I read a column recently in the New Yorker that reminded me:  1) to emphasize to you the importance of data in real life as well, to likewise cut through through the distortions that interfere with your relationships and thinking;  2) why I stopped reading the New York Times decades ago.

In the April 22 issue, on page 38 is a one-page article reviewing David Stockman’s new book “The Great Deformation”.  The first part of the article summarizes Mr. Stockman’s argument that the federal government’s “relentless campaign to keep interest rates artificially low” is only postponing and increasing what he believes is the coming financial disaster.  Mr. Stockman argues that FDR taking us off the gold standard was a recipe for “disaster”, and he complains that the federal government has been encouraging one economic “bubble” after another ever since.  The arguments, at least as summarized in the review, are initially impressive to my intelligent layman’s mind.  But then, one can read the exact opposite, argued just as convincingly, from other equally scholarly and convincing authors.

Fortunately the New Yorker then introduces blessed data.  The reviewer has done his homework, and he points out to us that prior to FDR, while we were still under the gold standard, the United States had economic crises at just about the same frequency and intensity from the mid-1800s until 1907, just as we have had since FDR.  Britain, too, had five such crises between 1825 in 1866.  Moreover, the reviewer points out, “recessions in the gold-standard era tended to be longer and more severe than subsequent ones” and he suggests that government intervention, such as that which we have in the 20th century – might even have mitigated the pain and duration of those recessions.

In contrast with this article, the typical American piece of journalism – take a look at the any newspaper front page – tends to emphasize what this one and that one said about things as opposed to what the data really show.  And of course anyone can say anything, and people in power are motivated to say what will impress or please their constituents, not what is true or useful.  All the more reason why anchoring one’s digestion of such material in facts is crucial, and this is what was so good about the New Yorker article.  I still don’t know exactly what to do with my investments, but I am much clearer – and calmer – as I consider how to proceed having read the article; the alternative is frantic ping-ponging between superficially convincing viewpoints, depending on whose I read last.

We have already seen in these pages how important data are in life and psychotherapy.  Look, for example, at the page on resistance in the main website; the full book chapter on this topic has some particularly telling and comic examples from daily life.

So always take a moment to consider whether – to put it bluntly – you actually know what you’re talking about.  This is particularly important at the start of therapy but it can be an ongoing problem as well.  One patient I saw for many years persisted in describing himself as having been “an extremely angry kid” who “held grudges”.  In fact, when he got down to actually telling me about his childhood it emerged that he was not at all a particularly angry kid; in fact he was a rather pleading and desperate child.  As for holding a grudge, it became clear that it was his mother and sister who hold grudges, not him.  One relatively mild misbehavior on his part would be the subject of relentless reminding over subsequent weeks, even months, each time causing him tremendous shame.  No one in his life, past or present, had apparently ever described him as angry, vindictive, holding a grudge, or anything along those lines, and in fact he was usually described to the contrary.

Another patient, Jenny, announced to me that she had “control issues” and could not sustain a relationship because she was too bossy.  In fact, what became very clear as we talked was that if anything she was too accommodating.  The anxiety symptoms of which she complained – trouble sleeping, nailbiting, skin rashes, and chronic irritability – were being greatly fueled by her efforts to put up with an obnoxious boyfriend.  Not only was that my perception of the boyfriend, but she confirmed that mutual friends who knew him likewise described him as “difficult”, or worse.  Once she began speaking up to him, he began adjusting his behavior, their relationship improved, and some of Jenny’s anxiety symptoms went away.

Thus, one of the first lessons I often teach new patients is don’t generalize, don’t diagnose yourself, don’t assume you know anything.  Just tell me the story – any story – so that we can look at the data together.  The stories might seem trivial to you, as some of them did to Jenny, but that is almost invariably where useful information lies.  Jenny had to force herself to tell me about an evening with her boyfriend in which her complaints felt “petty” to her and her irritation level only rose to about a 3 on a 10 point scale (where level 10 would be “wanting to jump out of my skin”).  But once she talked freely about the evening, it emerged that 1) on the same evening with any other friend she would not feel that degree of irritation, 2) the irritation started at about the 3^rd of her boyfriend’s typically unfunny (to her) jokes, and 2) she often felt this level of discomfort with him.  Having said all this out loud, it was obvious to her that either she had to break up with the man or she needed to speak up and tell him.

Think about seeing your physician.  If your leg hurts for no clear reason, you would probably let the doctor asked his/her questions, probe here and there, and eventually tell you whether you have something going on in the leg or perhaps a problem in your back which is causing referred pain, whether you have an unnoticed bruise, a lymph problem, a circulation problem, or something worse.  You’re paying him/her to be the expert; your job is only to report the data – what hurts, where, when, how bad.  Give yourself the same luxury in psychotherapy and don’t decide what kind of person you are and what your problems are before you walk in.

