Saturday, January 29, 2011


Talk therapy gets a bad rap. Yackety-yak therapy. Woody Allen poking fun at therapy, therapists, and people like Woody Allen who go to therapy. Penis envy, castration anxiety, Freud and his red couch—they’re just too good not to make fun of.
In the early days, if you underwent psychoanalysis, the granddaddy of talking psychodynamic therapies, you could spend days each week of your adult life on your analyst’s couch talking about a few days from your childhood. How fun!
Now we have cognitive behavior therapy, rational emotive therapy and their cousins, streamlined therapies that get you to look at how and what you think, and change them for the better. There are piles of studies. Insurance companies love these therapies. No need to dwell on the past, no need to go into the stories, no need to look at the hidden motives for why you do certain things, like get divorced all the time, or feel depressed. No reason to dig up dirt. No reason to shed any tears or beat any pillows. No muss, no fuss, no mess.
We love it!
Cognitive therapy, ‘think’ therapy, is the way to go.
Except it’s not so simple.
We’ve learned a lot since Freud.
Some of the things we’ve learned are the techniques of cognitive behavior therapy, which are amazing.
But when it comes to human beings, to who we are, how we behave, what we feel, how we react, and what we believe—and how to change all that for the better—no single way of looking at things, or working with things, will cover all things human.
Turns out that yackety-yak therapy, when done well, is actually really good stuff, even, it seems, better than cognitive behavior therapy, the gold standard for many insurance companies and other data-driven types.
While cognitive behavior therapy has been getting all the favorable press, the data has been quietly piling up in favor of the new and improved versions of talk therapy. 
We human beings are a complicated and tricky lot, which is a great thing and makes for great literature and movies, and the luscious stories of the foolish escapades of the rich and famous, but it also makes us genuinely tragic. We can suffer so profoundly, often because of our own actions, because we do not know ourselves, our deeper motives, the nature of our inner conflicts, our forgotten, but still powerful wounds.
We do at times seem like fallen angels, not angels gone to hell, but angels fallen from heaven trying hard to get back there, but we’re not sure how. It’s a tricky business, this mind/body of ours, how it works, how it sees the world, what it knows but can’t speak, and how it is divided against itself by design.
Talk therapy, more properly called psychodynamic therapy, is an attempt to open up the doors to deeper material that a person may be unable to access by himself.
The trained and attuned person listens for the material in the gaps, hears what is not being said, intimates hints of unexpressed emotion, and resonates with the client and begins to ‘feel’ some of what the client is feeling, though possibly not able to say.
It’s not easy work, especially not for the client. That’s why it often takes help to go where she has never gone before, in a way that is not traumatizing.
Let’s make up an example.
A man finds himself at a very difficult place in his life. This is the culmination of many miss-steps he has made over the years. He really seems to have almost intentionally dug himself into a hole, and now he has almost buried himself alive. His life is a shambles.
Why? Why would he do this to himself?
With help, he begins to share the details of his painful childhood. Not only does he share the details, he feels the pain of it, the sadness, the disappointment and the shame. He begins to see, feel and know that much of his self-destructive behavior took place as he was trying not to feel the pain he had been carrying with him all his life.
“Oh yeah, sure”, you might be saying. “I’ve heard this liberal crap before. But show me the meat. That’s why we’ve made fun of you talking types for years, because it doesn’t do any good. Oh, woe-is-me therapy. Enough, already, just get off your butt and do the right thing.”
If only it were that easy. In some sense, that’s what cognitive behavior therapy tries to do in a thoughtful, organized and sustained way: address the issues head-on by challenging the thoughts that lead to the destructive behaviors. Change the thinking and you change the feelings and the behaviors. That’s the theory anyway. Often it’s quite effective, but not always.
Research is now showing that psychodynamic therapy does have the ‘meat’ to show for its efforts. Like the big bad hunter, psychotherapy brings home the meat, the bacon, or the tofu—whichever you prefer.
In a recent research review by Dr. Jonathan Shedler, published in American Psychologist, the well-respected journal of the American Psychological Association, psychodynamic therapy was shown to be very effective in rigorous controlled studies, and its benefits continued to accrue even after the therapy was over.
Research has shown that there’s a lot that goes into making good therapy good. Psychodynamic therapy explores emotions and helps the client feel things she may have been avoiding. She is helped to ‘see’ and ‘feel’ and understand her avoidances. Patterns are looked at and felt. The past is carefully explored, where necessary, to a great degree, the stories, the images, the sounds, the feelings, and the judgments.
It’s in relationship that problems often arise, so exploring the client’s experiences in relationship is important.
The challenge is that we are complex, multi-storied, multifaceted beings, who are often ignorant of much of what is going on in us. Good talk therapists use talk to go beyond talk, to drop into the places where unspoken material lies. The job of the therapist, or good friend, or minister is to help the person ‘hear’ the inner story, to be able to go beyond the barriers of shame, fear, and discomfort, and see, hear, and feel what is going on at a deeper level. 
Good talk therapy is not really ‘talk’ as we normally understand it. Just talking about things can be helpful, but only goes so far, because it usually stays close to where the person is comfortable. Good therapy involves going to the uncomfortable, but doing so in ways that are not traumatic.
This process is much more expanded than talking. It involves experiencing sensations, seeing images, feeling into the body, sharing the stories and words without editing or discounting them, and observing the meaning, judgments and commentary that arise from all this. Talking is used to share a report of the process. It’s part of the process, but often not the most important part.
            “Know thyself”, turns out to be good advice, as good as it has ever been. Though we’ve learned a good bit more, and gotten better at helping others to know themselves, knowing yourself is still hard work. But it’s good work, work worth doing, work that can change the course of a life, maybe your life, for the better.

