not really much to see here.” So they took me to see Chittenango Falls, which, though no Niagara Falls, is a very cute falls indeed, and I didn’t even have to wear an embarrassing pink plastic Breast Cancer Awareness raincoat thingy like they make you wear at Niagara Falls. And the leaves were spectacular, and the little Chittenango River was pretty darn cute, and Cazenovia Lake is very darn cute, and I can definitely see why it’s a bedroom community for people who work in Syracuse, because it’s a lot darn cuter than Syracuse, so there! (We Cazenovians have to stick together, you know.)

But that’s not all of the good stuff. Nancy, the woman of the nice couple, asked me, when I was on my way here, if I wanted her to set me up at one of the “really nice inns” they’ve got here in town, for the night. I figured, why not? The worst it could be is a little, dorky, embarrassing dump with fake-everything, right?


I am staying at the Brae Loch Inn, and dude, it’s just about the most beautiful, amazing place I’ve ever stayed in my life. And not only is everything not fake, nothing is fake! It’s old, but ‘real’ old: the furniture in my room is honest-to-god antiques, the bed is one of those fabulous canopy jobs that you see in magazines, and not one of those fake-sweet Laura Ashley-oid canopy jobs, but a real one. The carpet is thick, wool and handsome – the real deal.

And, I kid thee not – there is an honest-to-god working fireplace in my room! As in, you light a match, touch it to the log inside the big hole in the wall, and boom, you have a god’s honest FIRE, right in your own bedroom, that you can sit and moon over till all hours, or even moon over from your own bed!

The restaurant is all dark wood and antiques, and the food is fabulous. I guess people have known about this place for a long time, because I saw autographed pictures of a lot of my old film noir ‘friends’ all over the walls in the restaurant and bar. I can’t remember who, exactly, but I’m pretty sure I saw Ed Begley there (that’s Senior, dude, not Junior: yeah, the fat guy who always played shady police chiefs). And by autographed, I mean personally autographed, to the owners of this place. Like, they actually drove all the way up here just for this place – as well they should.

So here I go again: I set out to go on this kind of nerdy little trip, and I found a new ‘home’, that I would want to come back to, again and again. I mean, Jeez, I’m writing this with all the lights out in my room, except the fire blazing before me! And, not to sound like an ad or anything, but in a few, minutes I’m going to bed in my honest-to-goodness canopy bed, which by the way has an honest-to-goodness Tempur-pedic mattress, and lie there in luxury and watch the fire die down, with visions of roast duck with plum sauce and chocolate lava cake swimming around in my head.

So, do you remember in American Graffiti, when John Milner, the coolest guy in town, who drives this boss ’32 Ford, gets stuck driving ‘the strip’ with Carol, a pre-teen MacKenzie Phillips, in his car? And man, he’s humiliated, and starts putting her down. But then, in a move of sheer genius, she says, “I’m gonna tell everyone you raped me, unless you say, ‘I take back everything I said about Carol. She’s not grungy, she’s bitchin’.” And she makes him say it.

Do you remember that?

Well, ahem, here goes:

I take back everything I said about Cazenovia, and especially about the Brae Loch Inn. It’s not grungy – it’s bitchin’.

So the whole thing turned out to be a supernova after all, but not a Sam Walton supernova. A quiet supernova – my kind of supernova.

Excuse me – I have to go poke at the fire a little bit, like you do when the fire’s actually doing fine, but you want to remind yourself that you’re the Lord of the Manor, who has to keep the home fires burning properly all night, to keep all the vassals and serfs and stuff warm.

And I am the Lord of the Manor, except the manor is this cute little apartment building on William Street in Cazenovia, New York, my ‘home’. And we don’t need no stinkin’ Wal-Marts, or Tall Marts, or All-Marts, either – we got buildings from the 1700’s, and real antiques, and a real lake, and a real waterfall, and real people, too.

Sam Walton, eat your heart out!

Oh, and one more thing. Just a friendly tip, but never mess with small-town people around here, and here’s why: they’re tough, and they stick together. They shovel snow, they drive on ice, they stack wood, and they don’t complain about winter lasting five months.