He came in one day struggling – agonizing, really – over what to talk about.  This is a common occurrence even with experienced patients.  Everything he started to discuss petered out.  For example, he told me that he was worried about his apparent loss of motivation.  He said he used to stay up late doing research and reading in his field, but lately preferred to socialize.  I asked when he had last felt motivated, however, and he told me that just two nights earlier he had in fact stayed up and worked.  Then I asked him when he last had a sustained period of such behavior, and he could not answer.  I asked him about the work he stayed up doing and he could not even answer whether he was in fact interested in the project or not.  He started to say “yes”, then corrected himself to say “well, it might be something that later on…”, then said again “yes”, then added “hmm.  I don’t know why I can’t answer”.

At this point I interrupted with the observation that thus far in the session he was unable to answer almost any of my questions without a great deal of hedging and at times muttering inaudibly as if in some private reminiscence.  He acknowledged this, relaxed a bit, and then tried to focus on the question that is always useful one:  What is of interest to you right now?  What are you feeling or thinking about right now?

He answered, feeling silly, “I’d like to be somewhere warm”.

Trivial as this bit of information may appear at first, here is where the session really began.  If that seems hard to swallow, hang on for a few paragraphs.  Unlike everything else he said, this was a statement without hesitation or backpedaling, which clearly expressed his feelings and his interests.  At this point we can begin to find out something about him, his functioning, his issues, etc.  Consider the possibilities:

1)    We might discover with further questioning that his fantasy is to be in the Caribbean.  Further inquiry might reveal that the fantasy is one of escaping pressures, that he is troubled by his job, his love life, his friends, etc., i.e. that being cold or warm is not even the issue but that escape from stress and pressure is.  He might be lonely, pressured at work, unsure about handling difficult people, or something else.  At that point, clearly we have plenty to talk about some of which would very possibly resolve in a single session – how to handle a difficult boss, colleague, lover, work load, etc.

2)    Simon might tell us of a Caribbean fantasy involving water sports.  Further inquiry might reveal that his problems could be solved by getting some exercise, that he has been gluing himself too persistently to his desk and needs to take a run.

3)    Simon might tell us that his fantasy is literally to be warm, at which point the question becomes why doesn’t he put on another sweater or turn up the heat.

This last possibility is the one Simon voiced.  Without my asking anything, however, he then speculated as to why he had been sitting not only during our session but all morning (we spoke at noon) in a cold apartment.  He then realized with frustration that he had not turned up the heat because of a preposterous concern with the heating bill.  He did a quick calculation and told me that the morning’s heat would’ve cost him less than a dollar.

From here, Simon continued to talk about the way he’d spend the day so far and noted that all morning he had been in his words “worried about what I should do and doing none of it”.  He had made a list of chores, projects for work, and some long-term goals, then had rethought these several times until before he knew it the morning was gone.  Moreover, all the while he was aware of being cold – had even looked online at some sweaters and warm slippers he might buy, then decided against it because of the price and mainly because “I shouldn’t need those things”.

At this point he articulated what had been barely conscious to him all morning although was apparent in how he spoke at the start of our session:  “I get consumed with whether what I’m thinking, what I want, what I feel, is okay, if it looks cool, like how would this look to me if I read it about me” and so on.  He then noted that his entire week had been dominated by such concerns with what he should and should not feel, think, want, do.  This brought us back to where we had been the previous weeks, to discoveries and insights that have been brewing and consolidating in recent sessions in which Simon was realizing the degree to which he moved through the world in a state of apology, anxiety, insecurity, and indecision.

All this emerged because I got him to stop fidgeting and answer the question “What’s on your mind right now (however apparently trivial)?”  After that I didn’t have to say much.  The simple statement of where he was at – that he wanted to be warmer – got him back in touch with everything else about him and it all came pouring out, including a cheerful frustration with having wasted the day being cold when for the price of half a cup of coffee he could have worked in a comfortable home.  (He also mentioned at that point his complaint – something he never dared pay attention to – that his tea had become cold; we laughed at this brilliant Ivy League graduate not thinking to warm it the microwave.)

Amid this burst of insight, one of the things Simon said was “if I realize that I like it warm, what will I do when I can’t be warm in the house?  It’s like I have to get used to it so I’ll be okay when it’s taken from me.”  I did ask him to stop and take note of that issue – the idea that things will be taken from him – and see if it brought up any other thoughts.  He immediately mentioned his father becoming very ill when Simon was quite young.  From there he spoke about other memories that brought on that feeling of profound insecurity, of having to be entirely self-sufficient to the point of not even using heat or a sweater if he could possibly avoid such dependency.  Amid all this, he calmed, made some decisions about his day and future without so much obsessing and anxiety, and ended the session feeling much better than he had at the start of it.

