Short Therapy Quotes

In short, physicians are getting more and more data, which requires more sophisticated interpretation and which takes more time. AI is the solution, enhancing every stage of patient care from research and discovery to diagnosis and therapy selection. As a result, clinical practice will become more efficient, convenient, personalized, and effective.

I create beautiful art, so I can look back on the life my body fell short of in such a way that it brings me peace.

We need this help from the outside because we don't know how to to do this for ourselves. We start with a deep deficit—a chasm really—when it comes to understanding and being tolerant of ourselves, and that's even before we go forth to do battle with the rest of the world. As soon as someone judges, criticizes, dismisses, or ignores, the cycle of pain and reactivity ramps up, compounded by shame, remorse, and rejection. The act of validation, simply saying, 'I can see things from your perspective,' can short-circuit that emotional detour.

Something’s up,’ I say, handing the phone back. ‘Not necessarily,’ Jack says. ‘You think this is the first time Lila’s been hot-headed? Seriously, dude, you do remember my sister, right? Short, blonde, impulsive as shock therapy? Stubborn as a mule who won’t take no for an answer?’ Does Jack ever listen to himself? Does he appreciate the irony of this statement? I shake my head at him in wonder. ‘Hey, I’m not short or blond,’ Jack protests as he catches the look on my face.

ALL-OR-NOTHING THINKING: You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure.

Suppressing Your Thoughts Suppose you have a thought you don’t like. You’ll apply your verbal problem-solving strategies to it. For example, when the thought comes up, you may try to stop thinking it. There is extensive literature on what is likely to happen as a result. Harvard psychologist Dan Wegner (1994) has shown that the frequency of the thought that you try not to think may go down for a short while, but it soon appears more often than ever. The thought becomes even more central to your thinking, and it is even more likely to evoke a response. Thought suppression only makes the situation worse.

...in the lower self, love is neediness, “chemistry” or infatuation, possession, strong admiration, or even worship—in short, traditional romantic love. Many people who grew up in troubled homes and who experienced a stifling of their Child Within become stuck at these lower levels or ways of experiencing love.

The true aspiration of art should be to reduce the need for it. It is not that we should one day lose our devotion to the things that art addresses: beauty, depth of meaning, good relationships, the appreciation of nature, recognition of the shortness of life, empathy, compassion, and so on. Rather, having imbibed the ideals that art displays, we should fight to attain in reality the things art merely symbolises, however graciously and intently. The ultimate goal of the art lover should be to build a world where works of art have become a little less necessary

You think this is the first time Lila’s been impulsive? Seriously, dude, you do remember my sister, right? Short, blonde, impulsive as shock therapy? Stubborn as a mule who won’t take no for an answer?’ Alex raises an eyebrow. Without reading his mind I can tell he’s thinking that that’s like the ear wax laughing at the snot.

My days began and ended with my fear of food. Even though all that was left of me was skin and bones, the only thing I could think was, Still not thin enough!

While performing the great majority of the actions in their life, people are totally unaware. We tend to go through our daily activities mechanically. We talk without real purpose. We do things without even knowing that we do them. We are not really present to what we are doing. Even if we practise being aware, entire portions of our days can elapse before we retrieve our thread of awareness. In short, we are not living our life, we are sleeping it.

I hadn't realized how supremely shit-housed I was until we stumbled into our room at the Embassy Suites. You ever been so drunk you forgot that you have to shit until the last minute? Well I was at that stage. I nearly had my pants completely off when SlingBlade snaked past me and got into the toilet first. Fine, I go get out of my bar clothes and change into a t-shirt and pink Gap boxers to sleep in. I wait patiently for about three minutes, then I start pounding on the door, screaming at him that I am going to shit on his bed if he doesn't get out of there. A short time later he opens the door laughing his ass off, and says, "That was perhaps the most prodigious shit ever. I just put that toilet into therapy." I take a gander into the bathroom. It looks like Revelations. The toilet is overflowing, brown shit water is spilling out all over the bathroom floor, and the tank is making demonic gurgling noises. THE MOTHERFUCKER CLOGGED UP A HOTEL TOILET! Hotel toilets are industrial size; they are designed to be able to accommodate repeated elephant-sized shits, and their ram-jet engine flushes generate enough force to suck down a human infant, yet skinny ass 170-pound SlingBlade completely killed ours.

Soon, everyone around me had come to terms with my peculiar eating habits and started accepting me for who I was. It felt peculiar at first, but when someone said things like, “I wish I could resist eating all that,” in whatever parallel universe I existed, I felt powerful.

Some seek the comfort of their therapist’s office, others head for the corner pub and dive into a pint, but I choose running as my therapy. It was the best source of renewal there was. I couldn’t recall a single time that I felt worse after a run than before. What drug could compete? As Lily Tomlin said, “Exercise is for people who can’t handle drugs and alcohol.” I’d also come to recognize that the simplicity of running was quite liberating. Modern man has virtually everything one could desire, but too often we’re still not fulfilled. “Things” don’t bring happiness. Some of my finest moments came while running down the open road, little more than a pair of shoes and shorts to my name. A runner doesn’t need much. Thoreau once said that a man’s riches are based on what he can do without. Perhaps in needing less, you’re actually getting more.

That was when I realized I had no control over my actions anymore. All I knew was that though no one knew what hell felt like, my life had become a version of fire and brimstone. My restrictive anorexia was completely and inexorably interfering with my ability to live like a normal human being.

He helped me sit up on my bed and tried to force-feed me glucose dissolved in water and a biscuit he’d grabbed from my roommate’s bedside. But I spat it right out, still thinking about calories and numbers. “That’s enough, Amira. I’m literally trying to feed you water. It’s not going to hurt you!” he screamed.

In many cases in psychiatry, the patient who comes to us has a story that is not told, and which as a rule no one knows of. To my mind, therapy only really begins after the investigation of that wholly personal story. It is the patient’s secret, the rock against which he is shattered. If I know his secret story, I have a key to the treatment. . . . In therapy the problem is always the whole person, never the symptom alone. We must ask questions which challenge the whole personality. (MDR 118)

We now talk about fast food, speed dating, power-naps and short-term therapy. Recently, I tested an app called Spritz. It only shows a single word at a time, but increases your reading speed from 250 to 500-600 words a minute. Suddenly you can read a novel in a couple of hours! But does this help you understand literature any better?

These two poles, the unconditional and the conditional, are absolutely heterogeneous, and must remain irreducible to one another. They are nonetheless indissociable: if one wants, and it is necessary, forgiveness to become effective, concrete, historic; if one wants it to arrive, to happen by changing things, it is necessary that this purity engage itself in a series of conditions of all kinds (psychosociological, political, etc.). It is between these two poles, irreconcilable but indissociable, that decisions and responsibilities are to be taken. Yet despite all the confusions which reduce forgiveness to amnesty or to amnesia, to acquittal or prescription, to the work of mourning or some political therapy of reconciliation, in short to some historical ecology, it must never be forgotten, nevertheless, that all of that refers to a certain idea of pure and unconditional forgiveness, without which this discourse would not have the least meaning. What complicates the question of ‘meaning’ is again what I suggested a moment ago: pure and unconditional forgiveness, in order to have its own meaning, must have no ‘meaning’, no finality, even no intelligibility. It is a madness of the impossible.

This is a remarkably sturdy research finding: kids are happiest when raised in a loving environment that holds their behavior to high standards, expects them to contribute meaningfully to the household, and is willing to punish when behavior falls short. And it flies in the face of virtually everything therapists and parenting books now exhort.

A modern fad which has gained widespread acceptance amongst the semi-educated who wish to appear secular is the practice of meditation. They proclaim with an air of smug superiority, ‘Main mandir-vandir nahin jaata, meditate karta hoon (I don’t go to temples or other such places, I meditate).’ The exercise involves sitting lotus-pose (padma asana), regulating one’s breathing and making your mind go blank to prevent it from ‘jumping about like monkeys’ from one (thought) branch to another. This intense concentration awakens the kundalini serpent coiled at the base of the spine. It travels upwards through chakras (circles) till it reaches its destination in the cranium. Then the kundalini is fully jaagrit (roused) and the person is assured to have reached his goal. What does meditation achieve? The usual answer is ‘peace of mind’. If you probe further, ‘and what does peace of mind achieve?’, you will get no answer because there is none. Peace of mind is a sterile concept which achieves nothing. The exercise may be justified as therapy for those with disturbed minds or those suffering from hypertension, but there is no evidence to prove that it enhances creativity. On the contrary it can be established by statistical data that all the great works of art, literature, science and music were works of highly agitated minds, at times minds on the verge of collapse. Allama Iqbal’s short prayer is pertinent: Khuda tujhey kisee toofaan say aashna kar dey Keh terey beher kee maujon mein iztiraab naheen (May God bring a storm in your life, There is no agitation in the waves of your life’s ocean.)

