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CONGRESS
ATTACHMENT AND TRAUMA
The Neurobiology of Healing
DANIEL SIEGEL RACHEL YEHUDA ROBIN SHAPIRO
STEPHEN W. PORGES ALLAN SCHORE DIANA FOSHA
VITTORIO GALLESE SUE JOHNSON
ANTONIO DAMASIO PETER A. LEVINE

Times Square
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2017
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CONGRESS
ATTACHMENT AND TRAUMA
The Resilience of Mind and Body
DANIEL SIEGEL STEPHEN W. PORGES DIANA FOSHA
BESSEL VAN DER KOLK JUDITH LEWIS HERMAN LOUIS COZOLINO
ANTONIO DAMASIO VITTORIO GALLESE ROBIN SHAPIRO
RACHEL YEHUDA PAT OGDEN

LONDON
MAY 12-13-14
2017
WWW.UK-CONGRESS.COM
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J A N U A R Y/ F E B R U A R Y 2 0 1 7 Save time! Take the quiz online and get your
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Psychotherapy’s Pilgrimage page 18
7 Doherty says that at this time of fragmentation 14 Preston says an issue that will profoundly
1 According to Doherty, therapy movements are and division, therapists need to affect mental health treatment is that, in the
about what it means to be a human being at a A. r ecover our belief that we have something to last 20 years, the number of medical students
particular time and in a particular culture. offer beyond symptom reduction signing up for psychiatry as a speciality has
A. t rue B. false B. recover our conviction and passionate intensity dropped by
2 According to Doherty, psychoanalysis had as a profession A. 1 0 percent
offered up the idea of C. recognize that we’re in the glue business B. 50 percent
A. t he Rational/Linear Self D. all of the above C. 30 percent
B. the Weary/Worrisome Self D. none of the above
8 Doherty proposes a new vision for the self he calls
C. the Complex/Conflicted Self A. t he Corrective/Collective Self 15 According to Dan Siegel, the ’90s brought us a
D. none of the above B. the Active/Ethical Self new perspective on the brain as
3 Doherty calls the understanding of human C. the Connected/Committed Self A. s elf-destructive
growth and potential that emerged in the ’60s D. none of the above B. self-sustaining
and ’70s C. self-renewing
Then, Now & Tomorrow page 32
A. t he Authentic/Liberated Self D. none of the above
9 Salvador Minuchin’s goal as a therapist was to
B. the Hippie/Happy Self
be an intervenor who creates uncertainty in Overall Course Evaluation
C. the Loose/Liberated Self
clients about who they were and are and what
D. none of the above Rate on a scale of 1 (poor/very little) to 5 (excellent/a lot).
they’re capable of becoming.
4 After learning the outcome of his medical family A. t rue B. false Overall CE course
therapy with Jeanne and her parents, Doherty Usefulness to your clinical needs
10 According to Mary Jo Barrett, a tenet of the
writes that he handed in his Appropriateness to your education, experience,
family-preservation movement in the mid-’80s
A. c opy of the DSM and license level
was the goal of
B. license to practice Information is current and up to date
A. e stablishing a sense of hierarchy in a family
C. “miracle worker” badge How much you learned from this CE course
B. getting the foster parent and the biological
D. all of the above The technology was user friendly.
parents to work together
5 Doherty argues that what new image of the C. performing a “parentectomy”
self started taking hold in the wider American D. getting children to draw a new family tree Learning Objectives Evaluation
culture and showing up in therapy in the ’80s? Rate on a scale of 1 (not at all) to 5 (very well).
11 According to Bessel van der Kolk, a key
A. t he Contrived Self
development that’s advanced trauma treatment is I can discuss Doherty’s view of psychotherapy
B. the Consumer Self
A. t he recognition of the role dissociation plays in and the wider culture.
C. the Calculated Self
the aftermath of trauma I can describe van der Kolk’s view of the changes
D. none of the above
B. the revitalization of bottom-up approaches in trauma treatment over the last 40 years.
6 What does Doherty claim we’d lost in the ’90s C. the emergence of EMDR  I can explain Siegel’s view on the importance
that had inspired many therapists in earlier D. all of the above of understanding neural integration.
decades?
12 According to Ken Hardy, the feminist critique
A. a ttention to the larger context and a sense Author Evaluation
hindered the progress of exposing and addressing
that we could make a difference outside the
issues of race in family therapy. Rate on a scale of 1 (poor) to 5 (excellent).
consulting room
A. t rue B. false
B. attention to improving techniques for dealing 
Author(s) showed knowledge and expertise.
with child abuse and neglect 13 John Preston notes that the outcomes for people 
Author(s) had an organized delivery.
C. the influence of charismatic therapy gurus treated for depression by primary care physicians are
D. none of the above A. v ery poor
B. very good
C. there are no studies on this
D. none of the above

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Mail with payment to: Networker CE Quiz , PO Box 1000, Eau Claire, WI 54702-1000, or fax with credit card info to (800) 554-9775
 A few weeks ago, I was having dinner with my
daughter and several of her millennial friends
at a trendy New York restaurant. One young
woman proudly told me that she was the long-
est-serving employee at her start-up compa-
ny—she’d been there five whole years, a vir-
tual lifetime in her worldview. When I told
her that I’d been employed at the same outfit
in the same position for 40 years, she looked
a bit alarmed, as if the incarnation of some
Old Testament figure had suddenly appeared
beside her. How was it possible to spend that
much time doing, more or less, the same job?
In truth, I sometimes wonder the same
thing. Have we at the Networker really been
doing the same thing for scarily close to half
a century? Maybe we’re still so fully engaged
in what we do because, even after all this
time, we’re still seeking the ingredients to
the elusive magic formula (or formulae) that
will dependably resolve more of the complex
issues clients bring to us.
But if the story of therapy remains basically
unfinished, unresolved, unperfected, so does
human nature itself. After all, aren’t we all
imperfect beings in an extended process of
becoming? Far from being a mark of dishonor,
this is actually a great thing for us. Our calling
as therapists is based on the idea that people
can and do change—it may not come easily,
but we grow and learn throughout life, and
in ways that are often unexpected, even baf-
fling. This therapeutic uncertainty principle is
of profound value to the society at large, espe-
cially now, at a time of dizzying uncertainty,
when our collective path ahead seems unsure,
to say the least.
In the therapy room, we don’t know what
will happen, but we’re willing to explore
alternative possible stories, asking probing
questions and listening with open minds to
unexpected answers. This comfort with uncer-
tainty, this faith in the process and trust in the
4 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/F E BR U AR Y 2 01 7
power of relationship, enables us to believe
that ultimately, if we can fully put our heart
and soul and savvy and embodied wisdom into
it, something good will come of the process—
what and how we don’t really know.
Every Networker issue begins with an incipient
idea, often vague and hardly formed, that may
come from any one of a hundred sources—a
note from a reader or one of our writers, an
article we’ve seen, a conference we’ve attend-
ed, a news story. Once the thought is embed-
ded in our collective brain, we call around to
different members of our extended profes-
sional tribe to develop this fragile, sometimes
fleeting, bit of inspiration. And at the end
of the intense and unpredictable process, as
we’re holding an alluringly bright and shiny
new issue in our hands, we feel once again, as
we have for the past 240 issues, a sense of giddy
astonishment. And perhaps with unwarranted
pride, we feel that we’ve produced something
that matters, not only to our profession, but to
the wider world—because every issue is, in its
own way, a celebration of the human capacity
to make new discoveries and add further con-
tributions to this vast, perpetually unfinished
story that connects us all.
With that, we think this look back at the last
40 years of this magazine and our profession
comes at a time when we could all use perspec-
tive on what we’ve learned from the challeng-
es of the past—both within and outside the
consulting room—and how to best face the
difficult trials and out-of-the-blue twists and
turns of the next 40.
EDITOR
rsimon@psychnetworker.org
 J A N UA RY/ F E B R UA RY

2017

Vol. 41 n No. 1

The Connected Self — Special 4Oth Anniversary Issue

18 Psychotherapy’s Pilgrimage BY WILLIAM DOHERTY
Despite what grad school textbooks may imply, therapy movements are more than a set of
theories and techniques. They’re about what it means to be a human being at a particular time
amid all the forces that shape a culture. Here, a therapist who entered the field at the same time
the Networker made its debut brings to life 40 years of the key moments in psychotherapy’s
unfolding, exploring both how the field was influenced by social changes and how the
consciousness of our times—and our view of what it means to be a fully realized person—have
been transformed by the intimate conversations that take place in our consulting rooms.

32  Then, Now & Tomorrow:

Oral Histories of Psychotherapy 1978–2017
A group of innovators and leaders look back over different realms of therapeutic practice and offer
their view of the eureka moments, the mistakes and misdirections, and the inevitable trial-and-
error processes that have shaped the evolution of different specialty areas within the field.

n Trauma: Retreats and Advances BY BESSEL VAN DER KOLK

n Couples: In Search of a Safe Haven BY JOHN GOTTMAN

n  ystems Therapy: The Art of Creating Uncertainty

S BY SALVADOR MINUCHIN

n Family Violence: Out of the Shadows BY MARY JO BARRETT

n Psychopharmacology: The Jury Is Still Out B Y J O H N P R E S T O N

n Race Matters: How Far Have We Come? BY KENNETH HARDY

n Neuroscience and Therapy: The Craft of Rewiring the Brain BY DANIEL SIEGEL

psychotherapynetworker.org

C O V E R I L L U S T R AT I O N © J O S E O R T E G A / I L L U S T R AT I O N S O U R C E . C O M PSYCHOTHERAPYNETWORKER.ORG 5 
 48  Turns in the Road:
Highlights from the Networker Journey
Out of all the hundreds and hundreds of articles that have appeared in the Networker
over the past four decades, we’ve chosen a small sampling that captures the magazine’s
most journalistic side, conveying not so much the eternal verities of our profession, but
the sense of reading a first draft of the field’s history. Among other things, you’ll find
therapeutic methods that, as exciting as they seemed at the moment, didn’t stand the
test of time as well as initial forays into discussing complex issues we’re still struggling
with today. We’ve also added in a few examples of writing so immediate and compelling
that they have an air of timelessness. Prepare yourself for an interesting journey.

n Personalities & Profiles

n Challenges & Changes
n Controversies & Debates
n Sex, Marriage & Parenthood

Dep rtments
13 Clinician’s Digest BY CHRIS LYFORD
What minority clients are saying to their therapists
after the election, and how therapists are responding.

