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Thoughts on Psychotherapy

Blog | Dr. Jamey Hecht | Beverly Hills, CA
 
Posts in Happiness
Gift-Giving: Perils and Possibilities

A client came into session today looking mildly dejected. He wanted me to know it was nothing he couldn't handle. But something was bothering him, and he didn’t entirely approve of his own discomfort. He explained that his wife’s birthday was a few days ago, and they had experienced another go-round in a pattern they’ve played-out before on anniversaries, Valentine’s day, and Christmas. He puts in plenty of effort, but she’s usually disappointed in the results, and he blames himself. 

Why does he blame himself? Because she tells him what she wants as her gift, but again and again, he misses the mark anyway. Then he feels angry with himself for sabotaging the whole process. She feels let down; he feels judged (as incompetent, or withholding). So he tries to make it right, by fetching and handing over whatever it was she asked for in the first place. Then things settle down, and all is more or less well—until next time.

Whenever you’re puzzled about why you’ve done what you’ve done, there is internal conflict going on. Otherwise the confusion about your own choices wouldn’t be there. Part of him wanted to please his wife, in the only way that seemed likely to work (just take her instructions and carry them out). But part of him protested at that, with a quietly passionate conviction that something valuable would be lost by doing so. He did not seem clear about what that thing might be, yet he wasn’t willing to let go of it. If he told her what it was, he might have to give it up. So, to prevent that, he kept it hidden—even from himself. 

I suggested that maybe what he wanted was an opportunity to give expressively: to select something for her himself, something that would show not only his care and affection, but his knowledge of her, her interests and tastes. Compared to that, her version of gift-giving seemed less expressive, even impersonal. And since the culture frames gift-giving as a point of emotional contact—it’s one of the famous “five love languages”—it can feel lonely to exchange gifts without the closeness we associate with presents. Loneliness did seem to be part of the mix of feelings he had around this subject. That’s not a verdict about their marriage; far from it. They’re doing quite well, in general. But this issue has been a sore spot for a while.

I asked about the holidays and birthdays of his childhood. Sure enough, his parents rarely gave him anything that he wanted; when they did, it was something he had specified in advance. And they almost never managed to present him with an item that showed their affectionate understanding of just what kind of kid he was. They did their bit, and though some areas of their parenting were actually quite terrible, their gift-giving was merely underwhelming, mechanical, and a bit cold. So he knew his way around gift-related disappointment, and wanted me to realize he was well able to deal with it. 

Nevertheless, he seemed deflated and frustrated—sad, without being willing to be sad, and just slightly angry, with a strong disapproval of his own anger. He said his feelings didn’t fit the situation. I asked if the mismatch was one of quality, or just quantity. Because to me, his feelings made plenty of sense, and if they felt stronger than they “should,” maybe that was due to the resemblance between the current situation and some childhood birthday experiences that hurt more.

Part of what made it a bit daunting to realize all this was the dread of telling his wife about it and being misunderstood. What if she heard it as nothing but criticism, or a reluctance to spend money on her? She hadn’t come from poverty, but the home she grew up in didn’t always have financial security, either. When she went to high school, she felt undervalued by peers who wore designer clothes and waved their BMW keys around, long before she got the hand-me-down Plymouth station wagon. For her, the purpose of receiving gifts was to soothe-away this dreadful sense of being less-than, or undeserving, or unsuccessful. Instagram made that more intense, with its constant glittering displays of what we all supposedly want. 

Telling her husband what to buy was a way of ensuring a good outcome, by preventing the repetition of those old moments of adolescent misery. She didn’t really want jewelry for its own sake, didn’t know much about it, and rarely wore what she kept in her armoire. The meaning was the important thing, and the meaning was: I matter, I have value, I merit whatever it is that other people have already pronounced beautiful. She, too, wanted him to have room to choose what her present would be. But since another miss would be painful, she compromised by giving him a short list of possibilities from which to pick something. The trouble was, she wanted him to read her mind and realize that only the bracelet would hit the spot. The list of alternatives (she hoped) would not only create the illusion of initiative that he needed, it would sweeten the experience of his understanding her, and getting it right, and correctly selecting the bracelet instead of those alternatives. 

