Therapy Sessions Quotes

Hollowness: that I understand. I'm starting to believe that there isn't anything you can do to fix it. That's what I've taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mold yourself through the gaps

The only way I'm keeping my hands off her is if I'm dead. Find another way to fix us.

You didn't expect these notes to turn into my therapy session, did you?

You don't scare me, Cadence Jones. I've lived with crazy, I've ridden with crazy, I've vacationed with crazy, I've visited crazy in various hospitals, I've sat in on therapy sessions with crazy. Frankly, I think women who don't have major emotional disorders are really very dull.

becoming your own savior sometimes means knowing when you need to ask for help. - therapy session no. 1

I used to think someone needed to be my best friend before I'd burden her with my problems or my tears. Now I think those interactions--the sobfest or therapy session--are the encounters that earn someone BFF status.

ISABEL: Sorry I missed my session Monday. DR. RUSH: Would you like to tell me why? ISABEL: I was depressed. DR. RUSH: That's a good reason to come to therapy.

The second people felt alone, I noticed, usually in the space between things—leaving a therapy session, at a red light, standing in a checkout line, riding the elevator—they picked up devices and ran away from that feeling. In a state of perpetual distraction, they seemed to be losing the ability to be with others and losing their ability to be with themselves.

I don’t believe in soul mates, but there’s an understanding between us that I just haven’t felt before, or at least, not for a long time. It comes from shared experience, from knowing how it feels to be broken. Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

An abusive man who is adept in the language of feelings can make his partner feel crazy by turning each argument into a therapy session in which he puts her reactions under a microscope and assigns himself the role of “helping” her. He may, for example, “explain” to her the emotional issues she needs to work through, or analyze her reasons for “mistakenly” believing that he is mistreating her.

Are you repeating someone else's narrative, taking it for granted? Talk therapy sessions and 12-step recovery shares help develop the ability to present a coherent life narrative through the safe structure of clear rules of communication that support healthy self-expression and self-awareness.

You can’t be beaten by something you laugh at.

Jenks shook his head. "Rache, I really feel bad for her, but Ivy's right. She can't stay here. She needs professional help." "Really?" I said belligerently, feeling myself warm. "I haven't heard of any group therapy sessions for retired demon familiars, have you?

So on a scale of one to Adele, how bad was this breakup?

It’s time to go. We’ll continue this therapy session later.” “So you’re my therapist now?” “Apparently, I’m a life coach for idiots.

When I look at my father, I can see that he doesn't get it, either, and right then and there, I realize that there's a big part of me that my parents will never get no matter how many therapy sessions we attend - even if we have a million and one conversations about who I am.

I wanted to go to a few therapy sessions and be back to normal. As I saw it, the panic attacks were the problem. What I really wanted was to stop having them. I genuinely thought I could do that. I didn't want to think about the past.

In residency, I studied in a bookstore’s coffee shop, which was where a clutch of women gathered monthly for book club. They would set their library books and blueberry scones on the table. I started eavesdropping and realized that the books they read were just an excuse to talk about their own lives. Every character, every broken heart, every twist of fate inspired a story about an unruly mother-in-law, a philandering father, or the cousin who came out to his unforgiving parents. Sometimes it sounded more like a therapy session than a book discussion. I could never join a book club.

I remember a group therapy session when one of the patients was reluctantly turning his corner. He would accept it, he said, but he wouldn't like the idea of having to solve problems every day for the rest of his life. My co-therapist told him that it was not required that he like it. She shared her own displeasure, saying: 'I remember that when I first discovered what life was like, I was furious. I guess I'm still kind of mad sometimes.' (135)

People who need regulation often leave therapy sessions feeling calmer, stronger, safer, more able to handle the world. Often they don't know why. Nothing obviously helpful happened - telling a stranger about your pain sounds nothing like a certain recipe for relief. And the feeling inevitably dwindles, sometimes within minutes, taking the warmth and security with it. But the longer a patient depends, the more his stability swells, expanding infinitesimally with ever session as length is added to a woven cloth with each pass of the shuttle, each contraction of the loom. And after he weaves enough of it, the day comes when the patient will unfurl his independence like a pair of spread wings. Free at last, he catches a wind and rides into other lands. (172)

Whatever the problem, it generally “presents” because the person has reached an inflection point in life. Do I turn left or right? Do I try to preserve the status quo or move into uncharted territory? (Be forewarned: therapy will always take you into uncharted territory, even if you choose to preserve the status quo.) But people don’t care about inflection points when they come for their first therapy session. Mostly, they just want relief. They want to tell you their stories, beginning with their presenting problem. So let me fill you in on the Boyfriend Incident.

All I can do in one session is to be real, to leap into the patient’s life, to offer observations in the hope that he’ll be able to open doors and explore some new parts of himself in his ongoing therapy.

