Saturday, October 6, 2012




“Home”

Most of us have a physical address, for example, 333 Main Street, Anytown, USA.  But where does our heart reside?  Is it where we grew up as young children, with memories of riding tricycles and our young neighbors?  Is it where we spent our adolescence, feeling those pangs of attraction for that cute boy or girl down the street?

By the time we’ve completed high school, our sense of home is fairly well defined.  Later in life, as we contemplate “home” , that will function as a reference point.  “Home” was a place where, regardless of how we had failed our parents’ expectations, we could still return.

But, as adults, we also create our own sense of home.  This may have to do with the part of the country we choose to live in, a spouse’s personal history and sense of place, the career path we follow, and decisions we make for our children, regarding schooling, etc.

The idea of “home”  has recently been very much on my mind.  My elder daughter married a few weeks ago, and the ceremony and associated festivities were all held in areas of a city where I used to spend a great deal of time.  And, this weekend, my husband and I are traveling in our motor home through parts of the state that were home to me for many years.

A strange sense of disconnect during these last two trips led me to ponder how we establish that sense of home.  A number of years ago, as I was going through a major life upheaval, I was elated to travel to the city that would become my new home.  The sense of exhilaration as I departed was unparalleled.  The return trip was agony, except for the awareness that I’d soon see my college-age daughters. 

This process went on for several months, until I had my new residence established and resolution of legal matters under way.  And so the transition from home in one city, where I had resided for many years and where my children had been born and raised, began.

I immersed myself in the professional community in my new city and experienced a great deal of satisfaction in that.  I made rewarding connections and found that exciting professional opportunities emerged from those.  And, so, my new city has become home in a very vibrant and promising way.  And yet, a trip through my former home is enough to powerfully tug at my heartstrings.  The moral of the story is, I guess, that we invest ourselves emotionally wherever we go, and that that’s just fine.

Friday, March 23, 2012

Who Are Your Friends?

One of my favorite radio talk show hosts is Dennis Prager. He is highly intelligent, provocative, and yet retains a wry, but benign, sense of humor. He isn't afraid to tackle life's big questions, such as the nature of God, the meaning of the Bible, and relationships between men and women. During my commute, I'll often eagerly tune into his show. Other days, there's so much noise in my head from my clinical sessions and any writing projects I'm doing that I crave silence.

Today, Dennis was hosting his "Happiness Hour", devoted to exploring various facets of contentment and positivity in life. His specific topic today was friendship and how and why friendships end. I was fascinated by his callers and their stories. What most captivated me were the stories of decades-long friendships in which eventually one friend encouraged the other to take a course of action that violated that person's moral compass, for example, to actually take a test for one's child so that he wouldn't fail a college course, or to abandon one's family and "just go be happy".

There is a saying that "Friends want the best for each other and bring out the best in each other." Several of the calls I heard on the show today seemed to fly in the face of that conventional wisdom. I'd like to encourage you, if faced with a friendship dilemma, to consider whether your friend has your best and truest interests at heart, or has some other agenda.

Monday, October 10, 2011

My Best Friend's Suicide

Right up front, I'll be clear that names and other details have most definitely been changed. Suicide is about pain, the kind that never goes away, for those left behind. The last thing I want to do here is inflict more pain by exposing personal details that could reveal identities.

Several years ago, my best friend of twenty years killed herself. We had done our psychology internships together. Although we came at the practice of psychology from different perspectives (she was strongly behavioral and I was much more psychodynamic at the time), we had many stimulating discussions about our work. She and her husband also became an integral part of our family and became "Aunt Sheryl" and "Uncle Gary" to my two young children.

Gary was a physician in a fast-paced high-pressure trauma center. Years in that setting eventually wore on him, and he took a job with a small practice in northern California. Sheryl moved out there after handling the sale of their home on the east coast. She had practiced psychology only intermittently after internship, and hadn't completed the requirements for licensure, so still had to be supervised by others in her work. She spent the rest of her time in community and charitable work.

The move to California was hard on Sheryl. She was thousands of miles away from family, had no friends there, and no professional identity. While she had had some vague physical ailments over the years, her health took a definite turn for the worse after the move. Gary spent much of his free time researching possible diagnoses, but to no avail. To say that he became frustrated is to put it mildly. Sheryl, on the other hand, became quietly despondent and withdrawn.

The details of the night I got the call is forever seared into my brain. As soon as I heard Gary's voice, I knew Sheryl was dead, but I instantly assumed it was an auto accident. As he went through the details of coming home from work and finding her body, I was enveloped by a whirlwind of emotions--indescribable pain, anger, loss, bewilderment. I also knew that my life was forever changed by her act.

As Gary and I talked by phone during the next few days, more details came to light--the manner of death, how Sheryl had staged her death scene, the amount of planning she put into her suicide, and that Gary was even briefly considered a suspect in her death. To make matters worse, her family back East also accused him of somehow being responsible for her death, that perhaps he had neglected her after the move or hadn't done enough to ease the transition for her.

