Therapy Office Quotes

Some seek the comfort of their therapist's office, other head to the corner pub and dive into a pint, but I chose running as my therapy.

I want a dyke for president. I want a person with AIDS for president and I want a fag for vice president and I want someone with no health insurance and I want someone who grew up in a place where the earth is so saturated with toxic waste that they didn’t have a choice about getting leukemia. I want a president that had an abortion at sixteen and I want a candidate who isn’t the lesser of two evils and I want a president who lost their last lover to AIDS, who still sees that in their eyes every time they lay down to rest, who held their lover in their arms and knew they were dying. I want a president with no air-conditioning, a president who has stood in line at the clinic, at the DMV, at the welfare office, and has been unemployed and laid off and sexually harassed and gaybashed and deported. I want someone who has spent the night in the tombs and had a cross burned on their lawn and survived rape. I want someone who has been in love and been hurt, who respects sex, who has made mistakes and learned from them. I want a Black woman for president. I want someone with bad teeth and an attitude, someone who has eaten that nasty hospital food, someone who crossdresses and has done drugs and been in therapy. I want someone who has committed civil disobedience. And I want to know why this isn’t possible. I want to know why we started learning somewhere down the line that a president is always a clown. Always a john and never a hooker. Always a boss and never a worker. Always a liar, always a thief, and never caught.

I don't know why you would even bring up the internet. The xeno-intelligence officer responsible for evaluating your digital communication required invasive emergency therapy after an hour's exposure. One glance at that thing is the strongest argument possible against the sentience of humanity. I wouldn't draw attention to it, if I were you.

I bet you one million in money,” Rezvan said as he blew out smoke, “that the number of hours Americans spend per week in these—what do you call them?—therapy offices is exactly the same number of hours Romanians spend in line for bread. And for what? Nothing. To make their problems bigger. They talk about them all day so at night they are even bigger.

It wasn't a sign of weakness to tell what happened to me. I feel guilt no longer, only regret. The other emotions are coming around too. How much further do I need to go? I'm not sure, but there is comfort in the fact that I am in the hands of expert guides, both in the doctor's office and at home with Sue.

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.

Tantrums, doctor’s appointments, therapies, a dozen drives to and from the specialist’s office in Boise

With families, I stopped creating encyclopedias of data about all their issues and began to search instead for the member with the greatest capacity to be a leader as I have defined it. That person generally turned out to be the one who could express himself or herself with the least amount of blaming and the one who had the greatest capacity to take responsibility for his or her own emotional being and destiny. I began to coach the “leader” alone, letting the rest of the family drop out and stay home. I stopped trying to get people to “communicate” or find better ways of managing their issues. Instead, I began to concentrate on helping the leader to become better defined and to learn how to deal adroitly with the sabotage that almost invariably followed any success in this endeavor. Soon I found that the rest of the family was “in therapy” whether or not they came into my office.

Bo-an-throp-ee,” I sounded out the syllables for him. “It’s an extremely rare psychological disorder where the sufferer thinks they’re a bovine.” Officer Donahue furrowed his brow. “Bovine…” “Cattle animals,” I said impatiently.

If you want to be free, he suggests, if you want to heal your relationship with God, with others and yourself, enter your inner room—the office, where the Divine Therapy takes place. Close the door so you don’t run away. Quiet your interior dialogue so that you can listen to what the Spirit is saying to you.

I can’t tell you how many women have walked into my office trying to order themselves to get over their suffering. “Snap out of it!” they tell themselves. “Live with it.” “Deal with it.” “You made your bed, now lie in it.” “Count your blessings.” But if there’s one thing my therapy practice has taught me without a doubt, it is this: The army boot camp approach to yourself does not work. Not in the long run. The only thing that will end your distress and help you make lasting changes is compassion. Compassion

Of course, I should have known the kids would pop out in the atmosphere of Roberta's office. That's what they do when Alice is under stress. They see a gap in the space-time continuum and slip through like beams of light through a prism changing form and direction. We had got into the habit in recent weeks of starting our sessions with that marble and stick game called Ker-Plunk, which Billy liked. There were times when I caught myself entering the office with a teddy that Samuel had taken from the toy cupboard outside. Roberta told me that on a couple of occasions I had shot her with the plastic gun and once, as Samuel, I had climbed down from the high-tech chairs, rolled into a ball in the corner and just cried. 'This is embarrassing,' I admitted. 'It doesn't have to be.' 'It doesn't have to be, but it is,' I said. The thing is. I never knew when the 'others' were going to come out. I only discovered that one had been out when I lost time or found myself in the midst of some wacky occupation — finger-painting like a five-year-old, cutting my arms, wandering from shops with unwanted, unpaid-for clutter. In her reserved way, Roberta described the kids as an elaborate defence mechanism. As a child, I had blocked out my memories in order not to dwell on anything painful or uncertain. Even as a teenager, I had allowed the bizarre and terrifying to seem normal because the alternative would have upset the fiction of my loving little nuclear family. I made a mental note to look up defence mechanisms, something we had touched on in psychology.

When we are told what is healthy we are being told what is right to think and feel. When we are told what is mentally ill we are being told what ideas, behaviour, and fantasies are wrong. [...] The avenues of escape are blocked by the professioal abuse of pathologizing. To refuse the mental health approach confirms one's 'sickness'. One needs 'therapy', [...] How can we take back therapy [...] from a system which must find illness in order to promote health and which, in order to increase the range of its helping, is obliged to extend the area of sickness. Ever deeper pockets of pathology to be analyzed, ever earlier traumata: primal, prenatal, into my astral body; ever more people into the ritual: the family, the office force, community mental health, analysis for everyone. [...] Its practice may differ [...] but the premise is the same. The work of making soul requires professional help. Soul-making has become restricted by therapy and to therapy. And psychopathology has become restricted to therapy's negative definition of it, reduced to its role in the therapy game.

The most obvious examples of pathological problems are: uncontrollable negative cash flow, continuous emigration of key human resources away from the organization, unresolved quality problems, rapidly declining market share, and tremendous drops in the company’s capacity to raise financial resources. Organizations with those problems can’t afford therapy because therapy takes time, and time is a resource those organizations do not have. Instead of an organizational therapist, the board should hire an organizational turnaround specialist who can temporarily take on the chief executive officer’s role, and perform whatever “surgery” is necessary.

