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It Takes Time
Published on 2012-05-22 08:11:17
One of my clients tells me that I should have a neon sign on the wall behind me that reads, “It takes time.” She says I could simply flip a switch and turn it on instead of saying those words … Continue reading → > read more
Empathy for the Psychopath
Published on 2012-05-14 16:19:33
The New York Times magazine ran a chilling article yesterday about psychopathic children, and how the features that lead to anti-social personality disorder and sociopathy may be identified as early as age five. If you haven’t already seen it, I … Continue reading → > read more
When the Therapist Falls Asleep During Session
Published on 2012-05-09 15:47:09
I dozed off for about ten seconds during a session today. Over the last 30 years, this has happened to me three times that I recall. The first time was with an elderly client, benignly psychotic but disengaged from the … Continue reading → > read more
Contempt as a Defense (Mine)
Published on 2012-05-02 10:01:39
Last week, I decided to withdraw from my contract with New Harbinger for the publication of my book on defense mechanisms. If you’ve read my earlier post where I discussed what this book deal meant to me, you’ll understand this … Continue reading → > read more
Anders Breivik, You and Me: What We Have in Common
Published on 2012-04-26 09:47:04
When an anti-Islamic loner explodes a bomb outside a government building, killing eight people, then travels to a nearby island where he guns down 69 more, we naturally view that man as a dangerous lunatic. His paranoid tirades against multi-culturalism … Continue reading → > read more
Shame Trading
Published on 2012-04-22 13:50:37
In a very early post on this site, I described people who view the world in terms of winners and losers, where one person will shore up his own self-image by triumphing over someone else, usually by demonstrating that he’s … Continue reading → > read more
Video #3 – “The Transference Begins”
Published on 2012-04-19 16:03:50
I’ve now uploaded the third installation in my series on psychodynamic psychotherapy, which you can access through the video frame below. This one covers early manifestations of the transference and includes a lot of examples from recent sessions in my … Continue reading → > read more
Mothballing Your Parents
Published on 2012-04-15 14:13:41
Last night, we were out at our favorite restaurant, celebrating my daughter Emma’s birthday. After a fine meal, we came home and sat up late, discussing, as we often do, the fact that she seems more like 26 than 14 … Continue reading → > read more
Psychodynamic Psychotherapy Video No. 2: The Early Weeks
Published on 2012-04-10 16:10:18
This is the second installment in my video series about what to expect in psychodynamic psychotherapy, focusing on what happens during the early weeks. In addition to developing a deeper understanding of the client’s past and current emotional issues, these … Continue reading → > read more
‘Butterfly’s Child’ by Angela-Davis Gardner: A Review
Published on 2012-04-10 10:44:25
For the last 12 years, I’ve belonged to a writer’s group that meets every Thursday afternoon for two hours. We read our works-in-progress, giving support and constructive criticism to each other; we spend years reading and listening to different drafts … Continue reading → > read more
Why I’m a Therapist
Published on 2012-04-03 13:20:59
When people find out I’m a therapist, they usually assume I chose my profession because I want to help others. While I derive a deep sense of satisfaction from doing just that, I mostly chose to become a therapist because … Continue reading → > read more
New Video Series on Psychodynamic Psychotherapy
Published on 2012-03-30 09:33:21
Thanks to everyone who offered suggestions for future videos. I think I’ve settled on a series of lectures about the process of psychodynamic psychotherapy and what to expect from the process. I think this overall subject will allow me to … Continue reading → > read more
Transference: Uses and Abuses
Published on 2012-03-27 09:18:41
A visitor to the site submitted several questions about transference in response to an earlier post, and I thought they were so interesting and useful, they deserved a lengthy reply — hence today’s post. As a prelude, I’d like to … Continue reading → > read more
Second Radio Interview
Published on 2012-03-26 13:17:26
For anyone who’s interested, here’s the radio interview I did last week with Deb Scott on her program The Best People We Know. I felt completely at ease this time, and that experience has convinced me I need to speak … Continue reading → > read more
A Request for Input
Published on 2012-03-20 09:48:08
I’d like to continue making videos for my YouTube channel; I want to do a series of lectures or talks that would be easier and faster to produce, without all the editing involved in using film clips. I’ve got some … Continue reading → > read more