Therapy is a special kind of teaching or training which attempts to accomplish in a relatively short, intense period what should have established during normal growing up.

Days and weeks passed by with changes in seasons and the phases of the moon. But the one thing that remained unmoved and constant was something I told myself every single day, "Amira Kashyap, you are fat!

The better question is: Do you want to recover?” I didn’t have an answer; I wasn’t sure. Recovery sounded great on paper and in the calm and casual way he said it. But why did the very thought of recovery seem like the most excruciating and difficult thing? What if I started hating myself after a few months of making conscious efforts to be a healthy person again? What if recovery meant being fat all over again? What if I wasn’t ready? “I’m not sure,” I said.

Trust of others is in short supply for many adult survivors, as complex trauma generally involves major relational betrayal. It is, therefore, expectable (although paradoxical) that clients with these histories are predisposed to be mistrustful at the outset of therapy, precisely because of (and in proportion to) the actual trustworthiness of the therapist. When past experiences have thought hard lessons, namely, that one can least afford to trust the people who should be most trustworthy, it stands to reason that confusion about trust results. The therapist must understand and not take offense either personally or professionally and not react judgmentally or defensively. Practically speaking, this involves the therapist being prepared to patiently and empathically respond to active or passive tests or challenges to trustworthiness as legitimate and meaningful communication that deserves a respectful reply in action as well as in words.

The biggest lie anxiety whispers at us is that we're the only ones, that it's some sort of moral failing when we need help. Don't trade the short-term comfort avoidance gives for the long-term relief that comes with working through what's uncomfortable.

It was haunting to be entangled in this obnoxious cycle. I want to get out of this viciousness. That pizza is staring at me. I think that slice of pie might hurt me. Thirty-five calories for an Oreo cookie; 75caloriesfor a slice of bread; 285 for a slice of pizza; 350for a plate of pasta. You know, maybe I’ll just study the digits of eggs, wheat, vegetables, apples, oranges. Ugh! Stop. It all hurts so much. That’s it. Make it stop. Please, I beg you. Just make it stop. I felt like the walking and living encyclopedia of numbers and digits.

My life was now determined by the number on the scale or the digits behind food containers. But I was completely okay with it as long as my 24” waist size never felt even a tad tighter. But if it ever did, hell would freeze over, resulting in 21-day fasts until I felt thin enough.

The scars of my anorexia, perfectly hand-drawn in red, immaculately colouring one-fourth of my left arm. It had hurt like hell, but it still wasn’t as painful as the last two years of my life. The mental, excruciating pain within the depths of my brain had managed to surpass the aching pain of the pointed edge of the object I’d used on my arm. I’d thought that overshadowing the pain I already felt with a much harsher form and intensity would make the emotional pain disappear. I was wrong. The latter pain always remains stronger; that is something I realized.

The I Ching insists upon self-knowledge throughout. The method by which this is to be achieved is open to every kind of misuse, and is therefore not for the frivolous-minded and immature; nor is it for intellectualists and rationalists. It is appropriate only for thoughtful and reflective people who like to think about what they do and what happens to them -- a predilection not to be confused with the morbid brooding of the hypochondriac. As I have indicated above, I have no answer to the multitude of problems that arise when we seek to harmonize the oracle of the I Ching with our accepted scientific canons. But needless to say, nothing "occult" is to be inferred. My position in these matters is pragmatic, and the great disciplines that have taught me the practical usefulness of this viewpoint are psychotherapy and medical psychology. Probably in no other field do we have to reckon with so many unknown quantities, and nowhere else do we become more accustomed to adopting methods that work even though for a long time we may not know why they work. Unexpected cures may arise from questionable therapies and unexpected failures from allegedly reliable methods. In the exploration of the unconscious we come upon very strange things, from which a rationalist turns away with horror, claiming afterward that he did not see anything. The irrational fullness of life has taught me never to discard anything, even when it goes against all our theories (so short-lived at best) or otherwise admits of no immediate explanation. It is of course disquieting, and one is not certain whether the compass is pointing true or not; but security, certitude, and peace do not lead to discoveries.

If you are reading this book, a clear betrayal has probably happened in your life. Chances are that you have also bonded with the person or persons who have let you down. Now here is the important part: You will never mend the wound without dealing with the betrayal bond. Like gravity, you may defy it for a while, but ultimately it will pull you back. You cannot walk away from it. Time will not heal it. Burying yourself in compulsive and addictive behaviors will bring no relief, just more pain. Being crazy will not make it better. No amount of therapy, long-term or short-term, will help without confronting it. Your ability to have a spiritual experience will be impaired. Any form of conversion or starting over only postpones the inevitable. And there is no credit for feeling sorry for yourself. You must acknowledge, understand and come to terms with the relationship.

Once, at the end of a session with Wendell, I told him that sometimes, on days when I left more upset than when I came in—tossed out into the world, having so much more to say, holding so many painful feelings—I hated therapy. “Most things worth doing are difficult,” he replied. He said this not in a glib way but in a tone and with an expression that made me think he spoke from personal experience. He added that while everyone wants to leave each session feeling better, I, of all people, should know that that’s not always how therapy works. If I wanted to feel good in the short term, he said, I could eat a piece of cake or have an orgasm. But he wasn’t in the short-term-gratification business.

It wasn’t like I had started magically eating two entire meals in a day. I would still survive the day with black coffee and apples, but it just seemed like I’d taken one step heavenwards. The mirror felt a little less frightening with each passing day. It was refreshing to talk to someone who was fully convinced that my eating disorder was as real as I thought.

Correct me if I’m wrong,” he said, “but I was under the impression that you weren’t looking for anything more than a short-term arrangement either, Miss Free Spirit.” She flushed. “I wasn’t the one who ran for the door that night. I was doing just fine with the summer-fling thing.” “I did not run for the door. I left in a hurry, but I did not run.” “Details.” “Important details. And I’d like to remind you that I showed at your gallery the next morning,” he said. “It’s not like I didn’t call. And how the hell do you think I felt when you told me that the sex had been therapeutic? You made it sound like a good massage or a tonic, damn it.” She bit her lip. “Well, it was in a way.” “Great. Well, do me a favor. The next time you want physical therapy, call a masseuse or a chiropractor. Or buy a vibrator.

But he gave no greater gift than the one he offered me shortly before he died, and it was a gift that answers for all time the question of whether it is rational or appropriate to strive for “ambitious” therapy in those who are terminally ill. When I visited him in the hospital he was so weak he could barely move, but he raised his head, squeezed my hand, and whispered, “Thank you. Thank you for saving my life.

Everything was going perfectly well until Dr. Roy paused for a long minute to stare at me with utter shock and revelation. I knew I had messed up. I should have just worn my black, full-sleeved dress instead. But again, I thought that the scars had lightened to an unnoticeable extent. But I guess I was wrong. That was when I realized that scars never went away entirely. “Did you do that to yourself?” he asked.

During my short college stint, every time I picked up a pen, this grinding, unnamed fear overcame me—later identified as fear that my real self would spill out. One can’t mount a stripper pole wearing a metal diving suit. What I needed to write kept simmering up while I wrote down everything but that. In fact, I kept ginning out reasons that writing reality was impossible. I cranked up therapy and drank like a fish.

had been insulin shock therapy, in which the patient was injected with insulin to induce a short coma; the theory was that regular treatments, a coma a day, might slowly chip away at the effects of psychosis. Then came the lobotomy, the severing of the nerves of a patient’s frontal lobes—which, as the British psychiatrist W. F. McAuley delicately put it, “deprives the patient of certain qualities with which, and perhaps because of which, he has failed to adapt.

I wanted to be normal again. I wanted to be genuinely happy again and not just pretend. I didn’t want distorted mirror images to destroy and define my life any longer. I wished to breathe in the customary air, instead of the suffocating one people like me had accustomed themselves to breathe. I just wanted to break through these metal rods that I’d been caged behind for the last two years of my life. I wanted to feel plain, simple, genuine contentment again. I wanted to; I needed to.