You see, even after decades of therapy and workshops and retreats and twelve-steps and meditation and even experiencing a very weird session of rebirthings, even after rappeling down mountains and walking over hot coals and jumping out of airplanes and watching elephant races and climbing the Great Wall of China, and even after floating down the Amazon and taking ayahuasca with an ex-husband and a witch doctor and speaking in tongues and fasting (both nutritional and verbal), I remained pelted and plagued by feelings of uncertainty and despair. Yes, even after sleeping with a senator, and waking up next to a dead friend, and celebrating Michael Jackson’s last Christmas with him and his kids, I still did not feel—how shall I put this?—mentally sound.

Typically, a patient might have a difficult session about a childhood trauma, then come in the next week and announce that therapy is no longer needed.

Happiness is a state of mental,physical and spiritual well-being. Think pleasantly,engaged sport and read daily to enhance your well-being.

I have a memory-flash of something Dawn said in a family-therapy session, right before my dad spilt–He's calm but wrong, and I'm loud but right, but since he's calm, it always seems like he's right.

There were nights when I left the sessions physically and emotionally drained after hearing the anguish pour out like blood from a gaping wound. Don’t let anyone ever tell you different – psychotherapy is one of the most taxing endeavors known to mankind; I’ve done all sorts of work, from picking carrots in the scorching sun to sitting on national committees in paneled board rooms, and there’s nothing that compares to confronting human misery hour after hour and bearing the responsibility for easing that misery using only one’s mind and mouth. At its best it’s tremendously uplifting as you watch the patient open up, breathe, let go of the pain. At its worst is like surfing in a cesspool struggling for balance while being slapped with wave after putrid wave.

Toward the end of the first session, no matter how well it seems to have gone, the therapist is encouraged to ask clients how the session felt to them and whether they have any concerns about the treatment process or the therapist.

I hear a siren and, if we weren’t already in a hospital, I would have assumed they were coming for nearly everyone in this room.

You didn’t force me. Against my better judgment, and despite all the therapy sessions and spells, I just couldn’t help myself. You’re like crack to my heart.” His gaze narrowed. “Did you just compare me to a highly addictive, dangerous drug?” “Yes.” “Mon amour.

Although providing a corrective emotional experience may sound easy, it can be challenging to do—especially when all of this is so new to therapists-in-training. To help, Hill (2009) encourages therapists to be asking themselves the same process-oriented question throughout each session: Right now, am I co-creating a new and reparative relationship, or am I being drawn into a familiar but problematic interaction sequence that is reenacting for this client?

The stories told by ancient peoples from which we are descended have managed to put into pleasant and entertaining words what we’ve been repeating ever since in living rooms, courts, churches, and therapy sessions. The “life tips” that we seek have been there for us all along.

All those years of endless excruciating therapy sessions, of staying vigilant over every move and word and thought; I had been sure I was mended, all the breaks healed, all the blood washed away. I knew I had earned my way to safety. I had believed, beyond any doubt, that that meant I was safe.

You're convinced that anybody who meets you for the first time will consider you a shit, so you take preventive action. Relax, boychick. When they get to know you better they will realize that they were right. You are a shit.

Absolutely alone in the dark. Every outside stimulus vanishes and there’s nothing except me in the darkness and the silence. I swear I can hear my thoughts. All my thoughts. And it’s horribly uncomfortable, and I want to switch on the light and say something and shove that aside. But the feeling passes in a few panicked heartbeats, and then … and then it’s indescribable. This is what I’ve been looking for in all those therapy sessions. Not a chance to tell someone my story. A chance to be alone with it. Utterly alone with it, and maybe that makes no sense, but it’s what I feel. Just me and that one defining moment in my past. Grief and rage and pain and guilt and clarity. Yes, clarity.

Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All these things I know, but I don’t say them out loud, not now.

BDSM, in its nature, is a very intimate and intelligent therapy, if done properly.

That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

That’s what I've taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them—in other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world. If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered? Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

Julie told me that she wanted people to keep her in mind the way she keeps me in mind between sessions. “I’ll be driving, and I’ll panic about something, but then I’ll hear your voice,” she explained. “I’ll remember something you said.” I thought about how I did this with Wendell—how I’d internalized his lines of questioning, his way of reframing situations, his voice. This is such a universal experience that one litmus test of whether a patient is ready for termination is whether she carries around the therapist’s voice in her head, applying it to situations and essentially eliminating the need for the therapy.

I didn’t want to be abandoned, alone, isolated and feeling all of this on my own. He was all I had. All I even could get from this world. But I was a horrible human being, and that was just the start of it all.

They didn’t live anymore in a world where life was to be colorful and celebrated. Life had become something you clung to, that you bit down hard on against the pain, like the rubber block in a session of electroshock therapy.