The Narcissistic Mother
Published on 2012-03-20 09:44:34
Before I decided to stop writing my ‘Movies and Mental Health’ blog, I had intended to do a video about the narcissistic mother as portrayed in two different films, Black Swan and The Fighter; in this post, I’ll be referring … Continue reading → > read more
Vacation Breaks in Psychotherapy and Defenses Against Need
Published on 2012-03-14 15:30:14
Clients often react to their therapists' vacation breaks as a kind of "abandonment", responding in ways that shed light on their feelings about neediness and dependency. Continue reading → > read more
Emotional Dependency in Psychotherapy
Published on 2012-03-01 16:23:34
If psychotherapy is to be effective, the client must to a degree become emotionally dependent upon the therapist. Continue reading → > read more
Performance Anxiety and Shame
Published on 2012-02-23 09:12:19
When artists use their medium as an attempt to escape from internal "ugliness", performance anxiety may reflect the fear of being exposed, their true damaged self becoming visible to the audience. Continue reading → > read more
Shame and How It Produces Envy
Published on 2012-02-16 09:57:48
Envy is a normal human emotion; when coupled with a basic and profound sense of personal shame, it becomes toxic. Continue reading → > read more
ADHD Symptoms Revisited
Published on 2012-02-08 15:25:20
A reconsideration of Alan Sroufe's article in the New York Times about ADHD symptoms, as well as the rebuttals and reactions from Harold S. Koplewicz and Judth Warner. Continue reading → > read more
ADHD Symptoms and Their Treatment: Drugs Don’t Work
Published on 2012-01-30 14:12:18
Recent studies have shown that there is no evidence to support the "inborn defect" theory of attention deficit disorder, and that drugs such as Ritalin and Adderall have no lasting effect on ADHD symptoms. Continue reading → > read more
Autism Symptoms Get a Second Look
Published on 2012-01-25 15:05:08
The upcoming revision to the APA's Diagnostic and Statistical Manual will purportedly eliminate Asperger's Syndrome as a diagnosis, once again calling into question the scientific precision and validity of psychological diagnosis. Continue reading → > read more
Anxiety Symptoms, Mindfulness and the Enlargement of the Self
Published on 2012-01-19 09:59:35
Mindfulness meditation techniques are a useful adjunct to psychotherapy, allowing you to see your defense mechanisms in action and to disengage from them, rather than a replacement for it. Continue reading → > read more
Narcissistic Rage and the Failure of Empathy: ‘Citizen Kane’
Published on 2012-01-11 04:24:43
Charles Foster Kane from the classic film 'Citizen Kane' displays narcissistic rage and a lack of empathy, psychological features that show up in different personality and autistic spectrum disorders. Continue reading → > read more
Defense Mechanisms VII: Reaction Formation (Not to be Confused with Hypocrisy)
Published on 2012-01-08 16:04:58
Reaction formation, like all defense mechanisms, is an unconscious process. People with conscious but secret desires they publicly denounce in others are not resorting to reaction formation; they are hypocrites. Continue reading → > read more
The Interpretation of a Dream
Published on 2011-07-03 13:13:14
An example of dream interpretation with a client in psychotherapy, with some thoughts about Freud's The Interpretation of Dreams. Continue reading → > read more
The Mostly-Bad Mother
Published on 2011-06-28 09:34:08
Thoughts about preserving the "good" bits of the mostly-bad mother. Continue reading → > read more
Three Books about the Chemical Imbalance Theory of Mental Illness
Published on 2011-06-25 11:50:29
A discussion of Sharon Angell's two-part article from the New York Review of Books, in which she discusses recent volumes by Robert Whitaker, Irving Kirsch and Daniel Carlat addressing the chemical imbalance theory of mental illness, along with the i > read more
Freud’s Theory of the Id, Ego and Superego: Lost in Translation
Published on 2011-06-21 17:10:49
Good things about the superego, and how it came to have a bad rap. Continue reading → > read more
A Hiking Meditation
Published on 2011-06-17 11:34:11
Personal observations on the actual moment when a defensive maneuver occurs, in order to evade pain, as well some reflections on the nature and value of the spiritual experience. Continue reading → > read more
Why Empathy Fails
Published on 2011-06-14 13:17:29
In order to empathize with another person, you have to recognize that he or she actually exists apart from and without specific reference to you. Our ability to tolerate separateness largely determines how well we are able to empathize with others. > read more
Working with Borderline Personality Disorder
Published on 2011-06-10 13:23:13
What experience has taught me about borderline personality disorder -- in my work with clients from my practice as well as managing the volatile and difficult man who lives inside me. Continue reading → > read more