All of this demonstrates several important features of psychotherapy.  First, there really is nothing else to do until you answer the question “where are you at today? what’s on your mind now? what’s of interest to you?”  It seems simple, but people sometimes have great difficulty simply starting here.  Second, once you relax and let yourself consider that question everything about you can come out and be addressed – issues as immediate and trivial as physical comfort, as pervasively interfering as a neurotic preoccupation with perfectionism, and as deep as childhood trauma.

Third, this session answers in part the question I’ve so often heard over the years, “How can you listen to people’s problems all day?  Don’t you get bored?”  In fact, it’s life outside the office that can, by comparison, be dull.  Think about it.  If I were chatting with Simon in a pub and he was waffling as he was at the start of our meeting, it would be difficult to point out that he was rambling; I might have to listen to more of it and find some graceful way of ending the conversation, particularly if we weren’t more than casual friends.  But in psychotherapy it’s my job to point out to Simon what I see going on, that he’s hedging, drifting away in the middle of saying something, and ultimately saying nothing, in short avoiding any substantive talk and thus boring us.  As result of my speaking up, Simon came to life and the session became exciting for both of us.  Outside my office, in some other social settings, telling someone that he’s boring you can be offensive (and one does not want to offend a man in his late 20s who lifts weights for recreation)

But just how does one “get in touch”?  How do you do that?

First, you have to notice that you’re not doing it.  Many people think they are, but aren’t.  One patient said to me “I can’t leave Evan because I’d be same dissatisfied grump with any man”, but when I asked how she knew this she revealed that she’d been with this same man since college (11 years earlier) – that she’d had no other relationships or even dates all those years and thus couldn’t possibly know how she’d be with another man!  How could this smart, Ivy League college graduate jump to such a grossly unwarranted conclusion?  How could she not notice that she had absolutely no data on which to base such a statement?

Worse, the more important the subject, the more people skitter away from actually answering the question “and what happened to you then? how did that feel?”  Jim was a very bright, articulate filmmaker on the verge of moving into the big time when he came to see me.  His work with actors involved getting them to relax their defenses, their intellectual processes, their inhibitions, so that they could give convincing and spontaneous performances; he certainly understood intellectualizing, thinking your way out of your feelings.  But in our interactions, he did it all the time.  He could not answer such simple questions as “so when you got up that morning and knew there would be text messages from that woman you no longer wanted to see, how did you feel?  What happened to you?”  In response, he would say things like:  “there’s no reason for her to keep texting me” (not what I asked), “it made no sense but she sent messages every morning” (not what I asked), I can’t believe she wrote again” (not…), or at best “it was annoying”.  The latter may appear to you to be a response, however it is very superficial.  It was only when I asked him to simply remember the moment and tell me how his body felt that Jim was able to say he felt “dread” and even “terror in my gut”.

Again, why is this important?  Not because we shrinks believe you should “get in touch with your feelings”, but because it’s the cure!  At the end of our session, Jim felt more relaxed, focused, clear, and optimistic; he felt freer to concentrate on his work and other projects in his life, less anxious about everything he had to face that day, and less preoccupied with the woman.  Moreover, as he described the “terror”, he found himself remembering similar moments of terror when he was much younger – moments in which such terror would be completely justified, unlike his extreme reaction to the pestering of a soon to be ex-girlfriend.  And our continued exploration of both the terror he felt in the present – which was always an overreaction – and in the past resulted in a steady and rapid decrease of the anxiety that brought him into treatment.

Jim’s problems with answering that annoying therapist question “and how did you feel?” are very common.  People resist it in different ways.  Some avoid it by becoming intellectual, as Jim did.  Some do it by becoming hostile – you can see a good demonstration of that from the Tommy Lee Jones character in the recent movie “Hope Springs”, which has some realistic scenes of marital counseling.

Others do it by becoming indecisive or “confused”; they may begin restating, qualifying, and otherwise backpedaling on what they say.  (One teenaged patient described this kind of resistance as “hairsplitting the irrelevant”.) Jessica was particularly expert at this.  She came to see me complaining of virtual paralysis in her life dating back 12 years to her college days.  She was a bright, articulate, energetic woman who was clearly interested in continuing her studies in physical therapy or veterinary work, but she could not make a decision about career, domicile, her boyfriend, anything.   As we spoke, it initially seemed there was no reason why she should be so immobilized.  But as she talked more personally in our first session, her speech disintegrated.   She’d start to say something about her boyfriend, for example, and halfway through the sentence change topics, change her opinion of what she was describing in him, laugh off whatever she started to say, and then dismiss the whole subject as “silly”.  She described episodes of great tearfulness which would lead her friends to suggest that she consult a therapist or physician, that she consider medication, or that she in some way attend to the problem.  At that point in the discussions, Jessica said, she always expressed surprise and immediately dismissed her previous bad mood.  Similarly, in our sessions, as soon as she became at all interested in the topic – her boyfriend, her family, her feelings about an internship during college, anything that mattered to her – she would first clog the discussion as described above and then quickly dismiss it all as “trivial”.