I resolved to come right to the point. "Hello," I said as coldly as possible, "we've got to talk." "Yes, Bob," he said quietly, "what's on your mind?" I shut my eyes for a moment, letting the raging frustration well up inside, then stared angrily at the psychiatrist. "Look, I've been religious about this recovery business. I go to AA meetings daily and to your sessions twice a week. I know it's good that I've stopped drinking. But every other aspect of my life feels the same as it did before. No, it's worse. I hate my life. I hate myself." Suddenly I felt a slight warmth in my face, blinked my eyes a bit, and then stared at him. "Bob, I'm afraid our time's up," Smith said in a matter-of-fact style. "Time's up?" I exclaimed. "I just got here." "No." He shook his head, glancing at his clock. "It's been fifty minutes. You don't remember anything?" "I remember everything. I was just telling you that these sessions don't seem to be working for me." Smith paused to choose his words very carefully. "Do you know a very angry boy named 'Tommy'?" "No," I said in bewilderment, "except for my cousin Tommy whom I haven't seen in twenty years..." "No." He stopped me short. "This Tommy's not your cousin. I spent this last fifty minutes talking with another Tommy. He's full of anger. And he's inside of you." "You're kidding?" "No, I'm not. Look. I want to take a little time to think over what happened today. And don't worry about this. I'll set up an emergency session with you tomorrow. We'll deal with it then." Robert This is Robert speaking. Today I'm the only personality who is strongly visible inside and outside. My own term for such an MPD role is dominant personality. Fifteen years ago, I rarely appeared on the outside, though I had considerable influence on the inside; back then, I was what one might call a "recessive personality." My passage from "recessive" to "dominant" is a key part of our story; be patient, you'll learn lots more about me later on. Indeed, since you will meet all eleven personalities who once roamed about, it gets a bit complex in the first half of this book; but don't worry, you don't have to remember them all, and it gets sorted out in the last half of the book. You may be wondering -- if not "Robert," who, then, was the dominant MPD personality back in the 1980s and earlier? His name was "Bob," and his dominance amounted to a long reign, from the early 1960s to the early 1990s. Since "Robert B. Oxnam" was born in 1942, you can see that "Bob" was in command from early to middle adulthood. Although he was the dominant MPD personality for thirty years, Bob did not have a clue that he was afflicted by multiple personality disorder until 1990, the very last year of his dominance. That was the fateful moment when Bob first heard that he had an "angry boy named Tommy" inside of him. How, you might ask, can someone have MPD for half a lifetime without knowing it? And even if he didn't know it, didn't others around him spot it? To outsiders, this is one of the most perplexing aspects of MPD. Multiple personality is an extreme disorder, and yet it can go undetected for decades, by the patient, by family and close friends, even by trained therapists. Part of the explanation is the very nature of the disorder itself: MPD thrives on secrecy because the dissociative individual is repressing a terrible inner secret. The MPD individual becomes so skilled in hiding from himself that he becomes a specialist, often unknowingly, in hiding from others. Part of the explanation is rooted in outside observers: MPD often manifests itself in other behaviors, frequently addiction and emotional outbursts, which are wrongly seen as the "real problem." The fact of the matter is that Bob did not see himself as the dominant personality inside Robert B. Oxnam. Instead, he saw himself as a whole person. In his mind, Bob was merely a nickname for Bob Oxnam, Robert Oxnam, Dr. Robert B. Oxnam, PhD.

In short: all the woo is keeping us from dealing with our poo. Instead of medicating with Marlboros and martinis, we might be doing it with metaphysics and macrobiotics. And unlike boozing it up to drown our pain, the side effects of neurotic psychoanalyzing or forced flexibility are difficult to spot. We don't end up in rehab from too much meditation or therapy -- we just end up in more workshops. Think of that friend you have who has a not-so-loving relationship with her body, but because she eats "health foods" and talks a good "body positive" talk about just wanting to be strong, we cheer her on. But really, she's got self-destructive motivations and a mild eating disorder disguised as a holistic wellness routine. On the surface, positivity and wellness goalkeeping present so nicely that it can be hard to see when healthy actions are hooked to unhealthy ambitions. Like too much of anything, spiritual bypassing can numb us out from our Truth -- which is where the healing answers wait to be found.

I remembered all those times when the people around me believed that I had spent the last two years of my life faking an eating disorder for the sole purpose of attention. For that reason, every day I would read a thousand articles and watch a hundred videos on real survivors who’d battled anorexia. Then I would question myself. My ribs aren’t popping out of my stomach, so maybe it’s actually just in my mind. Then after a few days of surviving on nothing at all, I would look at myself, see my ribs popping out and ask myself, Am I now?

A short treatment of anti-nausea agents can be considered. A person may use benzodiazepines or meclizine to reduce the vertigo, but it is vital to remember NOT to use such medications for more than 2-3 days. After vestibular neuritis, the brain needs to adapt to the loss of inner ear function and reorganize the balance system (a process called central compensation). These medications impede central compensation, and will cause a person to feel off balance and dizzy for a very long time. On the other hand, vestibular rehabilitation therapy helps improve central compensation, and should be started as soon as possible after vestibular neuritis.

Yearning for some form of reconciliation, for a new, fresh beginning to their relationship, she looked forward to her father’s driving her to college—a time when she would be alone with him for several hours. But the long-anticipated trip proved a disaster: her father behaved true to form by grousing at length about the ugly, garbage-littered creek by the side of the road. She, on the other hand, saw no litter whatsoever in the beautiful, rustic, unspoiled stream. She could find no way to respond and eventually, lapsing into silence, they spent the remainder of the trip looking away from each other. Later, she made the same trip alone and was astounded to note that there were two streams—one on each side of the road. “This time I was the driver,” she said sadly, “and the stream I saw through my window on the driver’s side was just as ugly and polluted as my father had described it.” But by the time she had learned to look out her father’s window, it was too late—her father was dead and buried. That story has remained with me, and on many occasions I have reminded myself and my students, “Look out the other’s window. Try to see the world as your patient sees it.” The woman who told me this story died a short time later of breast cancer, and I regret that I cannot tell her how useful her story has been over the years, to me, my students, and many patients.

There were inquiries, Congressional hearings, books, exposés and documentaries. However, despite all this attention, it was still only a few short months before interest in these children dropped away. There were criminal trials, civil trials, lots of sound and fury. All of the systems—CPS, the FBI, the Rangers, our group in Houston—returned, in most ways, to our old models and our ways of doing things. But while little changed in our practice, a lot had changed in our thinking. We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.

The clearest short-term yardstick may be the PSA nadir (discussed above). One study of 743 patients at Memorial Sloan-Kettering Cancer Center in New York confirmed that higher-intensity radiation does a better job of achieving a rock-bottom PSA level. Of the men who received higher doses—76 to 81 Gy—90 percent achieved a PSA nadir of 1.0 ng/ml or less; 76 percent of men who received 70 Gy and 56 percent of men who received 64.8 Gy achieved those low PSA levels. But there was a trade-off—the men who received higher doses of radiation also had a significantly higher rate of gastrointestinal side effects, urinary tract complications, and impotence. To overcome these side effects at high doses, intensity-modulated radiation therapy

(IMRT) has an advantage. The newer, high-dose, conformally directed, external-beam techniques for radiation therapy such as IMRT have been in widespread use for less than ten years; IGRT has been around for an even shorter time. However, some reports of long-term success are now emerging. New studies suggest that at ten years, high radiation doses alone can produce PSA control or cure rates in 93 percent of men with low-risk prostate cancer. What about more aggressive prostate cancer? As we discussed in chapter 9, the best treatment regimen for men with intermediate- and high-risk prostate cancer is still a moving target, but it will likely turn out to be a combination of high-dose radiation and short- or long-term hormonal therapy.

If only I could coexist as peacefully with you as I do with my wolf,” Jaime said as they walked back to pack territory hand in hand. Dante frowned at her. “We coexist peacefully…when you’re not making a mess of our room and ignoring what I say.” “Maybe you could stop being a neat freak and ease off with barking orders at me.” “I resent the neat-freak statement. And I do not bark.” She snickered. “Sure you don’t, Popeye.” “And it wouldn’t kill you to use the shoe rack. I mean, it’s right by the door.” “Stop putting my CDs in chronological order, and I’ll work on the shoe rack thing.” A short pause. “How about alphabetical order?” “How about you go to therapy?” A frustrated growl escaped him. “How about I just shove my cock in your mouth? That should shut you up. Hey!” he whined when she drummed her fingers against his temple. “What’re you doing?” She shrugged. “I just felt like tapping some ass.” His mouth dropped open. Her smirk had him growling again. “Bitch.” “Jerk.” “Love you, baby.” “Love you, Popeye.