Instead he gave her the most expensive item on the list: a top-of-the line electronic tablet, roughly the same price. She was crestfallen. Unlike the bracelet, this was something he, too, might wind up using from time to time, and though this had never occurred to him, it made sense when she pointed it out. It embarrassed her to cry about it, because she didn’t want to seem ungrateful. But she didn’t feel grateful; she felt unheard. He took her to dinner and a movie, but she couldn’t manage not to mope. Her disappointment disappointed him.

In our session, he kept mentioning that this certainly wasn’t a crisis, and of course that’s true. But crises are not the only kind of problem that befalls a couple, and a minor bit of turbulence can be important if it’s part of larger pattern with an underlying issue. 

Sometimes in couple’s therapy, it becomes clear that the needful thing is for one of the two people to do a serious course of individual therapy. Conversely, sometimes in individual therapy the main theme turns out to be the client’s marriage, and the treatment resources might be better invested in couple’s therapy. This wasn’t that, since the client and I were also doing good work in other areas; parenting, career, time-of-life, and some broad existential issues. But because it’s an individual case, without his wife present, there was no opportunity to help them both directly. It would’ve been a discussion about their different understandings of what gift-giving is, and what it is for, and about how they can collaborate to adjust to each other’s needs.

Instead, he and I had to speculate about how he might try to discuss it with her. He wondered if she’d be able to meet him in the middle: she could ask him explicitly for something that would be sure to gratify her, something she already knew would be satisfying. And he could ask her to understand an additional gift as a personal communication of his feelings. As for gifts moving in the other direction, he seemed genuinely at a loss as to what he might want, apart from the online wishlist that has to do with his work as a musician. The whole subject of getting presents made him uncomfortable, and I understood why.

Without having met her, or seen the two of them together, it did seem to me worth his while to give it a shot. Part of the job would be to prevent her from jumping to the conclusion that he was just scolding, complaining, criticizing, or laying groundwork to deprive her of anything. It would help to spell out his understanding of her needs, and his desire to meet them. Having done so, he could try to explain to her what interpersonal customs he wishes they could have between them when it’s time to give a gift. A both/and, not an either/or.

Whatever the results, the main thing is to exit the pattern. Ideally, an open-hearted and insightful conversation dissolves it. But if that doesn’t work, or the support for an attempt just isn’t there, then the remaining alternative is to face that fact squarely, accept that it probably won’t change, and consciously resolve to make a unilateral change. In this case, that change would be to just get the specified shiny object that symbolizes value and security, and content himself with the quiet satisfaction of a job well done—a humbling, modest, nontrivial success in the role of husband to that particular spouse. 

If you can discern what it is that you can reasonably hope for, you can exercise your courage to suit the situation. There might be some sorrow in that accommodation, but it would not be the fussy self-sabotage of unintended repetition. Remember the “Serenity Prayer”? It applies to marriage ever so well: give me the courage to negotiate the things that are negotiable; the patience to accept the things that negotiation can’t fix; and the wisdom to know the difference.

Achieving that wisdom generally requires a few attempts at negotiation—compassionate, dignified negotiation. If those work, it’s a beautiful thing: shared growth, that brings the couple closer. If your efforts at negotiation don’t work, the beauty is more subtle, and harder to appreciate: your personal growth, that keeps the couple moving forward in parallel, instead of diverging in resentful conflict. 

See what you can do; do what you can.

Agency vs. Helplessness in Climate Change and Other Big Troubles

Therapy is a psychological effort to heal psychological wounds. But it also includes a “coaching piece” which supports your efforts to solve objective problems in the outside world. For example, getting and keeping a good enough job, partner, or circle of friends can require plenty of collaborative work, bringing the situation into sharper focus and finding the most strategic spots where a little pressure can turn things around.

But what about those giant historical forces that contribute to depression and/or anxiety, but that can’t be addressed by personal coaching? They shouldn’t be “therapized away” either, because they’re mostly objective and external, not subjective and internal. It isn’t neurotic at all to be concerned about climate change, or the loss of the natural world, or the rapid erosion of public institutions that used to guarantee a basic standard of political stability. In fact, being concerned about these huge trends is an important part of living together in the real world, and a therapeutic culture of atomized individualism can prevent the public from getting together to improve things.