80 Family Matters BY BRAD SACHS

The joys of being the oldest guy on the team.

2 CE Quiz 72 Calendar
8 Letters 76 Classifieds
46 2017 Symposium

EDITOR SYMPOSIUM DIRECTOR PSYCHOTHERAPY NETWORKER (ISSN 1535-573X) IS A MAGAZINE FOR

RICHARD SIMON HOLLY STEVENSON MENTAL HEALTH PROFESSIONALS LOCATED AT 5135 MACARTHUR BLVD., NW,
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 APA Journals®
PUBLISHING ON THE FOREFRONT OF PSYCHOLOGY

LEADING JOURNALS TO INFORM YOUR PRACTICE & RESEARCH

Asian American Journal of Psychology Psychoanalytic Psychology

Editor: Bryan S. K. Kim, PhD
Published quarterly – ISSN: 1948-1985
1.388 2015 Impact Factor®*
www.apa.org/pubs/journals/aap
Cultural Diversity & Ethnic Minority Psychology®
(Society for the Psychological Study of Culture, Ethnicity and Race)
Editor: Richard M. Lee, PhD, LP
Published quarterly – ISSN: 1099-9809
1.790 2015 Impact Factor®* – Indexed in MEDLINE®
Editor: Elliot L. Jurist, PhD, PhD
Published quarterly – ISSN: 0736-9735
0.833 2015 Impact Factor®*
www.apa.org/pubs/journals/pap
Psychology of Sexual Orientation and Gender Diversity®
(Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues)
Editor: John C. Gonsiorek, PhD, ABPP
Published quarterly – ISSN: 2329-0382
www.apa.org/pubs/journals/sgd

* ©Thomson Reuters, Journal Citation Reports® for 2015

www.apa.org/pubs/journals/cdp
Journal of Psychotherapy Integration
Editor: Jennifer L. Callahan, PhD, ABPP
Editor: Scott D. Churchill, PhD Published quarterly – ISSN: 1053-0479
Published quarterly – ISSN: 0887-3267 www.apa.org/pubs/journals/int
www.apa.org/pubs/journals/hum
Psychotherapy
Journal of Latina/o Psychology
Incoming Editor: Esteban V. Cardemil, PhD (Society for the Advancement of Psychotherapy)
Outgoing Editor: Azara Santiago-Rivera, PhD, NCC Editor: Mark Hilsenroth, PhD
Published quarterly – ISSN: 2168-1678 1.735 2015 Impact Factor®* – Indexed in MEDLINE®
www.apa.org/pubs/journals/lat Published quarterly – ISSN: 0033-3204
www.apa.org/pubs/journals/pst

These journals represent several of the many APA journals of interest to those engaged in practice and research
related to psychotherapy. For more information, please visit www.apa.org/pubs/journals or call 800-374-2721.
American Psychological Association | 750 First Street, NE | Washington, DC 20002-4242 USA