And listen to this: When I went to check out from the Inn, I casually said to the lady at the front desk, just as idle conversation,

“Wow – I came here because I had never even seen my property – just a little place I own, here in town. And my property manager said, ‘Hey, maybe you’d like to stay at a real nice Inn we have here in Caz.’ And I thought, ‘Well, it’ll probably be dorky, but what the hell.’ And then, this place turned out to be really amazing!”

And she said,

“Oh, Nancy must be your property manager. You probably own that cute little place down on William Street. And by the way, our bartender is one of your tenants.”

Whew! See what I mean? Don’t mess with ’em, because in no time flat, you’ll be surrounded, and big-city boy, you’re goin’ down!





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

Grow Up, but Stay Small!








The other day, I had a weird experience. Well, that’s not totally true – it was an experience I’ve had many times before, but for some reason this time it struck me differently. Maybe because I’m getting older, maybe because I’m caring deeper, maybe because as you get older, you tend to hold on tighter to the familiar, to the old days, to what has been so precious.

A patient whom I’ve been working with for a while had her last session before she embarked upon a long trip that, somehow, I knew would be transformative.

As she got ready to leave, I found myself saying, “See you on the other side.”

She cocked her head at me and said, “Yes, and it may really be the other side.”

What did all that mean? I don’t know – I just know that something compelled me to use that phrase, “the other side” – something that ‘knew’ something that I didn’t know, until I said it.

And she clearly got it – and responded in kind.

One of those magical moments that give you a little zing up your spine.

What did I know? I’m not positive – I just knew. I knew that she would be ‘different’ when I saw her next. Different in a good way, an expanded way.

And that’s great. But it’s also hard.

Anyone who’s had children knows what I mean: you work night and day to get your kids through their youth, to help them grow up, to reach those all-important milestones: first day of pre-school (oh my god, the heart-rending cries!); first day of ‘real’ school; first sleep-over at a friend’s house; the Halloween costumes, changing through the years; junior high; high school; dates, driving, broken hearts, doing homework, passing tests, sex, college; and then, leaving.

I often tell the over-involved parents I work with that you have to think of yourself as a mother lion: nursing your cubs, catching their food for them, teaching them to hunt with you, hunting on their own, and finally – leaving.

Leaving: that’s always the primary goal, the purpose of the whole thing.


Sure, bonding is important, but this above all: it’s all about preparation for leaving.

So I tell the parents that, and they get it, and they try. They do the right thing and let go – let go of the baby they gave birth to, let go of the expectations, the hopes, the dreams they have (at least some of them), let go of the closeness they felt with that sweet, innocent little bundle of softness they brought into the world. They try to let go of all of that, but I know how hard it is.

And every parent knows exactly what I’m talking about when I say that every step towards growing up, every step towards leaving, is hard. No matter how proud you are, or how glad – it’s still hard.

You want to make a ‘deal’ with the child, or fate, or god: Can’t there be two of my child? Let my ‘baby’ stay the way he is, always be that cute, that close to me, that precious, that close, while the ‘other one’ grows up as I want him to?

Can’t there be two: one for me, and one for the world?

Kids are always embarrassed and annoyed when parents drag out the photo album to show family members, or new girlfriends, or grandchildren, pictures of Little Johnny in the ‘old days’. Mind you, ‘Little Johnny’ may now be the forty-five year-old owner-operator of a fleet of cement mixers, may have five kids of his own, a big mortgage, tax problems, arthritis and a cocaine habit.

It doesn’t matter: he’ll always be ‘Little Johnny’ to them.

He’ll always be Little Johnny because those early days of connection and innocence are a Big Deal to parents: to be that involved, that needed, that close to a fellow creature is a rare and miraculous thing. I mean, what else do you do in life that’s that important? It informs and shapes every aspect of your life, and every aspect of your life affects the child: your job, your marriage, your hobbies, your interests, how you feel about your life, your friends, your own past life as a child.

They all matter, they all form the child, because to the child, you are the only game in town: he or she is watching you intently, to find out what life is all about, to find out if things are okay, and always wondering, wondering:

What do you think of me?

Do you want me here?