Yet this, too, is a delicate balance to be struck and maintained, because we don’t pay our therapists to sway us into their favorite world-saving projects. Politicized utopian therapy tends to help nobody at all. In it, the patient is manipulated and under-prioritized; the therapist becomes a self-important priest of virtue; and the public they pretend to rescue is never actually served in any detectable way. The proper balance, it seems to me, remains focused on the patient’s individual well-being, and includes bigger issues only insofar as the patient is already struggling with them. I don’t cause people to start worrying about global warming, but I do not flippantly suggest that patients who are losing sleep over rising sea levels should just forget about it.

I’m a member of the Climate Psychology Alliance, and I’m aware of the extremely serious state of the world’s natural systems on which our safety depends. I’ve been interviewed on Guy McPherson’s Nature Bats Last radio show several times, and the recent book I Want A Better Catastrophe by Andrew Boyd contains an interview he did with me in Los Angeles. So I get it. 

I’m a bit more hopeful about the human prospect than I was when those were recorded, some years back. But our industrial system of living arrangements hasn’t changed, and humanity still seems locked into the cornucopian dream of infinite economic growth on a finite planet. The world needs collective psychoanalysis, but there’s no way to deliver that. A decade ago, Naomi Klein wrote a book about the climate crisis, saying we had just about missed our chance to address it democratically, so that only a top-down, autocratic solution would have much chance of reversing our reckless course. Now it seems we’re getting the autocracy, but without much progress on climate change—indeed the opposite, at least for the moment. 

And yet, here and there amid the mayhem, courageous people achieve real improvements every day, with a local reforestation program here, a soil restoration project there; another solar power plant replaces another coal plant; a threatened species like the peregrine falcon is nursed back to sustainable population levels in the wild. Though Yes! Magazine ceased publication in June of this year, you can still get a regular dose of positive reporting, environmental and otherwise, at https://www.goodnewsnetwork.org/.

None of this is enough, of course, and the big climate problem is a trillion tons of excess carbon already in the atmosphere. “Net zero” is politically frozen, and even if it were enacted tomorrow, it would only prevent new carbon from adding to the existing load. Yet all is not lost, and that margin of brighter possibility—however slim—means two things: 

One, we have to try. As Rabbi Tarfon says in The Ethics of the Fathers: “It is not your duty to finish the work, but neither are you at liberty to neglect it” (Pirkei Avot, 2: 16).

Two, we cannot let the giant issues of our day prevent us from fulfilling our birthright: our lifetime’s chance at the earnest effort to achieve wisdom and well-being. I use those terms instead of the Declaration’s famous “pursuit of happiness” because the latter is often too light a word, given what many of us deal with, and what we face as a society and as a species. If happiness is to be our aim, let it be a deeper version that includes the bittersweet struggle to achieve it. As I often mention, Aristotle says happiness “is not amusement; it is good activity,” and goodness often involves the sober and courageous confrontation of what’s necessary. 

All is not lost. Two organizations, and probably more, are focused on restoring the climate, not just slowing its destruction. One is www.climatefoundation.org, based on a fine book by Peter Fiekowski called Climate Restoration. The other is Project Drawdown, which includes a range of already-existing efforts to pull carbon out of the air, and into commercial products and processes that benefit the public and the natural world. These need more attention than they now receive, but that’s changing every day. 

I’m a therapist and a writer, not a climate scientist or an industrial engineer. I don’t know the future. But I am entirely convinced that your best bet, and mine, is to live lives of hope and effort, reaching for agency and awareness rather than helplessness and dissociation. When I work with patients who aren’t troubled by the giant themes of our collective historical moment, I let those sleeping dragons snore in peace. But when patients suffer from excessive preoccupation with problems of greater-than-human scale, I invite them to toggle back and forth between brave confrontation and merciful rest. If your top priority is to push back against the Big Troubles of our historical moment, remember that you can contribute a lot less when you’re exhausted and despondent than when you’re healthy and strong.

If this perspective appeals to you, consider booking an appointment with me today at 917-873-0292, or use the contact form on this website.