The Bewildering World of
Therapeutic Apps
■■ Marian Sandmaier’s article “Left
to Our Own Devices” (November/
December) illustrates a great
point: often, while our behavior
appears sensible to us at a particu-
lar moment, it’s actually misguided.
When principles are finally uncov-
ered that reveal the truth about how
we live our lives, people realize the
foolishness—and the innocence—
of their past behavior. Case in point:
our relationships with our electronic
devices. Why would people prefer to
interact with machines rather than
other humans? Why would people
expect more from technology than
from one another? Why do so many
people find solitude painful? Why
do people pay more attention to
their phones than to each other?
In my view, the only reasonable
answer to these questions is that
many of us don’t realize the prin-
ciples of good mental health. We
seem to spend most of our present
moments misusing the creative pow-
er of thought, which could be better
used in service of helping human-
kind. Our addiction to electronics
is merely another form of coping,
another bucket under a leaky roof.
Understanding what connects us—
and connects us in a healthy way—is
the key to fixing that roof and end-
ing not only our addiction to elec-
tronics, but myriad other damaging
coping mechanisms.
THOMAS KELLEY
Detroit, MI
8 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/F E BR U AR Y 2 01 7
@PSYCHNETWORKER.ORG
The Empathy Gap
■■ As both a therapist and the moth-
er of screen-savvy young adults, as
well as an active participant in both
the real and digital world, I found
Sherry Turkle’s “The Empathy
Gap” (November/December) to be
especially poignant. It’s my favor-
ite Networker piece to date. I loved
its intensity, vividness, courage, and
humanity. Thank you for challeng-
ing all of us to reconsider the impor-
tance of life beyond the screen.
ANNE STOTTRUP
Sherry Turkle hit the nail on the
■■
head. Amidst all the buzz about
how the digital age has allowed us
to stay in touch with people, some-
where along the way it’s created an
empathy gap. You may sit at your
computer for hours, read hundreds
of articles, and watch thousands of
movies, but that can never replace
the value of talking to someone
you’re close to. People open up
when they talk, which is more impor-
tant than anything else when they’re
going through a hard time.
L I LY T H O M P S O N
Intimate Enemies
■■ Barry Jacobs’s Family Matters piece
“Intimate Enemies” (November/
December) is a beautiful and hon-
est telling of the vulnerabilities that
pull us apart and quietly draw us
near. I appreciate his willingness to
articulate the ambivalence that’s the
hallmark of many caregiving rela-
tionships. Excellent read.
SUZANNE DAUB
Barry Jacobs’s essay was beautiful-
■■
ly written and heartbreaking. Now I
feel inspired to try a little harder to
connect with the people in my life
who I’ve sometimes found difficult
to love.
M AT T M A R T I N
Barry Jacobs’s transparency in sto-
■■
rytelling brings to mind my own
family grief in an emotional and
inspiring way. Currently, as I untan-
gle the roots of my family’s history,
I’m learning how I can be gentle
with myself and my parents. As this
piece reveals so deeply, we all have a
story. Jacobs’s quirky and light-filled
writing has made a lasting impact
on me.
ANONYMOUS
I can’t tell you how moved I am
■■
by “Intimate Enemies.” It’s emotion-
ally honest and raw, a thoroughly
insightful and courageous essay.
R I C H A R D H O L L O W AY
The Food–Mood Link
■■ Ryan Howes’s “Food and Mood”
(November/December) is an
incredible resource. I wish most
people were as motivated in their
pursuit of knowledge about the con-
nection between mood and food
as Joan Borysenko. In the future, I
hope clinicians are encouraged to
study nutrition more comprehen-
sively in graduate school. Thank you
for another great publication.
ILISSA J.
Trigger Warnings
I loved the article “Trigger
■■
Warnings: Compassion or Coddling?”
(November/December) by Chris
Lyford. I deal daily with teens who
struggle with issues that potential-
ly bring up triggers due to past
issues. I enjoyed reading both sides
of the argument, but it still begs
the question: why are young adults
so much more "emotionally fragile"
than even a decade ago? Is there a
correlation between this issue and
an increased use of electronics and
social media? Or is it due to more
helicopter parenting than the older
generation experienced?
DEREK BARNEY
Apologizing Under Fire
■■Harriet Lerner’s “Apologizing
Under Fire” (November/December)
was an excellent article. It really
helped me learn more about how to
deal with criticism. A must-read for
even the seasoned therapist!
EUGENE B.
Tapping into Trauma
■■ I was happy to see David Feinstein’s
article “Teaching Couples to Tap”
(September/October). I’ve per-
sonally experienced the benefits of
tapping and find it to be an espe-
cially useful tool. I’m wondering if
Feinstein has ever used it to treat
sex addiction, either with individual
clients or as part of couples therapy.
If so, I’d be interested in hearing
about his experience.
PA M E L A E .
If you’d like to contribute, please keep
your letter to 250 words or less and
include your full name, city, and state.
Note that letters may be edited. Letters
may be emailed to letters@psychnetworker.org.
HAKOMI
MINDFUL SOMATIC PSYCHOTHERAPY
For over 35 years, Hakomi has integrated somatics
with the psychodynamic use of mindfulness within See our new book from
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This process creates an experiential route to Hakomi
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the unconscious “blueprints” and implicit memories
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Once conscious and directly experienced, hard-wired
psychological patterns are available to be powerfully
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reconsolidation, and the healing of attachment issues.
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The Hakomi Institute offers workshop and trainings
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A PRACTICAL GUIDE FOR UNDERSTANDING
AND WORKING WITH TRAUMATIC MEMORY
Best-selling author PETER
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Written for mental health care
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seven programs in the state of California
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Healing after the Election: What Therapists
and Their Minority Clients Are Saying
I
t was almost midnight when
Anita Mandley’s phone lit up
with yet another text message.
It was the seventh of her therapy
clients she’d heard from on elec-
tion night. Exhausted, she switched
off the small television in her bed-
room, crawled under the covers,
and turned out the lights. For
many people in Mandley’s Chicago
neighborhood, the unthinkable
was about to happen: by morn-
ing, Donald Trump would be
the president-elect.
Having spent more than 30
years working with trauma clients,
Mandley knew she was experienc-
ing some undeniable signs of trau-
ma herself. “As a woman of color,”
she recalls, “I was immobilized. My
heart felt like it was in my chest.”
She lives in one of Chicago’s blu-
est neighborhoods, along with
many Somali, Pakistani, Jewish, and
mixed-race families. That morning,
as she drove to work, just minutes
from Grant Park—where Barack
Obama had delivered his victory
speech nearly eight years ago—the
mood on the streets was suffocating-
ly eerie. “It felt like there’d been a
death,” Mandley says. “I kept think-
ing, what’s going to happen to my
block? My neighbors? How am I sup-
posed to help my clients find hope
when I can’t even find it myself?”
Since the election, therapists and
clients alike have been grappling
with the aftermath of what was argu-
ably one of the most contentious
and divisive races in modern his-
tory. Clinicians say it’s permeated
conversations in consulting rooms,
dredging up old traumas for some
and creating a slew of new problems
for others who couldn’t see eye to
eye with family members, friends,
coworkers, or even their spouses.
Both Republicans and Democrats
have been affected. According to the
American Psychological Association’s
Stress in America study, conduct-
ed in October, more than half of
American adults surveyed—55 per-
cent of Democrats and 59 percent
of Republicans—reported that the
election had been “a very or some-
what significant source of stress.”
But therapists like Mandley, who
work mainly with minorities, say their
clients have been disproportionately
affected by what’s been going on.
Since the election, the Southern
Poverty Law Center has recorded
more than four times the yearly aver-
age of hate crimes. According to
NAACP President Cornell Williams
Brooks, “The 2016 campaign has
regularized racism, standardized
anti-Semitism, de-exceptionalized
xenophobia, and mainstreamed
misogyny.” GLAAD announced
the creation of The Trump
Accountability Project, a catalog of
the president-elect’s anti-LGBTQ
statements and “other hateful rheto-
ric, discriminatory actions, and exclu-
sionary worldviews.” The Council
on American–Islamic Relations’
Government Affairs Director Robert
McCaw criticized several members
of Trump’s transition team, say-
ing they “demonstrate a troubling
acceptance of anti-Muslim bigotry,
conspiracy theories, and agenda-driven
policy proposals.”
A sense of mission resulting from
all this has helped jumpstart many
clinicians’ work in the therapy
room. “I needed a way to move out
of my contracted state,” Mandley
says. “And that meant getting to
work and being a compassionate
witness to my clients’ suffering.” In
PSYCHOTHERAPYNETWORKER.ORG
fact, Mandley’s first client the day
after the election was an undoc-
umented immigrant from Ireland
who as a child had been sexually
abused by neighbors. Since hear-
ing Trump’s hot mic comments on
the leaked Access Hollywood tape,
she’d been experiencing flashbacks
and nightmares. “There’s no jus-
tice,” the woman had sobbed. “With
Trump in office, there’s no safe
place for me now.” In that moment,
Mandley decided the best course
of action was a simple but impor-
tant one: creating an atmosphere of
safety through empathic presence.
“What you’re feeling is real and val-
id,” she told her client. “What does
it feel like to have someone sit with
you who gets what you’re going
through?” The woman nodded and
began to relax. “I couldn’t tell her
that everything was going to be
okay,” Mandley explains, “because
I don’t know that. But I could say,
‘I’m here with you, and I’m not
going anywhere.’”
Halfway across the country, thera-
pist Margie Nichols was dealing with
her own clients’ post-election cri-
ses. Since the late ’80s, she’d been
a fervent LGBTQ advocate in New
Jersey’s poor neighborhoods, man-
aging an overflow of AIDS patients
from New York’s beleaguered Gay
Men’s Health Crisis centers back
when, as she puts it, “there was pub-
lic talk about tattooing and quar-
antining gay people.” Nichols, who
mostly sees clients from the LGBTQ
community, says every single one
of them has expressed anxiety over
the election, but on a scale she says
is unprecedented in her 30 years of
practice. “The atmosphere of doom
has been really palpable for any-
body who comes to see me,” she
says. “They’re hypervigilant and on
guard. Trump is legitimizing hate
and bigotry in a way I haven’t seen
since the ’80s.”
Nichols says many of her trans-
gender clients have experienced
13 
 CONTINUED
setbacks since Trump’s election.
Before November, for example, an
older transgender woman she treats
had been planning to come out to
coworkers and her young son. But
after the election, she decided to put
her plans on hold, fearing Trump’s
win had cleared the way for anti-
trans discrimination. “I haven’t slept
since the election,” she told Nichols.
“I feel depressed in a way I haven’t
felt in years. I can’t escape the feel-
ing that everyone can see who I
am, and they hate me. I feel suicid-
al again.” Another transgender cli-
ent with a Republican father had
decided to skip his family’s annual
Thanksgiving celebration, explain-
ing that his father’s vote for Trump
felt like “a personal betrayal.”
Nichols is using a number of
interventions to help her LGBTQ
clients in these times. If they’ve
worked through initial self-care rou-
tines and feel prepared for more
active coping methods, she’ll role-
play encounters with Trump sup-
porters. In the case of the client
who skipped the Thanksgiving cel-
ebration, she’s helping him find
ways to connect with those who have
different views. “Being confronta-
tional isn’t going to help anything,”
Nichols says. “But if people can
offer some policy facts and explain
to someone why this is a scary
thing for them, they’re going to get
more empathy.”
Additionally, Nichols says a par-
ticularly effective remedy for post-
election anxiety is establishing a
sense of community by connecting
with like-minded people. There are
many outlets to choose from, she
explains, including joining march-
es, volunteering locally, or donating
money to organizations dedicat-
ed to change. Some of her clients
have even volunteered to walk fel-
low minority community members
home from the local train station
at night so they don’t feel unsafe.
“I try to go beyond just validating
14 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
and help people not only figure
out how to protect themselves, but
regain a sense of power and con-
trol,” Nichols says. “Ultimately, the
only antidote to feeling frightened
and helpless is feeling some sense
of agency.”
A few weeks after the election,
Nichols drove to a small, two-story
building on the outskirts of Jersey
City, the largest gay community
in the state. Inside, employees of
Hudson Pride, a transgender com-
munity organization, were busy plan-
ning a vigil for the Transgender Day
of Remembrance. They expected a
small crowd, maybe a dozen people
at most, but as time passed, some-
thing exceptional happened. More
and more people walked through
the door, until the cisgender attend-
ees nearly outnumbered the trans-
gender ones. Soon, more than 50
people were crammed into the front
lobby. “It brought tears to my eyes,”
Nichols recalls. “It’s really mean-
ingful to know there are allies who
support you. Just showing up can
provide a sense of safety. These days,
that’s what I’m trying to do in my
therapy work.”
For hours, the group, which includ-
ed many low-income people of color
from the neighborhood, talked and
laughed over dinner “as if they’d
known each other forever,” Nichols
recalls. Afterward, they filed into an
adjacent parking lot, held hands,
and lit candles. After a moment of
silence, they read aloud the names
of every transgender person killed in
hate crimes over the past year—87 in
all. “It’s a hell of a way to get unity,”
Nichols says with a sigh. “But I think
we’re going to be okay.”
Mainstream publications like USA
Today and The Boston Globe have lik-
ened post-election anxiety to post-
traumatic stress disorder, the latter
dubbing it “a new kind of grief.”
And given the heightened sense
of anxiety, shock, and helplessness
being reported among Clinton sup-
porters, especially in minority com-
munities, it’s easy to see why some
experts agree. But while there’s
overlap in symptoms, and trau-
ma survivors are certainly prone
to retraumatization after the elec-
tion, many clinicians emphasize the
importance of recognizing when
their clients are catastrophizing.
“Sometimes our clients’ con-
cerns aren’t realistic,” says thera-
pist Stephen Holland, a specialist
in mood and anxiety disorders. “We
shouldn’t invalidate their concerns,
and we shouldn’t tell them every-
thing is going to be okay either,”
he says. “But we have to do some
reality checking.” A gay client who
came to see Holland after the elec-
tion, for instance, was particular-
ly agitated, fearing Trump might
order the deportation of all homo-
sexuals. “Has anybody actually sug-
gested that?” Holland asked the
man. “People may be deport-
ed, and Trump may be no fan of
gay rights, but gay people aren’t
going anywhere.”
So what’s the best pathway to heal-
ing? For many of his clients, Holland
says, it’s rebuilding relationships
damaged during the election. After
all, contrary to the opinion of many
Clinton supporters, most people
who voted for Trump didn’t do so
out of bigotry, Nichols says. Seeking
to understand Trump supporters’
concerns—and seeking understand-
ing in return—should be the top
priority, she argues, adding, “We still
want them as allies.”
The real grief of this election,
adds Connecticut therapist Elaine
Ducharme, is that so many peo-
ple say they’ve lost someone they
loved. “At the end of the day, if we
can remember that as a country
we share a lot of commonalities,
maybe it’ll help us come together
and shape politics in a healthier
way,” she says. Of course, some cli-
ents continue to work through the
grief of Hillary Clinton’s loss. As

