Psychotherapy Articles

Can a Narcissist Change?

Thursday, August 28th, 2014

Many of us are involved with narcissists (people who have difficulty empathizing with others, and behave accordingly, often manipulatively.)  The narcissist may be your parent, your significant other, even your child.  In order to decide what your options are in this relationship, you’re wondering: Can a narcissist change?

Finding the Right Couples Therapist

Saturday, June 14th, 2014

curlsThis is not the same as finding a “good” couples therapist.  I used to believe in the myth that therapists are either good or bad; now I think that there are some good therapists who are just a mismatch for certain clients.

So how to find the right one?

When to Seek Couples Therapy

Saturday, June 7th, 2014

coupleMost people treat couples therapy as a measure of last resort: Your relationship is completely on the rocks, one or both of you is considering calling it quits.   It’s like dialing 911.

But as I’ve said before, that’s the worst time to start therapy–when you’re feeling hopeless, when one or both of you has little investment in the relationship.  Seeking professional help sooner can make all the difference.

So what is the best time?

Couples Counseling in the Eleventh Hour

Tuesday, April 1st, 2014

There are a lot of reasons couples might procrastinate about entering therapy.  It might feel shameful, like an admission they can’t do it on their own.  They might be afraid of what will come out in the room, and more comfortable maintaining some level of denial about just how distressed their relationship is.  They might feel overloaded and overwhelmed with all they have to do in their week, between jobs and kids and other commitments.

They might also hold the belief that if things get really bad, they can just do therapy then.  They might as well wait, they reason.  What difference could it make?

A lot.  And here’s why.

Social Media: When to Stop Clicking

Wednesday, October 9th, 2013

I am finally on Facebook.  It’s a strange declaration for 2013, I know, but it’s time to start thinking about promoting my novel, which comes out in July.  Time to bite the bullet and enter contemporary life.

Weirder still: My novel is about a woman who embarks on a social media campaign to find her runaway daughter.   Art does not always imitate life.

Part of my reticence has been the time-suck of it.  I fear going down into the rabbit hole of everyone’s musings and links and never being seen again.  But the other part has been witnessing the negative impact social media has had on some of my clients.

So in this post, I’ll ask: How do you know, from a mental health perspective, when to stop clicking?

To Medicate or Not to Medicate

Saturday, August 24th, 2013

medsIn certain cases, it’s obvious that medication is needed.  It can even be a prerequisite for therapy (when people are too severely depressed, suicidal or hopeless to engage; when they’re floridly psychotic.)  But for others with, say, mild depression or non-debilitating anxiety, then the answer is not so obvious.

Of course, suffering is in the eye of the beholder (well, the experiencer, if I can coin a term.)  And it’s relatively easy to get psychotropic medication.  The vast majority of prescriptions for psychotropic meds are written by primary care physicians, often at the patients’ request.

But the decision of whether to seek medication can feel downright existential, and is extremely personal.

The Isolation Dilemma

Saturday, August 17th, 2013

hideWhen faced with adversity, many of us find ourselves daunted.  We might feel depressed and hopeless.  And when we feel that way, we certainly aren’t in the mood for company.

But the more we isolate, the harder it is to pull out of the negative spiral in which we’ve find ourselves, and the harder it is to generate solutions.  There, in a nutshell, is the isolation dilemma.

High Stakes Clients

Wednesday, August 7th, 2013

babyI recently got a new client–a very young mom with an addiction and domestic violence history, trying her best to stay away from her abuser and to stay clean, bouncing a four-month-old baby on her knee.

She belongs to a class of clients that I’m calling “high stakes”, because when they show up in my office, I feel intense empathy, sympathy, and a desire to make it all turn out all right.  I looked at her thin shoulders and that baby she’s holding, and thought, “I really have to pull this off, for her and her daughter.”

But does that pressure actually make for good therapy, or do the reverse?

Moms R Us

Saturday, August 3rd, 2013

scoldI was talking to a mom client of mine about her parenting struggles.  She finds herself more short-tempered than she’d like to be with her two young children.  Tearfully, she confessed her fear that she’s not well-suited for motherhood.

It’s a common fear.  Parenting presents challenges we never had to face before, and it highlights aspects of our personality that we might not be so fond of.

So what’s a mom to do?

The Problem with Heroes and Villains

Friday, July 26th, 2013

protestIn a bizarre twist this past week, George Zimmerman rescued a family from an overturned SUV.  The reason I call it “bizarre” is that so many (myself included) have been presuming Zimmerman’s villainy, given the killing of Trayvon Martin.

And in light of an obvious act of heroism (yes, I know, many will call it too coincidental, or staged to rehab his image, but that seems rather unlikely), I had to recognize that I had diminished his humanity in my mind.  It wasn’t something I did consciously, but something that as a therapist, I should have caught sooner.

I should know better.  And here’s why it’s important for everyone to be aware of that kind of reductionist tendency.


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