Nancy Mcwilliams Quotes

The experience of speaking from the heart and being taken seriously builds the psychic architecture that supports the capacity to bear life.

Feelings have their own kind of wisdom.

Freudian notion that people act out what they cannot remember or what they cannot allow themselves to feel. It follows that as long as people are able to enact a dynamic (in this case, most frequently a disavowed dependency or a compulsion to be in control), they do not have to think about why they persistently behave in a particular way. When there are no negative consequences for their behavior, interpretations just roll off them.

What I mean by this is that it is natural to want to demonstrate our competence, to show our patients that we have something to offer. This inclination can get in the way of maintaining enough reserve to let people make their own discoveries and come up with their own solutions to the problems in their lives.

Putting out crackers and cheese is reasonable when visitors show up with wine, but not when they arrive with cyanide.

Many patients are so terrified of emotional intimacy that they are driven over and over again to provoke crises that allow them to distance with impunity (see Hedges, 2000).

I see the quintessential task of the clinician as one of coming to know him-or herself sufficiently to be able to register the experience of the other in progressively more profound and also more useful ways. This process begins with our own discomfort at finding ourselves sitting in the chair that has somehow become designated as “the authority”: the person ostensibly in charge of something we haven’t even begun to comprehend. —MARILYN CHARLES (in press)

When its patent on Prozac expired, Eli Lilly put the same recipe into a pink pill, named it Serafem, and created a new "illness": premenstrual dysphoric disorder (PMDD) (Cosgrove, 2010). Many women become irritable when premenstrual, but it is one thing to say "I'm sorry I'm kind of cranky today; my period is due" and another to announce "I have PMDD." It seems to me that the former owns one's behavior, increases the likelihood of warm connection with others, and acknowledges that life is sometimes difficult, while the latter implies that one has a treatable ailment, distances others from one's experience, and supports an infantile belief that everything can be fixed.

Jedna z moich maniakalnych pacjentek opisała siebie jako wirujący bączek. Zdawała sobie sprawę z własnej potrzeby nieustannego poruszania się - bycie w ruchu broniło ją przed odczuwaniem czegoś bolesnego. Jednostki maniakalne obawiają się przywiązania, ponieważ boją się nieznośnego bólu w razie utraty bliskiej osoby. Na kontinuum osobowości od psychotycznej do neurotycznej zaburzenie maniakalne plasuje się raczej w obszarze borderline i psychotycznym ze względu na zachodzące w nim stosunkowo prymitywne procesy. W konsekwencji wielu osobom w manii, hipomanii i cyklotymii grozi subiektywne odczucie dezintegracji Ja, przez psychologów nazywane fragmentacją Ja. Osoby w manii boją się po prostu tego, że jeśli się zatrzymają, rozpadną się na kawałki.

Nonschizoid people often conclude that, because schizoid individuals resolve their closeness/distance conflicts in the direction of distance and seem to thrive on being alone, they are not particularly attached and therefore are not reactive to separation. Yet, internally, schizoid people may have powerful attachments. In fact, their attachments may be more intensely invested with emotion than are the attachments of people with much more obviously ’anaclitic’ psychologies. Because schizoid individuals tend to feel safe with comparatively few others, any threat to or loss of their connection with these people can be devastating. If there are only three individuals by whom one feels truly known, and one of these is lost, then one third of one’s support system has vanished.

When students are taught psychoanalytic therapy as a prototypical technique from which unfortunate deviations are sometimes required, they quickly notice how inconsistently such an approach actually meets the needs of their clients. Beginning therapists rarely get the reasonably healthy, neurotic-level patients who respond well to strict classical technique. They can easily develop the sense that they are “not doing it right,” that some imagined experienced therapist could have made the conventional approach work for this person. Sometimes they lose patients because they are afraid to be flexible. More often, fortunately, they address their clients’ individual needs with adaptations that are empathic, intuitively sound, and effective. But then they suffer over whether they can safely reveal to a supervisor or classmate what they really did. When beginning therapists feel inhibited about talking openly about what they do, their maturation as therapists is needlessly delayed. Despite the fact that we all need a general sense of what to do (and what not to do) in the role of therapist, and notwithstanding the time-honored principle that one needs to master a discipline thoroughly before deviating from it, the feeling that one is breaking time-honored, incontestable rules is the enemy of developing one’s authentic individual style of working as a therapist.

Once I have a good feel for a person, and the work is going well, I stop thinking diagnostically and simply immerse myself in the unique relationship that unfolds between me and the client. If I find myself preoccupied with issues of diagnosis in an ongoing way, I suspect myself of defending against being fully present with the patient's pain. Diagnosis can, like anything else, be used as a defense against anxiety about the unknown.

Even those schizoid people who are confident of the superiority of their perceptions are not indifferent to the effect they may have in alienating others.

therapists seem to be seeing more and more people at all socioeconomic levels who are deeply in debt—will be glad to take advantage of a therapist’s willingness to underwrite their self-defeating habits by reducing the fee or “carrying” them for a while. Not only is it not in the therapist’s interest to promote this accommodation, it is not in the client’s interest, either.

Patients with symptom neuroses feel on the side of the therapist in opposing a problematic part of the self. They rarely require a long period to develop a shared perspective. In contrast, those whose problems are complexly interwoven with their personality may easily feel alone and under attack.

From their mentors, therapists need to learn how to weather storms of negative feeling coming directly at them from miserable people, how to keep their self-esteem when being relentlessly devalued, how to recognize and deal with the grain of truth in patients’ complaints about them, how to handle their traumatic internal responses to searing accounts of trauma, how to bear ugly and personally alien feelings in themselves, how to tolerate uncertainty, how to set boundaries with people who feel wounded by reasonable limits, how to maintain an unnatural level of secret keeping, how to find hope when clients fill the office with their despair, how to manage anxieties that a patient may die by suicide, and other emotionally taxing lessons.