Original Statement by Hunger Strikers to Psychiatric Association, National Alliance for the Mentally Ill and the U.S. Office of the Surgeon General 1. A Hunger Strike to Challenge International Domination by Biopsychiatry. This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to “first do no harm.” Psychiatrists are able with impunity to: Incarcerate citizens who have committed crimes against neither persons nor property. Impose diagnostic labels on people that stigmatize and defame them. Induce proven neurological damage by force and coercion with powerful psychotropic drugs. Stimulate violence and suicide with drugs promoted as able to control these activities. Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy). Employ restraint and solitary confinement—which frequently cause severe emotional trauma, humiliation, physical harm, and even death—in preference to patience and understanding. Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public.21

One study showed that omega-3s were equivalent in effect to Prozac in treating depression, and the combination was more effective than either one alone.64 In a related study, administration of omega-3s to patients with recurrent self-harm (e.g., cutting, picking, scratching, burning—the ultimate expression of anxiety) showed a reduction in suicidality, depression, and daily stress.65 A recent trial gave omega-3s along with minerals to eleven-year-old kids with conduct disorder or oppositional defiant disorder (the ones who routinely find themselves in the principal’s office), and within three months their aggression was reduced, and way better than talk therapy.66 Lastly, omega-3 consumption can help ward off depression in children67 and adults,68 and can serve as an adjunct to SSRIs in its treatment.69

golden opportunity to learn to cope with criticism and anger effectively. This came as a complete surprise to me; I hadn't realized what good fortune I had. In addition to urging me to use cognitive techniques to reduce and eliminate my own sense of irritation. Dr. Beck proposed I try out an unusual strategy for interacting with Hank when he was in an angry mood. The essence of this method was: (1) Don't turn Hank off by defending yourself. Instead, do the opposite—urge him to say all the worst things he can say about you. (2) Try to find a grain of truth in all his criticisms and then agree with him. (3) After this, point out any areas of disagreement in a straightforward, tactful, nonargumentative manner. (4) Emphasize the importance of sticking together, in spite of these occasional disagreements. I could remind Hank that frustration and fighting might slow down our therapy at times, but this need not destroy the relationship or prevent our work from ultimately becoming fruitful. I applied this strategy the next time Hank started storming around the office screaming at me. Just as I had planned, I urged Hank to keep it up and say all the worst things he could think of about me. The result was immediate and dramatic. Within a few moments, all the wind went out of his sails—all his vengeance seemed to melt away. He began communicating sensibly and calmly, and sat down. In fact, when I agreed with some of his criticisms, he suddenly began to defend me and say some nice things about me! I was so impressed with this result that I began using the same approach with other angry, explosive individuals, and I actually did begin to enjoy his hostile outbursts because I had an effective way to handle them. I also used the double-column technique for recording and talking back to my automatic thoughts after one of Hank's midnight calls (see Figure 16–1, page 415).

Peer into any corner of current American life, and you’ll find the positive-thinking outlook. From the mass-media ministries of evangelists such as Joel Osteen, Creflo Dollar, and T.D. Jakes to the millions-strong audiences of Oprah, Dr. Phil, and Mehmet Oz, from the motivational bestsellers and seminars of the self-help movement to myriad twelve-step programs and support groups, from the rise of positive psychology, mind-body therapies, and stress-reduction programs to the self-affirmative posters and pamphlets found on walls and racks in churches, human-resources offices, medical suites, and corporate corridors, this one idea—to think positively—is metaphysics morphed into mass belief. It is the ever-present, every-man-and-woman wisdom of our time. It forms the foundation of business motivation, self-help, and therapeutic spirituality, including within the world of evangelism. Its influence has remade American religion from being a salvational force to also being a healing one.

Did those “new gays” spinning about like giddy tops in discos care to know that dancing with someone of the same sex was punishable as “lewd conduct” then? Still, a club in Topanga Canyon boasted a system of warning lights. When they flashed, lesbians and gay men shifted—what a grand adventure!—and danced with each other, laughing at the officers’ disappointed faces! How much pleasure—and camaraderie, yes, real kinship—had managed to exist in exile. Did those arrogant young people know that, only years ago, you could be sentenced to life in prison for consensual sex with another man? A friend of his destroyed by shock therapy decreed by the courts. Another friend sobbing on the telephone before he slashed his wrists— Thomas's hands on his steering wheel had clenched in anger, anger he had felt then, anger he felt now. And all those pressures attempted to deplete you, and disallow— “—the yearnings of the heart,” he said aloud. Yet he and others of his generation had lived through those barbaric times—and survived—those who had survived—with style. Faced with those same outrages, what would these “new gays” have done? “Exactly as we did,” he answered himself. The wind had resurged, sweeping sheaths of dust across the City, pitching tumbleweeds from the desert into the streets, where they shattered, splintering into fragments that joined others and swept away. Now, they said, everything was fine, no more battles to fight. Oh, really? What about arrests that continued, muggings, bashings, murder, and hatred still spewing from pulpits, political platforms, and nightly from the mouths of so-called comedians? Didn't the “new gays” know—care!—that entrenched “sodomy” laws still existed, dormant, ready to spring on them, send them to prison? How could they think they had escaped the tensions when those pressures were part of the legacy of being gay? Didn't they see that they remained—as his generation and generations before his had been—the most openly despised? And where, today, was the kinship of exile?

We’ve become so focused as a society on the question of whether a given sexual behavior is evolutionarily “natural” or “unnatural” that we’ve lost sight of the more important question: Is it harmful? In many ways, it’s an even more challenging question, because although naturalness can be assessed by relatively straightforward queries about statistical averages—for example, “How frequently does it appear in other species?” and “In what percentage of the human population does it occur?”—the experience of harm is largely subjective. As such, it defies such direct analyses and requires definitions that resonate with people in vastly different ways. When it comes to sexual harm in particular, what’s harmful to one person not only is completely harmless to another but may even, believe it or not, be helpful or positive. If the supermodel Kate Upton were to walk into my office right now and tie me to my chair before doing a slow striptease and depositing her vagina in my face, I think I’d require therapy for years. But if this identical event were to happen to my heterosexual brother or to one of my lesbian friends, I suspect their brains would process such a “tragic” experience very differently. (And that of my not-very-amused sister-in-law would see my brother’s encounter with said vagina differently still.)

Cohen continued to struggle with his own well-being. Even though he had achieved his life’s dream of running his own firm, he was still unhappy, and he had become dependent on a psychiatrist named Ari Kiev to help him manage his moods. In addition to treating depression, Kiev’s other area of expertise was success and how to achieve it. He had worked as a psychiatrist and coach with Olympic basketball players and rowers trying to improve their performance and overcome their fear of failure. His background building athletic champions appealed to Cohen’s unrelenting need to dominate in every transaction he entered into, and he started asking Kiev to spend entire days at SAC’s offices, tending to his staff. Kiev was tall, with a bushy mustache and a portly midsection, and he would often appear silently at a trader’s side and ask him how he was feeling. Sometimes the trader would be so startled to see Kiev there he’d practically jump out of his seat. Cohen asked Kiev to give motivational speeches to his employees, to help them get over their anxieties about losing money. Basically, Kiev was there to teach them to be ruthless. Once a week, after the market closed, Cohen’s traders would gather in a conference room and Kiev would lead them through group therapy sessions focused on how to make them more comfortable with risk. Kiev had them talk about their trades and try to understand why some had gone well and others hadn’t. “Are you really motivated to make as much money as you can? This guy’s going to help you become a real killer at it,” was how one skeptical staff member remembered Kiev being pitched to them. Kiev’s work with Olympians had led him to believe that the thing that blocked most people was fear. You might have two investors with the same amount of money: One was prepared to buy 250,000 shares of a stock they liked, while the other wasn’t. Why? Kiev believed that the reluctance was a form of anxiety—and that it could be overcome with proper treatment. Kiev would ask the traders to close their eyes and visualize themselves making trades and generating profits. “Surrendering to the moment” and “speaking the truth” were some of his favorite phrases. “Why weren’t you bigger in the trades that worked? What did you do right?” he’d ask. “Being preoccupied with not losing interferes with winning,” he would say. “Trading not to lose is not a good strategy. You need to trade to win.” Many of the traders hated the group therapy sessions. Some considered Kiev a fraud. “Ari was very aggressive,” said one. “He liked money.” Patricia, Cohen’s first wife, was suspicious of Kiev’s motives and believed that he was using his sessions with Cohen to find stock tips. From Kiev’s perspective, he found the perfect client in Cohen, a patient with unlimited resources who could pay enormous fees and whose reputation as one of the best traders on Wall Street could help Kiev realize his own goal of becoming a bestselling author. Being able to say that you were the