Meanwhile, the annual U.N. climate summit, which remains the best hope for a political breakthrough on climate action, has started to seem less like a forum for serious negotiation than a very costly and high-carbon group therapy session, a place for the representatives of the most vulnerable countries in the world to vent their grief and rage while low-level representatives of the nations largely responsible for their tragedies stare at their shoes.

Nita: I think I overdid the vulnerability stuff in this last letter. and that’s why I’m having an anxiety attack. Howard: With the vulnerability comes the possibility that you’ll be betrayed. Now that you’ve laid yourself wide open, I am the agent of this betrayal? It’s not my style. Nita: I’ve thought it wasn't other people’s style, too.

When clients relinquish symptoms, succeed in achieving a personal goal, or make healthier choices for themselves, subsequently many will feel anxious, guilty, or depressed. That is, when clients make progress in treatment and get better, new therapists understandably are excited. But sometimes they will also be dismayed as they watch the client sabotage her success by gaining back unwanted weight or missing the next session after an important breakthrough and deep sharing with the therapist. Thus, loyalty and allegiance to symptoms—maladaptive behaviors originally developed to manage the “bad” or painfully frustrating aspects of parents—are not maladaptive to insecurely attached children. Such loyalty preserves “object ties,” or the connection to the “good” or loving aspects of the parent. Attachment fears of being left alone, helpless, or unwanted can be activated if clients disengage from the symptoms that represent these internalized “bad” objects (for example, if the client resolves an eating disorder or terminates a problematic relationship with a controlling/jealous partner). The goal of the interpersonal process approach is to help clients modify these early maladaptive schemas or internal working models by providing them with experiential or in vivo re-learning (that is, a “corrective emotional experience”). Through this real-life experience with the therapist, clients learn that, at least sometimes, some relationships can be different and do not have to follow the same familiar but problematic lines they have come to expect.

Death is just one long therapy session. You have gone over every second of your life and divided them into the misery you caused and the misery others caused you. You have been waiting for six years for this motherfucker to die, and you know that the day has finally arrived.

Hollowness: that I understand. I'm starting to believe that there isn't anything you can do to fix it. That's what I've taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mold yourself through the gaps.

Hollowness: that I understand. I'm starting to believe that there isn't anything you can do to fix it. That's what I've taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All

COMMUNITY WAS HELD IN A LONG ROOM with tall barred windows that overlooked a redbrick wall. The smell of coffee was in the air, mingled with traces of Yuri’s aftershave. About thirty people were sitting in a circle. Most were clutching paper cups of tea or coffee, yawning and doing their best to wake up. Some, having drunk their coffees, were fidgeting with the empty cups, crumpling, flattening them, or tearing them to shreds. Community met once or twice daily; it was something between an administrative meeting and a group therapy session. Items relating to the running of the unit or the patients’ care were put on the agenda to be discussed

In closing, new therapists are encouraged to be themselves with clients rather than trying to fulfill the role of a therapist. Perhaps Kahn says it best: When all is said and done, nothing in our work may be more important than our willingness to bring as much of ourselves as possible to the therapeutic session.... One of the great satisfactions of this work comes at the moment students realize that when they enter the consulting room, they don’t need to don a therapist mask, a therapist voice, a therapist posture, and a therapist vocabulary. They can discard those accouterments because they have much, much more than that to give their clients.

I did not trap myself inside my walls this time. I've torn down the walls that trapped me from exiting. This time, I put up a protective wall to keep you out instead. You cannot enter. I am inside, in a private, exclusive and intimate therapy session. So yes, there is a wall. But this time it's effectively serving its purpose

The very first picture that came up on the camera’s little view screen was of him. What did that mean that she’d kept this picture of him? Was it because she still cared? Or had she saved it as a warning? Like, “Never forget how completely screwed up your relationship was with this loser . . .” It wasn’t a particularly good picture. In fact, it was pretty embarrassing. Sitting up in his bed, Max was in his room at Sheffield. It was the photo Gina had taken the day after he’d arrived there. He looked like crap warmed over after his very first physical therapy session, and he was glowering into the camera because he goddamn didn’t want his picture taken.

Every man's penis is the prettiest thing in the world to him. From the day he's born until the day he dies. It never loses its endless fascination. And, I kid you not, baby, the same is true of every woman and her pussy. It's the closest thing to a real, blind, helpless love and religious adoration that most people ever achieve. But they'd rather die than admit it. Homosexuality, the urge to kill, petty spites and treacheries, fantasies of sadism, masochism, transvestism, any weird thing you can name, they'll confess all that in a group therapy session. But that deep submerged constant narcissism, that perpetual mental masturbation, is the earliest and most powerful block. They'll never admit it.