Jim and Jessica, like so many others, are not really aware that they are avoiding.  Moreover, friends and others often go along with this kind of resistance, may even encourage it.  Picture being in a bar with a friend who talks this way.  It keeps the conversation cheerful, entertaining, and flowing.  Furthermore, it’s comforting when someone begins talking about something painful and then finds a quick way out, a dismissal, a bromide.  Our tendency is to agree, to nod “yeah, I go back and forth about my boyfriend too”, and order the next round.  But this is precisely how people get lost.  Yes, distraction and changing the subject have their place in life, but if they worked I wouldn’t have a job.

So how do you get un-lost?  How do you get in touch?  Start by realizing – if you’re a thinker type – that all that thought may be the opposite of being in touch.  Simon was a very intelligent computer programmer, games designer, athlete, and recent Ivy League graduate.  He was socially adept, had some close friends, dated with ease, and gracefully handled some difficult colleagues and superiors even though he was so new to the job world.  But in private he struggled with obsessive thinking, considerable anxiety, even panic; these sometimes interfered with his sleep.  As with Jim, Simon made a lot of progress simply by focusing on my question “and what happened to you next”, that is “what did you feel, in your body”.  Like Jim, he only answered those questions with a lot of guidance; otherwise, in a very slippery way his answers always drifted quickly back to what he was thinking.  But with help he did start answering my questions and in the process he realized that his endlessly racing thoughts – the worry, the “what if”s, etc. that occurred one day on an outing with two friends – was triggered by the simpler anxiety over “what will this person think of me” and “I’ll have no friends, I’ll be alone”.

Simon had such trouble seeing – i.e. feeling – this simple anxiety in part because in our culture we are taught not to notice such perceptions, such feelings, especially if we are men.  Simon could not see the hand in front of his face – that all of his anxiety during the outing described above was so simple – because he simply could not believe that he would be prey to such “stupid worries”.  (And they are stupid, because in fact the people involved are long-standing good friends, and from his description not at all the type to be judgmental or dismissive of him.)  But it is only by becoming aware of such anxieties that Simon could really see how silly they were.  Once he did, he was much more relaxed – both during the session and subsequently with his friends.  And that, once again, is why psychologists are always asking you what you feel and trying to help you “get in touch”.

Simon’s case illustrates an important first step in starting to notice what happens to you:  Drop all the preconceptions.  You can’t notice what happens to you if you have already decided what is or is not acceptable or sensible to feel.  By any casual observation of Simon, he is the last person we – or he – would imagine could be so fragile in such a safe social encounter.  He was very independent on the surface, making career and college decisions on his own, traveling alone to foreign countries where he does not speak the language, etc.  But as I have said elsewhere in these pages, you cannot argue with data.  And the data are that once he stopped racing his thoughts and words, once he simply answered my question about what he experienced as he stood with his friends in the market, he remembered feeling a strong and clear anxiety that he was not being “entertaining enough” to keep their friendship and would be left alone.  It may sound silly to him or to us, but that’s what he felt.

One good way to break away from any preconceptions that are hampering your awareness is to take note of things that happen at the edge of your awareness, things that happen to you when you are not really thinking about anything.  A former supervisor of mine calls these “marginal experiences”.   If you are in Starbucks and find yourself oddly furious or timid or anything else, that’s a good time to stop and see what happened.  It is very important not to make the mistake of asking yourself “why do I feel this way?”  That question is for me to answer in our sessions.  If you ask it, you are already looking for a sensible, logical answer, and you may therefore blind yourself to what actually happened to you.  Instead ask yourself “when did this feeling start?”, “did I feel this way 2 minutes ago?  5 minutes ago?  30 seconds ago?”  You may realize that the feeling started – for no clear reason – when you saw a shelf of coffee mugs for sale.  Try to suspend any concern with explaining how coffee mugs might make you feel whatever you’re feeling.  Don’t be like Simon who couldn’t notice what was happening to him because “that’s stupid”.  Instead try to just notice or remember what the mugs brought to mind.  Try to notice what you felt in your body, as much as what may have passed through your mind.  You never know what might emerge.  Maybe the mugs reminded you of the furniture you have yet to decide on, of the decorating you’ve not done that people who are better than you surely did and what a loser you are to be indecisive about wallpaper….  Maybe the mugs reminded you of a similarly well-appointed hutch in your boss’ office and you resent being an underling and why doesn’t anyone appreciate your own taste and it must be because you don’t have any and you’ll never get a promotion and you’ll be stuck in the job forever and die miserable and who’d want to marry such a loser…. Maybe the mugs remind you of spilling soda in school and the teacher who humiliated you over it and you never got even and boy! it would be nice to punch her face in now….  Believe it or not, I haven’t invented these scenarios (although I’ve altered them slightly for this blog to protect patient confidentiality).

