First of all, it's up to you. You decide if you need therapy, and when you're ready to start. Others can suggest it, but it's your call. It won't work unless you are sick of living an unfulfilling life, and you feel that something's at stake...something about you is on the line. Do you want the following: To better understand your relational style and your expectations of the world? To better understand why and how you defend yourself from pain and discomfort? To learn, th

In protecting yourself and others, you can bring about the thing you fear the most. If you tell someone 'no,' they might get mad, or seem mad. Okay... Then what? If you're honest with your boss about your workload, they might have a reaction that's disconcerting. They might get frustrated with you. They might like you a little less than before. Okay... Then what? If you're really honest with your partner, they might be offended, or disgusted, or frustrated, or annoyed. Okay..

Have you ever thought about this, or discussed it in your therapy? Therapy sessions are usually around 50 minutes in length, and usually take place once per week. If you meet with your therapist for 6 months or more, that's a lot of sessions, and that's a lot of time together. Therapists say all sorts of things during those minutes with you. They make mistakes, including grammatical errors, they misquote, misunderstand, and misspeak. They use the wrong name, and forget key in

My role as a therapist can be summarized using the following analogy: You're an expert archeologist. You've embarked on a new project in a remote part of the world. Dinosaur fossils have been discovered, and you're on the case. You're trying to find the fossils, extricate them from the earth, dust them off, assemble them, and make sense of them. From these, dinosaur 'bones' will be made, and your life might change forever as a result. You'll have new opportunities, money, and

Like the wrought iron railings in New Orleans, wisdom is still around. It's sturdy, and it's beautiful. It's known the world over. I love old stuff. The railings in New Orleans, the cobbled streets in Hoboken (or what's left of them), the endless dive bars in Detroit, and The Flats in Cleveland all have my heart. Wisdom, though, is my new thing. When a patient is barely getting by, under the gun with work, grief, relational turmoil, or illness, I've taken to asking them about

We're brilliant. Without realizing it, and in a span of nanoseconds, we know just how to lean, how to stand, how to sit, and how to run, to avoid physical discomfort. Our back, our shoulders, our neck, and our feet have all adjusted to years and years of avoidance. They know just what to do, and when, to avoid pain. Really, our nervous system controls all of this, so it should be given the credit. Our physical world, what's inside us and what's pressing on us from without, in

Jean-Paul Sartre said 'Life begins on the other side of despair.' I don't know Sartre, so I won't venture an interpretation of this quote. But, when I heard this line some years ago, it stuck with me. I have my own version of it: Life begins in sorrow. Have you ever felt sorrow? Deep sadness? Profound pain and suffering? The immense nature of grief and mourning? What an honor these are. When you feel these, you feel something special. While it may be uncomfortable and in some

Life without friction is unfulfilling. Today, we see angst on the rise, and we see confusion, division, and a narrowing of possibilities. People are opting out of life, in subtle and overt ways. There's less interpersonal connection, and less genuine, useful interpersonal conflict. We rely on the internet and social media for connection and information, and we feel alienated from one another, and from the truth. When everything is available, nothing is available. When everyth

What aren't you doing in the bedroom that you'd like to be doing? Did you used to do those things? Have you ever done them? Which of you is the more adventerous one? Which of you is more shy? Which of you approaches sex more emotionally, and which of you more practically? What gets in the way of more and/or better sex? Time? What does 'time' mean here, anyway? Energy? Well, what does 'energy' mean in this context? All of this may be worth wondering about, discussing openly,

You're wearing armor. It works great. It protects you from harm. It's not steel, and it's not a cutting-edge weapon fending off enemies. Your armor is much more impenetrable than those, but it's also less visible. Yours is psychological. Yours is one that defends you from pain and anguish. It fends off loss, abandonment, and rejection. Seems to me that these are what humans fear most. In my personal life, and in my clinical life, these themes dominate. Even when the issue app

You don't say what you think. When we don't say what we really think, and we opt for something less complete, we're being dishonest. If I'm asked to go to a party (that I don't want to go to), and I say: 'Well, uh, I'll just have to see what I'm up to that night. I might be able to make it, but let's see.' This isn't honest. It's not complete, either. It's a soft, cheap way out. Actually, some people even skip that, and end up going to the party they'd rather not be at. This

Should you end your relationship? Ask yourself these questions.

Anxiety is a commonly used word, but can you define it? Do you understand what it is, where it comes from, and its purpose?

When you feel anxiety, what should you do?