It’s not like I wasn’t busy. I was an officer in good standing of my kids’ PTA. I owned a car that put my comfort ahead of the health and future of the planet. I had an IRA and a 401(k) and I went on vacations and swam with dolphins and taught my kids to ski. I contributed to the school’s annual fund. I flossed twice a day; I saw a dentist twice a year. I got Pap smears and had my moles checked. I read books about oppressed minorities with my book club. I did physical therapy for an old knee injury, forgoing the other things I’d like to do to ensure I didn’t end up with a repeat injury. I made breakfast. I went on endless moms’ nights out, where I put on tight jeans and trendy blouses and high heels like it mattered and went to the restaurant that was right next to the restaurant we went to with our families. (There were no dads’ nights out for my husband, because the supposition was that the men got to live life all the time, whereas we were caged animals who were sometimes allowed to prowl our local town bar and drink the blood of the free people.) I took polls on whether the Y or the JCC had better swimming lessons. I signed up for soccer leagues in time for the season cutoff, which was months before you’d even think of enrolling a child in soccer, and then organized their attendant carpools. I planned playdates and barbecues and pediatric dental checkups and adult dental checkups and plain old internists and plain old pediatricians and hair salon treatments and educational testing and cleats-buying and art class attendance and pediatric ophthalmologist and adult ophthalmologist and now, suddenly, mammograms. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner.

Remind yourself where you come from. I spent the majority of my life running away from Utah, from the life I led there, from the memories I associated with those early years. It felt very someone-else-ago to me. London changed me profoundly. When we were dancing on DWTS together, Jennifer Grey called me one night. She was having trouble with her back and wanted to see a physiotherapist. “Can you come with me?” she asked. She drove us through a residential section of Beverly Hills. We pulled into a house with a shed out back. Oddly, it didn’t look like a doctor’s office. There was a couch and incense burning. An Australian guy with a white beard came in : “Hey, mates.” I looked at Jen and she winked at me. This was no physical therapy. She’d signed us up for some bizarre couples therapy! The guy spoke to us for a while, then he asked Jennifer if she wouldn’t mind leaving us to chat. I thought the whole thing was pretty out there, but I didn’t think I could make a run for it. “So, Derek,” he said. “Tell me about your childhood.” I laid it all out for him--I talked for almost two hours--and he nodded. “You can go pick him up now.” I raised an eyebrow. “Pick who up?” The therapist smiled. “That younger boy, that self you left in Utah. You left him there while you’ve been on a mission moving forward so vigorously. Now you can go get him back.” I sat there, utterly stunned and speechless. It was beyond powerful and enlightening. Had I really left that part of me behind? Had I lost that fun-loving, wide-eyed kid and all his creative exuberance? When I came out of my therapy session, Jennifer was waiting for me. “If I’d told you this was where we were going, you wouldn’t have come,” she said. She was right. She had to blindside me to get me to grapple with this. She’s a very spiritual person, and she saw how I was struggling, how I seemed to be in some kind of emotional rut. Just visualizing myself taking the old Derek by the hand was an incredible exercise. I think we often tuck our younger selves away for safekeeping. In my case, I associated my early years with painful memories. I wanted to keep young Derek at a distance. But what I forgot was all the good I experienced with him as well: the joy, the hope, the excitement, the wonder. I forgot what a great kid Derek was. I gave myself permission to reconnect with that little boy, to see the world through his eyes again. It was the kick in the butt I needed. Jennifer would say, “Told ya so.

Treating Abuse Today (Tat), 3(4), pp. 26-33 Freyd: You were also looking for some operational criteria for false memory syndrome: what a clinician could look for or test for, and so on. I spoke with several of our scientific advisory board members and I have some information for you that isn't really in writing at this point but I think it's a direction you want us to go in. So if I can read some of these notes . . . TAT: Please do. Freyd: One would look for false memory syndrome: 1. If a patient reports having been sexually abused by a parent, relative or someone in very early childhood, but then claims that she or he had complete amnesia about it for a decade or more; 2. If the patient attributes his or her current reason for being in therapy to delayed-memories. And this is where one would want to look for evidence suggesting that the abuse did not occur as demonstrated by a list of things, including firm, confident denials by the alleged perpetrators; 3. If there is denial by the entire family; 4. In the absence of evidence of familial disturbances or psychiatric illnesses. For example, if there's no evidence that the perpetrator had alcohol dependency or bipolar disorder or tendencies to pedophilia; 5. If some of the accusations are preposterous or impossible or they contain impossible or implausible elements such as a person being made pregnant prior to menarche, being forced to engage in sex with animals, or participating in the ritual killing of animals, and; 6. In the absence of evidence of distress surrounding the putative abuse. That is, despite alleged abuse going from age two to 27 or from three to 16, the child displayed normal social and academic functioning and that there was no evidence of any kind of psychopathology. Are these the kind of things you were asking for? TAT: Yeah, it's a little bit more specific. I take issue with several, but at least it gives us more of a sense of what you all mean when you say "false memory syndrome." Freyd: Right. Well, you know I think that things are moving in that direction since that seems to be what people are requesting. Nobody's denying that people are abused and there's no one denying that someone who was abused a decade ago or two decades ago probably would not have talked about it to anybody. I think I mentioned to you that somebody who works in this office had that very experience of having been abused when she was a young teenager-not extremely abused, but made very uncomfortable by an uncle who was older-and she dealt with it for about three days at the time and then it got pushed to the back of her mind and she completely forgot about it until she was in therapy. TAT: There you go. That's how dissociation works! Freyd: That's how it worked. And after this came up and she had discussed and dealt with it in therapy, she could again put it to one side and go on with her life. Certainly confronting her uncle and doing all these other things was not a part of what she had to do. Interestingly, though, at the same time, she has a daughter who went into therapy and came up with memories of having been abused by her parents. This daughter ran away and is cutoff from the family-hasn't spoken to anyone for three years. And there has never been any meeting between the therapist and the whole family to try to find out what was involved. TAT: If we take the first example -- that of her own abuse -- and follow the criteria you gave, we would have a very strong disbelief in the truth of what she told.