Another good thing to pay attention to is anything that either sticks in your mind for no clear reason or that stirs up a lot of feeling.  When a scene sticks oddly in our memories, it is because there is unprocessed feeling fueling the memory.  One patient remembered his father’s hat flying off during a road trip when he was about 4; everyone laughed, a seemingly trivial moment.  When he focused on it and let himself notice what feelings, memories, thoughts it stirred, he began to see how much he yearned for such rare moments of family happiness, and he then understood why he was badgering his wife so constantly and unreasonably to create some impossibly perfect family for their children, why he was so agitated if things were spontaneous in their home, and why he was also becoming similarly fussy and unreasonable at work (and he stopped).  So see if you can similarly let yourself muse on the memory – without trying to figure it out, understand its significance, or otherwise diagnose yourself.  Answers may emerge without talking to a therapist.

In contrast with memories that persist for no clear reason, there are feelings that emerge for no clear reason.  Gerry was a very independent, aggressive, masculine fellow who ran his own business, was married, had a very active social and sex life, who came to see me because he was increasingly uncertain about his marriage and because he had skin rashes that his physician said were psychological in cause.  He described a physically abusive father, a childhood that was alternately dreary and dangerous, a history of bar fights and other such aggressiveness, but he denied any connections among all this.  He did, however, express an interest in the fact that Brahms always made him cry.  He did not mind discussing this, did not resist it as he did discussions of more obviously personal matters.  As he talked about it, as he remembered the music and his tearfulness, a whole other side of him emerged.  And again the reason this matters is that as Gerry became more tolerant and aware of his “mushy side” (his term), his symptoms and uncertainties diminished.  Music, smells, sounds can often trigger such initially perplexing reactions.  I know someone who used to choke up when she heard the opening music to the film version of “Little Shop of Horrors”.  Eventually she came to understand such moments as episodes of “good tears”, her term for moments in which she felt finally able to enjoy something that was deeply hers in a way that music can be for some people – in contrast with her rather rigid, stifling, and by her own account “dull” life the rest of the time.  And again why does this matter?  Because in making contact with those “good tears”, she grew stronger, more decisive, less inhibited, and ultimately made some changes in her life that left her much happier and more productive.

Of course, there are those of us who cry with minimal stimulation.  Part of the getting in touch process involves realizing when you’re tears are somewhat skin deep and when they are emanating from more substantial concerns.  That is a tricky process and usually cannot be done without the help of a therapist.  There is a similar distinction to be made between defensive irritation or rage, and the much more revealing and important experience of anger, betrayal, outrage.  Rage – for example road rage – tends to be superficial, yet intense.  It is usually a defense against feeling helpless, uncertain, or otherwise shaky.  But then – and here’s why psychotherapy can be endlessly fascinating to someone like me – underneath that defensive reaction, even as the underlying shakiness emerges, may lurk the more substantial anger.  Archeology of the mind, Freud called it.

Exploring these layers can become part of your whole life, part of what keeps you growing, keeps you interested.  Careers, marriages, hobbies may all have a shelf life.  What keeps them alive is our ever changing relationship to them.  Anything can become stale if you do not continue the process of rediscovering your experience of them; anyone in a successful marriage of more than 20 years will tell you that.  What kept Bruce Lee fascinated with martial arts is something he articulated in an interview late in his life.  He said “I can do something flashy and impressive that will make you say ‘wow’, but the real challenge is to do something honest.”

But again, start small.  To know what you’re feeling, to be “in touch”, to be “honest”, has to start with the smallest experiences, like what really happened to Jim as he turned to his cell phone expecting a text from his demanding girlfriend.  And as we saw in the cases of Jim and Simon, above, you can’t know what you feel if you’ve already decided what feelings make sense, which are acceptable.  Just notice what happens to you, second by second, without assuming you already know.

One final note.  People often can’t do this alone.  Some people’s anxieties, tensions, inhibitions are too great or are too embedded in their way of functioning.  (As Peter Schaffer put it in the play Equus – as spoken by a psychiatrist, actually – “all reined up in old language and old assumptions, straining to jump onto a whole new track of being I only suspect is there.  I can’t see it because my educated average head is being held at the wrong angle.”)  Such people need the help of a guide, a therapist.  Also, some with particularly intense anxiety may need medication.  Such people struggle with racing thoughts, obsessing, worrying, of an intensity that one patient described to me as being a “constant tornado inside, so you can’t stop and notice anything”.  In such a state you can’t do it on your own, and don’t be ashamed or worried if you need medication to relax you enough to start the process; doesn’t mean you’ll be on it forever.