I was ready to get on the next plane and head to California to be with Gary and help him with whatever arrangements needed to be made. He asked me to wait a couple of months until he felt ready to face the task of going through her possessions. Of course, I honored that and actually shared a very special time with Gary when I finally did visit. He turned over the task of sorting her belongings to me. We sat around and talked and laughed and cried. Gary and I remain good friends. He has remarried, a very special lady who has introduced him to an entirely different way of life.

The thing about suicide is that, so often, you never get what it was really about. Sheryl left a very lengthy, cryptic letter to both Gary and me. I read that letter over and over on my way home to my family. I concluded it actually raised more questions than it answered, and I even wondered if that was Sheryl's intent in writing it. Certainly Gary and I kept second-guessing ourselves. What had we missed that might have saved her life? I read and reread her emails to me over the last few years of her life to see what was between the lines that I didn't pick up on. And I found nothing. I don't know whether that was a blessing or not. To think that I might have been able to do something, but failed to do it, would have flooded me with a sense of lifelong guilt. On the other hand, to find no clues as to her state of mind, what the tipping point between life and death was for her, has left me with a sense of helplessness that I'll carry forever.

Monday, September 12, 2011

The Intimate Hour (Part II)

What is a patient looking for when he or she comes to therapy? My experience is that, in general, he has tried everything he knows to do in dealing with an issue. He has exhausted his own personal resources. But making that initial call can be fraught with anxiety. The patient has delayed it and delayed it, while he struggles along with the situation. Admitting that you're unable to resolve a life problem on your own, that you'll have to address it with a stranger, can be a daunting prospect.

A patient is seeking first and foremost understanding. Whether in therapy or not, each of us ultimately wants our life narrative to be heard. Whether it's someone wanting to share her rage at her husband's infidelity; a person isolated and in the throes of hopelessness who writes a suicide note; or a serial killer who eventually feels compelled to describe his horrific crimes; we all desire for at least one other fellow human being to hear our story and understand our motivations.

A patient is seeking acceptance. The slightest whiff of judgment will taint a therapeutic relationship. The therapist must have a very high tolerance for dealing with attitudes, behaviors, even lifestyles that he does not personally endorse. If he struggles with this, it behooves him--and is in his patient's best interest--to either do some work in therapy himself regarding his discomfort, or to make a referral to another therapist.

Most patients are seeking some specific means for effecting change in their lives. For all but a few, gone are the days when an individual can spend an hour a day, four to five days a week, on a therapist's couch. The vast majority of today's patients come in with a specific problem or problems. Pursuing self-actualization in therapy is a luxury that few can afford. To that end, as a new patient and I wrap up our intake session, I help them formulate and prioritize their goals for therapy. The question might be something like, "What would you like to be different in your life as a result of coming here?"

Finally, patients frequently need what I call a "takeaway". This can be something as specific as an "assignment" to journal, to chart behavior (e.g., eating, exercise), to take turns planning special events with a spouse, to read certain portions of a book or listen to a podcast, to contact an estranged family member, to think about their goals at work. You get the point. A small task or bit of information at the end of a session can reinforce the work done in the session and enhance the patient's sense that she has gained something positive and concrete from her work in therapy.

The Intimate Hour (Part I)

The process of psychotherapy is as different as each therapist-patient combination. The chemistry between patient and therapist is undeniable and plays a key role in the process. My approach has been to address each patient as an unfolding life story, with its own unique narrative, and not as a diagnostic exemplar. As we work together, I listen for and identify recurrent themes, with their moments of triumph, as well as depths of despair; with their areas of strength and resilience, and their places of weakness and flagging hope.

As a therapist, my job is to assist the patient in writing a new chapter in his narrative. Perhaps his past has been marked by repeated failures at valued tasks. Perhaps her undertakings in life have been tinged by fear and self-doubt. The therapist is a companion on the patient's journey of self-discovery and healing.

As the companion on the patient's journey, I look at the elements of the patient's life as the pieces of glass in a kaleidoscope. When the kaleidoscope is held in one way, one picture emerges. However, when the patient rotates the kaleidoscope, a different picture comes into view. And with that different picture come new possibilities. New ways of understanding what has gone before in one's life and what could lie ahead. And this is where the therapist brings her experience and psychotherapeutic tools to bear.

Sunday, November 14, 2010

Endless Tears

My husband and I are on our way to the north Georgia mountains to spend yet another gorgeous fall weekend with some dear friends. As my husband took a call from a fellow racer, I gazed off at the exquisite color of the leaves. Something along the side of the road caught my eye. It was a roadside memorial. Someone had taken their last breath at that very spot. A chill ran down my spine.

It was a cross made of red and white flowers, faded and graying. An immense sadness gripped me, thinking not only of the woman (judging from the color of the flowers) who had died there, but for the family and friends who had erected that small, poignant reminder of their lost loved one.

