Therapy is perhaps best described as the art and science of change. We are immensely complicated and sophisticated beings; and, this is both wonderful and awful. Wonderful because it allows us to hold deep complexity and paradox but awful because we can feel opaque, frequently even to ourselves. Even change that we know how to accomplish (e.g. losing weight) is often very difficult. Part of this complexity is that our motivation for change waxes and wanes without our awareness or permission; change is hard! Effective therapy helps us to tolerate the frustrations of not changing, even while working towards new outcomes.

 

When therapy is most exciting it can work to not only reduce the occurrence of painful events in our lives but also to help us feel more durable when suffering becomes unavoidable. It offers us the chance to become better company to our own selves during painful moments, so that we are less likely to act out in ways that deepen our pain rather than easing it.

 

I propose that therapy operates on numerous levels. On the most concrete, it can help problem solve specific situations so that you more fully understand your choices and their possible consequences. This process can feel fairly linear and straight-forward, while hopefully offering immediate and tangible results: What can I do to feel less depressed? How do I soothe myself when I feel anxious? How can I control my anger better? Answers to these questions take the form of empirically derived tips and techniques that are then personalized for you to employ in particular contexts. Cognitive behavioral therapy offers a helpful framework to guide this work; I coach patients to identify critical settings and triggers and then to tailor effective responses through trial and error.

 

However, people can also yearn for satisfying answers to thornier, more existential questions:

• What are the important themes in my life?

• Why out of all possible themes that humans experience….
  are these mine?

• How do I actively create meaning in my life?

• Why am I so frustrated by human relationships?

• Why do I feel so unloved and unappreciated?

• How do I love better?

 

In the pursuit of these questions, symptoms are actually immensely important clues rather than unpleasant aspects of life to be eradicated. Symptoms are windows into both our conscious and unconscious processes that in turn create much of our day-to-day experience. When these insights are gained in an emotionally engaging and resonant environment, people cultivate new levels of intimacy, spontaneity and effectiveness in their lives; people learn to love themselves and others more easily.

 

This work, often described as psychodynamic or psychoanalytic, is more open-ended and dreamlike. It involves telling the stories of your life, and within the context of a co-constructed reality (yours and the therapist’s), looking for new perspectives and narratives that can yield deeper understanding and acceptance. This process entails many feelings: whimsy, grief, gripping relevance, boredom, a felt sense of both the sacred and the profane, relief, laughter, anger and many others… This kind of therapy is alive and riveting because salient patterns in your life will actually play themselves out in the therapeutic relationship; when the relationship is secure enough to acknowledge and contain these experiences, immense growth becomes possible.

 

All of this is to say that I believe answers to the most fundamental questions about our lives occur within an existential and relational framework; I assume that we all must make peace with a certain inescapable truth: we will feel at times insignificant and alone in a world that feels indifferent to our heartfelt needs and desires:

• People we depend on will fail us, even when they love us.

• We will fail others whom depend on us, even when we love them.

• We will suffer.

• We will die.

 

We all must develop ways of relating to the world, and the people in it, that offer protection from these terrifying revelations; over time, these protective beliefs and scripts can become stale and constrictive. Instead of just protecting us from hurt and disappointment, they begin to crowd out the living world. We see less beauty, feel less awe and give less freely of ourselves. We can no longer respond effectively to challenges, disappointments as well as opportunities.

 

I believe our best, and perhaps only, way to live joyfully in the face of these truths is to deepen our capacity to find and make meaning in the world (most often through relationships) and to embrace paradox. For example: only through being capable of grief can we really feel joy; only by being able to be comforted through dependence on others can we actually experience independence; and, only in embracing our brokenness can we feel whole. These themes are frequently the grist of therapy.