            I can be reached at or 805/680-5572.

Wednesday, January 26, 2011


           It is very difficult at times to be aware of how many ways we have for making ourselves miserable by our own thoughts and beliefs. So often we structure an argument that begins, “I am unhappy because of “blankety-blank.” And believe that our unhappiness is well founded, justified, almost unavoidable, as if it were a law of physics.
          It may be true that times are tough, that someone is sick, that there is no work, that someone has left, that something is wrong. It may be true that we feel tired and stressed and at our wit’s end. It may be true that our gut is in knots and our head aches. 
          But maybe there’s a way for us to be with whatever is happening, accepting it deeply, that allows for a bit more breathing room and a little more happiness. It has something to do with really accepting ourselves as we are, including how we suffer, and how we make ourselves suffer, and how we view our perceived faults, and how harshly we can sometimes judge what we think we see. It has something to do with loving ourselves just as we are, the whole beautiful mess of a human being we are with our wounds, our shortcomings, our judgments, and our confusion, along with our glory and our magnificence. I think that’s what some people get from Jesus. Jesus opens the door for some people to love themselves and others just as they are. That’s the good part of religion: the love. The love for self and others opens the door to happiness.
            “May I love myself just the way I am, suffering and all, imperfections and all.”
Our goal, our mission is to be happy from moment to moment. It’s about being happy, here and now. And to do that, you’ve got have a little love for yourself as well as for everyone else
A lot of people have problems with this. They think happiness is too shallow, that love is for sissies. Happiness is not a good enough goal or a deep enough value. It’s selfish, small. What about my responsibilities? My job? My family? What about injustice? What about war and global warming? 
Is anybody going to solve any of these big problems anytime soon? Which is not to say you shouldn’t spend you life working on them. But how does being a miserable son-of-a-gun help you to solve any problems whether personal or global?
            The Dalai Lama has a plate full of problems he’s working on, maybe for more than one lifetime if you believe in reincarnation, yet he says happiness is the goal of life. And he appears to be succeeding at it in spite of all the travails he and his people are facing.
So, along with peace, give happiness a chance.
What’s so great about being miserable, anyway? Most miserable people are a pain. Being miserable takes up so much time and energy that miserable people often don’t have anything left over for anyone or anything else. So, do all you can to give up your misery. It may be harsh to hear, but often we hold onto our misery for dear life. Edgar Allan Poe wrote a story, The Oblong Box, where a young man goes down to his death in a maelstrom because he will not let go of the coffin of his deceased wife. It may make for a dramatic story, and who doesn’t like a good story now and then, but we must do all we can to let go of our suffering. Addiction to our own suffering is one of the hardest addictions to break. 
I am not discounting the depths of despair and the severity of depression that can afflict us. Some depression is literally gut wrenching, blinding, vomit-spewing, diarrhea-producing depression, a howlingly miserable disease of mind and body. I am not saying it is easy or our fault. I am grateful for the medications, and therapies, and procedures that can help those of us who suffer the most acutely. We must do all we can to live our lives with a sense of peace, gratitude, love and yes, happiness.
Happiness is the goal, right now. Which means we can’t be unhappy about being unhappy when we’re unhappy. Hmmm. When the alarms go off and we begin to feel like crap, we may not know whether we started off by thinking painful thoughts, or whether something started in our body that made us feel badly and then our thoughts aligned with the crappy feeling and became crappy too.