Therapy must begin with empathy - not a patronizing sympathy, but instead one that is unflinching (Marotta, 2003). Empathy of this sort is highly attuned to the client, no matter the circumstance. The therapist strives to "travel in the client's shoes" or to "view the world from the client's perspective" in order to really understand his or her emotions, cognitions, and beliefs - in short, to understand from the perspective of the other (Wilson & Thomas, 2004). Treatment involves understanding that a client's defeatist and apparently helpless, disempowered, or "masochistic" perspectives can be a logical outgrowth of formative traumatic experiences and, further, may be highly creative means of self-protection. The therapist must not attempt to undo or "make up for" past abandonment or betrayals by their client's caregivers or in their close relationships, but instead first understand the client's perspective and approach to the world, while working to provide alternative perspectives on both past and present that promote change.

Dr. Morris Netherton, a pioneer in the field of past-life therapy (and my teacher),7 relates the incident of a patient who returned to her previous life as Rita McCullum. Rita was born in 1903 and lived in rural Pennsylvania with her foster parents until they were killed in a car accident in 1916. In the early 1920s she married a man named McCullum and moved to New York, where they had a garment manufacturing company off Seventh Avenue in midtown Manhattan. Life was hard and money short. Her husband died in 1928. In 1929, her son died from polio, and the stock market crashed. Like many others during the Great Depression, Rita succumbed to bankruptcy and depression. On the sunny day of June 11, 1933, she hanged herself from the ceiling fan of her factory. Because this memory featured traceable facts, Netherton and his patient contacted New York City’s Hall of Records. They received a photocopy of a notarized death certificate of a woman named Rita McCullum. Under manner of death, it stated that she died by hanging at an address in the West Thirties, still today the heart of the garment district. The date of death was June 11, 1933.8

As many speakers noted, this tool wasn’t particularly well suited for assessing outcomes of a psychiatric drug. How could a study of a neuroleptic possibly be “double-blind”? The psychiatrist would quickly see who was on the drug and who was not, and any patient given Thorazine would know he was on a medication as well. Then there was the problem of diagnosis: How would a researcher know if the patients randomized into a trial really had “schizophrenia”? The diagnostic boundaries of mental disorders were forever changing. Equally problematic, what defined a “good outcome”? Psychiatrists and hospital staff might want to see drug-induced behavioral changes that made the patient “more socially acceptable” but weren’t to the “ultimate benefit of the patient,” said one conference speaker.11 And how could outcomes be measured? In a study of a drug for a known disease, mortality rates or laboratory results could serve as objective measures of whether a treatment worked. For instance, to test whether a drug for tuberculosis was effective, an X-ray of the lung could show whether the bacillus that caused the disease was gone. What would be the measurable endpoint in a trial of a drug for schizophrenia? The problem, said NIMH physician Edward Evarts at the conference, was that “the goals of therapy in schizophrenia, short of getting the patient ‘well,’ have not been clearly defined.

For things to change, somebody somewhere has to start acting differently. Maybe it’s you, maybe it’s your team. Picture that person (or people). Each has an emotional Elephant side and a rational Rider side. You’ve got to reach both. And you’ve also got to clear the way for them to succeed. In short, you must do three things: → DIRECT the Rider FOLLOW THE BRIGHT SPOTS. Investigate what’s working and clone it. [Jerry Sternin in Vietnam, solutions-focused therapy] SCRIPT THE CRITICAL MOVES. Don’t think big picture, think in terms of specific behaviors. [1% milk, four rules at the Brazilian railroad] POINT TO THE DESTINATION. Change is easier when you know where you’re going and why it’s worth it. [“You’ll be third graders soon,” “No dry holes” at BP] → MOTIVATE the Elephant FIND THE FEELING. Knowing something isn’t enough to cause change. Make people feel something. [Piling gloves on the table, the chemotherapy video game, Robyn Waters’s demos at Target] SHRINK THE CHANGE. Break down the change until it no longer spooks the Elephant. [The 5-Minute Room Rescue, procurement reform] GROW YOUR PEOPLE. Cultivate a sense of identity and instill the growth mindset. [Brasilata’s “inventors,” junior-high math kids’ turnaround] → SHAPE the Path TWEAK THE ENVIRONMENT. When the situation changes, the behavior changes. So change the situation. [Throwing out the phone system at Rackspace, 1-Click ordering, simplifying the online time sheet] BUILD HABITS. When behavior is habitual, it’s “free”—it doesn’t tax the Rider. Look for ways to encourage habits. [Setting “action triggers,” eating two bowls of soup while dieting, using checklists] RALLY THE HERD.

1. ALL-OR-NOTHING THINKING: You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure. 2. OVERGENERALIZATION: You see a single negative event as a never-ending pattern of defeat. 3. MENTAL FILTER: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that colors the entire beaker of water. 4. DISQUALIFYING THE POSITIVE: You reject positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences. 5. JUMPING TO CONCLUSIONS: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. a. Mind reading. You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out. b. The Fortune Teller Error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact. 6. MAGNIFICATION (CATASTROPHIZING) OR MINIMIZATION: You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.” 7. EMOTIONAL REASONING: You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.” 8. SHOULD STATEMENTS: You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment. 9. LABELING AND MISLABELING: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to him: “He’s a goddam louse.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. 10. PERSONALIZATION: You see yourself as me cause of some negative external event which in fact you were not primarily responsible for.

With the relief of knowing I had passed through a crisis, I sighed because there was nothing to hold me back. It was no time for fear or pretense, because it could never be this way with anyone else. All the barriers were gone. I had unwound the string she had given me, and found my way out of the labyrinth to where she was waiting. I loved her with more than my body. I don’t pretend to understand the mystery of love, but this time it was more than sex, more than using a woman’s body. It was being lifted off the earth, outside fear and torment, being part of something greater than myself. I was lifted out of the dark cell of my own mind, to become part of someone else—just as I had experienced it that day on the couch in therapy. It was the first step outward to the universe—beyond the universe—because in it and with it we merged to recreate and perpetuate the human spirit. Expanding and bursting outward, and contracting and forming inward, it was the rhythm of being—of breathing, of heartbeat, of day and night—and the rhythm of our bodies set off an echo in my mind. It was the way it had been back there in that strange vision. The gray murk lifted from my mind, and through it the light pierced into my brain (how strange that light should blind!), and my body was absorbed back into a great sea of space, washed under in a strange baptism. My body shuddered with giving, and her body shuddered its acceptance. This was the way we loved, until the night became a silent day. And as I lay there with her I could see how important physical love was, how necessary it was for us to be in each other’s arms, giving and taking. The universe was exploding, each particle away from the next, hurtling us into dark and lonely space, eternally tearing us away from each other—child out of the womb, friend away from friend, moving from each other, each through his own pathway toward the goal-box of solitary death. But this was the counterweight, the act of binding and holding. As when men to keep from being swept overboard in the storm clutch at each other’s hands to resist being torn apart, so our bodies fused a link in the human chain that kept us from being swept into nothing. And in the moment before I fell off into sleep, I remembered the way it had been between Fay and myself, and I smiled. No wonder that had been easy. It had been only physical. This with Alice was a mystery. I leaned over and kissed her eyes. Alice knows everything about me now, and accepts the fact that we can be together for only a short while. She has agreed to go away when I tell her to go. It’s painful to think about that, but what we have, I suspect, is more than most people find in a lifetime.

What is one of the best or most worthwhile investments you’ve ever made? Flying trapeze lessons. It’s like shock therapy for the soul. Once you’re 50 feet high, soaring on a trapeze, it’s just you, your fear, and your instincts. It’s the most intimate experience I’ve had with myself.

Why is this? How can experience be so valuable in some professions but almost worthless in others? To see why, suppose that you are playing golf. You are out on the driving range, hitting balls toward a target. You are concentrating, and every time you fire the ball wide you adjust your technique in order to get it closer to where you want it to go. This is how practice happens in sport. It is a process of trial and error. But now suppose that instead of practicing in daylight, you practice at night—in the pitch-black. In these circumstances, you could practice for ten years or ten thousand years without improving at all. How could you progress if you don’t have a clue where the ball has landed? With each shot, it could have gone long, short, left, or right. Every shot has been swallowed by the night. You wouldn’t have any data to improve your accuracy. This metaphor solves the apparent mystery of expertise. Think about being a chess player. When you make a poor move, you are instantly punished by your opponent. Think of being a clinical nurse. When you make a mistaken diagnosis, you are rapidly alerted by the condition of the patient (and by later testing). The intuitions of nurses and chess players are constantly checked and challenged by their errors. They are forced to adapt, to improve, to restructure their judgments. This is a hallmark of what is called deliberate practice. For psychotherapists things are radically different. Their job is to improve the mental functioning of their patients. But how can they tell when their interventions are going wrong or, for that matter, right? Where is the feedback? Most psychotherapists gauge how their clients are responding to treatment not with objective data, but by observing them in clinic. But these data are highly unreliable. After all, patients might be inclined to exaggerate how well they are to please the therapist, a well-known issue in psychotherapy. But there is a deeper problem. Psychotherapists rarely track their clients after therapy has finished. This means that they do not get any feedback on the lasting impact of their interventions. They have no idea if their methods are working or failing—if the client’s long-term mental functioning is actually improving. And that is why the clinical judgments of many practitioners don’t improve over time. They are effectively playing golf in the dark.11