Do you love me?

Am I a joy, or a pain in the neck?

Am I just another job, or a pleasure that is meaningful and real to you?

Do you like me, or just put up with me because you have to?

Are we alike?

Do you like being with me?

Notice that every one of those questions has “you” as the focus. To the child, you are his everything, his pole star, the one constant in life: you, you, you. And that’s heady stuff for anybody – to be that important, that much of a big deal, to somebody who really matters to you. Aside from being in love, that’s the only time one can matterthat much to another person.

Sure, it’s a lot of responsibility, but then it’s also a lot of power and importance.

Okay – back to my patient.

What does all this have to do with her?

Well, a lot, actually. If you’re being honest with yourself, and you give a damn, as a therapist, you begin to feel about your patients some of the things a parent feels about a child. After all, if the core of ‘transference’ is that patients are projecting onto you the things they felt towards their parents, and using the therapy as a crucible to work those things out, it follows that the same is just as true of the ‘countertransference’ the therapist feels back towards the patient: It involves many of the things parents feel towards their children:

How am I doing?

Could I be doing more?

Are they reaching their therapy ‘milestones’? (“Baby’s” first eruption of the unconscious, first being late to a session, first strong disagreement with you, first acknowledgment of the connection, first obvious pushing away from the connection, first obvious claiming of the self, first worry about losing you, first thoughts of leaving you – I could go on and on.)

(Note: just received an email from a former patient, who’s now a nurse, working with a difficult teen, worried if she’s ‘doing it right’, and saying that if she does get it right, “I feel I’ll be redeemed.” Well, there ya go – it doesn’t get much more ‘countertransfer-y’ than that, and that’s not unusual, folks! All helpers (including therapists!) are people, too – their own unconscious, their ‘issues’, are constantly triggered by all kinds of qualities in the patient. It’s not that a therapist shouldn’t have these things happening, it’s that a good therapist is AWARE of them, and works with them, and uses them to the patient’s benefit.)

Countertransference, as a general phenomenon, has of course been extensively documented and discussed. But what about the ‘normal’ parental feeling of loss, of sadness, of even hurt, even anger, even abandonment, that therapists feel when patients do get better? Many therapists – and I’ve supervised and consulted with many in my day – aren’t even aware of these feelings. Sure, they’re ‘all over’ the typical countertransference issues, i.e. the personal emotional reactions one feels towards another person whom you sit with closely for long periods of time:

My god, he reminds me of my cousin Saul – I never could stand him!

My god, she’s so hot – I can’t stop myself from flirting with her.

My god, he’s a died-in-the-wool Republican capitalist – how am I supposed to be sympathetic that he’s firing half his workforce to cut costs?

My god, her arrogant self-centeredness is so much like my father’s, it makes me want to yell, “You’re not the only person in the world, you jerk!”

Yep, bet on it, therapy patients: your very own therapist really does have his or her very own real feelings about you, feelings that come from ‘some time before’. Just hope that he or she is conscientiously noting them, claiming them in a conscious way, working with them, getting consultation about them if needed, and using this awareness to further the work.

What do I mean by ‘using’ this awareness? Well, here is an example from my own practice:

I had been seeing this big, beefy, fiftyish guy for quite a while. He was what you might call the ‘hail fellow well met’ type – a corporate salesman who had a story or a joke for every occasion. He made sure he ‘bonded’ with me about everything he could dig out of me: baseball (I’m always a sucker for being sidetracked by baseball talk, and I have to watch myself like a hawk!), talking about our kids, my interest in World War II (his father had won the Navy Cross as a Marine, and he figured out – correctly – that he could really ‘get me going’ on that one), old movies (don’t even get me started!), stories about how he’d gone marlin fishing in Mexico – you get the picture.

He was charming, he was funny, and the ‘lure’ was to just yak the session away with him every time, being ‘buds’. Except that, d’ohh, he hadn’t come to me to become best buds!

His marriage was falling apart, he was estranged from his grown kids, he was in trouble at work, and he had no real friends, even though everyone was his ‘friend’. He had grown up on a farm in rural Indiana – a lonely, isolated farm, an only child, with cold, distant parents. So his ‘solution’ was to shed all that isolation by becoming a big-city backslapper, bonding and hail-fellowing with everyone he met, ‘proving’ that he was no hick, and surrounded by people.