We may not know and it may not matter what came first, the body or the mind. All we know is that we feel like crap. And that’s the point. Stop and stay with that. You fell badly. At this moment, do not get lost in long drawn out cascades of psychic babble that you use to justify why you feel this way.
“Well, you see, it started before I was born. I was in my mother’s…”
Save that for your therapy sessions where you can actually work on it. For now, stay with the feeling of feeling badly. Keep breathing. Observe your body. Look for a way to return to happiness.
This is not trivial or shallow. It’s a lifelong work.
Your mom dies. Are you supposed to feel happy on the spot? No, not unless you hated the old girl for torturing you, and maybe not even then.
So what am I saying you do?
We need to explore what we mean by happiness. It’s not giddiness. It’s not being stoned. It’s not irresponsible.
By happiness we mean a deep sense of acceptance, peace, gratitude, being present to the present moment even when it’s the moment of our mom’s death. Even when tears are rolling down our cheeks and words are stuck in our throat. Happiness pays the bills, takes care of the children, does the work, learns the lessons, supports the relationship, cares about others, knows loss, looks to the future, prays to heaven, and buries the dead.
Happiness knows sadness and knows death is coming.
So, moment to moment, pay attention and enjoy your life. Live in the present. Look around. Let your eyes take in the world and feed you. Bless and be blest. If you start to feel disconnected, sad, lonely, fearful, tight, worried, or just plain shitty, stay focused on that, riveted as if your life depended on it, because it does—at least your happy life does. Don’t move away. Look for the shortest distance back to happiness, back to your centerline. Do not pass GO. Do not get sucked in by ‘problems’.
“Are you saying I have no problems?”
No, I am not saying that. I am saying that being unhappy is the problem we are talking about here and now. Fix that first, and fix it fast, if you can. If you can’t, then stay connected to your suffering. Accept it. Do what you need to do to get back the connection with your life and the present moment, even if the present moment is painful. Go to gratitude. Check in with your body. Deepen your breath. Slow down your pace. Look around and see the world. Look at your negative thinking. Pay attention to what it is saying to you and how it is making you feel. See the limiting irrational beliefs, the harsh conditioning, or the pain of early childhood issues.
Be really heroic. Get up, if you can, and dance. Stretch. Recommit to your work or your relationship. Make that phone call. Tell that girl that you love her, or that she scares you. Tell that friend that your feelings were hurt. Go to that beach and tell your story to the waves. Kneel and kiss the ground. Do what you have to do to re-establish the connection to life and the present. Get back to happy. And don’t knock it. Happy is not stupid.
If God is love, then maybe we can say that the goal of life is to know God, and to know God is to know love, love for ourselves as we are and for the world as it is, in all its mystery, beauty, and sadness.     
Love isn’t sad. Love isn’t disconnected. Love is grateful, joyful, alive, and full of possibility. That’s what you want to get back to moment by moment. That’s the prize. Keep your eye on it. It will give you what you need to live your life and solve your problems, even the problems you don’t really have, and the ones you don’t ever really ‘solve.’
We close with a quote by the American monk Thomas Merton that celebrates the transformative power of acceptance and self-love, the foundation of real happiness, and one of our deepest connections to the Sacred.          
                   "Finally I am coming to the conclusion that my highest ambition is to be what I already am. That I will never fulfill my obligation to surpass myself unless I first accept myself, and if I   
accept myself fully in the right way, I will already have surpassed myself."
Thomas Merton