Despite the objection from his mother he had decided to visit a clinic with the woman. He knew, he would forever be obliged to her. He had found a job, but he could not keep it because of his addiction. He had no money. The woman paid the expenses. She introduced him to people who would understand his problem and help him deal with it. She made him join Sex Addicts Anonymous. She helped him deal with his urges. He had started to believe that sexual addiction was real. Suddenly, everything made sense. He was not a freak, he had a serious problem. He suffered from a disorder. He had the option to set things straight. He underwent Cognitive Behavioral Therapy, which he benefited from. A prostitute had set him free. - from story 109 of You Me & Stories

The beauty of poker is that while luck is always involved, luck doesn’t dictate the long-term results of the game. A person can get dealt terrible cards and beat someone who was dealt great cards. Sure, the person who gets dealt great cards has a higher likelihood of winning the hand, but ultimately the winner is determined by—yup, you guessed it—the choices each player makes throughout play. I see life in the same terms. We all get dealt cards. Some of us get better cards than others. And while it’s easy to get hung up on our cards, and feel we got screwed over, the real game lies in the choices we make with those cards, the risks we decide to take, and the consequences we choose to live with. People who consistently make the best choices in the situations they’re given are the ones who eventually come out ahead in poker, just as in life. And it’s not necessarily the people with the best cards. There are those who suffer psychologically and emotionally from neurological and/or genetic deficiencies. But this changes nothing. Sure, they inherited a bad hand and are not to blame. No more than the short guy wanting to get a date is to blame for being short. Or the person who got robbed is to blame for being robbed. But it’s still their responsibility. Whether they choose to seek psychiatric treatment, undergo therapy, or do nothing, the choice is ultimately theirs to make. There are those who suffer through bad childhoods. There are those who are abused and violated and screwed over, physically, emotionally, financially. They are not to blame for their problems and their hindrances, but they are still responsible—always responsible—to move on despite their problems and to make the best choices they can, given their circumstances.

Once I began to become conscious of the emotional messages I was getting from my body instead of just trying to figure things out in my head, then I had a choice to follow the guidance I was receiving.  I could let my gut reaction choose the books I read.  I could let my heart guide me to the talks or workshops that I needed to attend.  I realized that if my attention was drawn to  something - an author, a workshop, a certain type of healing therapy, a psychic, a gathering, a movie, anything that caught my attention on a feeling level - three or more times from different sources in a short time span that the Universe was probably sending me a message.

From the perspective of Islam, the ultimate goal of therapy is not simply to change thinking, emotion, or behaviour, but rather to have an impact upon the soul. This impact, in turn, will affect the other components of the human being. The foundation of any interventions will revolve around the spiritual development of the client. The focus on spiritual aspects will enhance the likelihood of effective and enduring outcomes. This is in contrast to secular approaches that focus on symptoms rather than addressing the primary cause, generally resulting in short-lived effects.

Though I’m not opposed to hormone therapy (more on that shortly), I reject the notion that every woman needs hormone “replacement” therapy to stay young.

When I die I hope that there will be laughter. I hope that champagne will be served. I hope that people wear red. And I hope when people speak of me that this is what they will say: She hugged too hard. She laughed too loud. She felt too much. She swore too much. She talked too much. She wore heels that were too tall. She wore skirts that were too short. She had too many tattoos. She made too many inappropriate jokes. She asked too many questions. She drank too much caffeine. She drank too much wine. She made peace with being too much for too many. She was overdressed. She was never early. She couldn’t sing but that never stopped her. She couldn’t sew. She couldn’t bake. She couldn’t be contained. She never had a shortage of people in her kitchen. She made her own traditions. She stopped using her voice for apologies unearned. She loved with reckless abandon. She tried to see the whole world. She tried to save the corners that she could. She tried to give her children deep roots and wide wings. She fell. She rose. She danced. She unraveled. She let go. She evolved. She carried herself as though she was made of feathers. She never smoothed her wild edges. She never stopped writing new chapters. She never stopped chasing the light. She was a tangled mess. She was strong. She was fierce. She was brave. She was a badass. She dreamed out loud. Her friends were her soulmates. The ocean was her therapy. Grace was her religion. Imperfection was her backbone. Forgiveness was her freedom. She lived like there was magic enveloped in the every day. She lived like there would never be enough time. She lived like there was fire in her veins. She lived.

Simple tasks became monumental nightmares. A short trip to vote turned into a long, nerve-wracking experience. The voting booths were conveniently located just around the block from my house. I jumped into the car, and I was suddenly overcome with dizziness when I tried to look left and right. I kept driving, thinking I would get there shortly. But something went wrong. Much time passed, and I had no clue where I was. It was now dark outside, and I was lost. I caught a whiff of ocean water, which was at least a half-hour away from my home. Frightened and confused, I pulled over and cried.

Wool was just an idea for a short story. It was a bit of therapy following the death of my beloved dog, Jolie. I wanted

Swedish massage is the most common form of massage therapy in the United States. This classic technique targets muscles in ways that promote relaxation and possible short-term pain relief.

Some of the prominent ones that have been particularly useful for many trauma survivors include dialectical behavior therapy for borderline personality (Linehan, 1993); systems training for emotional predictability and problem solving (STEPPS; Blum et al., 2008; Bos, Van Wel, Appelo, & Verbraak, 2010 also for borderline personality; short-term psychodynamic treatment of affect phobia (McCullough et al., 2003); and mindfulness and mentalization-based treatments such as acceptance and commitment therapy (ACT; Follette & Pistorello, 2007). In the past decade, manuals that specifically address the

The treatments for chronic pain come from several disciplines. Traditional analgesics may have only a marginal effect, but many other drugs have been found to be useful, including the anticonvulsants carbamazepine and gabapentin, the antidepressant amitriptyline, the hormone calcitonin, and the fiery extract of chilli pepper, capsaicin. Other interventions include nerve blocks, and even implantable devices such as spinal cord stimulators. These are supported by psychological treatments such as cognitive behavioural therapy.

...common phobias of heights and snakes can be cured relatively easily through short-term desensitization therapy.

Each night after the children went to bed our team would meet to review the day and discuss each child. This “staffing” process began to reveal patterns that suggested therapeutic experiences were taking place in short, minutes-long interactions. As we charted these contacts we found that, despite having no formal “therapy” sessions, each child was actually getting hours of intimate, nurturing, therapeutic connections each day. The child controlled when, with whom and how she interacted with the child-sensitive adults around her. Because our staff had a variety of strengths—some were very touchy-feely and nurturing, others were humorous, still others good listeners or sources of information—the children could seek out what they needed, when they needed it. This created a powerful therapeutic web.

Valerie pulled down Angelia’s shorts and panties. Her sexual aroma filled the air.

think there is an important lesson here, especially as states like California start to swing back to a policy of therapy and early release. Predators like Rodney Alcala do not reform. There is no “treatment” that can modify the behavior of a genuine sexual psychopath, and attempting to fix these people is nothing short of reckless folly.