At sixty one, I was at the top of my professional career, a wife, mother, and grandmother with many wonderful friends--and absolutely terrified....I was unaware of living as multiple identifies, but did spend my life running away from a 'me' I could neither understand nor tolerate....The first step to becoming one whole person happened to me the day in therapy when I became aware of the three adults who had been living in separate compartments in my brain. I saw them and they saw each other....A perfect three-point landing.

Hollowness: that I understand. I'm starting to believe that there isn't anything you can do to fix it. That's what I've taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All these things I know, but I don't say them out loud, not now.

In fact, he'd admitted as much when the subject of his mother had come up in one of their early sessions. Of course it came up. Would therapy even exist without mothers?

Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All these things I know, but I don’t say them out loud, not now. “When

broken. Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All these things I know, but I don’t say them out loud, not now.

Why? Because therapy culture often pushes us deeper into hiding. As individualistic westerners, we are bent toward isolation, not openness. And for many people, therapy sessions are a warped form of individualism. People want to go someplace safe where nobody in their real, actual life—people who know them, love them, and have a history with them—get to hear what’s going on deep inside. There is a profound danger to that.

Only discovering and healing the root causes of each individual's dependency puts an end to dependency. One-on-one sessions are key because the individual issues at the core of dependency are just that- completely individual.

Liberals have elections to contest and centrist working-class voters to win back. That is job number one. And nothing will turn voters off more surely than being hectored in this way. So a couple of reminders to the identity conscious: Elections are not prayer meetings, and no one is interested in your personal testimony. They are not therapy sessions or occasions to obtain recognition. They are not seminars or “teaching moments.” They are not about exposing degenerates and running them out of town. If you want to save America’s soul, consider becoming a minister. If you want to force people to confess their sins and convert, don a white robe and head to the River Jordan. If you are determined to bring the Last Judgment down on the United States of America, become a god. But if you want to win the country back from the right, and bring about lasting change for the people you care about, it’s time to descend from the pulpit.*

Women who see a therapist who is also a woman is destined to be unhappy and will have endless jargon that can easily be warped and restructured to keep them walking circles in the desert thinking they've crossed the horizon every session.

I don’t believe in soulmates, but there’s an understanding between us which I just haven’t felt before, or at least, not for a long time. It comes from shared experience, from knowing how it feels to be broken. Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps.

The men who pay for sex feel entitled to women’s time and emotional labor, to such an extent that it doesn’t occur to them that they’ve paid for what amounts to a therapy session with a side of blow job. Much of the work, as Petro describes it, is sympathetically listening to men bitch about their ex-girlfriends. “I love to dance, and that part was enjoyable. The physical work of prostitution wasn’t particularly different than nonpaid sexual encounters. It was the emotional labor that was really taxing.

I don’t believe in soul mates, but there’s an understanding between us that I just haven’t felt before, or at least, not for a long time. It comes from shared experience, from knowing how it feels to be broken. Hollowness: that I understand. I’m starting to believe that there isn’t anything you can do to fix it. That’s what I’ve taken from the therapy sessions: the holes in your life are permanent. You have to grow around them, like tree roots around concrete; you mould yourself through the gaps. All these things I know, but I don’t say them out loud, not now.

Jorja felt great after her session with the crew from physical therapy. She'd never been one for acting, but if Cat could have seen her, she'd have offered her the Academy Award for "Best Performance by a Previously Dead Person in a Reincarnated Body." Jorja chuckled at the thought...

I'm not a particularly good daughter, but I sat through a month of therapy for my parents' sake. I'd like to think they got more out of it than I did. Couldn't have been too hard. Any system that requires the patient's family to pay someone else to care about her is fundamentally flawed.

Upon entering therapy, adult children of borderlines are initially reluctant to discuss their childhood experiences. Several patients developed psychosomatic symptoms such as feeling a lump in their throat or experienced panic attacks following sessions during which they discussed their mother.

When's the last time Andrew saw fit to talk to you at all?" Neil asked. "Last Wednesday," Aaron reminded him. It wasn't the answer Neil expected. He'd laid the groundwork for Aaron and Andrew's therapy and it'd been weeks since Aaron first muscled his way into one of Andrew's sessions, but this was the first hint that they were actually doing something real with that time. Aaron's awful attitude that first Wednesday was the only reaction they'd ever gotten from the brothers. Neil had assumed the two were still getting nowhere fast. Triumph was a quiet, smoldering heat in his stomach.

Quite the opposite. I had to prop her up with her therapies and her health club and her yoga sessions and all the rest of it. After the honeymoon, she hardly ever let me into her bed and even on the honeymoon I had to chase her round the bloody ecolodge that she’d chosen in the middle of Mexico.