Body Image: It's the Feelings, Not the Facts

A couple asked me about body-image issues today. They had already communicated with each other about their preferences—which is not always a great idea. She now knows he (thinks that he) prefers a certain waist-to-hip ratio, and he knows she (thinks that she) likes it better when he’s got a bit more muscle than he seems to have these days. Saying that stuff costs more than it’s worth. Why not just assume your partner shares the same general taste as the rest of the culture around you, and live your life? If and when you’re ready to attempt the kinds of changes that suit you, give it a shot. If you have some success, and your main squeeze actually notices it, that’s great. You want to be changing for you, not for them, anyway. 

Fussing about how you think you prefer your partner’s body to look, is a fool’s errand. You can advocate for an increase in your shared activity level; get some bicycles; get a dog to have to take constant walks with, etc. There’s plenty of stuff you can do that may help get you both into shape. But there’s usually no good reason to say you’re disappointed with the other person’s body—unless things are really out of control, and the physical issues are egregious enough to be part of a larger problem. Which is pretty rare.

Most of the time, our bodies remain more or less the same, and most of us exercise just enough to keep them roughly the way they are, staving off deterioration. Sometimes an exercise program will get sustained, and somebody will win-through to eventually obvious good results. But most of us aren’t chasing that anyway—just exercising to stay healthy. Life is for living, and as a professor of mine once said, “It’s not a damn beauty contest.”

Often patients report feeling icky about the naked body they see in the mirror. That hurts, and there are many good books (not all of them addressed to women, though most are) about how to cope with those painful feelings and neutralize them. I want to offer an analogy that the people I saw this morning found very helpful.

It goes like this: 

When we talk about monetary wealth, it seems obvious that the more dollars you have, the less poor you are. What seems to count is simply the number of dollars in the bank. But that’s only part of the truth; it’s just an approximation. The real measure of financial freedom is purchasing power. One dollar in the year 1900 paid for the same goods you can only buy today for $38. So the single bill in that era was worth more than a twenty is worth now. Because of inflation, the absolute number of dollars is relevant but misleading; their actual value is the meaningful thing. 

In a similar way, the numerical data you associate with your appearance—your weight, measurements, various muscle sizes, BMI, the dimensions of gendered body parts, all that quantitative stuff—is relevant but misleading. The actual value lies in the quality of your experience as an embodied human being. It’s your body image, not your actual body, that determines whether you’re at home in your own skin or miserable about not looking like someone else, whether that’s a past self or a rival or a movie star. 

If you don’t like your belly, or your arms, or whatever, there are two main issues: the physical facts, and your difficult feelings about them. Both can change. But you can start with the feelings. Easing up on the scornful judgments will make you more free, not less free, to govern your own policies about your physical life. Hating the flesh that keeps you alive is not much of a real contributor to your motivated self care (i.e., getting-in plenty of regular physical activity, or refraining from impulsively eating your feelings). People work out or stay active because it makes them feel good, not because they’re at war with themselves. Letting go of the anxious high standards, letting go of the contempt, letting go of the relentless measuring and comparing—it won’t prevent you at all from going on to do the kind of incremental improvement that feels good and gradually makes a sustained positive difference. If loving your body still feels unfeasible just now, start off by being polite to it, and build from there.

If you’re married, or in a committed relationship, the way your partner responds to your physicality is probably part of how you feel about what you see in the mirror. Give each other the working materials to easily generate an erotic home-base that feels hot and sexy sometimes, warm and friendly most of the time, and coldly evaluative never.

Judgements and measurements are for competition, and home is not a place to compete. Make it easy to feel good naked there. Make it easy to delight in your gift of aliveness, as you both already are, right now. And if it feels important, you can also make it easy to reach for small wise lifestyle changes in the name of longevity and embodiment, not shame or guilt. Help each other to move away from the darkness of measurement and evaluation, toward the light of acceptance and exploration. You might as well.

Work, Overwork, and the Need to Belong

People have an evolved need to be part of something – to belong to a family that belongs to a tribe. Anyone who doesn’t have that can become susceptible to whatever offers itself as a substitute, even if the eventual price of belonging is unclear at the outset, and turns out to be too high. We are a profoundly social species, and the more isolated somebody is, the greater their risk for getting absorbed into a company that has cult-like features—especially if these only become obvious after some time has passed, and ties have been formed.  