Nice hammer,” Harlow said from behind me. “Hey,” I said, glancing around casually to see if Winnie was with her. “Nice shiner.” “You should see the other chick,” she muttered. “Can we talk?” Setting down my hammer, I followed her away from the other guys. Harlow seemed tense and I worried something was wrong with Winnie. “This is awkward and I feel weird coming here like this,” she said, pushing her blonde hair behind her ears. “Are you dating anyone?” My breath caught. A fear rose up in my chest at the thought of Harlow wanting to date me. What would that mean for me and Winnie? The look in Harlow’s eyes calmed my terror. I might as well have been a brick wall based on the lack of attraction she showed. “No.” “Some girl was hugging you outside a restaurant. Wasn’t that a date?” Frowning, I scratched at my jaw where I forgot to shave that morning. “That was a girl from high school. She might have been into me, but we went out as friends. I’m not dating anyone.” “Winnie saw you with that girl and she got really upset. I know she’s not ready to have a boyfriend, but she wants you. Do you want her?” Playing it cool might be the stud move, but I didn’t want to be a player. I wanted Winnie. Besides, for the second time in twenty four hours, someone close to Winnie wanted to play matchmaker. “Yes.” Harlow nodded. “She’s messed up. You know that, right?” “I know she’s fragile, yeah.” “Winnie has a lot of phobias. Not stupid shit for attention, but real chronic problems that won’t go away because you’re hot. She’s been in therapy for years and gotten stronger, but she’ll never be okay.” “I understand.” Harlow bit her lip then nodded again. “Do you want to take her out to dinner tomorrow?” “Yes.” Harlow smiled. “You better be chattier than that on the date or else no one will say anything. Winnie likely won’t say anything all night, but that doesn’t mean she doesn’t want to. She just takes a long time to warm up to people.” I wasn’t sure what Harlow saw on my face, but she grinned. “She really wants to warm up to you, Dylan. Don’t fuck it up, okay?” “I’ll do my best.” When Harlow narrowed her eyes, I was pretty sure she might hit me. “I appreciate the way you tried to save us that day. You showed balls and I respect that. With that said, you better be taking this seriously, understand?” Leaning closer, I stared right into those suspicious eyes. “No one makes me feel like Winnie. If she needs to take it slow, we’ll go slow. If she wants to rush into it, we’ll rush. If she needs me to stand on my fucking head and sing the National Anthem, I’ll do it. So yes, I’m taking this very seriously,” I said, running a hand where short dark stubble took the place of my mohawk. “I told Winnie I would wait and I meant it. What you think is me being passive is just patience.” “Okay,” Harlow said softly. “You know when I came to Ellsberg, I was pretty messed up. My family was dead and I was in this new place with strangers. Winnie took care of me. She became my sister and best friend. I love her like she’s blood. Nothing personal, but if you hurt her, I’ll have to kill you.” “Fair enough,” I said, grinning. “Smile all you want, buddy, but I’ve got moves.” Harlow faked a punch, but I didn’t flinch. My mind was already focused on tomorrow. I hadn’t talked to Winnie since the day Nick’s dad showed up. I hadn’t seen her close up in weeks. I needed to be close to her even if she couldn’t do more than hide behind her hair all night.

It is probably more adaptive, at least in the short run, to believe that you are to blame and deserve cruel treatment, than that you are helpless and dependent on people who wish you harm.

The personal case histories were the most encouraging. A prominent Los Angeles public relations executive has been living with MM for fourteen years, rides horses, and has an altogether active life on drug maintenance. An Arizona man survived MM and with his wife set up a foundation and website for other families bewildered by the diagnosis. I learned, for the first time, that Frank McGee, host of the Today show from 1971 to 1974, suffered from MM and kept it from everyone despite his ever more gaunt appearance. When he died after putting in another full week on the air his producers and friends were stunned. Sam Walton, founder of Walmart, was another MM casualty, which led many to believe that he had established the high-profile multiple myeloma treatment center in Little Rock, Arkansas. This is a full-immersion process in which MM is the singular target under the commanding title of Myeloma Institute for Research and Therapy. There is a Walton auditorium on the institute’s University of Arkansas medical school campus, but the institute itself was founded by Bart Barlogie, a renowned MM specialist from the MD Anderson Cancer Center in Houston. The institute has an impressive record, running well ahead of the national average for survival for those who are dealing with MM. One number is especially notable. The institute has followed 1,070 patients for more than ten years, and 783 have never had a relapse of the disease. Sam Walton was treated by Dr. Barlogie at MD Anderson before the Little Rock institute was founded, but the connection ended there. Walton, who’d had an earlier struggle with leukemia, didn’t survive his encounter with multiple myeloma, dying in April 1992, a time when life expectancy for a man his age with this cancer was short. I was unaware of all of this when I was diagnosed. I took comfort in the repeated reassurances of specialists that great progress in treating MM with a new class of drugs, your own body’s reengineered immunology system, was rapidly improving chances of a longer survival than the published five to ten years. As I began to respond to treatment the favored and welcome line was, “You’re gonna die but from something else.

The real therapy only begins when the patient sees that it is no longer father and mother who are standing in his way, but himself . .

For things to change, somebody somewhere has to start acting differently. Maybe it’s you, maybe it’s your team. Picture that person (or people). Each has an emotional Elephant side and a rational Rider side. You’ve got to reach both. And you’ve also got to clear the way for them to succeed. In short, you must do three things: → DIRECT the Rider FOLLOW THE BRIGHT SPOTS. Investigate what’s working and clone it. [Jerry Sternin in Vietnam, solutions-focused therapy] SCRIPT THE CRITICAL MOVES. Don’t think big picture, think in terms of specific behaviors. [1% milk, four rules at the Brazilian railroad] POINT TO THE DESTINATION. Change is easier when you know where you’re going and why it’s worth it. [“You’ll be third graders soon,” “No dry holes” at BP]               → MOTIVATE the Elephant FIND THE FEELING. Knowing something isn’t enough to cause change. Make people feel something. [Piling gloves on the table, the chemotherapy video game, Robyn Waters’s demos at Target] SHRINK THE CHANGE. Break down the change until it no longer spooks the Elephant. [The 5-Minute Room Rescue, procurement reform] GROW YOUR PEOPLE. Cultivate a sense of identity and instill the growth mindset. [Brasilata’s “inventors,” junior-high math kids’ turnaround]                             → SHAPE the Path TWEAK THE ENVIRONMENT. When the situation changes, the behavior changes. So change the situation. [Throwing out the phone system at Rackspace, 1-Click ordering, simplifying the online time sheet] BUILD HABITS. When behavior is habitual, it’s “free”—it doesn’t tax the Rider. Look for ways to encourage habits. [Setting “action triggers,” eating two bowls of soup while dieting, using checklists] RALLY THE HERD. Behavior is contagious. Help it spread. [“Fataki” in Tanzania, “free spaces” in hospitals, seeding the tip jar] ————— OVERCOMING OBSTACLES ————— Here we list twelve common problems that people encounter as they fight for change, along with some advice about overcoming them. (Note

immunotherapy making use of Lymphokine Activated Killer Cells. These LAK cells, as they became known, were derived from a patient’s own blood. When grown in the laboratory with some special proteins, they had the ability to selectively attack solid tumor cancers, regardless of type, and destroy them with only minimal side effects. In short, it was the ideal treatment for persons afflicted with this terrible disease. “Unfortunately, there were two problems; only thirty-nine percent of the patients treated responded to the therapy, and the process of collecting and growing the killer cells in the laboratory was time consuming and incredibly expensive. Then, with Doctor Steinberg’s death, and the drying up of government funding, this work at NIH ceased.

Well, good. I figured you were, but…” He turned down our street and glanced at me. “Wait, there’s another guy, isn’t there?” He grinned. “Ugh, Dad. I’m not talking boys with you.” “What’s his name?” I feigned a scowl. “Does he go to Sutton?” I rolled my eyes. “Where’d you meet?” A smile cracked. We pulled into the driveway. “What’s he do?” I sighed then rattled off his answers. “Cade. He’s a therapy dog handler who volunteers at the hospital where I did my internship, and he works at the university rec center.” Dad let out a low, long whistle. “I approve.” I rolled my eyes again. “If you tell Mom, I’ll deny everything and tell her I’ve started dating girls.” “Your life choices don’t change how I feel about you, though your mom may be slow to come around.” “I’m not a lesbian, Dad.” “I’d love you even if you were.” “Dad.” I covered my face with my hands. “This conversation is so over.” He chuckled. “C’mon, short stack. Later, you can show me a picture of this young man or special lady in your life, that’s your choice.” I groaned. “That was meant to deter this conversation.” With another laugh, he hopped out, grabbed my suitcase from the back and unlocked the front door.