Mandley points out, “There’s no
Hallmark sympathy card for when
Donald Trump becomes president.
There’s no wake, and there’s no
shiva.” But slowly, many therapists
say their clients are beginning to
rebound, employing self-care, keep-
ing things in perspective, and when
possible, doing what they can to
stay vigilant. “Everybody’s coming
up with their own version of what
they need to do,” says Nichols. “In a
month or two, we’ll be seeing a lot
less anxiety and a lot more activity.”
Several days after the election,
Mandley held a session with one of her
quieter female clients, a young black
woman who’s a sexual assault survivor.
“You must be worried,” Mandley said
to her. “I say good,” her client chuck-
led in response. Before the election,
she went on to explain, rampant big-
otry was seldom acknowledged by
many Americans. Now that it had
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been brought to the surface, she felt
motivated to be more of an activist. solutions for
Soon afterward, she joined the online
community group Pantsuit Nation— complex
named after Hillary Clinton’s affin-
ity for the outfit—where she was able
problems.
to connect with other trauma sur-
vivors, trade stories, and eventually
network with local organizations ded-
icated to policy change. “There was
a point in my life where I couldn’t
fight back,” the woman told Mandley.
“Not anymore.”
Mandley recalls this session fond-
ly, calling it a turning point in
her client’s healing and her own.
“There’s energy in them,” she says
of her minority clients. “What’s my
Useful to
job? They already have the answers both therapists
inside of them,” she explains. “I’m and clients!
just welcoming the unfolding of
parts that can stand up and fight.
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•
 Psychotherapy s ’ BY
WI L L IA M