We don’t treat each other very well, I suppose. Even from the start. It was as though we had the seven-year itch the day we met. The day she went into a coma, I heard her telling her friend Shelley that I was useless, that I leave my socks hanging on every doorknob in the house. At weddings we roll our eyes at the burgeoning love around us, the vows that we know will morph into new kinds of promises: I vow not to kiss you when you’re trying to read. I will tolerate you in sickness and ignore you in health. I promise to let you watch that stupid news show about celebrities, since you’re so disenchanted with your own life. Joanie and I were urged by her brother, Barry, to subject ourselves to counseling as a decent couple would. Barry is a man of the couch, a believer in weekly therapy, affirmations, and pulse points. Once he tried to show us exercises he’d been doing in session with his girlfriend. We were instructed to trade reasons, abstract or specific, why we stayed with each other. I started off by saying that Joanie would get drunk and pretend I was someone else and do this neat thing with her tongue. Joanie said tax breaks. Barry cried. Openly. His second wife had recently left him for someone who understood that a man didn’t do volunteer work.

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.

Third, after each meeting I dictated and mailed to the members a weekly summary which was not only a narrative of the content of each session but also self-revealing. I described my experience in the group—my puzzlement, my pleasure with certain of my contributions, my chagrin at errors I had made, or issues I had overlooked, or members I felt I had neglected.

To return to my blunder in group therapy, a veteran whose voice is often heard in this book turned black with anger and, glaring at me, said, "I won my war. It's you who fucking lost!" He got up and left the room to remove himself from the opportunity to physically hurt me. Toward the end of the group session he returned and said, "What we lost in Vietnam was some good fucking kids!

Dr. van der Kolk asked the man directly: “What happened to you on July 5 at 6:30 in the morning?” He responded immediately. While he was in Vietnam, the man’s platoon had been ambushed by the Viet Cong. Everyone had been killed except for himself and his friend, Jim. The date was July 4. Darkness fell and the helicopters were unable to evacuate them. They spent a terrifying night together huddled in a rice paddy surrounded by the Viet Cong. At about 3:30 in the morning, Jim was hit in the chest by a Viet Cong bullet. He died in his friend’s arms at 6:30 on the morning of July 5. After returning to the States, every July 5 (that he did not spend in jail), the man had re-enacted the anniversary of his friend’s death. In the therapy session with Dr. van der Kolk, the vet experienced grief over the loss ...

Anger was good, she'd said, while I was putting my coat on. If I was finally getting in touch with my anger, then I was starting to do some important work, unpicking & addressing things that I'd buried too deep. I hadn't thought about it before, but I suppose I'd never really been angry before now. Irritated, bored, sad, yes, but not actually angry. I supposed she had a point; perhaps things had happened that I ought to feel angry about.

​Dr. Wallace shook her head and I swear her voice was slightly condescending."Mrs. Davis, Shannon is very ill. Although she has been discharged, she still needs to come to therapy for quite some time. Even though she won’t speak to me now, I’m hoping for some breakthroughs with Shannon. She needs you to attend these therapy sessions in order to make progress."  ​Rolling my eyes upwards, I replied with annoyance, "I have other things in my life, Doctor. I do have two children. Five and six. Boys. They have very busy schedules. Hockey and piano lessons and play dates. I'm not like Shannon with no responsibilities or a care in the world." I also have a live in nanny, but the doctor doesn’t need to know that, right?  ​"I understand. Boys are busy little creatures. I have four of them," she replied, no malice in her voice whatsoever.  ​"Oh," I replied curtly. Well, I'm sure her social calendar is not nearly as filled as yours, Kathryn.

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.

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.

My legs are not quite properly operating and I’m having physiotherapy every Tuesday,” Michael said after Emma had beaten him to the phone. I accompanied him on one of these sessions, where he had to wait like anyone else for his turn. I was amazed that he did not have someone come to the house and that the therapy was not more frequent. He could barely walk now. But he was loyal to the National Health Service, the creation of his hero Nye Bevan and avoided any appearance of seeking special treatment or assistance outside the NHS.

A recent 2013 randomized, placebo-controlled study in hypothyroid patients demonstrated that in people who got near-infrared light therapy, thyroid function dramatically improved, and remarkably, that thyroid antibody (TPOAb) levels were massively reduced. Amazingly, 47% of patients were able to stop medication completely! Moreover, the researchers also followed up 9 months after treatment and found that the effects were still evident!116 They even published a 6-year follow-up, which basically said that even at 6 years, some of the benefits still remained, but periodic sessions were recommended to maintain all benefits.117