It was worse than she’d expected. “None?” she asked. “No fresh boot prints anywhere around the perimeter of the house,” Sheriff Coughlin confirmed. “It was windy last night. Maybe the drifting snow filled in the prints?” Even before she finished speaking, the sheriff was shaking his head. “With the warm temperatures we’ve been having, the snow is either frozen or wet and heavy. If someone had walked through that yard last night, there would’ve been prints.” Daisy hid her wince at his words, even though they hit as hard as an elbow to the gut, and struggled to keep her voice firm. “There was someone walking around the outside of that house last night, Sheriff. I don’t know why there aren’t any boot prints, but I definitely saw someone.” He was giving her that look again, but it was worse, because she saw a thread of pity mixed in with the condescension. “Have you given more thought to starting therapy again?” The question surprised her. “Not really. What does that have to do…?” As comprehension dawned, a surge of rage shoved out her bewilderment. “I didn’t imagine that I saw someone last night. There really was a person there, looking in the side window.” All her protest did was increase the pity in his expression. “It must get lonely here by yourself.” “I’m not making things up to get attention!” Her voice had gotten shrill, so she took a deep breath. “I even said there was no need for you to get involved. I only suggested one of the on-duty deputies drive past to scare away the kid.” “Ms. Little.” His tone made it clear that impatience had drowned out any feelings of sympathy. “Physical evidence doesn’t lie. No one was in that yard last night.” “I know what I saw.” The sheriff took a step closer. Daisy hated how she had to crane her neck back to look at him. It made her feel so small and vulnerable. “Do you really?” he asked. “Eyewitness accounts are notoriously unreliable. Even people without your issues misinterpret what they see all the time. The brain is a tricky thing.” Daisy set her jaw as she stared back at the sheriff, fighting the urge to step back, to retreat from the man looming over her. There had been someone there, footprints or no footprints. She couldn’t start doubting what she’d witnessed the night before. If she did, then that meant she’d gone from mildly, can’t-leave-the-house crazy, to the kind of crazy that involved hallucinations, medications, and institutionalization. There had to be some other explanation, because she wasn’t going to accept that. Not when her life was getting so much better. She could tell by looking at his expression that she wasn’t going to convince Coughlin of anything. “Thank you for checking on it, Sheriff. I promise not to bother you again.” Although he kept his face impassive, his eyes narrowed slightly. “If you…see anything else, Ms. Little, please call me.” That wasn’t going to happen, especially when he put that meaningful pause in front of “see” that just screamed “delusional.” Trying to mask her true feelings, she plastered on a smile and turned her body toward the door in a not-so-subtle hint for him to leave. “Of course.” Apparently, she needed some lessons in deception, since the sheriff frowned, unconvinced. Daisy met his eyes with as much calmness as she could muster, dropping the fake smile because she could feel it shifting into manic territory. She’d lost enough credibility with the sheriff as it was. The silence stretched until Daisy wanted to run away and hide in a closet, but she managed to continue holding his gaze. The memory of Chris telling her about the sheriff using his “going to confession” stare-down on suspects helped her to stay quiet. Finally, Coughlin turned toward the door. Daisy barely managed to keep her sigh of relief silent. “Ms. Little,” he said with a short nod, which she returned. “Sheriff.” Only when he was through the doorway with the door locked behind him did Daisy’s knees start to shake.

The professor would describe all sorts of aberrant types, their prominent, wild eyes, their too thick or too narrow chests or hips and their too thin or too heavy leg muscles; he would illustrate the swagger of the feminine type and the mincing short-stepped swaying gait of the masculine, the fluttering, so called; he would tell of their nocturnal amusements and occupations, and when he had finished he had so enthused his entire class that they were ready to go down town and start a laboratory course at once.

Here are some examples of long, over-stretched muscles at odds with short, tight muscles: rhomboids versus pectoralis major infraspinatus and teres minor versus subscapularis and pectoralis major superficial spinal muscles versus abdominal muscles hamstrings versus the rectus femoris triceps versus the biceps supinator versus pronator teres

Emotionally focused couple therapy (EFT) is a short-term, systematic, and tested intervention to reduce distress in adult love relationships and create more secure attachment bonds.

The FDA will accept a certain level of risk for a new treatment that is to be applied to a group of very sick patients who would otherwise die in the near future, but not for a group who have a relatively long life expectancy on the basis of existing therapies.

The psychiatrist R. D. Laing, at one of the first conferences on Buddhism and psychotherapy that I attended, declared that we are all afraid of three things: other people, our own minds, and death. His statement was all the more powerful because it came shortly before his own death. If bare attention is to be of any real use, it must be applied in exactly these spheres. Physical illness usually provides us with such an opportunity. When my father-in-law, an observant Jew with little overt interest in Eastern philosophy, was facing radical surgery not so long ago, he sought my counsel because he knew of some work I was engaged in about stress reduction. He wanted to know how he could manage his thoughts while going into the surgery, and what he could do while lying awake at night? I taught him bare attention to a simple Jewish prayer; he was gradually able to expand the mental state that developed around the prayer to encompass his thoughts, anxieties, and fears. Even in the intensive care unit after surgery, when he could not tell day from night, move, swallow, or talk, he was able to use bare attention to rest in the moment, dissolving his fears in the meditative space of his own mind. Several years later, after attending Yom Kippur services, he showed me a particular passage in the prayer book that reminded him of what he had learned through his ordeal. A more Buddhist verse he could not have uncovered: A man’s origin is from dust and his destiny is back to dust, at risk of his life he earns his bread; he is likened to a broken shard, withering grass, a fading flower, a passing shade, a dissipating cloud, a blowing wind, flying dust, and a fleeting dream. The fearlessness of bare attention is necessary in the psychological venue as well, where the practice of psychotherapy has revealed just how ingenious and intransigent the ego’s defenses can be. Even when they are in therapy, people are afraid of discovering things about themselves that they do not wish to know.

Yet another pitfall of language is the illusion that our thinking can easily be corrected if it doesn’t “make sense.” The “cognitive” part of cognitive behavioral therapy focuses on changing such “dysfunctional thinking.” This is a top-down approach to change in which the therapist challenges or “reframes” negative cognitions, as in “Let’s compare your feelings that you are to blame for your rape with the actual facts of the matter” or “Let’s compare your terror of driving with the statistics about road safety today.” I’m reminded of the distraught woman who once came to our clinic asking for help with her two-month-old because the baby was “so selfish.” Would she have benefited from a fact sheet on child development or an explanation of the concept of altruism? Such information would be unlikely to help her until she gained access to the frightened, abandoned parts of herself—the parts expressed by her terror of dependence. There is no question traumatized people have irrational thoughts: “I was to blame for being so sexy.” “The other guys weren’t afraid—they’re real men.” “I should have known better than to walk down that street.” It’s best to treat those thoughts as cognitive flashbacks—you don’t argue with them any more than you would argue with someone who keeps having visual flashbacks of a terrible accident. They are residues of traumatic incidents: thoughts they were thinking when, or shortly after, the traumas occurred that are reactivated under stressful conditions.

Take a short example. Ali Hajaji’s son was sick. Elders in his Yemeni village proposed a folk remedy: shove the tip of a burning stick through his son’s chest to drain the sickness from his body. After the procedure, Hajaji told The New York Times: “When you have no money, and your son is sick, you’ll believe anything.”64 Medicine predates useful medicine by thousands of years. Before the scientific method and the discovery of germs there was blood-letting, starvation therapy, cutting holes in your body to let the evils out, and other treatments that did nothing but hasten your demise.

Mirror, Mirror on the wall, who's the skinniest of them all?" "Not you, Amir, not you.

I looked at my reflection in the glass door at the entrance of the house. For the millionth time, I saw something entirely different from what I desperately wished to see. But to be fair, what I wished to see was a replica of the skeletons I had come to worship. I often wondered as to why my eyes couldn't see what the world around me could. Why did my eyes see differently than others?

Every day, I saw this new distorted reflection of myself, and everyday, I despised it a little more than the day before. It was uncanny and delusional, my reflection, and I felt this urge to change everything about myself. 'What is happening to me', was a question that remained unanswered for a great amount of time because I was as unaware about it as every other person around me.

Whenever I looked at myself in the mirror, I always saw a morbidly obese reflection, while in truth I was achingly underweight. My obsession of looking good corresponded to wanting to look the way skinny models looked in television ads and fashion magazines, the personification of being attractive as described by the world around me.

As it turned out, an apple a day did not keep the doctor away, especially if that happened to be the only thing I ate for an entire day.

So Amira Kashyap, what’s your story?” he asked as he set the big display stopwatch to a designated period of 59 minutes and 59 seconds. The perfectly tranquil way in which he asked me the question made me slightly nervous, even though I had spent the last few years of my life having imaginary conversations with an imaginary therapist. There were a lot of things I wished to tell him. From wanting to tell him about my first triggers to the very thought of me standing in front of a mirror haunting the living daylights out of me.These were just a couple out of the many thoughts in the archives of my brain. However, my mind went completely blank. I stammered and hesitated and managed to utter a total of seven words.“I don’t know where to start.” “Just say the first thing that crosses your mind,” he said. “I’m scared of food,” I blurted.

But although my body constantly reminded me that it was starving, the voices inside my mind never gave me permission to satisfy my hunger. At times, I would get affected when people passed statements like, “Why can’t you just eat?” However, I convinced myself that the only person who could understand anorexia was someone who had been through the eating disorder. I chose to remain quiet.

