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October 17 - October 26, 2022
“I see that you’re in love with words, Mr. Andrews. You enjoy waltzing with them. But words are just the notes. It’s the ideas that form the melody. It’s the ideas that give our life structure.”
I’ve always found it important to understand what helps. Could you expound for a moment on what you received from me? I believe that some greater clarification of this will serve you well in the future, and might be useful for me and my future clients.”
On the one hand, I want to be like a father to you, but I also want to help you get past the need for a father.”
anticipating endings may encourage us to grasp the present with greater vitality.”
Do you speak like that to all your patients?” “Please consider it a compliment to the strength I see in you.”
Sergei was part of that magical time of youth, and because he was there at that time you imbued him with love—that is, you put the love into him.”
I’m just siding with the part of you where wisdom dwells.”
“At the end of his senior year, he became involved with a girl who ended up defining his future. She was a fellow druggie, good-looking in a cheap way but intellectually limited: her life aspiration was to be a manicurist.
“Any questions for me so far?” I asked, wanting to establish the norm of free interchange.
seems paradoxical, but often we grieve the loss of those with whom we had fulfilled relationships more easily than those with whom so much was unsatisfying, those with whom there was so much unfinished business.
Being a good older brother requires some cooperation from the younger brother.
When parents die, we always feel vulnerable because we’re dealing not only with loss but also with confronting our own death. When we become orphans, there is no one between us and the grave. So I’m not surprised that the death of your whole family has left you feeling exposed and frightened by death and more vulnerable to death anxiety.”
sexual feelings arise in order to neutralize fears of death.
“I’m okay with short-term. Let’s plan on three sessions, today and two more. If you find you need more in the future, we can renegotiate.
It will take time and a guide, but you can do it. I’m certain of it, and if you wish, I’m glad to be the guide.”
Call me whenever you’re ready.”
You Must Give Up the Hope for a Better Past
“We’re going to have to stop now, but first we should plan how to proceed. For sure I think we should meet tomorrow or the next day.”
Your job is simply to offer her your full presence. Trust her to find the things she needs from the session.
Ellie jousted with death using an arsenal of denial-free ideas—ideas so effective she compared them to cancer drugs: I’m alive now and that’s what matters. Life is temporary—always, for everyone. My work is to live until I die. My work is to make peace with my body and to love it, whole and entire, so that, from that stable core, I can reach out with strength and generosity.
Maybe I can be a kind of pioneer of dying for my friends and siblings. It sounds weird, maybe Pollyannaish, but it sustains me and is a thought that doesn’t fade like the others.”
The Buddhists advise living with death on your left shoulder; sometimes I feel like it’s sitting on both shoulders and in fact has climbed right inside my body. Which of course is exactly where it has always been.
This body that is failing at the one essential job of life, to stay alive, to stay alive.
let’s use up all there is and leave death nothing to claim.’
has a start and then proceeds in linear fashion. I’m just a carrier passing it on to my son, who will pass life along, and then he, too, will face death. I guess it brought home that we’re on a schedule, every one of us, and I sure ain’t no exception.”
every act is not necessarily a message about the relationship.”
Diagnostic categories are invented and arbitrary: they are a product of committee vote and invariably undergo considerable revision with each passing decade.
I considered that my primary task just then was to attend to our therapeutic relationship. That always takes precedence.
do you remember my telling you at our first meeting that it was important to take a risk each session? Now’s the time! Try to risk it.”
I always teach my students that, when you’re in trouble in a session, you can always bail yourself out by calling on your ever-reliable tool, the “process check”—you halt the action and explore the relationship between you and the patient. I heeded my own advice. “Jarod, can we stop for a moment and turn our attention to what’s going on between you and me? How do you feel about the last fifteen minutes?”
to put it mildly, my timing could’ve been better.
I read somewhere that Thoreau’s mother packed him lunches for his retreats and took care of his dirty laundry.
If someone can prove me wrong and show me my mistakes in any thought or action. I shall gladly change. I seek the truth, which never harmed anyone: the harm is to persist in one’s own self-deception and ignorance.’”
There was no single epiphany. It’s more global. It was the overall process.”
Though I’ve been treating patients for fifty years, I continue to thirst for answers to the question of what really helps.
I sensed his hesitation but decided not to comment on it. I knew what it meant: I was out of tune with him. My need to know is a good thing in that it fuels my interest in my patient, but sometimes, like that moment, it may be a bad thing in that I can’t be satisfied with simply being present in the hour.
The most important thing I, or any other therapist, can do is offer an authentic healing relationship from which patients can draw whatever they need. We delude ourselves if we think that some specified action, be it an interpretation, suggestion, relabeling, or reassurance, is the healing factor.
Over and again the patients in these tales found benefit in ways I could not possibly have anticipated. One patient anoints me as witness to the fact that a significant person had deemed him significant. A patient’s sense of fractured reality is mended by an unflinchingly authentic encounter with her therapist. Another grasps that real life is lived in the present moment. Another patient’s life is changed by my referring him to a household organizer.
In each instance, I devised, or sometimes stumbled on, a unique approach for each patient that would not be found in any therapy manual. Because we may never know with precision how we have helped, we therapists have to learn to live comfortably with mystery as we accompany patients on their journey of self-discovery.
Most training programs today (often under pressure by accreditation boards or insurance companies) offer instruction only in brief, “empirically validated” therapies that consist of highly specific techniques addressing discrete diagnostic categories, such as depression, eating disorder, panic attacks, bipolar disease, addictions, or specific phobias. I worry that this current focus in education will ultimately result in losing sight of the whole person and that the humanistic, holistic approach I used with these ten patients may soon become extinct. Though research on effective psychotherapy
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I search for commentary on our relationship in dreams. In short, I never fail to place the highest priority on the development of an honest, transparent, helping bond between us.
Ruthellen Josselson,