Defense Mechanisms V: Idealization
Published on 2011-06-07 19:02:35
Idealization reflects a drive to escape from an internal experience felt to be unbearable and to connect with something perfect. This defense mechanism may take aim at another person, an actual experience or one's own self. Continue reading → > read more
Defense Mechanisms IV: “Thinking”
Published on 2011-06-03 15:36:18
The precocious development of verbal thought can function as a defense against unbearable emotional chaos; in later life, this kind of "thinking" often takes on a life of its own, can feel persecutory and underlies problems with insomnia. Continue re > read more
Defense Mechanisms III: Further Uses for Projection
Published on 2011-05-30 16:08:27
In addition to ridding the self of painful experience, projection may also defuse internal conflict between opposing impulses or ideas. People who use projection in this way often provoke behavior in others than appears to "validate" the projection. > read more
The Hatred of Authority
Published on 2011-05-24 08:19:13
While rebellion against established authority often leads to progress and positive change, legitimate authority exerted with concern has its value. Some people can't tolerate the expression of authority in any form, however, and live in constant reb > read more
Defense Mechanisms II: Denial
Published on 2011-05-19 10:15:47
Like all defense mechanisms, denial has its normal and constructive uses: by denying the awareness of unavoidable death, for instance, we're able to continue with our daily lives. Continue reading → > read more
The Difference Between Shame and Guilt
Published on 2011-05-14 15:42:50
While people generally use the words 'guilt' and 'shame' interchangeably, they actually refer to different experiences. Shame concerns painful feelings about oneself; guilt relates to the hurt or harm one may have caused somebody else and depends up > read more
The Healing of Shame
Published on 2011-05-10 10:18:39
The healing of shame does not mean "triumphing" over it, but rather learning to bear that shame and not respond defensively to it, thereby earning feelings of pride and self-respect. Continue reading → > read more
Defense Mechanisms I: Splitting
Published on 2011-05-06 12:35:52
Splitting (along with its companion defense, projection) is one of the primary defense mechanisms; it's also an indispensable part of everyday mental processes, enabling us to make distinctions and evolve meaning out of our experience. Continue readi > read more
60 Minutes and Greg Mortenson’s Fraud: The Power of Sentimentality
Published on 2011-04-30 09:57:22
Greg Mortenson's fraud upon the American public, recently exposed by Steve Kroft on '60 Minutes', catered to our weakness for a sentimental view of the world, with an all-white hero whose saintly deeds evoked a misty-eyed response that made us reach > read more
60 Minutes and Greg Mortenson’s Fraud: The Power of Sentimentality
Published on 2011-04-30 09:57:22
Greg Mortenson's fraud upon the American public, recently exposed by Steve Kroft on '60 Minutes', catered to our weakness for a sentimental view of the world, with an all-white hero whose saintly deeds evoked a misty-eyed response that made us reach > read more
Narcissistic Rage and the Sense of Entitlement
Published on 2011-04-27 09:24:53
A sense of entitlement, along with the expectation that life should be much easier and less frustrating than it actually is, often lies behind the expression of narcissistic rage, a feature of Narcissistic Personality Disorder, Bipolar Disorder, Bord > read more
The Role of Helplessness in PTSD Symptoms and Other Disorders
Published on 2011-04-23 14:02:16
The experience of helplessness in the face of trauma plays a central role in post traumatic stress disorder and the development of ptsd symptoms, but also has an impact on the genesis of other psychological disorders and maladaptive character traits. > read more
Psychological Obstacles to Grief and the Grieving Process
Published on 2011-04-20 10:31:04
Though we tend to talk about grief and the grieving process as a unique category of experience, it also involves painful feelings akin to other kinds of suffering, and we will mobilize our habitual defenses against such pain when it becomes unbearabl > read more
New Menu Added to Site
Published on 2011-04-18 10:36:48
When I first began building my site last year, I was playing with road imagery as a metaphor for the journey of self-discovery; all the menu choices listed beneath the photograph above (Rules of the Road, Detours, etc.) follow that … Continue r > read more
On Everyday Narcissism
Published on 2011-04-15 12:35:32
The desire for attention, respect and admiration from others is normal, a kind of everyday narcissism, as long as it doesn't interfere with our ability to notice, respect and admire others and to have meaningful relationships with them. Continue read > read more
When Is It Appropriate to Feel Shame?