The topic of motivation often comes up when dealing with the issue of follow-through on plans. Many adults with ADHD may aspire to achieve a goal (e.g., exercise) or get through an unavoidable obligation (e.g., exam, paying bills), but fall prey to an apparent lack of motivation, despite their best intentions. This situation reminds us of a quote attributed to the late fitness expert, Jack LaLanne, who at the age of 93 was quoted as saying, “I’m feeling great and I still have sex almost every day. Almost on Monday, almost on Tuesday . . .” Returning to the executive dysfunction view of ADHD, motivation is defined as the ability to generate an emotion about a task that promotes follow-through in the absence of immediate reward or consequence (and often in the face of some degree of discomfort in the short-term). Said differently, motivation is the ability to make yourself “feel like” doing the task when there is no pressing reason to do so. Thus, you will have to find a way to make yourself feel like exercising before you achieve the results you desire or feel like studying for a midterm exam that is still several days away. You “know” logically that these are good ideas, but it is negative feelings (including boredom) or lack of feelings about a task that undercut your attempts to get started. In fact, one of the common thinking errors exhibited by adults with ADHD when procrastinating is the magnification of emotional discomfort associated with starting a task usually coupled with a minimization of the positive feelings associated with it. Adults with ADHD experience the double whammy of having greater difficulty generating positive emotions (i.e., motivation) needed to get engaged in tasks and greater difficulty inhibiting the allure of more immediate distractions, including those that provide an escape from discomfort. In fairness, from a developmental standpoint, adults with ADHD have often experienced more than their fair share of frustrations and setbacks with regard to many important aspects of their lives. Hence, our experience has been that various life responsibilities and duties have become associated with a degree of stress and little perceived reward, which magnifies the motivational challenges already faced by ADHD adults. We have adopted the metaphor of food poisoning to illustrate how one’s learning history due to ADHD creates barriers to the pursuit of valued personal goals. Food poisoning involves ingesting some sort of tainted food. It is an adaptive response that your brain and digestive system notice the presence of a toxin in the body and react with feelings of nausea and rapid expulsion of said toxin through diarrhea, vomiting, or both. Even after you have fully recuperated and have figured out that you had food poisoning, the next time you encounter that same food item, even before it reaches your lips, the sight and smell of the food will reactivate protective feelings of nausea due to the previous association of the stimulus (i.e., the food) with illness and discomfort. You can make all the intellectual arguments about your safety, and obtain assurances that the food is untainted, but your body will have this initial aversive reaction, regardless. It takes progressive exposure to untainted morsels of the food (sometimes mixing it in with “safe” food, in extreme cases) in order to break the food poisoning association. Similarly, in the course of your efforts to establish and maintain good habits for managing ADHD, you will encounter some tasks that elicit discomfort despite knowing the value of the task at hand. Therefore, it is essential to be able to manufacture motivation, just enough of it, in order to be able to shift out of avoidance and to take a “taste” of the task that you are delaying.

kept up with my therapy sessions and I was in an online support group for people living with terminal loved ones. I took care of my mental well-being with the same commitment that I took care of my family—because I couldn’t do one unless I did the other.

because everyone has demons—big, small, old, new, quiet, loud, whatever. These shared demons are testament to the fact that we aren’t such outliers after all. And it’s with this discovery that we can create a different relationship with our demons, one in which we no longer try to reason our way out of an inconvenient inner voice or numb our feelings with distractions like too much wine or food or hours spent surfing the internet (an activity my colleague calls “the most effective short-term nonprescription painkiller”). One of the most important steps in therapy is helping people take responsibility for their current predicaments, because once they realize that they can (and must) construct their own lives, they’re free to generate change.

when I gently advised against this, pointing out that the studies would not end until 2024, they became irate. This was my people, my tribe, my whole life, the progressive, right-on part of the ideological world — and it became more and more uncritical, less and less able to discuss or reason. Friends and colleagues who their whole adult lives had known the dangers of Big Pharma (and, reflexively wellness-oriented, would only think of using Burt’s Bees on their babies’ bottoms and sunscreen with no PABAs on themselves) rushed to take the experimental genetic-based therapy; then, like the stone throwers in Shirley Jackson’s short story “The Lottery,” crowded around to lash out at, shun, punish anyone who raised the slightest question about Big Pharma. Their entire knowledge base about that industry seemed to have magically evaporated into the ether.

her takes a good deal of clinical experience. More importantly, the therapist needs to have worked deeply with her own early life experiences, and has to actively work with it throughout the life span. A successful therapeutic relation precipitates emotional growth not only in the patient but also in the therapist. Sieff refered to the fact that short-term cognitive behavioral therapy (CBT) is currently very popular and widely used. Can it help with healing relational trauma? Schore answered that CBT is grounded in cognitive psychology, and its research base is grounded cognitive processes such as explicit memory, rational thought, language, and effortful conscious control. Cognitively based therapy’s basic theoretical assumption is grounded in the assumption that we can change how we feel by consciously changing how we think and what we believe. This means that cognitive therapy focuses on language and thought, both of which are located in the left brain. People who have trouble regulating their emotions typically have a left brain that is already more developed than their right brain, and they may well have learned to use rational thinking and words to obscure the deeper emotional experiences and to keep them dissociated. Cognitive therapy may strengthen the very strategies that keep the affect dampening defense of dissociation in place. Even if the left brain becomes more able to control the emotions of the right brain, it can only control emotional arousal that is of low or moderate intensity. As a rule, when emotional arousal reaches a certain level of intensity the left brain goes off-line and the right brain becomes dominant. Changes made in the cognitive strategies of the left brain are unavailable when this happens. At these times, emotionally-focused therapy may enhance the neural connections between the right amygdala and the right orbifrontal cortex which allows the patient to more effectively tolerate and regulate intense emotions. Cognitive therapy which exclusively focuses on the ability of the left brain to control the right cannot directly alter changes within the right-lateralized limbic system. The

final problem of cognitive therapy is that it is generally a short-term treatment so it is unable to build a strong enough therapeutic alliance to allow the patient to experience the corrective emotional experience. Deep change does not happen when a patient is consciously reflecting on an emotion. Rather it happens when the patient actively experiences the emotion and when a resonating emotionally present therapist recognizes and regulates that emotion, thereby modeling new ways of being with another while one is under stress. There is no interpersonal space for this repair of attachment ruptures in current models of cognitive therapy, where left brain insight dominates over right brain interactive regulation. Coming to the end, Sieff asked Schore what message he would like people to take home from this interview. Schore answered that the earliest stages of life are critical as they form the foundation of everything that follows. Our early attachment relationships, for better or worse, shape our right brain unconscious system and have lifelong consequences. An attuned early attachment relationship enables us to grow an interconnected, well-developed right brain and sets us up to become secure individuals, open to new social and emotional experiences. A traumatic early attachment relationship impairs the development of a healthy right brain and locks us into an emotionally dysregulated, amygdala-driven emotional world. As a result, our only way to defend against intense unregulated emotions is via the over reliance on repression and/or pathological characterological dissociation. Faced with relational stress, we are cut off from the world, from other people, from our emotions, from our bodies and from our sense of self. Our right brains cannot further develop or grow emotionally from our interactions with other right brains. Too many people suffer alone with their desperate pain due to their early relational trauma. For somebody struggling with such emotional dysregulation, the way to emotional security, and to a more vital, alive, and fulfilling life, does not come from making the unconscious conscious – which is essentially a left brain process

JD was born in Poland in 1894. When he was eighteen years old, he immigrated to the United States, where he worked in a ball-bearing factory. In August 1940, a severe form of lymphoma invaded the entire right side of his neck. He could barely open his mouth, turn his head, swallow, or sleep. In February 1941, he was referred to the Yale Medical Center for radiation therapy. After two weeks of daily radiation, he improved. But the improvement was short-lived. By August 1942, he had trouble breathing, couldn’t eat, and had lost a substantial amount of weight. On August 27 at 10 a.m., JD became the first person in history to receive a medicine to treat cancer. Every day, for ten consecutive days, he received an injection of nitrogen mustard. After the fifth dose, his tumor regressed; finally, he was able to move his head and eat. One month later, however, his tumor came back, necessitating another three-day course of nitrogen mustard; again, the response was short-lived. So, he received a six-day course, without effect. On December 1, 1942, ninety-six days after he had received his first dose of nitrogen mustard, JD died. Because this was a covert operation run by the OSRD, the phrase “nitrogen mustard” never appeared in his medical chart. Instead, doctors referred to it as “substance X.” The first paper describing nitrogen mustard’s effects on cancer wasn’t published until 1946, four years after JD was treated. On October 6, 1946, the New York Times, under the headline “War Gases Tried in Cancer Therapy,” wrote, “The possibility that deadly blister gases prepared for wartime use may aid victims of cancer will be investigated by the Army Chemical Corps’ Medical Division.” Nitrogen mustard had provided the first ray of hope in the fight against cancer. The modern age of chemotherapy had begun.