In Bowling Alone: The Collapse and Revival of American Community, Robert Putnam showed that people in the USA used to be connected to large numbers of neighbors and peers, by all sorts of clubs and civic groups and religious institutions that were larger than the household, but smaller than the state—the Elks Club, the Knights of Columbus, Boy Scouts, B'nai B’rith, and so on—and that since the 1970’s, most of these have shrunk or even vanished. For my MFT internship (2012-2016), I trained in Gestalt therapy at a Los Angeles nonprofit called The Relational Center whose motto was and is: Isolation hurts. We help. See also Johann Hari’s excellent book on this issue, Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions.  

Our drive to be part of something larger than ourselves is a core need that’s sometimes fulfilled in wholesome ways, even today. If we’re fortunate, it can arise where we earn our daily bread. Teamwork on the job, if it goes well, feels good and works effectively. It’s not necessary to spoil it with cynicism by deciding that it’s all a swindle, just because management planned it for the purpose of maximizing the owners’ profits and the shareholders’ return on their investment. Yes, management did set up a personnel structure, with its cooperative and competitive dynamics; and yes, they did so mainly with those financial motives. But it’s a wasteful mistake to use this fact to empty-out the value of a collaborative experience. Enjoying your job doesn’t make you the dupe of exploiters—unless your employer happens to be exploitative. So it’s pretty important to have some criteria for that category.  

If the company’s internal communications are laced with the rhetoric of family life, does it feel icky and bogus?  

Prioritize your physical and mental health, and take a close look at the effects of your current employment on those two factors.

Is it a permissive environment, where bad interpersonal behavior has no consequences? Or an over-policed one, where H.R. feels overzealous and unpredictable?  

Do rewards for extra hard (or extra good) work go to everybody, not just the suits in the suites?  

Are you stuck in your current role, or can the leadership be convinced that they could make better use of you in another one where you feel you’d add more value? If you contribute advice for improving processes, products, or practices, does that get rewarded or punished?  

Do you feel misled about important aspects of your role, or are they frank with you where it counts?  

Bonuses and raises are not the only genuine sort of rewards—there’s paid time off, broader choice of tasks and teammates, more control over your schedule and remote work, and so on. Be wary if you put in a heroic chunk of overwork, and they either ignore it, or pay you in symbolism, praise, and thanks, but nothing more.

Consider that the ideal job, the real peach on a high branch, gives you three things:

·      enough meaning

·      enough money

·      adequate work-life balance  (WLB) 

Awful jobs are missing all three, and are way too close to what sociologists have called “social death,” in which one’s humanity is under dire assault by some combination of abuse and neglect. The late Barbara Ehrenreich wrote a poignant bestseller called Nickel and Dimed: On (Not) Getting By in America, about such jobs, and the vexing struggle for upward mobility. More recently, in Democracy Awakening, professor Heather Cox Richardson has taken account of the way access to opportunity waxes and wanes cyclically through the history of the United States.  

A good job can provide you with any two of these, but not all three—and if the one you need most is the one that’s missing, the job’s not so good. Sociologist David Graeber made a splash with his Jeremiad on corporate culture, Bullshit Jobs, which he defined thus: “…a form of paid employment that is so completely pointless, unnecessary, or pernicious that even the employee cannot justify its existence even though, as part of the conditions of employment, the employee feels obliged to pretend that this is not the case.” Bullshit jobs pay plenty, and they don’t take over your whole week—but their lack of meaning takes on a creeping toxicity the longer you work there, because the company culture requires you to fake it. Even if the work is (relatively speaking) socially and environmentally harmless, you still come to feel you are selling your integrity because you have to bullshit other people, and yourself, that the work is not, in fact, the bullshit it really is. This is sometimes called “golden handcuffs.” 

If there’s work-life balance and meaning, but not much money, it may be possible to add a lucrative side-hustle without becoming exhausted. If there’s good money and real meaning, but you’re frazzled and sleepless, that strategy’s not available; you may need to negotiate more time away, or build an exit ramp.  

Aristotle wrote a book of ethics for his son, where he states: Happiness is not amusement, it is good activity. Ideally, work is a form of serious play that gives us a role in the community and compensation for our labor in that role. On your way to a vocation that really suits you, remember that the gatekeepers will be behind you one day; that the stepping-stones are temporary phases of your life with something to teach you, however unpleasant; and that you must steer your life in the direction where you want it to go.

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.