Pilgrimage
D O H E RT Y

SHAPING THE CONSCIOUSNESS

OF OUR TIME
L
ike many people who entered
the field in the late 1970s and
early ’80s, when the therapy
profession was in an expansive
phase, I grew up profession-
ally reading the Psychotherapy
Networker. We Boomers were surfers
riding a big cultural wave, which
took psychotherapy off the couch
and made it into a force shaping
the zeitgeist. Along the way, the
Networker’s goal was to capture the
collective adventure of understand-
ing human experience from fresh
angles and offer up-close and per-
sonal reporting on what it was like
for practitioners to try out the range
of the novel and often emotionally
intense methods being generated by
a field filled with creative ferment.
In the Networker, I could count on
regularly hearing the voice of my fel-
low adventurers who were facing the
same challenges I was, who shared
my intellectual curiosity and sense
of being on a quest for the authentic
and the true.
What follows is my take on the
last 40 years of psychotherapy, inev-
itably reflected through both the
prism of my personal biases and the
attitudes common within my gen-
eration of therapists. But beyond
describing my own experience, it’s
an attempt to offer the perspective
that time and reflection make pos-
sible about what I now see as the
intimate relationship between what
goes on within the seeming sanctu-
ary of therapists’ offices and the hur-
ly-burly of the wider culture.
nnnnn
As an idealistic Catholic boy grow-
ing up in Philly in the 1950s, I
saw just two pilgrim paths to the
consequential life I wanted to live:
become a priest and save souls, or
become a therapist and save minds.
After a stint in a seminary, where the
celibacy requirement and I had a
disagreement, I entered the therapy
field in the early ’70s, when the slow,
archaeological-dig approach of psy-
choanalysis was being challenged by
a new tribe of humanistic therapists
and encounter-group leaders, who
P H OTO © M I C H A E L H O U G H TO N P H OTO G R A P H Y/ G E T T Y I M A G E S
went for quick breakthroughs.
In those days, you could get grad-
uate course credit for doing an
encounter group that culminated
in a marathon overnight session to
break down our defenses and reveal
our true selves. I found my “true
self” late one night by telling some-
one asking for hugs all around that
I didn’t want to hug him. After he
responded with his “true hurt self,”
it was game on. By morning, we all
felt more enlightened—and superi-
or to people who had never encoun-
tered one another in this way.
The Gestalt therapy experiential
training groups I later joined were
more skillfully conducted. Through
enactments and open-chair work, we
learned to get unblocked and open
up our core emotions and desires. I
had one of those powerful moments
when I used the open chair to chal-
lenge, first cautiously and then loud-
ly, a father figure from my seminary
days, after which I felt a visceral
release from guilt and resentment.
We watched videos of Fritz Perl doing
sadistic-looking confrontations of
emotionally stuck clients whom he
called fakes and frauds. After first
responding with intellectualizations,
these clients would eventually get
angry and scream back at Perls—
who’d then turn gentle and say, “Now
you’re here with us.” Watching this
was ghastly but fascinating for those
of us familiar with unconditional
positive regard.
Sometimes I got up the courage
to try this stuff in my own work, and
it created some dramatic moments.
I recall inviting a pedantic husband
telling me how to run a couples ther-
apy session to continue his advice-
giving by standing up and delivering
a lecture on good therapy. When he
complied, I coached him on using
his gestures more forcefully to make
his points. After a moment or two,
he ran out of gas and sheepishly sat
down. My technique was right out of
the Gestalt therapy playbook, and I
felt proud of myself. Unfortunately, it
turned out to be our last session.
For many of us, this way of working
PSYCHOTHERAPYNETWORKER.ORG
was about more than individual and
group therapy: it was about social
change. We were challenging the
strictures of psychological oppres-
sion that infected society: rigidi-
ty, either/or thinking, conformity
rather than authenticity. Businesses
were experimenting with weekend
encounter groups to improve team
functioning. I even remember think-
ing that if we could just get every
member of Congress into a person-
al growth group, political enlight-
enment and social justice would be
right around the corner.
THE COMING OF THE
LIBERATED SELF
Eventually I (and lot of other thera-
pists) came to see these intense ther-
apeutic encounters as a kind of sugar
high, with a crash afterward—or at
least a return to baseline function-
ing. I also came to see the humanis-
tic psychology movement as having
lost its intellectual moorings with
the waning influence of people like
Carl Rogers and Rollo May. And I
saw it as not relational enough—
too much about the individual cli-
ent and not the extended emotional
web of the client’s connections to
others. In recent years, I’ve real-
ized that my dormant Catholic roots
had left me with a more collec-
tivist, less individualistic worldview,
which occasionally asserted itself
early in my career. Catholicism was
also not into quick breakthroughs,
but rather the long pilgrimage, with
many slips, falls, confessions, and
reconciliations along the way. Rinse
and repeat.
In forging an alternative to psy-
choanalysis, the humanistic thera-
py movement was offering a new
idea of the self in modern soci-
ety. Therapy movements are more
than a set of theories and tech-
niques—they’re about what it means
to be a human being at a particu-
lar time and in a particular culture.
Psychoanalysis had offered up the
idea of the Complex/Conflicted Self,
the psyche full of ambivalence and
contradiction. Successful therapy
19 
aimed to help people understand
and accept their basic needs and
desires, many of them socially unac-
ceptable, and integrate them in a
complex sense of being, never entire-
ly free of internal conflict, but com-
bining love and hate, attachment
and fear of engulfment, responsi-
bility and self-indulgence, insight
and self-delusion.
Despite what our therapy text-
books imply, ideas like this don’t
just spring purely out the heads
of founders of therapy models, or
just from distinct scientific break-
throughs. Social historians and writ-
ers like Adam Curtis, author of The
Century of the Self, have shown how
this conflicted Freudian Self fit with
the darkness of World War I and the
Great Depression, followed by the
horror of Nazi genocide. The era
between 1920, after Freud landed
on American shores, and the 1950s,
when psychoanalysis flowered among
cultural elites, was mostly a
time of survival and living
with limits. Indeed, James
Strachey, Freud’s transla-
tor and editor, wrote that
one of Freud’s enduring
themes was “the irredeem-
and the new therapies promised immediate
able antagonism between
the demands of instinct
change, which didn’t require years of archival
and the restrictions of civi-
lization.” Sometimes the
instincts won out.
Baby Boomers in the
Age of Aquarius wanted nothing to
do with this mindset. An unprece-
dented economic boom and a ris-
ing educated middle class set the
stage for the social revolutions of the
1960s. The world was being recre-
ated—and the new therapies prom-
ised immediate change, which didn’t
require years of archival work on the
human psyche. Social historian Jessica
Grogan, in her book on humanis-
tic psychology and the making of
the modern self, describes how psy-
chologists like Abraham Maslow both
instigated and responded to a hun-
ger in American culture for a more
positive understanding of human
growth and potential. What emerged
20 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
was a new image of the self—I’ll call
it the Authentic/Liberated Self. It
appealed to pent-up desires to be
self-determining, self-actualizing, indi-
viduated from overbearing families,
and not boxed in by expectations of
social conformity.
And boy, did we like self-deter-
mination! When I was in graduate
school, many of us hung posters in
our rooms of the Gestalt “prayer,”
penned by Fritz Perls:
I do my thing and you do your thing.
I am not in this world to live up to
your expectations.
And you are not in this world to live
up to mine.
You are you, and I am I.
And if by chance we find each other,
it’s beautiful.
If not, it can’t be helped.
I attended weddings where this
prayer was recited by the bride and
the groom. It was sometimes fol-
“The world was being recreated—
work on the human psyche.”
lowed by new vows, ending with “as
long as we both shall love.” Like
Dorothy, I knew I wasn’t in Kansas
(or in my case, seminary) any more.
While underlying conceptions of
the self loom far in the background
for most clinicians, they’re at the
heart of what shapes the way ther-
apists practice. For me, during the
1970s and early ’80s, when a cli-
ent would bring a conflict between
needs of the self and responsibili-
ties to others, I reflexively, at times
blindly, would side firmly with the
self. This would show up with cli-
ents making decisions during the
big divorce revolution. I used to rec-
ommend that clients considering
divorce think about four things: how
would leaving help you, what would
leaving cost you, how would stay-
ing help you, and what would stay-
ing cost you? In retrospect, this was
a classic cost–benefit analysis, which
left out any other stakeholders in
the decision. When clients intro-
duced concerns about their chil-
dren, I (and many other therapists)
reassuringly urged them to focus on
what they needed to do for them-
selves: the children would be fine if
the parents were fine.
I recall a client, Maureen, who had
four teenage children and an alco-
holic husband who was emotionally
checked-out but a good breadwin-
ner. She was unhappy in her mar-
riage, and her husband wouldn’t
work on his drinking problem.
Despite my urging her to focus on
the implications of her unmet needs
in the marriage, she decided to
stay until the last child left home,
because she wanted to launch the
children from a stable, economical-
ly sound family—and because she
thought her husband wouldn’t be a
competent single parent when the
children were with him. I accepted
her decision, but inside I felt she
was selling herself short, betraying
her authentic self. I now under-
stand that she was doing a complex
juggling of her personal needs and
parental responsibilities.
Some of my new perspective comes
from more decades of life experi-
ence, including 45 years of marriage
and seeing in my clinical practice
as many casualties as success stories
from decisions to leave marriages.
But at the time, my membership
in the Liberated Self club didn’t
allow me to validate Maureen’s
sense of moral responsibility as
a legitimate consideration in her
divorce decision.
THE FAMILY SYSTEMS
MOVEMENT
Around the time that therapists were
pulling back from the excesses of the
human potential movement of the
’70s, some of us began a love affair
with family therapy and systems the-
ory. This was the new road on my
pilgrim path. It turned out to be an
even more definitive break with staid
old psychoanalysis. First of all, fam-
ily therapy was grounded in cutting-
edge cybernetics, which eventually
brought the digital revolution, and
in general systems theory, challeng-
ing the field of biology. It was about
interdependence in the here and
now. The clinical dramas that pio-
neers like Salvador Minuchin, Carl
Whitaker, and Virginia Satir creat-
ed were breathtaking. Even though
nobody on the faculty in my gradu-
ate program was particularly into
family therapy, in the intellectually
fertile atmosphere of the field in the
mid-’70s, I could learn from going to
workshops, watching videos of these
masters, and reading the torrent of
literature that was being generated
by the family therapy movement.
For me and many others, being a
family therapist was a kind of awaken-
ing into a powerful and encompass-
ing worldview, complete with the hero
worship of charismatic gurus who
competed with one another for pri-
macy. And it was thrilling to share that
excitement with others during con-
ferences, like this magazine’s annual
Symposium, that regularly brought us
devoted followers together. Oh, how
we loved getting together!
The Networker initially established
its position among us with a series
of personality profiles that captured
both the thinking and personal
appeal of family therapy leaders,
who each had their own fan club.
I was a staunch member of the
Salvador Minuchin fan club (still
am, in fact). I’d learned how to do
family therapy from watching his
videos and reading his book Families
and Family Therapy—and here was
my hero profiled in a cover story by
the magazine’s editor that captured
the incandescence of his clinical
style doing a live demonstration:
“Standing in front of an audience
of 200 therapists, Minuchin, a com-
pact, dapper man with a
Latin accent as thick as
his black mustache, exud-
ed an air of brusque com-
mand at odds with the
traditionally pacifist cul-
ture of psychotherapy.
Heaven protect anyone
who stumbled through a
lame question or tried to
say a kind word about psy-
choanalysis. He seemed
to me the most confident
person I’d ever met, as if he had
been to the mountaintop, seen the
Truth and discovered he was It. Of
course, he was exactly the kind of
hero I was looking for. And when
he began to explain a clinical strat-