The first comes from everyday life.  When I was 20, I was visibly balding.  By the time I was 30 I looked like Patrick Stewart.  I joked about it, frequently performed as an actor and cheerfully donned whatever wigs were requested by the director, and otherwise gave the impression – to myself and to others – that I had long accepted this this development in my development.  About 10 years later, I shaved the remaining hair off.  Now remember that for the previous decade I’d had only the smallest fringe around the back of my head, reaching around just over my ears; otherwise I was a cue ball (in fact I think Patrick Stewart has more hair than I do).  Yet for well over a month after I did the deed I would find myself physically startled by my reflection in the mirror.  Each time I looked at myself I was genuinely astonished to realize “wow!  I’m bald!”  And don’t forget most of what I shaved can’t even be seen when looking in the mirror anyway, as it’s in back of me.

The first thing to understand about resistance is that it happens at the unconscious level.  My experience after shaving my head is a perfect example.  Although I firmly believed that I knew I was bald – had gone through my self-conscious phase and had accepted the loss – you cannot deny my physical reaction.  And that reaction can’t be explained by anything other than my less than conscious denial that I’m bald.  At some level, despite a decade of all evidence to the contrary, I held onto some belief that I had hair like Mel Gibson in the “Lethal Weapon” movies.

In a more serious vein, as is so for all patients Amy’s resistance was at the core of her therapy.  She came to me in her early 30s complaining of emotional constriction – she could scarcely remember having cried in her life – an obsession with getting attention from strange men, a series of failed relationships, chronic distrust, and other unhappiness.  She grew up very poor, with a chaotic and cruel family.  Her mother and stepfather routinely humiliated or neglected her; her life history is peppered with one horrible story after another of raised and then violently dashed hopes.  As she tells it, Amy learned by the time she was about eight years old to take care of herself.  She found ways to comfort and even entertain herself; at the conscious level she understood that her parents were alternately unreliable and cruel, and she managed successfully to seek out emotional and practical support from others.  When she was 17 she left home.  She has become a successful businesswoman, is now in a fairly stable relationship despite her anxieties about it, and on the surface she seems to understand her past and to some degree what it has done to her.

But as I like to remind patients, you can’t argue with data.  My reaction to my shaved head must be accounted for, regardless of what I think I already know (i.e. that I’d been bald half my life by then, long gotten used to it).  And the data with Amy include that she was continuing to devote a great deal of thought and effort to trying to communicate with her mother and stepfather, constantly astounded by their lack of response – just as I was repeatedly astounded by the sight of my bald head, 15 years after it got that way.  She would obsess during our sessions, for example, about a phone message from her mother, wondering why she had called, whether she should call back, recounting stories about her mother illustrating the latter’s neglect and lack of interest in her (past and present), resentful of it and yet dwelling on the possibility of finally getting this woman to finally acknowledged and appreciate her, and so on.  She spent much energy and money on long distance holidays with the family, seeking the perfect gifts and activities they might appreciate, yet for her entire life was never rewarded with an ounce of recognition for all this, and she was never given anything remotely similar in return; meanwhile she failed to appreciate and build upon the relationships with available people in her own life, some of who loved her and had much to offer.  She claimed never to think about her biological father, yet found herself experiencing the kind of physical surprise that I did over my shaved head when she managed to make contact with paternal relatives and had to face – again – the reality that this man had no interest in her overtures.  Despite what she thought she knew about herself, Amy found that she was depressed, enraged, and otherwise astonished that her father and his family were so unresponsive to her.

In short, Amy thought she knew where she had come from, and what she felt about it.  But her unrelenting efforts to build her relationship with these unavailable people, and her repeated shock at finding them so unresponsive and uninterested in her – despite a lifetime of experiences with them – show that she did not know, that she was in fact resisting awareness of exactly that which she claimed to know.

It was only when she began to really face – remember, feel, relive – the reality of her family and their past and present behavior towards her, that two important things happened to her.  First she gradually abandoned the draining, repetitive, endlessly frustrating efforts to make them appreciate her.   Second, her other symptoms started to abate:  She lost her obsession with getting attention from men and her panic when such attention wasn’t constant, she cried and physically loosened up, she began to enjoy herself and her talents instead of living in tense hope that the next accomplishment would finally make her feel better, and she relaxed with her boyfriend instead of constantly worrying that he was cheating on her.  But all along – like me with the hair – Amy thought she knew herself.

Some branches of psychoanalysis are fond of saying “analysis of the resistance is the treatment”.  There is a lot of truth to this, and you can see how this worked with Amy.  More examples to come, and again be sure to read the “Resistance” page of the main website (“AboutPsychotherapy.com“) for a more complete description of the phenomenon.   And watch for examples in your own life!  They happen frequently, and I’ll have examples in future entries.

When Jack started with me, he was an extremely successful businessman, not yet 30, utterly unable to enjoy his many successes, on the verge of ruining his marriage.  He could participate in a party or dinner with his wife for perhaps 10 minutes before feeling deeply, intensely compelled either to rush off to another social event or to jump up and check e-mails he’d checked scarcely an hour earlier.  During our sessions it was difficult for me to get a word in.  He spoke rapidly, with a pleading quality, and almost nonstop.  He had a beautiful, bright, sensitive, and aware wife – I met her for several sessions as well – on whom he often depended to prevent his anxieties from escalating into panic; she was very helpful to him, for example, as he agonized over how best to cope with a client, colleague, or employee.  And yes, their sex life was great.  Still, he obsessively thought about other women.