At first, they joked about it but as they became more detoxed and more assertive from therapy, paid ironically by the husbands, they began to realize that they each had unique strengths and powers and a burning desire for revenge. Between the Three Wise Women they had an IT expert, an actress and a supermodel, all very wealthy and beautiful. All the three men’s’ brains appeared to reside in their pants and they wondered if they set a honey trap could it possibly work. A plan was proposed by Felicity and she called it Operation Devastation. Angelina would hack into their MIS computer systems, bug their telephones, offices, cars and homes. Ava would seduce Ryan, who owned Novels and the computer firm, Angelina’s husband in a honey trap and get it all on DVD for the divorce court. Then Ava would seduce Felicity’s husband, James, the Irish footballer. Finally, Sean who was Felicity’s friend who was an out of work actor would seduce Patrick

Workaholism’ is endemic, and for many of us our life is governed entirely by work. Once upon a time, we worked to live; now, we live to work. Any ‘life’ we do have is merely recovery from work. We work, recover from work and then work again. We go to the office to work. After work, we bring some work home with us. For rest, we go to the gym for a workout. Totally exhausted, we go to therapy to work through our problems – ’I’ve done a lot of work on myself,’ we say. After all that, there’s the housework! Finally, we go to bed, too tired to be happy, but our mind is still working and we can’t sleep. No problem. Insomnia is a wonderful chance to get more work done! The work ethic is motivated by the belief that anything worthwhile requires great work, effort and labour. According to the work ethic – creativity isn’t inspiration, it’s perspiration; love is a labour, not a joy; success is a marathon, it never comes easily; health is about a ‘no pain, no gain’ attitude; salvation is hardest of all – it is a wrestling match with the angels, just ask Jacob. Nothing comes easily, according to the work ethic. Has it ever occurred to you that ... you’re trying too hard to be happy?

IN some ways, the relentless electronic interconnectivity of our lives serves to highlight therapy’s singular virtues. We are more appreciative of the strange, private dialogue that is the heart of therapy. There are precious few times and spaces left in our society in which people quietly speak to one another in a sustained, intimate conversation. The therapist’s office is one of the last safe places. Secrets, reflections, fears or confusion never leave the room. And it is also a refuge. My patients often arrive early just to sit in the waiting room — an unusual interlude of quiet. Then there’s the session itself. In some ways therapy is, more than ever, the ultimate luxury: To be the focus of a thoughtful person who is listening, caring and helping to make sense of life’s chaos is something that the Internet can never provide. Anna Fels is a psychiatrist and faculty member at Weill Cornell Medical College.

It’s exhausting,” I said. “I have to battle this part along with the sense of frustration and hopelessness it creates. It’s so tough and strong that it seems undefeatable.” “What does the overburdened restless part want?” “It wants someone to bring it under control to rest and have peace. It’s like a hyperactive fidgety child, pacing back and forth, crying for someone to make it stop.” I was having trouble connecting my inner true self to the stressed part because of the intense energy it was creating. Keith guided me by helping me communicate with the stressed part. I needed to make it understand that by stepping aside it would allow the healing process of unburdening the emotional component that was holding in the shame. Without the burden of the disgrace, the anxious, stressed-out, perfectionist, striver part would not have to work so hard to compensate for its self-perceived shortcomings. Furthermore, relieving the humiliating burdens would bring rest, tranquility, and peace. The intense energy could then be orchestrated in better ways. At this point, we ended our session. I left his office once again annoyed and uncertain, wondering if I was ever going to be able to live a normal peaceful life. As I meditated on the session during the week, I understood what my therapist was explaining. I visualized fast-forwarding directly to the ultimate goal of un-blending the various multiple defender traits from the abuse. Getting to the root of the therapy and healing process of dealing with the disgraceful iniquity was my goal. I had trouble believing whether or not my logic in understanding the process was correct. It seemed too simplistic to me at first. I envisioned confessing all my scandalous deeds and desires for the world to know. I imagined no more secrets or lies and eliminating the need to masquerade with a phony façade to hide the atrocious creature I thought I was. Instantly, I was buoyant as helium. The crushing weight from the wicked acts was lifted from my shoulders. The mortifying and disgusting impressions I had were no longer there. I was able to get a brief glimpse of the divine true self. For a moment, I physically felt what life could be like while at peace with myself. Happiness and comfort engulfed me at the possibility of living a life free of judgment, low selfesteem, anxiety and paranoia. While in this good frame of mind, I became aware of all the goodness inside of me and the decent things I was doing in life. My human flaws appeared to be minor bumps in the road rather than being amplified into major roadblocks. I began to see how I pulled myself out of mental illness, addiction, and sexual perversion. I became conscious that I survived sexual abuse at an early age and persevered by holding it together. I was imbued with a sense of accomplishment. I now comprehended and conquered the difficult therapeutic work of dealing with the harmful emotions associated with bringing the misconduct to the surface.

I’d wake up feeling good, but this part would overpower me with negative thoughts, certain that trouble lay in wait. It was as though none of the good things I did existed or mattered; it was all about the one wrong thing I did. In my next therapy session, as I walked up the stairs to Keith’s office, I organized my thoughts. When I settled into the love seat, I explained what I thought was a new part I discovered, and detailed the characteristics. Upon further discussion, Keith said, “The part you’re actually describing is the shameful feelings that were conceived from the abuse and the ensuing conditioned reprehensible actions that followed. It was the feeling of shame that brought on the anxiety and all its feelings of guilt.” Following my understanding and ability to distinguish the shame versus the anxiety and the shameful part’s origin and roots, I went back to identifying its physical symptoms. “I get overtaken with restlessness and remorse. It paralyzes me with fear. There's tightness in my chest. My breathing becomes heavy, sometimes to the point of hyperventilating. When I get a feeling of unrest I’ll pace, fidget my leg up and down, sometimes my face will twitch.” As

Failures as people: millions of Americans felt that this description fit them to a T. Seeking a solution, any solution, they eagerly forked over their cash to any huckster who promised release, the quicker and more effortlessly the better: therapies like “bioenergetics” (“The Revolutionary Therapy That Uses the Language of the Body to Heal the Problems of the Mind”); Primal Scream (which held that when patients shrieked in a therapist’s office, childhood trauma could be reexperienced, then released; John Lennon and James Earl Jones were fans); or Transcendental Meditation, which promised that deliverance could come if you merely closed your eyes and chanted a mantra (the “TM” organization sold personal mantras, each supposedly “unique,” to hundreds of thousands of devotees). Or “religions” like the Church Universal and Triumphant, or the Reverend Sun Myung Moon’s Unification Church, or “Scientology”—this last one invented by a science fiction writer, reportedly on a bet. Devotees paid cash to be “audited” by practitioners who claimed the power—if, naturally, you paid for enough sessions—to remove “trauma patterns” accreted over the 75 million years that had passed since Xenu, tyrant of the Galactic Confederacy, deposited billions of people on earth next to volcanoes and detonated hydrogen bombs inside those volcanos, thus scattering harming “body thetans” to attach to the souls of the living, which once unlatched allowed practitioners to cross the “bridge to total freedom” and “unlimited creativity.” Another religion, the story had it, promised “perfect knowledge”—though its adherents’ public meeting was held up several hours because none of them knew how to run the movie projector. Gallup reported that six million Americans had tried TM, five million had twisted themselves into yoga poses, and two million had sampled some sort of Oriental religion. And hundreds of thousands of Americans in eleven cities had plunked down $250 for the privilege being screamed at as “assholes.” “est”—Erhard Seminars Training, named after the only-in-America hustler who invented it, Werner Erhard, originally Jack Rosenberg, a former used-car and encyclopedia salesman who had tried and failed to join the Marines (this was not incidental) at the age of seventeen, and experienced a spiritual rebirth one morning while driving across the Golden Gate Bridge (“I realized that I knew nothing. . . . In the next instant—after I realized that I knew nothing—I realized that I knew everything”)—promised “to transform one’s ability to experience living so that the situations one had been trying to change or had been putting up with, clear up just in the process of life itself,” all that in just sixty hours, courtesy of a for-profit corporation whose president had been general manager of the Coca-Cola Bottling Company of California and a former member of the Harvard Business School faculty. A

After seeing a couple therapists on and off through student health, I finally got sent to a private practice so someone could see me for more than 6 weeks. When I called to make my first appointment at the first therapist on my list, the last thing she said to me after setting up the appointment was "Oh, on Thursdays I bring my golden retriever to the office. Is that a problem for you? Let me know and I'll keep her home." I spent every Thursday for the next eight months sitting on the floor with Skyler as we worked through my general anxiety depression and family issues. And then when my class schedule changed for my last semester, Skyler's schedule changed, too. She started coming on Tuesdays to see me. Skyler wasn't a trained therapy dog, just a goofy golden with a pure heart, very soft fur, and a very amazing therapist as an owner. 7 years later I still haven't found another therapist team as amazing of Missy and Skyler.