egy by quoting from a 16th-century
book called The Way of the Samurai,
any last reservations I may have had
completely disappeared.
“The centerpiece of the work-
shop was a live family therapy ses-
sion broadcast to the audience via
closed circuit TV. Once the inter-
view started, Minuchin’s intimidat-
ing aura dissolved and he became a
kind of therapeutic sleuth—patient,
respectful, infinitely curious, fre-
PSYCHOTHERAPYNETWORKER.ORG
quently playful, surprisingly gentle,
but above all, utterly focused on
figuring out the puzzle of what was
maintaining the problem the fam-
ily was trying to resolve. Sometimes
Minuchin leaned back in his chair
and took long drags on his cigarette
as he questioned the family—a poor
black single mother and her three
young children—about their pre-
senting problem: the eight-year-old
boy’s disobedience and school dif-
ficulties. Hyperalert to the family’s
every gesture, every pause, every
shift of mood, he seemed to drink in
information through all his pores as
he pursued his inquiry.
“Toward the end of the session,
Minuchin asked the defiant eight-
year-old to stand up, explaining, “I’m
still trying to figure out what makes
you so powerful.” The boy smiled
slyly as he rose to his feet, clearly
delighted to take part in whatever
game this curious man was devis-
ing. After speaking with the boy for
a while and complimenting him on
how strong and healthy he looked,
Minuchin asked the mother to stand
up. As she did, towering over her
small child, Minuchin asked, “Where
has he got the idea that he’s so pow-
erful? He’s just a little kid who has
somehow convinced you that he’s
much older than he really is.
“It was, I learned later, one of
Minuchin’s favorite gambits, but as I
watched it unfold, I was stunned by
both the power and the sweetness of
the moment. Both mother and son
were smiling, basking in the atten-
tion they were receiving, coming
more fully to life as if renewed by
the prospect of order being restored
in the family. And later, as the moth-
er, with Minuchin’s gentle persis-
tent coaching, was finally able to
lay down some simple rules in the
session with a newfound authority in
her voice, there was no doubt that
she and her family had recorded a
small victory in that room.”
Minuchin’s example even freed
up my inner theater director. In
my first job working with teens
21 
and their families, I’d get on the
floor to draw nearer to someone in
the family, playfully turn kids’ seats
to face the wall if they wouldn’t
stop interrupting people, alterna-
tively being affectionate and tough,
admiring and sometimes even a
bit harsh. I recall a widowed moth-
er and her 15-year-old daughter,
Jessie. Six months after the death
of her husband, the mother was
starting a new social life
by going to community
dances, and Jessie wasn’t
happy about it. In fact,
Jessie would yell and curse
at her, and refused to stay
home alone if she knew
her mother was going to
a dance. So the placat-
ing mother took her to
the dance one night, dur-
down our defenses and reveal our ‘true selves.’ ”
ing which the girl made
a public scene while pull-
ing her mother away from a male
dance partner. The mother was
upset and befuddled, the daughter
overly defiant.
During the first family therapy ses-
sion, Jessie wouldn’t let me speak
directly to her mother; she interrupt-
ed continually and told her mother
it was ridiculous to be talking with
a shrink. Clearly, she was having a
serious grief response to the death
of her father, and an anxious attach-
ment reaction when her mother
tried to connect with any other
man. Sensing that she was thorough-
ly in charge of her mother at this
point, and that this power scared
her, I channeled my inner Minuchin
and asked the mother how she felt
about her daughter interrupting
and talking to her so disrespectful-
ly. The mother acknowledged that
she hated it, whereupon Jessie esca-
lated her verbal attacks—“You’re
stupid! You don’t know what you’re
talking about!”
I decided that the one bound-
ary I could be in charge of was
around my relationship with the
mother. So I told her I wanted to
have a conversation with her even
if Jessie interrupted, and I asked
22 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
if she’d be willing to maintain ver-
bal and eye contact with me no
matter what Jessie did or said. (I’d
learned in a bit of theater train-
ing that it’s possible to keep a
quiet conversation going despite
a lot of distracting noise if you
maintain eye contact.) She agreed,
and we began an exchange about
her concerns around getting out
socially and Jessie’s reaction, which
“You could get graduate credit for
doing an encounter group that culminated in
a marathon overnight session to break
became almost comical because
Jessie kept up a steady flow of
critical commentary.
Finally, Jessie stood up dramati-
cally between me and her moth-
er to block our view of each other.
When I looked to either side, she
stretched out her arms that way.
I somehow relaxed with the dra-
ma of the moment, calmly saying,
“I can’t see through teenage girls,
but fortunately my voice can trav-
el around them.” So the mother
and I kept talking, and Jessie finally
gave up, looking defeated but not
upset. I ended the session by say-
ing that Jessie was doing her best
to protect her mother from mak-
ing a mistake by moving on too fast
from the death of her husband, and
that it was the mother’s job to take
Jessie’s concern into account and
then make her own decision about
resuming a social life.
When I saw them a month later,
everything had shifted. Jessie was
friendly in the session and being
a normal teen at home. Mom had
gone to a couple of dances, and
they’d had some good conversa-
tions (their first) about how hard
it was to lose a father and hus-
band. What Jessie now had was a
confident mother. Of course, there
could’ve been other appropriate
therapeutic ways to help Jessie and
her mother, but this structural fam-
ily therapy approach worked by
lancing a boil so that they could
move on and heal together. It all
made me even more convinced
of the deep wisdom of structural
family therapy.
PSYCHOTHERAPY FALLS
FROM GRACE
All too soon, this blissful era of
enchantment ended. The optimistic,
even messianic, spirit of the 1970s
gave way in the ’80s to an awareness
of the dark side of family life (abuse,
secrets, sexism) and how societal
oppression could be enacted in the
therapy room. Incest in particular
was a game changer, both as a sym-
bol of male domination and a hor-
rible pathology that therapists had
ignored since the time of Freud. (In
my early training, I was told that if
I ever saw a single case of incest in
my career, that would be remark-
able.) The “pass” that therapy had
somehow received from social fer-
ment about gender (and race and
sexual orientation) expired in the
mid-’80s. Erstwhile, gurus were now
accused of being patriarchs, and the
Networker documented the upheav-
al. Searching articles by therapists
like Virginia Goldner questioned
whether, rather than transforming
therapeutic practice, feminism had
merely been co-opted and defanged:
“I’ve sometimes wondered this
year whether feminism has become
our newest fashion, replacing epis-
temology as a high-status subject
for competitive family therapists to
claim as their own. I’m pleased,
as any outsider wanting to ‘get in’
would be, since epistemology, with
only a few exceptions, has been a
turf owned by men. But now that
everyone is declaring themselves a
feminist, I can’t help being con-
cerned that the critical edge which
is feminism’s essential attribute has
been blunted by quick success.
“This wouldn’t be an unusual out-
come. Taming a dangerous idea by
claiming it as one’s own is a time-
honored political strategy, and I do
believe that feminism is dangerous
to family therapy. One of the most
effective tactics I’ve seen for disarm-
ing this subversive point of view is
a simple one—transforming femi-
nist commentary from a threatening
critique into a banal who-could-dis-
agree, piece of liberal cant.”
At first I followed the critiques of
the therapy field with wounded inter-
est. I hated the attacks on my therapy
P H OTO © M A N U E L L I T RA N / CO N T R I B U TO R
masters (I hadn’t noticed that they
were mainly white men like me), and
I worried that therapy was becoming
“politicized.” But I came to realize
that my field, and my own practice,
weren’t immune to the patholo-
gies and power imbalances
of society. I’d accepted tradi-
tional gender roles, ignored
racial injustice as a therapy
issue, and embraced a systems
view of domes-
tic violence that
ignored the fact
that injuries and
fear were usually
one-sided.
The only path
of integrity was
to agree that my
beloved profes-
sion sometimes
caused harm,
both to margin-
alized clients and also to the
fabric of society—and that we
had to change. Chastened by
the vehemence of some of the
critiques, I hoped our well-
intentioned profession would
make some collective head-
way toward a more socially
conscious psychotherapy.
But then, quite publicly and dra-
matically, the therapy field lost its
moorings, when we went from deni-
al to obsession, from constructive
critique to fearmongering. With
media celebrities like Oprah and
Sally Jessy Raphael now focusing
on the sexual abuse of children,
some therapists started finding it
everywhere. I recall colleagues say-
ing, with no research justification,
that 90 percent of women with buli-
mia had been sexually abused as
children. (Those who didn’t recall
abuse were encouraged to locate it
in their memories.) Daycare centers
were seen as rife with molestation
when questionable interview tactics
drew stories out of young children.
And influenced by the “satanic pan-
ic” occurring in the culture of the
early ’80s, therapists started report-
ing a plague of ritual abuse and even
PSYCHOTHERAPYNETWORKER.ORG
the sacrificial murders of babies in
forests and cult houses. Pushback
came from courts (which required
actual evidence that daycare teach-
ers were molesting children), and
the FBI (which couldn’t find the
cults or the missing babies).
As much as I regretted dismissing
sexual abuse earlier in my career, I
was now alarmed at the witch-hunt
mentality I saw around me. (A local
therapist started to carry a hand
gun because he feared the satanic
cult leaders would come for him.)
Thus, I welcomed the corrective of
Lawrence Wright’s blockbuster 1993
New Yorker article “Remembering
Satan,” and subsequent book with
the same title, which painstakingly
dissected how therapists absorbed
and then gave support for 1980s and
’90s cultural beliefs about cult sexu-
al abuse and even alien abductions,
often through questionable thera-
peutic practices that led to “recov-
ered memories,” which therapists
nearly always believed.
The lack of standards in the field,
Wright and others argued, had led
to “fads and malpractice.” This was
a powerful blow to therapists’ cred-
ibility: it’s one thing for therapists
to say that your mother messed you
up, but it’s entirely different to say
that she gave you up to a satan-
ic cult. The Networker, for its part,
weighed in with its own critique
in an issue entitled “Fallen from
Grace,” showing Icarus, the victim
of his own hubris, plummeting to
earth. As senior editor Katy Butler
put it, “Some therapists believed
every memory of satanic ritual abuse
as gospel, passed around their own
invented statistics, misused hypnosis,
overdiagnosed, and drew heavily on
self-help literature, autobiography,
and pop psychology.” In retrospect,
she concluded, the profession had
wound up feeding a broader cultur-
al fixation on victimhood.
I feel guilty today that I didn’t
speak out about it at the time. When
colleagues said that 90 percent of
women with bulimia were incest
victims, I didn’t ask for the evidence,
23 
 afraid that I was behind the times
and perhaps insensitive as a male
therapist to what women had expe-
rienced. But silently, I wasn’t buying
the moral panic of the time. So
when the field recovered its san-
ity, I vowed that I’d never again be
silent if I saw therapists go to either
extreme, ignoring or exaggerating
serious problems in our society.
Around that time, I received some
bracing lessons in the limits of ther-
apeutic miracles. I was working in
a family medicine setting and got a
call from a gastroenterology resident
asking me to see 25-year-old Jeanne
and her parents. Jeanne was at grave
risk because of her out-of-control
Crohn’s disease, and the resident
hoped that addressing her family
issues and drug problem would low-
er her stress level. When I met with
them in the first session of medi-
cal family therapy, Jeanne admitted
using cocaine and expressed little
“After the authors critiqued Reagan-era
economic individualism, they faulted
therapists for promoting something
parallel: expressive individualism.”
desire to quit. The parents admit-
ted to having given her a generous
amount of financial support, know-
ing that she probably used some of
it for drugs. Halfway through the
session, I asked the parents if they
wanted to keep subsidizing their
daughter’s drug use, even though
it was killing her. They both sat up
and said, “No!”—whereupon Jeanne
bolted out of her chair, screamed
that this was unfair, and threw her
can of Coke up to the ceiling, spray-
ing the room and everyone in it. She
then bolted out, slamming the door
behind her.
I calmly urged the parents to not
pursue her or apologize in any way,
24 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/FE BR U AR Y 2 01 7