Things are much better now.  He no longer works 25 hours a day, he enjoys his wife and friends, his marriage is better, he is an attentive father, and when facing or finishing a task or decision he no longer agonizes as he used to do.  His business continues to thrive and grow, despite his somewhat more relaxed approach to everything.

But dealing with people still triggers his old problems and sometimes he astounds both of us with the degree to which he distorts things.  For example, an important CEO client  forwarded a copy to Jack of an e-mail this CEO had sent to colleagues praising Jack and encouraging other large companies to use his services; in response, Jack felt only intense anxiety that he was about to be exposed as a worthless fraud.  Similarly, Jack describes himself almost drowning in uncertainty and rage when one of his employees spoke to him with a rather sarcastic and an entirely inappropriate tone.  Despite Jack’s position as the owner/manager of his own company, his years of experience compared with this underling, and the feedback from me and his wife that indeed the employee was quite out of line, Jack worries that he has no right to object or that he will overreact; he finds himself raging, “burning” with frustration that he realizes is far beyond a reasonable response to such a minor slight.   (When Jack eventually confronted this employee, the latter apologized profusely and has since gone out of his way to be more respectful and cooperative.)

What is going on with Jack?  As with all of us, when the current situation cannot account for his reactions we can be sure he is enacting forgotten or barely remembered scenarios from his past.  This is where “getting in touch” comes in.  First, he has to articulate just what he is feeling, not rehash the particulars of the employee’s behavior, his own options for responding, or the surface reactions such as “I was pissed”.  Jack described “burning fear, terrified someone’s got a gun in my face, like I have to run for my life” all triggered by this awkward moment with his underling.  Then – and with most patients this seems to happen almost automatically, without much guidance from me – Jack must begin to notice from where else he knows such intense feelings.

Jack has become adept at this.  Over the years we have worked together, he has vividly described earlier experiences in his life which - unlike the episode with his employee – account entirely for his bouts of intense indecision, anxiety, and rage.  The rejection, humiliation, and baffling inconsistency to which he was subjected as a child and young man are beyond what I can describe in this blog entry; the case examples in the main website go into such histories in more detail.  The important point here is that when Jack is able to focus on and articulate the feelings aroused by whatever triggering event started things, e.g. his employee’s sarcasm, he suddenly remembers and recounts to me something from his childhood or from more recent experience with his family – and in those stories, the intensity of his feelings always seems entirely justified!   By contrast, such strong reactions to the minor triggering events he describes (such as the snide employee) do not match up and thus we label them “symptoms” of deeper problems.  In his conscious daily life, then, Jack was reenacting those intense experiences in more current and trivial situations.  If all this sounds a bit theoretic or speculative, hang on for a few paragraphs!

People do this – displace painful experiences onto trivial events – because it is safer and easier.  It is easier to obsess about handwashing, a door lock, an insult from a friend or lover, or some minor decision, than it is to face the more frightening and unwieldy causes of one’s unhappiness such as having perhaps married the wrong person, chosen the wrong career, or grown up feeling unwanted or worse.  When people begin to face those issues, they do feel better and they function better – see next paragraph – but it hurts.  Remember, Jack felt not just “pissed” but “burning fear”, terror for his life, panic, all triggered by this awkward moment with his underling.  Then once he articulated those feelings, he immediately remembered other times he felt that way – times when such feelings were justified by the circumstances and scary people involved.  Those are the half buried experiences that people resist “getting in touch” with, events they’ve completely forgotten or which they may remember but claim to have no feeling about.  But those memories hurt.

A quick digression to provide an example of this kind of resistance:  Fred is a lawyer who saw me for about three years.  One day he began telling me a story from when he was seven years old in which he was publicly humiliated and punished by his father for misbehaving at a large family gathering.  Halfway through the telling, to his considerable surprise, Fred became tearful; he described how painful, humiliating, frightening the experience was.  He’d told this story many times to friends and dates, but it always felt like an entertaining and mildly amusing anecdote.  It was only in the context of our session that the buried part of the story emerged – the pain of it.  And again why is this pain important?  Why “get in touch”?  Because that buried pain was never really gone.  It was something that I and others who know Fred could always see in his tense, overly apologetic, even tortured speech, and in his social demeanor in general; and although he did not know why, Fred did indeed know that he was an unhappy, tense guy.