I can be reached at or 805/680-5572.

Monday, January 24, 2011


In today’s New York Times there’s an article about the resurgence of electro-convulsive shock therapy as a treatment for severe depression. Last week, also in the Times, a psychiatrist, Dr. Friedman, wrote an article about insight not being enough to make for a happy life. These two articles illustrate the challenge and opportunity we have for dealing with our problems in a myriad of ways other than the extremes presented in these two articles.
             In one article we read that most therapists feel that insight is the cornerstone of healing psychological problems, and is the foundation of a happy life. Dr. Friedman does not agree. Though Dr. Friedman accepts that insight can be helpful, he points out that often insight is not enough, nor is it always necessary.
We know he’s right. Just because we know why we do something or react a certain way, does not mean we can change our behavior or our reactions, though it may make us feel better to know why we do certain things. With traumatic material, knowing what happened and being able to play it over again and again can actually make things worse.
Dr. Friedman shares that he feels good that he can use meds and some talk to alleviate suffering. Happiness, well, Dr. Friedman says, that’s another matter. Happiness, like self-esteem, you have to work for.
And I couldn’t agree with him more, but unlike Dr. Friedman, I feel that professionals can do a great deal to help clients live happier lives and improve their self-esteem. 
What can we offer that might help? Dr. Friedman points out a very well researched finding that most forms of therapy seem to do about as good a job as any other form.
What distinguishes good therapy from not-so-good therapy is not the therapy, but the therapist. It ‘s the quality of the relationship between the client and the therapist, coach, teacher, minister, or social worker that makes the difference. As professionals, we can offer a trained ear, and more importantly, a trained heart and mind. Most of us don’t listen very well, not even to ourselves. One of the most powerful things we can do is to learn how to ‘listen’ to ourselves better. I’ll talk more about this later.
            The other article offers that in difficult cases ECT can help with very severe depression. Though the treatment remains controversial, ECT can knock out a serious bout of depression and buy the client some time and breathing room while they try to address issues and make life changes and get on a track that does not once again lead to depression.
Clearly, ECT is for extreme cases, and no one is suggesting, otherwise, but we often take for granted the many things we can, and often must do to keep ourselves functional and happy throughout the ups and downs of life.
As Dr. Friedman said, for many of us, happiness takes work. So let’s not forget the basics.
If you want to be happy, start with your foundation: your body. Make sure you get enough exercise every day, especially if you’re prone to depression, anxiety, or moods.
Aerobic exercise may be a better antidepressant than anything you can buy. Make exercise part of your daily routine.
Watch what you put into your body and when. Do not run yourself down by not eating and then collapsing. Watch how much caffeine, sugar, and refined carbohydrates you eat. Notice what happens after meals, especially at midday.
Make sure you get enough sleep. Teenagers are prone to depression if they don’t sleep enough. It may be true for the rest of us.
Get outside, especially during the day when the sun is out. SAD, seasonal affective disorder, is real. Sunlight is the cure. 
Meditate every day for at least 15 minutes. There is a lot of research out there that supports the claim that sitting quietly every day for fifteen to forty five minutes, simply letting your mind be quiet, for example, observing your breath, can have many beneficial effects on mind, body, outlook, and mood.
Learn to pay attention to your body, noticing how you breathe, how you hold tension, how you collapse in certain situations. Meditation or mindfulness practice will help you become more aware of how your body is reacting to your life.
Watch what you think and say to yourself. Watch your ‘stinking thinking’.
Watch what you say to yourself as you face challenges. If one thing goes wrong, is everything wrong? If the weather is bad, does that mean the world is against you? Do you take temporary setbacks as evidence that you and/or the world are fatally flawed? If so, there are books, workshops, and practices that can help you change what you say to yourself and increase your happiness and wellbeing. This is powerful stuff and you need to do what you can to make sure that your mental machinery is not grinding you into the ground.
There are daily practices that can help you. Practice gratitude. Take note of and give thanks for the good things in your life. See where the glass is full, not where it’s empty.
Take healthy action in small incremental steps that move you where you want to go.
Help others. It’s a great way to help yourself.
Get out of your head, specifically, your left hemisphere, listen to great music and dance--scary for many of you guys out there, I know.
            Be mindful of your body. The philosopher Descartes said, “I think, therefore, I am.” Many of us fall into the trap of thinking, “I am my thinking.” That’s it. Period. We think thinking is all there is to us. We forget that we don’t simply have a body, but we are a body.
You are not separate from your body. If you were, why would magic mushrooms or prescription drugs radically alter your experience and how you feel? Why would sending electricity through your brain shake you out of depression? Why would exercise make you feel better?
Since you have and are this amazing being with body, mind, and possibly soul,
it makes perfect sense to use the zillions of cells and receptors and nerve endings and synapses to help you live your life.
But to do that you’ve got to slow down a bit and let yourself feel what your body is trying to tell you.
That’s not exactly right.
You’re not smart enough in this area.
Your body couldn’t tell you all that’s going on even if it wanted to. You wouldn’t get it all. Just imagine the overload you would experience if you had to consciously work every muscle and fire every nerve and control every gland necessary for you to successfully chew, swallow, and digest lunch. If you think about it, we’re morons in this area. And yet, when faced with emotional challenges, we deal with them primarily from the neck up, though emotions, by definition, involve motion within our bodies.
So, pay attention to your body when you’re going through difficult times. Notice your breathing, your areas of tightness and discomfort. Do not try to make them do anything, but let yourself feel and experience what is going on.
            Silently give a name to what you are experiencing, such as sadness, anger, anxiety, joy, anticipation, or whatever. Really let yourself feel the emotion, the movements and changes and sensations in your body. Pay attention and notice the change. Don’t try to change anything unless you feel it is really sucking you in and bringing you down. If so, then bring in resources that feed you. Breath more deeply. Imagine places and people you know and love that inspire you, make you feel alive, grounded, and present. Let yourself get to a place where you feel a little better. This should show up as a change in breathing or muscle tone. You might yawn or take a deep breath or relax a bit, whatever it is take note of it.
            Over time, as you do the work, like the star athlete you are, you will find that you get better and better at dealing with life’s challenges. So good, in fact, that you may find yourself feeling good, and feeling good paves the way for feeling happy.
            It’s great that we have meds available to us when we need them, and that in extreme cases things like ECT are available if we need them, but happiness is not to be found there. Happiness, for many of us, requires work, attention, commitment, insight, practice, tools, and good friends. The Dalai Lama said happiness is the purpose of life. That’s because life is tough and being happy throughout the ups and downs is a profound and radical act that takes work and a transformed human being. Maybe being happy is the most important work we can do.

I can be reached at or 805/680-5572