and we continued to talk about
how they could stay in her life but
communicate that their drug sup-
port was over. About five minutes
later, Jeanne came back with apolo-
gies. She cleaned up the mess she’d
made and rejoined the conversa-
tion, acting like the adult she was.
I called the referring resident the
next morning to say that the session
was an important start but proba-
bly not stress-reducing in the short
run. In turn, the resident informed
me that Jeanne had just called to
say that the therapy wasn’t working
because it had increased her stress.
We had a few more sessions and
ended on an uncertain note, as it
wasn’t clear whether Jeanne had
stopped using drugs or found anoth-
er source of funding. My key learn-
ing from this case came six months
later, when I got a call from the
mother. She wanted to thank me
for my work because the past six
months, with Jeanne off drugs, had
been the best times they’d expe-
rienced with her since her child-
hood—and she also wanted to let
me know that Jeanne had died after
a flare-up of her Crohn’s disease.
I can’t recall ever having such
conflicted feelings about a thera-
py case. I’d assumed that success-
ful therapy improves lives and, in
the case of nonterminal medical
illness, extends them. But that day
I grew up a little as a therapist
and handed in my “miracle work-
er” badge, accepting with a more
mature awareness that even when
my clients and I work together well
and they move on to do their best,
some sad outcomes are out of any-
one’s control. Writing this now, it
seems embarrassingly obvious. But
it took Jeanne and her family to ram
home the lesson that therapy, even
activist family therapy, often has
mixed outcomes. Addictions resur-
face, depression fails to loosen its
grip, or the patient feels better but
dies anyway. Therapy is more about
the journey than the destination.
THE CONSUMER SELF
In addition to the sobering clini-
cal revelations I was having dur-
ing the 1980s, I had one especially
head-spinning intellectual epipha-
ny. In May 1985, I picked up a copy
of Habits of the Heart: Individualism
and Commitment in American Life, by
sociologist Robert Bellah and col-
leagues. As I read it in bed one night,
I felt the hair on my neck stand
up. After the authors offered a cri-
tique of Reagan-era economic indi-
vidualism, they went on
to fault psychotherapists
for promoting something
quite parallel: expressive
individualism, the primary
pursuit of fulfilling one’s
emotional needs, with the
expectation that if I take
care of me, others in my
life, as well as society itself,
will automatically benefit.
To highlight this idea, the
authors included an inter-
view with a therapist named Sheila,
whose religion she said was “Sheila-
ism.” The kicker for me was how
Sheila answered the question about
why she was committed to her chil-
dren. All she could say is that it was
her “thing” to be faithful to her chil-
dren—that she’d feel badly about
herself if she ever abandoned them.
The scary part was that I saw
myself in Sheila’s explanation that
her moral commitment to her chil-
dren was just in terms of what felt
right to do at this point in her life.
The point wasn’t that she lacked
fidelity to her children, but that she
couldn’t allow herself to articulate
any broader ethical values beyond
completely voluntary standards of
what feels good and authentic for
herself. Would I have done any bet-
ter at this point, with all my liberat-
ed rhetoric? I wasn’t sure.
Habits of the Heart was the defining
blow to my fantasy that my therapy
tribe was always on the side of the
angels. Not only had we ignored
social pathologies like sexism and
racism, but we were promoting an
image of the self that was a version
of trickle-down psychological eco-
nomics, a kissing cousin to what
conservatives were doing with the
economy. In my own practice, what
Bellah called “expressive individu-
alism” showed up in how I guid-
ed clients through decisions about
divorce, and in how I challenged
any client who uttered the s-word,
should—a sure sign of inauthenticity.
My life journey had led me from the
stifling communalism of my youth
to the excessive individualism of my
professional life. I knew I couldn’t
stay where I was, or go back, but
which way forward?
Fortunately, I wasn’t alone in my
discomfort. By the end of the ’80s,
the Authentic/Liberated Self was
due for reevaluation. Although it’d
been a powerful antidote to the post-
World War II era of button-down con-
formity, it now looked out of balance,
with too much self-absorption and
freedom to manipulate others, not
to mention ignorance of institution-
al forms of oppression. The broader
society itself was now mired in identi-
ty politics and a conservative backlash
against the liberationist movements
of the ’60s. Reagan’s election in 1980
ushered in 12 years of conservative
political leadership as political liber-
als struggled to find a way to replace
the now-defunct New Deal coalition.
Funding was slashed for the National
Institute of Mental Health. In this
environment of skepticism and
retrenchment, psychotherapy lost its
confidence as an expression of larg-
er human purposes. Multiculturalism
replaced feminism as the leading
edge of soul searching among thera-
pists, but it focused more on institu-
26 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
tional oppression and what therapists egory in the ’90s had moved from
were doing wrong than on ideas “runaway kids” to “throwaway kids.”
for what everyday therapists, most of Many were casualties of churning
them white and middle-class, could stepfamilies, in which they didn’t
do in their offices beyond being sen- get along with mom or dad’s new
sitive to cultural differences and the partner, and it came down to who
realities of oppression. It left
us with a call to consciousness,
but not a call to action or to a
new formulation of the self.
In the midst of psychothera-
py’s cultural purga-
tory, a new image of
the self was taking
hold in the wider
American culture:
the Consumer Self.
As documented
by Harvard social
historian Lizabeth
Cohen in her
book A Consumers’
Republic, the con-
sumer culture had
kicked into high gear after
World War II, when the
US government had asked
Americans to spend their
way out of the aftereffects of
the Great Depression. It was
augmented by the unprec-
edented economic boom of
that period, when so many
Americans moved into the mid- was going to be forced out. The
dle class. The psychologically self- partner brought resources, and the
absorbed Me Decade of the ’70s teen drained them.
morphed into the greed-is-good eco- I’ll never forget a depressed
nomic Me Decade of the ’80s, and 14-year old girl named Tobi, whose
continued its ascendance in the ’90s. middle-class parents wanted her to
More and more, I began to see be more communicative. The fam-
the language and attitudes of the ily had come to therapy because
new Consumer Self (homo economic- of issues with her younger brother,
us) in therapy. Clients who in ear- who had a brain disorder, but Tobi
lier times would’ve just said they soon became the focus of the par-
weren’t happy in their marriage ents’ concerns. In one session, the
were now adding something like, father described a family dinner
“This isn’t the deal I signed up for where he and his wife had asked
when I got married.” Therapists Tobi about her day. She’d respond-
began asking whether a marital ed (like a typical adolescent) with
problem was a “deal breaker” for a no information, whereupon they’d
client. Consumer images even start- angrily sent her to her room, say-
ed invading parenting. For exam- ing, “If that’s the attitude you’re
ple, the director of a local shelter going to have, you can eat by your-
and therapy center for runaway self.” Then, as Tobi sat silent on
youth, founded in the late ’60s, my couch, the father asked me a
told me that the biggest client cat- question that sent chills down my
P H OTO © BA R BA RA A L P E R / CO N T R I B U TO R
 spine: “How long do we have to
keep giving to this child before
we can expect to get something
in return?”
I’d never faced a moment like
this in my years as a family thera-
pist. I couldn’t decide whether to
string up the parents or scoop up
the girl, or both. Instead I took a
breath and addressed the parents
slowly and intensely, barely holding
“The ‘pass’ that therapy
had somehow received from social ferment
about gender (and race and sexual orientation)
expired in the mid-’80s.”
back a tremble in my voice. “She’s
your daughter,” I said. “You have to
keep giving and giving. What you
can expect back is respect and coop-
eration, but not openness with her
feelings, because that’s a free gift.”
As the parents took this in, I noticed
the girl sit up in her chair.
The father softened and said, “I
don’t know how to reach her.”
I responded gently, “I think you
both know how to reach her, and I
can help.”
Over the subsequent week, I chose
to process what had happened
not by pathologizing the parents
(tempting as it was), but by seeing
them as loving people caught up in
a consumer culture of parenting, in
which disappointments and frustra-
tions are processed via the lingua
franca of self-interest. I was ner-
vous about the next session, but the
tone was different from the start.
Tobi was bright and participating,
and the parents said how important
the last session had been to them.
Choking up a bit, I told them how
much I admired them for taking
in a pretty strong challenge from
me. This wasn’t a miracle cure—
together, they had a longer journey
to go—but the parents had backed
away from entitled consumer par-
enting, and Tobi was no longer the
center of their frustrated expecta-
tions for family harmony. In the
big scheme, however, this was just
a small moral victory in a culture
war increasingly being won by the
American marketplace of entitled
individualism, with psychotherapy
on the sidelines.
PSYCHOTHERAPY TURNS
INWARD
During the ’90s and the 2000s,
the psychotherapy profession, now
less sure of itself, went through
an economic upheaval that further
drained its creative energies and
set it up for a takeover by the medi-
cal model. Previously based on a
prosperous middle class and insur-
ers willing to pay for therapy on
demand, the economics of thera-
py had allowed for successful pri-
vate group practices and training
institutes, which were key sourc-
es of innovation. (Think of teams
and one-way mirrors.) Healthcare
spending began surging in the US
in 1980, when annual costs were
about $1,000, to almost $4,000 per
capita in 1995 (a far higher rate of
increase than in Europe). With fis-
cal and culturally conservative polit-
ical forces ascendant, mental health
costs were easy pickings. Facing the
trifecta of limited insurance pan-
els, the predominance of DSM-IV in
1994, and the requirement of “med-
ical necessity,” therapists hunkered
down as auxiliaries to the medical
industry. As the ’90s was decreed
The Decade of the Brain (by the
PSYCHOTHERAPYNETWORKER.ORG
first President Bush), many thera-
pists got the sense that the tide had
turned against talk therapy.
The Networker took rueful note
of this fundamental change in the
world of therapy. As Editor Rich
Simon noted, “Therapists played
the diagnosing game as if the clients
they saw suffered from ‘medical dis-
orders,’ treating them according to
the equally fictitious ‘medical neces-
sity,’ and by so doing, ther-
apists were admitted into
the medical club. The bar-
gain worked well enough
for many years, until man-
aged care threw a wrench
into the system by not only
limiting reimbursement
to specific diagnoses, but
also accepting as ‘medi-
cally necessary’ only those
diagnoses that could be
cured quickly.”
This leveraged takeover of men-
tal health treatment came through
a big push from Big Pharma and its
flock of advertising agencies and
complicit psychiatrists. We became
Prozac Nation after the much-bal-
lyhooed SSRIs were introduced via
much-publicized studies and big-
league marketing. Never mind that
subsequent studies would find that
the SSRIs, although safer, are no
better for depression than earli-
er drugs, that they’re not notably
effective for the kinds of mild and
moderate depression that thera-
pists (and primary care physicians)
most often treat, and that they
can be dangerous for kids. At this
point, all we could cling to was
the both/and recommendation of
some researchers: medication plus
talk therapy. But that’s expensive
for insurers.
Of course, therapists didn’t stop
producing new ideas and healing
practices in the ’90s and 2000s.
We rediscovered trauma as not just
the product of violence and war,
but as a widespread human experi-
ence. After the national trauma of
9/11, we got new insight into the
sources of human resilience. The
27 
neuroscience fields gave us new
insights into emotion, self-regula-
tion, and interpersonal attunement.
Along with our fellow Americans,
we discovered mindfulness as a way
to cope with an era of anxiety and
social media saturation. Attachment
theory, previously the province of
developmental psychology, proved
to be fruitful for treating intimate
bonds. Cognitive behavioral ther-
apy, with its strong research tradi-
tion, reached beyond depression
into new areas like substance abuse
and psychosis.
But for me, even with all these
gains, we lost something that had
inspired many therapists in the ear-
lier decades: attention to the larger
context and a sense that we could
make a difference outside the con-
sulting room. We became more
focused on individuals and couples,