Now you are ready to greet the client. This moment is important. Although it may vary slightly depending on how many people are involved and the circumstances under which you are seeing the client, there are a few basic principles intended to transmit courtesy, interest, and a clear message that this is a professional rather than a social relationship. If at all possible, you should always go out and meet the client rather than having her sent to your office by a receptionist. Opinions vary on whether you should introduce yourself more or less formally, e.g., “I’m Ms. Lukas” versus “I’m Susan Lukas” versus “I’m Susan.” They also vary on the issue of whether or not to shake hands with clients. Depending on her clinical outlook and the circumstances under which a client is coming for therapy, your supervisor may feel that any physical contact might transmit a misleading or potentially threatening notion about therapy. Therefore, all these questions should be discussed before the first interview. Having greeted the client, and while leading the way to your office, you should remember that the interview has already started. Listen very carefully to what the client is saying and make a mental note of your overall first impression. When you have ushered her in, pay attention to how the client reacts to your office. What does she say? Where and how does she choose to sit? (If possible, you should arrange seating so the client can sit facing you at a distance that permits her to speak in a normal voice, but is far enough away so that she does not feel you could reach out and touch her. If the client comes from a culture in which reaching out and touching another person’s arm is a sign of friendship or interest, then she can move the chair closer to you if she chooses to.) Does she wait for you to suggest that she sit down? Does she sit on the edge of the chair? Does she seem disorganized? Try to help the client to feel more comfortable. Show her where she can hang her coat if she wants to. Suggest that she might feel more comfortable in another seat. But remember: If the client chooses not to do any of these things, do not urge her to. The goal is to “start where the client is,” rather than expecting her to do it your way. You are concerned with her feeling of what is comfortable, not yours.

Rocky had only worked once with a man who stalked his ex-girlfriend, and he came to therapy because he was convinced that going to therapy would get his girlfriend back. She had been struck by the absolute singularity of his pursuit; he became a laser beam, breaking into his ex-girlfriend’s computer, accessing her e-mail, her post office box, even tapping into her parent’s phone messages.

THE WALLFLOWER ORDER ATTEMPTS to meet the psychic plague by installing an anti-Jes Grew President, Warren Harding. He wins on the platform “Let’s be done with Wiggle and Wobble,”* indicating that he will not tolerate this spreading infection. All sympathizers will be dealt with; all carriers isolated and disinfected, Immumo-Therapy will begin once he takes office.

Reading is like therapy; the characters are the therapist, their world is their office, and the adventures are the sessions.

That’s when I finally quit. I don’t know if Lance quit, but I was done. The last thing I needed to do was think about another man’s testicles in my effort to straighten out. I thanked him for his time and walked out of his office. I drove back to the seminary, at peace with having ended the useless reparative therapy.

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3. Time Not spending enough time at home or with your partner is another major cause of a fight. You are always busy at the office. You never go out with me anywhere. You are always on your phone when you come home. We never do anything together. All of these are complaints one partner may have with the other which can easily start a fight. In almost all relationships, there is one person who wants to spend time with their partner and when they feel that their partner lacks a similar interest in them, it can lead to frustration. Thoughts like, “He/she doesn’t like me anymore,” can stir in one’s mind, adding to the aggravation. Some fights can also be about how partners choose to spend their time together. One partner might want to go for a movie whereas the other partner might want to go to the game. One might want to go hiking whereas others might want to go spend the weekend with their family. Instead of fighting over how you two want to spend 24 hours of the day, join forces and dedicate a “together time” for every day or the weekend. The goal shouldn’t be to prioritize one’s interests over the others but rather finding a middle ground. Do things you both enjoy doing, such as partying or going out for dinners.

Finding a person to declare your craziest, most profound insecurities to is not exactly a picnic. But the bureaucratic idiocy of America’s healthcare system turns what should be a chore into torture. If you’re a middle-class person in America, the dance goes like this: You call your insurance provider to find a meager list of therapists who take your insurance. Most of the people on the list are licensed clinical social workers or licensed mental health counselors. They can be wonderful and very helpful, but they often have less schooling and experience than, say, psychologists and PhDs. After digging deeper, you find that some of these therapists don’t take your insurance after all; others have full client lists. And even if they do have space in the day to treat someone, they might not be interested in treating you. According to one study, a low-income Black person had up to an 80 percent lower chance of receiving a callback for an appointment than a middle-class white person. And even though intellectually, therapists tell you that anger can be a helpful and legitimate emotion in processing trauma, God forbid you actually seem angry on the phone. Several mental health professionals have told me that therapists often avoid rageful clients because they seem threatening or scary. Therapists instead prefer to take on YAVIS—Young, Attractive, Verbal, Intelligent, and Successful clients. They love an amenable type, someone who is curious about their internal workings and eager to plumb them, someone who’s already read articles in The New Yorker about psychology to familiarize them with the language of metacognition and congruence. Good luck if you’re a regular-ass Joe who’d rather watch It’s Always Sunny in Philadelphia. But say you get lucky and find a licensed clinical psychologist with an open slot. The psychologist is white, of course (86 percent of psychologists in the United States are), which isn’t ideal if you are a person of color. But, fine, whatever: You just need to receive an official diagnosis for your insurance. You are certain you have complex PTSD, but he can’t diagnose you with that because it’s not in the Diagnostic and Statistical Manual of Mental Disorders. Your insurance only covers treatment for conditions listed in the DSM in order to assign a number of sessions to you. Most forms of insurance will pay for, say, only six months of therapy relating to anxiety, ten for depression, as if you should be better by then. Another consequence of C-PTSD not being in the DSM: This psychologist hasn’t been trained in treating it. He says he doesn’t believe that it’s a real diagnosis. He’d like to provide you with some questionnaires to see if you have something he can actually handle—bipolar disorder, maybe, or manic depression. This does not inspire confidence, so you leave. After some internet sleuthing, you find a woman of color who seems really cool. She’s specifically trained in the treatment of complex trauma. She has blurbs on her website that resonate with you—it seems as if she might truly understand you. But she doesn’t take insurance. (Psychologists are the least likely of any medical provider to take insurance—only about 45 percent of them do. And most of the time, the ones who don’t are the most qualified practitioners.) You can’t exactly blame her. You learn on the internet that insurance companies haven’t updated reimbursement rates for therapists in up to twenty years, despite rising rates for office rent and other administrative costs. If therapists were to rely on reimbursement rates from insurance alone, they’d wind up making about $50,000 a year on average, which is fine, but like, not great if you’re an actual doctor.