And the anger, the despair and the hurt? He kept it all stuffed down, deep inside. It’s a pretty well known dynamic that therapy patients will ‘use’ parts of themselves that they believe in, that they know will ‘work’, in order to get you to like them, to relate to them in ways they are familiar with, thereby maintaining control over the relationship. Unfortunately, if you allow yourself to ‘go for’ these ploys, both you and the client lose.

For example, sometimes an attractive young woman seeing a male therapist will ‘use’ her feminine charms to take a shortcut to connection and reassurance about herself: she ‘knows’ that her looks and her sexuality are strong suits, and if she can get the therapist to go down that road, it’s familiar territory. The only problem is, if the therapist allows this to happen, it is a betrayal of what the person came to therapy for in the first place. What she really needs is to have an experience in which another person (particularly a male, in this case) values her for WHO she is, not WHAT she is (i.e. an attractive ‘specimen’ – what shows on the outside).

Well, it was like that with this man: if he could get me to hang out and ‘chill’ with him, listen to his stories, laugh at his jokes, and be charmed by his charm, then he was on his own turf. But he came to me because always being on his own turf wasn’t working! He was alone, isolated, in trouble, and failing, at work and home.

So I had to head him off at every turn, frustrating and ultimately infuriating him: every time he would launch into another story, I would say, “But what’s happening right now – here?” When he would try to lure me into the weeds by talking about the time he got Ted Williams’ autograph, I (reluctantly!) had to drag him back by saying, “We’re not here to talk about Ted Williams.”

At first, he would just try another tack – a better story, a funnier joke. Then, when he saw that that wasn’t going to work, he would lapse into sullen silence, looking at his watch (translation: “I’ve got better things to do, and a lot better audiences than this!”).

One day, he finally said, “Look – whatever your game is, I don’t know how to play it.”

I said, “Of course you don’t – you’re not here to practice what you do know how to do. You’re here to work on things you don’t know how to do. Are you willing to trust me enough to hang in with this for a while, and see where it takes us? I love your jokes, and your stories. And, believe me, I’d love to talk about Ted Williams all day long, but it wouldn’t do a thing for you. I think you’re worth more than that – a lot more. And as for ‘playing my game’ goes – that’s not really accurate: what I’m suggesting is that we STOP playing games – your games – and see what happens. Sure, it’s uncomfortable: all you know is your game, and it works on almost everybody – hell, it works on me, too, but there’s more to you than jokes and stories, even though you don’t know it. I’m telling you that I know it – give me a chance to prove it. Okay?”

I held out my hand.

I wish I could say that I saved his marriage, healed his rift with his children, and raised the dead. But I will say this (with apologies to baseball fans everywhere): Stan became a Man. He actually became an organizational consultant (as he called it, a “therapist for businesses”), using his interpersonal gifts to help people forge workable and functional relationships. It was too late for his marriage, but he did remarry, a warm, big-hearted woman with whom he achieved genuine closeness.

He isn’t “alone in a crowd” anymore, and though nowadays everyone isn’t his ‘best friend’, he does have a few real friends, whom he doesn’t feel he has to entertain constantly.

So, am I ever going to get back to my original topic, which is the woman patient who’s going off on a trip which I know will ‘change’ her?

Yes, believe it or not.

Like a doting parent with a child who’s growing up, I want there to be ‘two’ of her: one to be the person I have come to know, respect and treasure, and the ‘other’ to be the one who goes off, has great adventures, expands her life in wonderful ways, and, maybe, comes back to teach me a few things!

But then, I will always have the ‘first one’ in my heart – the things we went through, the demons she faced, her journey to the ‘starting gate’.

Like the old song says,

Make new friends, but keep the old,

One is silver, and the other, gold.

Now she (and I) will have both: the silver and the gold.

She’s at the starting gate of her great adventure.

If you listen closely, you can hear them playing Call to the Post:

And . . . They’re Off!!!

See you on the other side.














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