Published on 2011-04-10 15:10:12
A discussion of the ubiquitous experience of shame in *civilized* cultures and why it is sometimes appropriate to feel shamed. Continue reading → > read more
The Rise of Bipolar Disorder Symptoms and Treatment
Published on 2011-04-06 14:25:56
Why has Bipolar Disorder, once a fairly rare phenomenon, become so pervasive in our society? This article looks at four influencing factors: (1) improved diagnosis; (2) an enlargement of our conception of the illness; (3) a "vogue" for the label th > read more
Empathy vs. Sympathy in Psychodynamic Psychotherapy
Published on 2011-04-01 09:13:14
Sympathy usually means entering into and sharing feelings that another person has verbally and intentionally expressed; empathy involves intuiting something unspoken, of which the other person may sometimes be entirely unaware. A psychotherapist's a > read more
Do You Want to Be a ‘Good’ Person?
Published on 2011-03-29 13:18:50
What we consider "moral behavior" can be motivated by religious beliefs, an inherited set of values, empathy and enlightened self-interest. The appearance of extreme virtue may mask highly "immoral" and destructive feelings through the process of sp > read more
“Psychiatric Meds Are Like Insulin for Diabetes” (Big Lie #3)
Published on 2011-03-25 12:28:02
Contrary to what we have been led to believe, psychiatric medications do not rectify a chemical imbalance in your brain but instead create one; the body then adapts to this imbalance, and when drug use is discontinued, the physical response is akin t > read more
“Psychiatric Medications Have Led to Dramatic Improvements in Mental Health Outcomes” (Big Lie No. 2)
Published on 2011-03-22 09:08:44
In the long-term, patients who have never been exposed to psychiatric medication have a much better prognosis than those who were placed on drugs. Continue reading → > read more
“You Have a Chemical Imbalance in Your Brain” (Big Lie No. 1)
Published on 2011-03-19 10:38:15
There is absolutely no scientific evidence to support the theory that mental illness is a result of an imbalance in brain chemistry. Continue reading → > read more
The Misuses of Sexual Excitement
Published on 2011-03-15 12:58:16
Sexual excitement, while crucial for the early stages of a romance, can be abused as a way to avoid true intimacy. Continue reading → > read more
Lessons from Amy Chua, the Tiger Mother
Published on 2011-03-11 10:23:22
A discussion of Amy Chua's book, Battle Hymn of the Tiger Mother, some useful lessons to be drawn about realistic expectations for ourselves and our children, and how to meet them without resorting to cruelty and perfectionism. Continue reading ͛ > read more
Coping with that Savage Inner Voice
Published on 2011-03-07 18:33:28
Some thoughts about how to silence the savage inner critic so that you can learn something from your experience, rather than simply beating yourself up. Continue reading → > read more
Can’t or Won’t?