In America, particularly in non-unionized workplaces, this sort of chronic understaffing acquires a logic all its own. If you can stand to lose employee weight, you should; if you don’t, you’re leaving profits on the table. Appropriately staffing isn’t a way to create a better work environment; it’s “bloat.” Workplaces attempt to counter the negative effects of understaffing with professional development, bonuses, perks, snacks, therapy dogs, subsidized gym memberships, swag, happy hours, access to meditation apps; the list is truly endless. One HR person told us that she was always amazed that employees complained about stress and overwork but then never took advantage of the perks. It makes sense, though. They don’t have the time. What would really make their lives better isn’t a meditation app, but adding a few more employees without also adding the expectation of more work.

Karen Pence had been working for days on goodie bags for staffers in her husband’s office, packing them with champagne flutes, honey from their beehive at the Naval Observatory, and cutting boards with the vice presidential seal. She also dropped in a print of her painting of the Naval Observatory, a nod toward her work to bring attention to art therapy, a mental health initiative she had promoted for years.

Censoring Measuring response rate and progression offers more problems than measurement error. We may not be considering the right denominator of patients. In 2017, the FDA approved the first cellular cancer therapy, called tisagenlecleucel (Kymriah, Novartis), or CAR-T, for short. A CAR-T is a chimeric antigen receptor T-cell, basically a genetically modified cell taken from a patient that is trained to attack cancer cells and then placed back in the patient. In the data submitted to the FDA, 88 patients had the cells removed, but 18% (16/88) did not receive the cells because some patients died and some patients’ cells could not be manufactured.17 Unfortunately, the FDA excluded these patients from the denominator and assessed response only in patients who got the cells. This violates a principle called intention to treat, that is, you should judge a drug based on all patients allocated to get it, irrespective of whether or not they received it. Why? Because therapies that take a long time to give (this CAR-T took approximately 22 days to make) may exclude the sickest patients who die while waiting, thus distorting their benefit. In fact, if I have a patient in my office and we decide to treat with tisagenlecleucel, the response rate from the package overestimates her chances of success, as I am unsure she will live long enough to receive the cells.

Around four years ago, they asked if I’d run a district meeting of UU ministers. I knew a lot of the attendees, of course, and on the last day a group of them staged an intervention of sorts, insisting there must be something I could do in the denomination. And there was: to process my failed ministry, I’d written my MSW thesis on how different religions settle their clergy, so I knew a lot about ministerial settlement. Someone hooked me up with the UU Transitions office and I’ve been a search consultant ever since—and for other denominations, too. In my therapy practice, I sit for thirty hours a week; this consulting work gets me out of that damn chair!

The Empowered Sonnet Woman empowered is civilization empowered. Dream empowered is progress empowered. Parents empowered is children empowered. Teachers empowered is future empowered. Don't defund the police, use those funds, To send the officers to behavioral therapy. To have an understanding of justice and order, We must have a grip over our impulses and biases. Discrimination don't disappear if we shut our eyes, Each of us must live as an antidote to discrimination. Ignorance doesn't become knowledge when peddled by scripture, Better burn all scriptures if they peddle hate and division. To conquer our biases and stereotypes is to conquer inhumanity. To expand our heart beyond assumption is to empower humanity.

chapter with a quotation from the Greek Stoic philosopher Epictetus, but we could just as easily have quoted Buddha (“Our life is the creation of our mind”)2 or Shakespeare (“There is nothing either good or bad, but thinking makes it so”)3 or Milton (“The mind is its own place, and in itself can make a heaven of hell, a hell of heaven”).4 Or we could have told you the story of Boethius, awaiting execution in the year 524. Boethius reached the pinnacle of success in the late Roman world—he had been a senator and scholar who held many high offices—but he crossed the Ostrogoth king, Theodoric. In The Consolation of Philosophy, written in his jail cell, he describes his (imaginary) encounter with “Lady Philosophy,” who visits him one night and conducts what is essentially a session of cognitive behavioral therapy (CBT). She chides him gently for his moping, fearfulness, and bitterness at his reversal of fortune, and then she helps him to reframe his thinking and shut off his negative emotions. She helps him see that fortune is fickle and he should be grateful that he enjoyed it for so long. She guides him to reflect on the fact that his wife, children, and father are all still alive and well, and each one is dearer to him than his own life. Each exercise helps him see his situation in a new light; each one weakens the grip of his emotions and prepares him to accept Lady Philosophy’s ultimate lesson: “Nothing is miserable unless you think it so; and on the other hand, nothing brings happiness unless you are content with it.”5

Deborah Weisberg, LMFT is a Marriage & Family Therapist in Los Angeles, CA. Her office accepts new patients. Whatever you’re struggling with, I want to help you get what you came to therapy for: another perspective in the room, new insight, and the possibility of real change.

Emotional Deprivation is the belief that your need for love will never be met adequately by other people. You feel that no one truly cares for you or understands how you feel. You find yourself attracted to cold and ungiving people, or you are cold and ungiving yourself, leading you to form relationships that inevitably prove unsatisfying. You feel cheated, and you alternate between being angry about it and feeling hurt and alone. Ironically, your anger just drives people further away. When patients with emotional deprivation come to see us for therapy sessions, there is a loneliness about them that stays with us even after they have left the office. It is a quality of emptiness, of emotional disconnection. These are people who do not know what love is.

Her office is similarly designed. Ordered yet comfortable. A safe and sheltering space. Like the name of her business, Oak Tree Therapy, signifying a solid yet growing organism that can endure the pressures of time, something with deep roots.

to escape, Ute had dissociated her fear and felt nothing. I see depersonalization regularly in my office when patients tell me horrendous stories without any feeling. All the energy drains out of the room, and I have to make a valiant effort to keep paying attention. A lifeless patient forces you to work much harder to keep the therapy alive, and I often used to pray for the hour to be over quickly. After seeing Ute’s scan, I started to take a very different approach toward blanked-out patients. With nearly every part of their brains tuned out, they obviously cannot think, feel deeply, remember, or make sense out of what is going on. Conventional talk therapy, in those circumstances, is virtually useless. In Ute’s case it was possible to guess why she responded so differently from Stan. She was utilizing a survival strategy her brain had learned in childhood to cope with her mother’s harsh treatment. Ute’s father died when she was nine years old, and her mother subsequently was often nasty and demeaning to her. At some point Ute discovered that she could blank out her mind when her mother yelled at her. Thirty-five years later, when she was trapped in her demolished car, Ute’s brain automatically went into the same survival mode—she made herself disappear.

I see depersonalization regularly in my office when patients tell me horrendous stories without any feeling. All the energy drains out of the room, and I have to make a valiant effort to keep paying attention. A lifeless patient forces you to work much harder to keep the therapy alive, and I often used to pray for the hour to be over quickly. After seeing Ute’s scan, I started to take a very different approach toward blanked-out patients. With nearly every part of their brains tuned out, they obviously cannot think, feel deeply, remember, or make sense out of what is going on. Conventional talk therapy, in those circumstances, is virtually useless.