Now to return to Jack, how do we know anything I said about him is true?  Because – and again this point is made more explicitly and with more illustrations in the main website – when he would remember, discuss, and feel the pain of the memories that arose as we spoke, he would afterwards feel “calmer, lighter”, sadder “but saner”; this is now the pattern in many of our sessions.  And most importantly outside of our sessions, as described above, facing those experiences has already resulted in a marked decrease in the many symptoms that originally drove him to seek treatment with me (as we saw with Fred, too.)

Certainly there are times to move, when stopping to notice what’s happening to you could be detrimental.  In the recent film “Beasts of the Southern Wild” a schoolteacher in a desperately poor area counsels her charges not to waste time whining “like a pussy”.  Perhaps that’s true when survival is fragile.  People who went through combat or emergency situations have said that the farthest thing from their minds at the time was what was actually happening around and inside them.  Rather they focused almost entirely on the next necessary step or on those they wanted to save.  My father grew up poor, Jewish in an anti-Semitic society, with no welfare, unemployment benefits, or other safety net.  His parents and grandmother died when he was young, some other relatives rejected him because of various family politics and prejudices, so he was on his own in ways my generation usually wasn’t.  He and his cohort survived, thrived, fought World War II, built the suburbs, and gave us our in some ways much safer life.

But even my father eventually went to a therapist.  And once there he too was asked that incessant question:  “and how did that make you feel?”  The case below illustrates why.

Alice is 61, divorced a year ago, and dating a successful divorced man with two somewhat difficult children.  The younger is in the throes of adolescence, still reacting to the separation, moody, sometimes engaging and other times maddeningly remote; she is leaving for college very soon.  The boy is 20 years old and suffers from more serious problems.  He is socially very awkward, has withdrawn totally from both parents for a year at a time, and has only recently resumed a relationship with his father.  This summer Alice helped with Fourth of July celebrations for her boyfriend, his children, and their respective partners, contributing heroically at times, occasionally sulking about feeling marginalized.  The boyfriend becomes a bit frantic over his limited contact with his children, and sometimes – quite reasonably to my ears – puts plans with Alice on hold as he waits to hear from his children; he has told her on occasion that he wants to be alone with them on certain weekends.

A year ago, Alice would have – and did with other men she was dating – sulked, “snipped and snapped”, and seethed over such perceived slights for weeks.  She would struggle with very limited success to distract herself, during our sessions would explain to me that she “of course” understood her boyfriends’ agendas and it was “of course” fair and “I don’t mean to complain”,…, but it all rang hollow.  She never really believed any of it, and outside our sessions her tension, preoccupation, unhappiness, and persistent sniping were proof that she was trapped by patterns she could not identify and break.  As I explain in more detail in the website – see the “Why Go” page – she was “lost or stuck”.

Now, however, Alice is much more aware of what goes on inside her.  Rather than get stuck in the dead-end of resentment and road rage – feelings she could never discharge – she has learned that a very painful feeling of being “left out” is what gets triggered by even minor frustrations; it is this experience she is trying to undo with all the seething, complaining (then trying not to complain, as described in the last paragraph), ruminating.  When she hits in session upon that experience of being left out, she is often suddenly reminded of some event from her childhood where the pain was similar – but the cause more severe.

And the result is almost magic.  Although it took time, now her boyfriend’s behavior has faded in importance, she is calmer, she sees his own limits as he struggles to deal with his children, she is more forgiving of both him and herself, her sulking passes more quickly into genuine grieving which itself does not last as long, she no longer badgers her boyfriend to understand her needs precisely when he is in the throes of his own anxieties – a very self-destructive habit – and she even laughs at the “bottomless pit of narcissism” to which she can sometimes sink.

Then she asks herself, much more calmly and with a far greater range of options, what she would like to do next.  Her choices include that she may complain articulately – in a way that might actually make her boyfriend more sensitive; she can set limits, in hopes of changing the tone of their interactions; she has already begun to attend more to other ways of addressing her own neediness as opposed to waiting for validation and reassurance from others; she might decide upon reflection that it is futile to try and reach this particular man and thus might end the relationship because it is so unsatisfying to her; she might decide to stick it out and see if he is more attentive after his children go back to school.

Most important, regardless of what she decides to do about her boyfriend, she can cease shouting at the universe to change.  Alice’s old habit was to sulk, resent, badger, and “snip”, and no matter what she told herself in calmer moments, she couldn’t really stop once she felt slighted.  The result of such behavior is of course to destroy the relationships she was trying to create.

So that is why we are always asking patients in some way what they really feel.  Notice, however, that “what are you feeling?” must go beyond the immediate, obvious answer – “frustrated” or “stressed” or “pissed off”, or even “sad”.  How we get to those more central and productive feelings is far beyond what we can cover here but I discuss it in the website and I will try to also provide examples in future blog postings.  The point of this entry is to illustrate that when you are not aware of what’s really going on with you, it controls you and you see few or no choices.  By contrast, when you are aware – again beyond the superficial – the world opens up; you can choose from a much wider range of responses, you feel better, and you end up living better.