Published on 2011-03-01 13:31:09
Psychologically speaking, does everyone *always* do the best he or she can? Continue reading → > read more
Charlie Sheen’s Rant and the Power of Destructive Narcissism
Published on 2011-02-25 11:57:06
Charlie Sheen's rant on The Alex Jones Show and how it demonstrates the characteristic defenses against shame, including features of pathological narcissism. Continue reading → > read more
How to Tell if You’re Projecting
Published on 2011-02-23 14:58:28
Knowing how to identify when we're projecting is extremely difficult, but an overly intense focus upon the behavior or attributes of another person may be a sign. Continue reading → > read more
The Tenacity of Defenses
Published on 2011-02-19 15:37:09
Psychological defenses are deeply etched neural pathways, like deep ruts in a well-traveled road, impossible to remove. Under psychological and emotional pressure, they will always come automatically and feel like the easiest, most natural response. > read more
The Cycle of Crime and Punishment
Published on 2011-02-16 16:52:37
A discussion of the psychological cycle of crime and punishment in people who never seem to learn from their experience or grow in psychotherapy. Continue reading → > read more
The Fallacies of Psychological Diagnosis
Published on 2011-02-13 11:21:49
The false analogy between diagnosing physical and mental illness provides a rationale for reimbursement from insurance companies to psychotherapists, helps alleviate shame in patients and enables the pharmaceutical companies to make billions of dolla > read more
Celebrity and Romantic Love: “Meaning” in the Modern World
Published on 2011-02-09 09:49:17
In modern American society, a large number of people pursue the twin cults of celebrity and romantic love as the sole sources of meaning in life. Continue reading → > read more
Varieties of Depression
Published on 2011-02-04 14:27:35
A discussion of three underlying dynamics in clinical depression: unconscious rage, a drastically fragmented self and toxic levels of shame. Continue reading → > read more
Art and the Dread of Experience
Published on 2011-02-01 10:27:00
A discussion of one particular form of artistic inhibition, where artists misuse their art form in order to deaden unbearable emotions. Great works of art have dimension; they contain and express vital human truths. Unsuccessful works of art create > read more
Defenses Against Shame
Published on 2011-01-29 12:43:26
Narcissism, blaming and contempt -- the three core defenses against shame -- are illustrated with clinical material from the author's psychotherapy practice. Continue reading → > read more
The Pleasures of Solitude
Published on 2011-01-25 08:05:28
Pleasure in solitude -- the enjoyment of one's own company -- is one of the compensations for the existential loneliness of the human condition. Continue reading → > read more
Envy and Jealousy
Published on 2011-01-22 09:23:19
A discussion of envy and how the envious person wishes to spoil or destroy the object of envy. This article includes a clinical example from one psychotherapy case, as well as a personal example of envious behavior from the author. Continue reading > read more
Merger Fantasies in Psychotherapy
Published on 2011-01-19 13:25:22
Bipolar and borderline clients who feel hopeless about their capacity for meaningful change often idealize their therapists and unconsciously try to merge with them; this fantasy of merger represents an escape from the damaged self into an alternativ > read more
Narcissism vs. Authentic Self-Esteem
Published on 2011-01-17 13:24:35
Authentic self-esteem is not something that can be obtained through outside sources such as praise or compliments but rather grows from living up to our own standards and expectations so that we feel ourselves to be a person we esteem. Continue readi > read more
A Portrait of Narcissistic Personality Disorder in ‘The Social Network’ (2010)
Published on 2011-01-14 15:20:01
An examination of Mark Zuckerberg's character in the film 'The Social Network' as a way to understand Narcissistic Personality Disorder and pathological narcissism. Continue reading → > read more
Relationships Advice You Won’t Find Elsewhere on the Internet
Published on 2011-01-11 10:55:21
Three unusual pieces of relationships advice you won't find on other Internet sites devoted to dating and relationship problems. Continue reading → > read more
Envy and Self-Sabotage
Published on 2011-01-07 16:13:19
A discussion of the subtle role of envy in certain forms of self-sabotage, with clinical material to illustrate it. Continue reading → > read more
Existential Aloneness
Published on 2011-01-05 13:58:05
Growth and psychological transformation stir up existential anxieties about what it means to be alone with personal responsibility; they also make us aware of the passage of time and the inevitability of death. Continue reading → > read more
Emotional Dependency and Stealth Control
Published on 2011-01-02 13:37:07
Behind the apparent helplessness of people who suffer from extreme emotional dependency often lies a a secret and unacknowledged fantasy of controlling everybody around them and coercing them to adopt the role of caretakers. Continue reading → > read more