Don’t you have a gun?” he asked. “Why didn’t you stop him?” “I’m not going to execute a man for mooing at me,” I snapped. “For God’s sake, please just find him. He needs help, and he needs it fast. He’s on the verge of a total mental collapse.” He sighed again, but then he rolled his eyes and leaned into his radio. “This is Officer Donahue, requesting backup for the cow situation.

I don't know why you would even bring up the Internet. The xeno-intelligence officer responsible for evaluating your digital communication required invasive emergency therapy after an hour's exposure.

Exercise: Putting Your Fear into Words In a single sentence, summarize the main source of your fears. For example, “I am afraid of speaking to people I don’t know,” “I am afraid of cats,” or “I am afraid of visiting the dentist.” This exercise gives you a starting point for your therapy and focuses your mind. Having figured out your root fear, you can start to put together a plan of action. Exercise: Make A Fear Ladder Following the steps above, make your own “fear ladder.” Try to think of 5-10 situations. Be precise. For example, if you are afraid of elevators, are you scared of elevators in department stores, office buildings, or other settings? Are you scared of traveling one floor, three floors, or from top to bottom of a building?

Did you know that if you’re a middle-aged woman, you have only a small window of opportunity between the beginning of perimenopause and the start of menopause to start estrogen replacement therapy to protect not only your brain but also your bones and cardiovascular system? I did not, until I dug into the science, because as a woman who was diagnosed with a stage 0 breast lump, I was scared off like so many of us from the results of the Women’s Health Initiative, which got blasted out all over the news and initially showed a link between estrogen replacement therapy and breast cancer, but guess what? That study had so many flaws, its findings are little more than useless and possibly harmful. Worse, women like me without uteri show a decrease in breast cancer with estrogen replacement therapy. But this information never made it either into the headlines or into our gynecologists’ offices. I had to find it in scientific publications such as The Lancet online. In fact, get this: Our medical system barely trains gynecologists in menopausal medicine. A recent study found that only 20 percent of ob-gyn residency programs in the U.S. provide any menopause training. Yes, any. Which means that 80 percent of all gynecological residents in school today are getting no training whatsoever in post-reproductive women’s health. These are people whose job it is to know everything going on in our ladyparts, but they have not been taught the basic tenets of how to care for either us or our plumbing after we stop menstruating. And by “us” I mean 30 percent of all women alive on earth at any given moment. Half of my middle-aged female friends deal with chronic urinary tract infections. Oh, well, we think, throwing up our hands in defeat and consuming far too many antibiotics than are rational or safe or even good for the future safety of humanity. It took Dr. Rachel Rubin, a urologist in Washington, D.C., reaching out to me over Twitter to explain that UTIs in menopausal women do not have to be recurrent. They can be mitigated with, yes, vaginal estrogen. Not once was I ever

All of us have different childhoods. The story of childhood is refracted in one’s own estimation of oneself, that’s where we pick up as it were how we feel about ourselves. Because of the language that we’ve learned in childhood, all of us have acquired expectations of how the world is, and how the world will respond to us, based on certain things that happened in the microcosmic world of the family. So we extrapolate what happened in the family, and generalize outwards to the whole world. It’s a natural thing that we do. Because our families of origin are carrying a lot of warps, and a lot of distortions, we’re likely to approach adult life full of expectations, that are not necessarily very fair, either on ourselves or on other people. We may for example think that everybody thinks we’re boring, or everyone’s out to get us, or anyone that we try to love is going to humiliate us, or that in order to win anyone’s favor we’ll always have to agree with them. We carry stories of what we need to do to get loved and also what we can expect from the world, and these stories carry distortions. And normally we play out these distortions in the busy world of relationships, and the office and our friendships, and no one quite notices, and they’re doing their stuff back to us, so everyone’s kind of projecting wildly into one another. Someone’s going “Everyone hates me”, and the other one’s going “I wanna aggress everyone”, and it’s a mess of projections and counter projections, and no one sees what’s going on and there’s no ultimate forgiveness or reconciliation. But what can happen in therapy is you take your issues and when it’s going well you play them out with the therapist, so you become really convinced that the therapist hates you because you are so boring and because therapy is just a room with a therapist, they can actually observe that and go “No, I don’t think that is necessarily right, but I think I am finding you quite interesting.” The therapist can see in a kind of petri dish things that are normally just lost in the complexity of the day-to-day world, and therefore there is a chance to correct what’s going on, so that all those slightly strange ideas, like we have a chance in the sort of clinical and clean confines of a therapy room, to see what we’re doing and get a chance to question whether it still makes sense. It has an origin but that origin may no longer be fair to reality as we have to live it.

There’s a magnet that somebody stuck on the refrigerator in our office’s kitchen: PEACE. IT DOES NOT MEAN TO BE IN A PLACE WHERE THERE IS NO NOISE, TROUBLE, OR HARD WORK. IT MEANS TO BE IN THE MIDST OF THOSE THINGS AND STILL BE CALM IN YOUR HEART. We can help patients find peace, but maybe a different kind than they imagined they’d find when they started treatment. As the late psychotherapist John Weakland famously said, “Before successful therapy, it’s the same damn thing over and over. After successful therapy, it’s one damn thing after another.

He/She Is Always “Working” Is he usually late? Does he/she always say that they are at the office and working on something important? It could be their new object of affection… just saying. When a partner cheats, they will try their best to minimize their contact with their spouses and use excuses to stay out of the house. They just feel a little guilty when they are with you, but boy does that stop them from cheating? Certainly not! Every Time You Confront Him/Her, They Call You Crazy Even if in just some casual banter, you bring up the topic of cheating, they start to act all weird and call you crazy for even thinking like that. No one likes to be caught red-handed and a cheater will always say they haven’t cheated. So take the hint if they act too surprised on the idea that you called them a cheater.

They Are Spending Too Much If all of a sudden you notice too many credit card bills and receipts in their pockets and yet you don’t receive any supposed gifts, then someone else is on the receiving end of them. When asked, they will always have an explanation over how they had to lend some money to a friend, how they had to pitch in the last minute for an office party for a guy’s farewell or how they had to pay a medical bill of some relative. He/He’s Doing Things They Hated Before Remember the time you asked them to go golfing with you and they flat out refused and joked about how it’s an old man’s sport? Look who is all polo shirts and hats now! If their interests have changed all of a sudden and they are doing stuff they hated, know something is up.

There Is No Intimacy Not just physically, but you also find them emotionally distant from you. Even when they are with you, their mind doesn’t seem to be. They have also lost interest in sex and always make excuses like being tired, not in the mood, had chili beef in the office and feeling bloated, etc. They Never Put Their Phone Down If they seem to be stuck with their phone all the time and even taking it with them when taking the trash or going for a bath, it is a sure tell sign that there is something in that phone they don’t want you to know about.