When problems of transference are involved, as they usually are, psychotherapy is, among other things, a process of map-revising. Patients come to therapy because their maps are clearly not working. But how they may cling to them and fight the process every step of the way! Frequently their need to cling to their maps and fight against losing them is so great that therapy becomes impossible, as it did in the case of the computer technician. Initially he requested a Saturday appointment. After three sessions he stopped coming because he took a job doing lawn-maintenance work on Saturdays and Sundays. I offered him a Thursday-evening appointment. He came for two sessions and then stopped because he was doing overtime work at the plant. I then rearranged my schedule so I could see him on Monday evenings, when, he had said, overtime work was unlikely. After two more sessions, however, he stopped coming because Monday-night overtime work seemed to have picked up. I confronted him with the impossibility of doing therapy under these circumstances. He admitted that he was not required to accept overtime work. He stated, however, that he needed the money and that the work was more important to him than therapy. He stipulated that he could see me only on those Monday evenings when there was no overtime work to be done and that he would call me at four o’clock every Monday afternoon to tell me if he could keep his appointment that evening. I told him that these conditions were not acceptable to me, that I was unwilling to set aside my plans every Monday evening on the chance that he might be able to come to his sessions. He felt that I was being unreasonably rigid, that I had no concern for his needs, that I was interested only in my own time and clearly cared nothing for him, and that therefore I could not be trusted. It was on this basis that our attempt to work together was terminated, with me as another landmark on his old map. The problem of transference is not simply a

In a therapy session, the only labels the horses get are the ones the client gives them.” “So you wouldn’t want me to notice that the Palomino horse, the one with the white mane and the tan body, looks like you and that she’s always making a nuisance of herself?” “Sackett?” I was outraged on Sackett’s behalf more than my own. “Sackett isn’t annoying! And Sackett’s a he, which just proves my point about pre-conceived ideas. If you knew he was a he and not a she, you wouldn’t be able to label him as Georgia and say mean things. Sackett is wise! Whenever things get really deep, you can always count on Sackett being right in the thick of things.” I heard the affront in my voice and I glowered at Moses for a moment before launching my own attack. “And Lucky is just like you!” I said. Moses just stared at me blandly, but I could tell he was enjoying himself. “Because he’s black?” “No, stupid. Because he’s in love with me, and he tries to pretend every day like he doesn’t want to have anything to do with me,” I shot back. Moses choked, and I punched him hard in the stomach, making him gasp and grab for my hands. “So you want the clients to not pay any attention to the color of the horse. That’s not even human nature, you know.” Moses pinned my hands over my head and stared down into my flushed face. When he could see I wasn’t going to continue punching he relaxed his hold, but he looked back toward the horses and continued talking.

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

Debbie Nathan blames the early symptoms on pernicious anemia yet explains their supposed remission by Shirley’s being out of contact with Dr. Wilbur for those 9 years. But Dr. Wilbur never diagnosed a dissociative disorder in 1945. Nathan does not seem to recognize the implausibility of Dr. Wilbur creating via suggestion a complex dissociative disorder in five sessions, particularly when the doctor herself did not diagnose it. Nathan attributes Shirley’s postintegration improvement in functioning to being out of contact with Dr. Wilbur rather than to the therapy. But the pernicious anemia continued to be undiagnosed and untreated during that time period, so any symptoms due to it should have continued rather than showing an improvement that coincided with psychotherapy with Dr. Wilbur. Debbie Nathan’s thesis is self-contradictory.

Confidence doesn’t come from the inside out. It moves from the outside in. People feel less anxious—and more confident—on the inside when they can point to things they have done well on the outside. Fake confidence comes from stuffing our self-doubt. Empty confidence comes from parental platitudes on our lunch hour. Real confidence comes from mastery experiences, which are actual, lived moments of success, especially when things seem difficult. Whether we are talking about love or work, the confidence that overrides insecurity comes from experience. There is no other way. It is not uncommon for twentysomething clients to come to therapy hoping I can help them increase their confidence. Some wonder if maybe I do hypnosis and a hypnotherapy session might do the trick (I don’t, and it wouldn’t), or they hope I can recommend some herbal remedy (I can’t). The way I help twentysomethings gain confidence is by sending them back to work or back to their relationships with some better information. I teach them about how they can have more mastery over their emotions. I talk to them about what confidence really is. Literally, confidence means “with trust.” In research psychology, the more precise term is self-efficacy, or one’s ability to be effective or produce the desired result. No matter what word you use, confidence is trusting yourself to get the job done—whether that job is public speaking, sales, teaching, or being an assistant—and that trust only comes from having gotten the job done many times before. As was the case for every other twentysomething I’d worked with, Danielle’s confidence on the job could only come from doing well on the job—but not all the time.