Whether she was young or old I'll never know. But somehow I imagined her to be in her early thirties. I imagined her mother, howling in anguish upon learning of the death of her daughter. I knew for a certainty that her life was forever changed in that moment. A mother myself, I can't fathom how she could continue another day without her beloved child.

We use the word "closure" so freely and so reassuringly in this culture. But closure is a lie. There is no such thing. Yes, as people like to remind us, life does go on, after a fashion. But it is never, ever the same. Emotional scar tissue begins to form around that raw, gaping wound. But the scar lives on, and often it aches like hell.

I couldn't stop imagining this woman's life after the loss of her daughter. Was she physically unable to get out of bed for days, weeks, even months? Did she lose her appetite and begin to wither away? Did she withdraw into the privacy of her home, away from the well-meaning, but painful, questions of friends and family?

How long was it before she felt she could begin to breathe again, to look around and see some small spot of beauty or comfort in the world? How long before that wracking, searing pain began to recede ever so slowly and she had a day here and there that, to the outside world, looked "normal"? For, mercifully, just as the flowers on the roadside cross have faded in the baking sun of the Georgia summer and the cold gray drizzle of winter, her unrelenting pain, though never absent, will also begin to fade.

Wednesday, November 3, 2010

The Holidays: Blessing or Curse?

It's that glorious time of year again. The heat of summer has abated (this was Georgia's hottest summer on record), and the light is changing along with the leaves. The calendar's pace seems to accelerate, each day passing faster and faster. As I schedule time with clients, family, and friends, the amount of available time seems to mysteriously dwindle.

Not that many years ago, when my children returned to school the middle of each August, a sort of mad rush toward the holidays would begin. With my girls gone during much of the day, I began planning Thanksgiving and Christmas celebrations. I began compiling gift lists based on hints dropped here and there, as well as observation of what my daughters seemed most interested in at the time, along with gift ideas that I thought would surprise, fascinate, inspire, or guide them. I planned elaborate menus for family dinners and dinner parties for sixty!

My elder daughter was home sick one day early in the school year. Over a lunch of chicken noodle soup and crackers, the subject of Christmas came up. We played a Windham Hill holiday CD as we chatted. One of the tracks had a rather Mexican flair, and we began imagining what a Mexican Christmas party would look like. We brainstormed about menus, decorations, and music. We were off and running with the idea.

My daughter was well enough for school the next day, but I kept returning to our lunchtime conversation. I decided to turn that vision of a Mexican Christmas party into a holiday reality. Over the next couple of months, I made hundreds of tissue paper flowers and yarn ojos de dios ("eye of God") to decorate Christmas trees and grace earthenware pots filled with tiny twinkling lights. I bought small chimineas and Mexican crèches. I purchased all sorts of linens in various shades of red and green, as well as vast quantities of votives and other types of candles. In other words, I transformed my home into a cozy suburban Mexican restaurant. We planned the musical selections and an extensive menu. We made nametags and ensured that everyone on the guest list would know at least one other person.

The evening went off without a hitch, everything as planned, and people thoroughly enjoyed themselves and the somewhat unconventional Christmas celebration. Our months of preparation paid off beautifully. As a result, I felt emboldened to plan other large-scale events and throw myself into months of cooking and decorating. These events were a labor of love for me, but eventually the "labor" part of the process came to loom large. While my children enjoyed the end products of my labors, I wasn't so sure about my then husband. His actions made it clear that he resented getting pulled into the process. I couldn't really blame him. After all, these shindigs were my idea and I didn't consult him about them, other than to check to see if he'd be in town that evening.

Years later, after my children were grown and had left the home and I had relocated to Georgia to start a new life, time didn't permit me to plan and host these events. After all, I was either teaching or seeing clients. And space was a factor, as well. I had downsized my home and was operating in a much smaller kitchen. I found myself going through a period of mourning my bygone entertaining diva days. I even felt guilty that I had done it for my family before, but wasn't able to do it for my beloved new husband. Frankly, he was probably relieved, knowing that I'd be preoccupied with my preparations and in a state of high anxiety.

I went through a few transitional years during which I did feel guilty about not serving up entirely homemade dishes at Thanksgiving and Christmas. I began purchasing pre-packaged holiday meals at my local grocery. To my surprise, they often rivaled my own recipes. They weren't inexpensive, but the really lovely part of finally giving myself permission to go this route was that it freed up several days before each holiday to spend with my husband and with visiting friends and relatives. This became a gift I gave to myself and them, the gift of time and loving attention.

As you prepare for your holidays this year--whatever you celebrate--perhaps a few moments of reflection on what you truly value for yourself and your family are in order. Are the holidays a time of anxiety and stress over all you need to get done, or are they occasions for reconnecting with loved ones and sharing yourself generously with them? As we approach these sacred times this year, I wish you the joys of togetherness and contentment with the blessings in your life.