Practice

We have been blessed to work with many very, very intelligent people over the years. It always stimulates us to have smart people ask challenging questions about the work that we do. One of the common complaints of smart people in therapy is: my therapist isn’t telling me anything I don’t already know. We used to try to point out …

Therapists Can Be So Annoying: Feeling Like You’re On Celebrity Roast

Therapists Have you ever found yourself all of a sudden the guest of honor at celebrity roast special. Sometimes that is what it is like being a therapist…. or husband… or wife… employee… boss…. or you name it… What do you do? You probably know that being defensive is not going to work. But how can you sit there and listen …

Chronic Anger Kills

Anger is a necessary emotion. It can motivate to change things for the better, to protect ourselves from evil, to re-shape our lives in better and more satisfying ways. But chronic anger, especially chronic anger about things that can’t be changed because they are in the distant past, is a life-destroying emotion. Occasionally we meet with people who are out …

Therapy and Curling

Therapists are like the sweepers in the winter olympic sport of curling. Curling, for those who are not intrigued by the sport,  involves hurling a heavy sphere down an icy lane (like a frozen bowling lane) with the goal of landing in a particular spot. What really makes the sport odd is the addition of two people who use brooms …

Bad Memories

Unstable moods and bad memories seem to go together. In the clinic where many of us work we have noticed how often it is that folks who we see with bipolar have had traumatic experiences in childhood. Why that happens is speculation. But we do know that dealing with those experiences can be very, very hard, and, potentially, life transforming. …

Francine Shapiro: EMDR – A Crazy Idea that Works

As a young psychiatrist I was interested in posttraumatic stress disorder (PTSD – psychological reactions to severe traumatic events) and did a research fellowship on the subject with Charles Marmar at the San Francisco VA Hospital. One Thursday morning, during our regular clinical case conference, we had a woman come in to tell us about her recently discovered technique for …

Starbucks Therapy

We aren’t sure how we feel about the spread of Starbucks into every corner of America. But it does allow us to suggest a kind of intervention that may help you if you are depressed. It is based on Interpersonal Social Rhythm Therapy – which is one of the best validated psychotherapies for people with bipolar moods. Every morning, at …

Learned Helplessness

This is an animal model of the human experience of depression. In the learned helplessness model an animal is repeatedly placed in a situation where it has no ability to avoid a painful outcome After a while the animal begins to look depressed (listless, passive). At that point if you place the animal in a situation where it could escape …

Doctors Part 2

Once you have found a good doctor (see Doctors Part 1 for thoughts on finding doctors), how can you make sure that you get the best help from that doctor (or doctors). Here are a few thoughts collected from our experiences working with many people over the years – 1. Plan ahead. It is almost always a good idea to …

Narcissism

“You’re such a narcissist!” It’s easy to see why people with moods are often accused of being narcissistic. When we are depressed we become focused on ourselves and our mood and our pain. This is also what happens to people with chronic pain of other types. And when we are manic, we become preoccupied with our importance and specialness. But …

Relationships and Chronic Depression

Many people with depression, particularly if they have been depressed for a long time, develop a pattern of interacting with others that is designed to protect them from disappointment. Avoiding disappointment is obviously a good thing, but it can lead to relationships that are not satisfying. Addressing relationship issues is important. Almost everybody who is unsatisfied with their relationships can …

Anxiety or Excitement?

Many folks not only have to figure out how to live creatively with moods, but also have to wrestle with anxiety. I have found that it is sometimes useful to compare two states of mind which are very, very similar in terms of how the body is reacting, but are very different from an emotional standpoint. Imagine that you are …

Self-Consciousness: You Can’t Fool Yourself

Many years ago we read a book by renowned social psychologist George Herbert Meade entitled Mind, Self and Society. In it Meade wrote about the origins of self-consciousness in childhood experiences. If you follow the development of children you notice that at first they act as though they and the world are one, with no apparent sense of others (especially …

The Antidepressant without Side Effects

Medications for depression can be life saving, but for many people they have disturbing side effects. But there is one antidepressant that doesn’t have side effects – behavioral activation (BA). Behavioral activation is a treatment that has been shown to work for people with moderate and even severe depression and, in some studies, it works about as well as antidepressants. …