Can you sleep-deprive your way out of a depressed episode? Some researchers think that it may be possible. Using a technique called TSD (total sleep deprivation), researchers subjected depressed bipolar patients to three cycles of sleep deprivation, each consisting of a 36-hour period of sleeplessness followed by a 12-hour sleep-in. After the sessions, over half the participants reported feeling less depressed. The trouble is, TSD runs about a 10 percent risk of kicking a bipolar sufferer into hypomania or mania — about the same rate as SSRI antidepressants. In addition, the positive effects of TSD generally wear off as soon as you return to your normal sleep/wake cycle. Researchers continue to study the potential benefits of TSD when used in combination with other therapies, but the only solid conclusion that researchers have reached is that TSD is definitely not something you should try on your own.

In The Body Keeps the Score, Bessel van der Kolk writes about a form of therapy called EMDR, or Eye Movement Desensitization and Reprocessing. It’s a strange process reminiscent of hypnosis, where a patient revisits past traumas while moving their eyes left and right. It seemed too simple, almost hokey, but van der Kolk passionately sang its praises. He told the story of a patient who came out of a single forty-five-minute session of EMDR, looked at him, and said that “he’d found dealing with me so unpleasant that he would never refer a patient to me. Otherwise, he remarked, the EMDR session had resolved the matter of his father’s abuse.” Resolved! Here was a form of therapy, van der Kolk said, that could help “even if the patient and the therapist do not have a trusting relationship.” Then again, he said that EMDR was far more effective for adult-onset trauma, and it cured only 9 percent of childhood trauma survivors.

In 2021 the respected journal Nature Medicine published a peer-reviewed, placebo-controlled trial on psychedelic assisted treatment of trauma. The results were impressive. With just three, medically supervised sessions using MDMA, 67 per cent no longer had PTSD – more than double the placebo group. There was no increased risk of abuse and, crucially, those with dissociation responded as well as those without.3 Given the special skills otherwise required to navigate dissociation, this latter finding was a big deal. There are currently over a hundred psychedelic-assisted therapy trials being conducted worldwide. It would appear that these drugs allow a resetting of a part of the brain known as the ‘Default Mode Network’ (DMN) that otherwise holds on to recurring, distressing thoughts – especially around guilt and shame. During REM/dreaming sleep the DMN fires up, but the normal resetting process fails with overwhelming trauma.

Alicia Brown loved the feeling of swimming. Face in water, smooth stroke, face out of water; another smooth stroke. It was a soothing and peaceful series of motions that carried her from one end of the pool to another, with the sleek turns at each end. Her hand touched the end of the pool, her body turned, her foot danced on the pool edge and she was off to the other end of the pool. There was no time for thought or worry or tension when she swam. There was no need to talk or compare swimming sessions. She looked at Sophie bobbing swiftly beside her, trying another stroke. Alicia preferred her tried and true basic swimming stroke that carried her powerfully from one end of the pool to the other and back again. Sophie had a variety of strokes she used. Alicia was aware that Sophie was coming to the end of her swim. She could see her slowing as she reached the end of a lap. Alicia didn’t want to stop. Not yet, anyway. For one thing, once she was out of the water, the same long list of tasks awaited her. She could feel the tension in her shoulders at the mere thought of having her water therapy end. That’s what she called

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.

The Japanese word seiki is also a way of pointing to this vitality of presence. Carl Whitaker hinted at it when he said therapy was as good as the goodness of the therapist. Though his words are easy to misunderstand, they imply a truth: “I found seiki at the heart of most healing traditions.” Keeney is referring to his decade-long journey around the world, studying with the most accomplished healers in southern Africa, Latin America, South Asia, among the aborigines of Australia, and to many other far-flung places that hold ancient practices. He finds it more than a little amusing that in the culture of therapy we are so obsessed with things that matter so little to others around the world. “I have learned that one’s model or protocols matter not at all and that evidence-based therapy is a gambler’s way of pulling the authority card. If you have seiki, or a powerful life force, then any model will come to life. Without it, the session will be dead and incapable of transformation.” Keeney finds it challenging, if not frustrating, to try to explain this idea to those who don’t speak this language. “I guess if you have seiki or n/om, you feel what I am talking about; if you don’t, no words will matter. The extent to which you feel, smell, taste, hear, and see this vitality is a measure of how much mastery there is in your practice and everyday life.” We believe it is an illusion that master therapists truly understand what therapy is all about and how it works. The reality is that the process has many different dimensions and nuances that we never really grasp. There are aspects that appear both mysterious and magical.

