Quickly jumping to express shame can be a defense against real shame “I screwed up.” “I’m so awful.” “I’m terrible. I feel bad about everything.” These statements, at a basic level, convey shame. However, in our struggle to tolerate having committed real harm to someone around us, they can also be used as a defenseRead more
Going Home for the Holidays: Advice From a Therapist on Not Just Enduring Your Crazy Family
Painful family dynamics reemerge during the holidays: Reflect on them rather than just enact them Every year around the holiday season, patients shrug and say to me, “My family is crazy,” or, another variation, “My family is weird,” before setting out to simply endure the holidays. Of course, those little words—“crazy” and “weird”—can stand inRead more
Anxiety Isn’t Just Normal: It’s Essential
Anxiety and panic are signals that something is amiss and needs attention Though they cause discomfort, anxiety and panic are more than just emotional experiences to be endured and tolerated. Anxiety is a signal that activates a certain amount of energy toward action (think of athletes feeling nervous in the locker room before the bigRead more
What to Do After a Breakup: The Case Against the Rebound
People love a rebound after a breakup. It’s understandable; it’s a rush to find a relationship that feels better, new, or different. However, in order to get that, you can’t go searching with the same set of eyes you were using in the last relationship. Speaking from their experiences providing individual therapy after breakups, ourRead more
Therapy-Speak is Everywhere: We Should Consider How We Use It
Therapy-speak is our collective emotional language Boundaries, narcissism, trauma, anxious, manic, neurotic, so OCD—it seems impossible to escape therapy-speak these days. Earlier this year, The New Yorker dedicated an issue to therapy, observing, “The language of the therapist’s office percolates in our everyday conversations.” They’re right—therapy-speak is our collective emotional language. Though it can beRead more
Is the Patient the Expert in Therapy?
“The patient is the expert,” but therapists should not overlook the misguidedness of individuals trying to resolve their own suffering Most therapists claim, “The patient is the expert” (Actually, they’d almost surely say, “The client is the expert,” which I consider part of the same problematic). On the surface, this is a fairly uncontroversial statement.Read more
Feeling Bad in a Useful Way: An Argument Against Comfort
Avoiding pain is a primary motivation for all humans—therapists included One needn’t read Freud or Darwin (both of whom have a lot to say on the subject) to understand that avoiding pain is a primary motivation for all human beings. Pavlov can suffice: I touch the hot stove, it hurts, and so, I avoid touchingRead more
The Real Issue with Boundaries in Therapy
Boundaries are needed in therapy, but we should also consider what we are walling out Like all relationships, boundaries are necessary in therapy. When I consider navigating boundaries as a therapist, I often think of Robert Frost’s poem “Mending Wall,” best known for its line, “Good fences make good neighbors”: “Before I built a wallRead more
Troubled Teen Programs Should Be a Last Resort: Less Authority Is More for Teens
Troubled teen programs are the logical, furthest extension of authority A recent New York Times editorial, “The Troubled-Teen Industry Offers Trauma, Not Therapy,” argues for more regulatory oversight and best practices for troubled teen programs, some of which have been exposed in recent years for abuse. The troubled teen industry, the teen wilderness treatment industry,Read more
College Students, You Want to Separate Your Therapy From Your School
College is a highly emotional transition, yet most college health centers can only offer triage In our therapy with college students, we often see young adults who are struggling turn to their schools’ health centers for mental health care. As writer Sofia Barnett argues in a recent Teen Vogue editorial, college students frequently find theseRead more
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