They Are Unreliable There was a time when you were the center of all their attention, but now you feel like you are no more than an afterthought in their lives. This can mean that they are unfaithful with you. He/She Kisses Less Often If they have started to avoid initiating a kiss and austerely avoid it during sex unless you pull them right into it, then they are cheating. They may also bail on the foreplay, avoid making eye contact, and time out their sex, it is a sign that their mind and heart are wandering someplace else. He/She Is Always “Working” Is he usually late? Does he/she always say that they are at the office and working on something important? It could be their new object of affection… just saying. When a partner cheats, they will try their best to minimize their contact with their spouses and use excuses to stay out of the house. They just feel a little guilty when they are with you, but boy does that stop them from cheating? Certainly not! Every Time You Confront Him/Her, They Call You Crazy Even if in just some casual banter, you bring up the topic of cheating, they start to act all weird and call you crazy for even thinking like that. No one likes to be caught red-handed and a cheater will always say they haven’t cheated. So take the hint if they act too surprised on the idea that you called them a cheater. His/Her Dressing Style Changes If he had a difficult time suiting/dolling up for any occasion previously and has started to do it too often now, it is again a sign that they are trying to impress someone. Also, if they seem obsessed with going to the gym or shopping for more sharp-looking/sexy clothes, it could mean they are cheating.

He/She Gets Angry When Questioned Where you were until now just riles him/her up like the Hulk. He/she hates being questioned about their whereabouts. Their stories won’t match, their tone and pitch will change paces and they will try to avoid talking about it altogether. He/She Stays Up Late A sudden shift in their bedtime routine indicates an affair. Cheating partners consider a partner’s sleeping time as the safest to text or message their new love interest. His/Her Stories Seem Inconsistent Sometimes they won’t say a word about where they were and sometimes they would give away too much. When asked if a friend was there with them too, they will not only confirm their presence but also tell you about all the other people who were there, including someone’s pets. Too much information is another sign that there is something fishy going on or else they won’t be this particular about it. There Is No Intimacy Not just physically, but you also find them emotionally distant from you. Even when they are with you, their mind doesn’t seem to be. They have also lost interest in sex and always make excuses like being tired, not in the mood, had chili beef in the office and feeling bloated, etc. They Never Put Their Phone Down If they seem to be stuck with their phone all the time and even taking it with them when taking the trash or going for a bath, it is a sure tell sign that there is something in that phone they don’t want you to know about. He/She Pays Attention to Himself/Herself It’s always appraisable that your spouse dresses up for you, but if they are suddenly worried about how they look naked or whether they should get a bikini wax or not, it’s probably an effort to look good for someone other than you. You Only Get One-Word Answers from Them You sense a barrier in your communications because they have resorted to a yes, no, or hmm at most. When partners lose interest in their spouses or are having an affair, they fear to communicate too much. They want to play it carefully and not say or do something that would get them caught. They Are Spending Too Much If all of a sudden you notice too many credit card bills and receipts in their pockets and yet you don’t receive any supposed gifts, then someone else is on the receiving end of them. When asked, they will always have an explanation over how they had to lend some money to a friend, how they had to pitch in the last minute for an office party for a guy’s farewell or how they had to pay a medical bill of some relative. He/He’s Doing Things They Hated Before Remember the time you asked them to go golfing with you and they flat out refused and joked about how it’s an old man’s sport? Look who is all polo shirts and hats now! If their interests have changed all of a sudden and they are doing stuff they hated, know something is up.

It was 1993. I was eighteen years old when I walked into my first therapy appointment in a stifling hot upstairs office with one window, no air conditioner, to see a counselor with teased bangs and a frizzy bleached perm. Mama had just signed herself into a psychiatric ward for the fourth extended treatment, each months long at a time. Dad had fallen into a vortex of depression [...] I tell myself this, try to believe this: no past can earmark you when you’ve heard the divine whisper of who you can still become.

We persisted with role playing and, about six weeks later, Adam came to therapy with a smile. He had said no. He said it was for something minor: a colleague had texted him to see if he could go in to the office on the weekend and help box some equipment that was going to be transported later that week. At the time of receiving the text, Adam was just about to go for a run along the beach. He had driven about 45 minutes just to get there. So Adam replied to his colleague saying he couldn't. After sending that text message, Adam said he felt an amazing surge of positive energy. He went on the run. But then the fear kicked in. He started thinking he'd get a text from his boss saying to get to the office and help. Despite checking his messages constantly, nothing ever came. A few days later in a staff meeting, Adam shared that he would like to take on a new client. The response was an immediate yes, with his supervisor saying she would set it up for him. When reflecting on these two experiences, Adam said, 'I know it sounds small and trivial, but these two things have given me such a boost. Why didn't I do this sooner?' By being assertive, saying no and sharing his feelings, Adam had unleased a part of himself he usually tried to suppress. He then said, 'What I'd really like to work on in therapy now is how to start thinking about asking a girl out.' In building assertiveness, he went from never saying no to colleagues to asking to take on a client in a staff meeting and wanting to start dating.

One of our goals with this book is to recruit new participants for what we call the Index: A “cultural reactor” that catalogs intentionally constructed family cultures and monitors their outcomes intergenerationally while distributing said information in a way that allows all participating cultures to improve at a faster rate than that of a non-cultivated society. We want to make it possible for cultures in the network to improve faster than normal intergenerational memetic evolutionary powers would allow through a system analogous to horizontal gene transfer in gene therapy or lateral gene transfer in bacteria.

Dear Lord, keep my name out of the therapist's office.

It seems like someone new is here?" I nodded. "Is it okay to talk to you?" I nodded again. "Are you the one who doesn't like the grocery store? "Yes," came the same soft voice. "What is it about the grocery store?" "It's not the store; it's the people. We get scared that some big person is going to hurt us. So we don't let her go places where there are lots of people." I felt dizziness in my head and then a different voice—a little stronger but still young—came out: "And then there's all that noise. We won't let her go in places with too much noise." "Is there someone new here?" "Yes." Is it okay if we talk together?" "Yes." "What's the problem with the noise?" "It was always noisy. A lot of yelling and crying. There was too much going on." "Is that the same kind of problem, the other part has?" "Yes. It's too hard for her to watch everyone to figure out who is going to hurt us next." "Don't you think Olga can take care of you?" "We want to think that, but we aren't sure." "Why is that?" "Because she couldn't take care of us before." "Do you all know what year it is?" "1968?" "Oh, I see. No, it's 1996, and Olga is big now. You all live inside her, and she has learned about you. She is also learning how to stop people from hurting you. She is strong and powerful. Were you there when she stopped the woman in the office from yelling at you?" It's 1996? She's big?" I paused to let the information sink in to all the parts that were listening. "She stopped people from yelling at us?" "Yes." Dr. Summer watched and waited. Home had been so chaotic. I had to watch Popi, Mike, Alex, and my mom very carefully. But I don't live there anymore. I'm grown up now.

Cognoscenti Therapy Associates, Austin, TX—Six Months Later I sat across from Dr. Larsen in her office, which was located in a hip, upscale business complex in a newly gentrified area of East Austin, just a few blocks from the downtown district.

Every therapy session belongs to both patient and therapist, to the interaction between them. It was the psychoanalyst Harry Stack Sullivan who, in the early twentieth century, developed a theory of psychiatry based on interpersonal relationships. Breaking away from Freud’s position that mental disorders were intrapsychic in origin (meaning “in one’s mind”), Sullivan believed that our struggles were interactional (meaning “relational”). He went so far as to say, “It’s the mark of a senior clinician that he or she is the same person in their living room that they are in their office.” We can’t teach patients to be relational if we aren’t relational with them.