Try Mindfulness Meditation Mindfulness meditation is like Tylenol, in that the same treatment is capable of helping with multiple issues: decreasing anxiety-induced overarousal, boosting your focus, and improving your ability to detect rumination. Mindfulness-based therapies have been shown to be effective for helping people reduce anxiety. Mindfulness meditation does not need to be intimidating. Research by the makers of the Lift goal-tracking app found that beginner meditators start with an average of three to five minutes. They also found that once people had meditated 12 times, there was around a 90% chance they’d do more mediation. Experiment: Explore and find a version of meditation that works for you. Start with three minutes of one of the following practices, and increase the time you spend meditating by 30 seconds each day: --Pay attention to the physical sensations of your breathing. Lie down and put your hand on your abdomen to feel the sensations of it rising as you breathe in and falling as you breathe out. --Sit or lie down and listen to any sounds and the silence between sounds. Let sounds just come in and out of your awareness regardless of whether they’re relaxing sounds or not. --Walk for three minutes and pay attention to what you see. --Walk and pay attention to the feelings of air on your skin. --Walk and pay attention to the physical sensations of your body moving. --Do three minutes of open awareness, in which you pay attention to any sensations that show up. Pay attention to anything in the here and now, which could be sounds, your breathing, the sensations of your body making contact with your chair, or the sensations of your feet on the floor. --Spend three minutes paying attention to any sensations of pain, tension, comfort, or relaxation in your body. You don’t need to try to change the sensations; just allow them to be what they are, and ebb and flow as they do. When your thoughts drift away from what you’re supposed to be paying attention to, gently (and without self-criticism) bring them back. Expect to need to do this a lot. It’s a normal part of doing mindfulness meditation and doesn’t mean you’re doing it wrong. You’re likely to get more benefits from meditation if you do it on a regular basis and for longer amounts of time per session.

• No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. We will talk about almost anyone about our physical health, even our sex lives, but bring depression, anxiety or grief , and the expression on the other person would probably be "get me out of this conversation" • We can distract our feelings with too much wine, food or surfing the internet, • Therapy is far from one-sided; it happens in a parallel process. Everyday patients are opening up questions that we have to think about for ourselves, • "The only way out is through" the only way to get out of the tunnel is to go through, not around it • Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of "feeling felt" • Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in peoples relationships too, influencing the kind of partners they pick, (stable or less stable), how they behave in a relationship (needy, distant, or volatile) and how the relationship tend to end (wistfully, amiably, or with an explosion) • The presenting problem, the issue somebody comes with, is often just one aspect of a larger problem, if not a red herring entirely. • "Help me understand more about the relationship" Here, here's trying to establish what’s known as a therapeutic alliance, trust that has to develop before any work can get done. • In early sessions is always more important for patients to feel understood than it is for them to gain any insight or make changes. • We can complain for free with a friend or family member, People make faulty narratives to make themselves feel better or look better in the moment, even thought it makes them feel worse over time, and that sometimes they need somebody else to read between the lines. • Here-and-now, it is when we work on what’s happening in the room, rather than focusing on patient's stories. • She didn't call him on his bullshit, which this makes patients feel unsafe, like children's whose parent's don’t hold them accountable • What is this going to feel like to the person I’m speaking to? • Neuroscientists discovered that humans have brain cells called mirror neurons, that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous system and help them stay present • Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth. • The things we protest against the most are often the very things we need to look at • How easy it is, I thought, to break someone’s heart, even when you take great care not to. • The purpose on inquiring about people's parent s is not to join them in blaming, judging or criticizing their parents. In fact it is not about their parents at all. It is solely about understanding how their early experiences informed who they are as adults so that they can separate the past from the present (and not wear psychological clothing that no longer fits) • But personality disorders lie on a spectrum. People with borderline personality disorder are terrified of abandonment, but for some that might mean feeling anxious when their partners don’t respond to texts right away; for others that may mean choosing to stay in volatile, dysfunctional relationships rather than being alone. • In therapy we aim for self compassion (am I a human?) versus self esteem (Am I good or bad: a judgment) • The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure, as the surgeons operate, they keep checking in with the patient: can you feel this? can you say this words? They are constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back up so as not to damage it.

While guilt and shame are very powerful emotions, think about what you’re doing before you make another community’s struggle into your therapy session.

In a study published in 2005 psychologist Steven A. Safren of Mass General and his colleagues showed that 12 training sessions, focused on adopting organizational strategies, combined with medication, was more effective for ADHD symptoms than medication alone in 31 adults with ADHD. In a followup study published in 2010 Safren found that 12 weeks of training in organizational techniques relieved the burden of ADHD in 79 adult patients more than relaxation therapy of the same duration did. Therapy can also curtail impulsive decision making. In our own clinical practices, we ask clients to pick “critical moments” in which they tend to stray from their intended course. Such a moment might be deciding to play one more video game instead of going to bed on time or hitting snooze on the alarm clock, until a person is so rushed that gym clothes are forgotten and the planned exercise never

Howard: Sometimes a betrayal can be so subtle that it clouds the whole thing. Nita: It would have to be a real betrayal. Not like canceling an appointment. It would be like you’d end the relationship in the middle. Howard: Why would I call it off? Nita: I don’t know!