losing sight of families, social net-
works, and communities. We con-
centrated on diagnosing discrete
disorders and treating specific con-
ditions. We lost sight of public men-
tal health and social conditions. We
got small and surrendered any pre-
tense that we offered the world a
vision of the healthy, fully function-
ing self beyond being symptom free.
We stopped claiming a place in the
big, contentious conversation that
every society must have about what
human flourishing should look like
at a particular time in history, and
how to promote it.
In other words, when we turned
inward toward economic survival
and a focus on the individual, we left
culture-shaping work to business
consultants, media celebrities, and
entrepreneurs, most of whom cel-
ebrated the Consumer Self, either
in the form of expressive individu-
alism (Oprah’s You go, girl!), or eco-
nomic individualism (the subtitle
of CEO Jack Welch’s book said it
all: Wisdom from the World’s Greatest
Business Leader). Meanwhile, a tsu-
nami of anger and social alienation
was forming offshore. It would soon
wash over the land, making our
turn inward seem claustrophobic.
28 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
THERAPY IN THE AGE OF
TRUMPISM
Donald Trump was elected presi-
dent while I was writing this article.
Like many therapists, I experienced
his election as a kick in the stomach
for the field of psychotherapy. In his
public persona, he’s the antithesis of
what we promote in our work. At a
cultural level, he’s the embodiment
of the empty Consumer Self. The
election laid bare the dysfunction of
so many of our institutions and the
frayed status of our social fabric. But
in a perversely ironic way, the move-
ment that Trump set in motion is
forcing the therapy community to
examine our own cultural role and
our underlying vision of the healthy
connection between self and society.
Almost 20 years ago, Robert
Putnam’s book Bowling Alone
described the gradual decline of
American voluntary social organi-
zations, civic groups, local political
activities, churches, and
sports leagues. A theme in
the media in the wake of
the recent election is that
this decline of social capi-
tal and a widespread sense
of alienation has gotten
worse. What we’ve seen is
the decline in real capital—
the interlaced phenome-
non of rust belt and rural
impoverishment—lost
jobs, lost unions, followed
by the hollowing out and board-
ing up of cities and towns (includ-
ing hinterland villages), which in
turn means the disappearance of
small-scale, locally owned stores and
restaurants that used to be busy
de facto social centers. Besides the
anger and fear for the future, all this
breeds a fierce sense of isolation and
emotional impoverishment.
In a recent address, New York Times
columnist David Brooks stated, “The
crisis of our moment is a crisis of
social isolation.” He went on to cite
statistics that show people trust their
neighbors less and have fewer close
friends and confidants than ever
before, and they experience loneli-
ness and depression at greater rates.
“They feel betrayed by institutions
and have lost the sense of dignity
they once achieved by doing humble
but fulfilling work,” he said. “That
code of dignity has been replaced
in America with a reality TV code
that says, ‘If you’re not making it
big, and if you’re not famous, then
you’re nothing.’ So you’ve got this
massive social isolation, this massive
sense of betrayal, and people want a
change. They’re completely realis-
tic about who Trump is, but they’re
willing to stomach it because they
feel threatened by the world order.”
Trump’s ascendancy revealed that
a large group of people feel that their
society is moving on without them,
that they’re not valued anymore,
that there’s nothing left for them.
They’re deeply alienated, and some
feel temporarily more powerful by
expressing or excusing expressions
of racism and xenophobia and sex-
ism. But Trump—with his rock-star
persona (whatever you may think of
his “music”), his ability to connect
emotionally with people, his achieve-
ment of wealth in the consumer
culture, his projection of at least
the appearance of raw power—has
brought them together into a move-
ment, given them a common pur-
pose, forming them into a focused
community, with, in their eyes, a real
moral and ethical point, which is
to “Make America Great Again,” or
at least to “Make America The Way
It Used To Be Again,” when they
themselves counted for something.
As Clare Malone of FiveThirtyEight.
com wrote about a crowd of Trump
 supporters, “Something inspiration-
al seems to be happening among
the assembled—a sense of collec-
tive identity being discovered.” And
all of this despite the fact that,
according to journalists who inter-
view Trump supporters, most don’t
take literally what the guy says he’ll
do. It’s enough that he’s given them
a voice.
It’s clear that multiculturalism
in the therapy field has missed
this white, working-class group, who
are particularly vulnerable because
their fall from grace has been so
precipitous. Unlike truly poor peo-
ple and people of color (who’ve
always been outliers in American
society), the Trump people did
count: they were part of respect-
able, respected, hard-working com-
munities, which saw themselves as
America’s backbone. So Trump tells
them they still count, that they’ve
been betrayed, that they’re part
“In today’s fragmented and polarized world,
the ideal of the Connected/Committed Self must
involve engagement with community.”
of a great all-American communi-
ty, dedicated to a great cause, and
should rise again. While it’s hard
to tolerate a lot of what they say
and do when they’re angry and
activated by Trump, there’s real
pain there, with a belief in a high-
er purpose. Nostalgia is homesick-
ness, grief for what’s been lost—or,
as many seem to believe, stolen—
in a world of globalization, immi-
gration, and affirmative action for
every group but their own, with
the federal government the chief
perpetrator and punisher. The
kindling was ready for Trump to
strike the match, and similar move-
ments are occurring in many of the
world’s democracies.
So you could argue that, inad-
vertently, Trump has issued a chal-
lenge to the therapy field, pointed
to a new direction therapists need
to take. His ascendency is a bugle
call that therapists must begin to
take seriously, so as to move beyond
focusing narrowly on individual
mental health problems when the
larger social glue is weakening.
At this time of fragmentation
and division, we need to recog-
nize that we’re in the glue business.
We know something about helping
people connect, about how to form
a healthy “we” out of self and oth-
er. We also know something about
how to depolarize conflict. But first
our society needs us to recover our
conviction and passionate inten-
sity as a profession, our belief that
we have something to offer beyond
symptom reduction, something that
embodies wisdom about what it
means to live a fulfilling, purpose-
ful life in healthy families and com-
munities. We need a new image of
the self to counteract the Consumer
Self of hyper-individualism, which,
because the individual alone is
impotent in a mass society, easily
falls prey to the tribal loyalties seen
in the Trump movement and its sib-
lings in other countries.
THE CONNECTED/
COMMITTED SELF
Fortunately, we’re moving past our
decades-long embrace of expres-
sive individualism toward a focus on
attachment and connection. This
shift can be seen in work as diverse
PSYCHOTHERAPYNETWORKER.ORG
as couples therapy (with its emphasis
on attachment bonds), trauma ther-
apy (with its emphasis on connec-
tion and community in the healing
process), mindfulness therapies (in
which self-attunement leads to attun-
ement with others), and interper-
sonal psychoanalysis (which attends
to current relationships as well as
past ones). New therapy masters
like Susan Johnson, John Gottman,
and Daniel Siegel teach that bonds
of connection can strengthen the
individual, rather than diminish or
threaten personal freedom. In a
world of centrifugal forces, where
politicians talk of building walls, our
field has a message of engagement
across differences. We’re evolving an
image of the self in which connection
is central.
But we need something more.
Although an emphasis on human
connections moves us past the
Authentic/Liberated Self, it can
easily be coopted by
the consumer culture.
Powerful advertising con-
stantly calls on our sense
of connection to sell us
things, as illustrated by
the classic Coke com-
mercial song “I’d Like to
Teach the World to Sing,”
which served as the per-
fect ending of the epic
TV series Mad Men, when
Don Draper, the emp-
ty-self protagonist, wedded the
advertising world to the human
potential movement.
As law professor Tim Wu points out
in his book The Attention Merchants,
consumer capitalism is the most
creative force in the contemporary
world, able to hijack any person-
al or collective ideal by turning it
into consumer desire, in this case
by encouraging us to feel entitled to
the best possible relationships that
require low maintenance and offer
high rewards. So the Connected
Self must have an ethical dimen-
sion. It must embrace commitment,
by which I mean sustained invest-
ments in something outside oneself,
29 
to relationships and causes that tran-
scend us, extend us, challenge us,
and require continual struggle to
balance and manage. It’s both feet
in, not a toe in the water. Dare I say
that commitments require sacrifice—
a dirty word in my training (forgive
me, Fritz Perls). This Connected/
Committed Self is an antidote to
the Consumer Self that honors no
past obligations unless they promise
future rewards.
The vision of the
Connected/Committed
Self as the underlying
foundation of therapy is
already becoming more
and more evident in the
therapy field. John and
Julie Gottman have begun
emphasizing the role of
commitment in couples
therapy. “Commitment,”
they write, “means believ-
ing (and acting on the belief) that
your relationship with this person
is completely your lifelong journey,
for better or for worse (meaning
that if it gets worse, you’ll both
work to improve it). It implies
cherishing and reinforcing your
partner’s positive qualities and cul-
tivating gratitude.” Michele Weiner-
Davis’s work has long emphasized
commitment in marriage, often
bucking the tide of expressive
individualism in the field. Steven
Hayes named his model Action and
Commitment Therapy, an approach
that helps clients access their deep-
est values about what it means to
embrace a flourishing life, and sup-
ports them in being committed
to live by those values.
Although attachment-based
approaches like Emotionally Focused
Therapy don’t use the term com-
mitment as a central concept, they
emphasize how secure attachment
creates the possibility of enduring
bonds of connection. Attachment
is impossible without a sense com-
mitment, which creates a safe space
for vulnerability. And attachment, in
turn, can lead to deeper commitment
and responsibility to repair the union
30 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
when it’s broken. As a folk marriage
counselor said in August Wilson’s
play Joe Turner’s Come and Gone, “You
can’t bind what don’t cling.”
The idea of the Connected/
Committed Self reflects an emerging
conceptual shift to seeing relation-
ships as part of the self, as inher-
ent in the very idea of the self—not
self in relationship, but the relation-
al self. This was a core principle of
“Trump’s ascendancy revealed that
there’s a large group of people who feel the society
is somehow moving on without them,
that they’re not valued anymore.”
family systems theory that got dilut-
ed when family therapy became just
one intervention among several to
treat DSM disorders. It’s at the heart
of interpersonal neurobiology and
attachment therapies. It resurrects
the premodern idea that the fully
separate self doesn’t exist—there’s
no I without we—but with a mod-
ern twist, which highlights both the
complexity and the agency of the
individual person and the embed-
dedness of this person in a web
of family, friends, and community.
Emphasis on commitment adds the
idea that long-term embeddedness
comes only when our closest rela-
tionships—and our relationships to
community—involve a strong dose of
ethical commitment.
New therapy ideas usually emerge
by rejecting what came before. But
I propose doing it differently this
time. Embracing the Connected/
Committed Self doesn’t mean that
we abandon the wisdom of thera-
py’s previous models of self; in fact,
we can claim the enduring wisdom
of Freud and humanistic psycholo-
gy. Starting with Freud’s two major
life tasks—love and work—we can
see our personal relationships and
our work not just as venues for the
Consumer Self (how much love am
I getting, and what’s in my pay-
check?), but as places where we
commit ourselves to people and to
meaningful tasks, and where our
lives become larger. Psychoanalysts
have also taught that we’re never
without ambivalence in our con-
nections and commitments. Even
though we’re always conflicted to
some extent, we press on.
Humanistic psychotherapy’s
enduring wisdom, for its part,
involves authenticity and personal
agency. Without these values, con-
nections are superficial and com-
mitments are externally driven
and soul-diminishing. But commit-
ment adds an underplayed element
in the Authentic/Liberated Self.
Therapists have often disparaged
commitments that create emotion-
al pain and struggle for the client:
difficult marriages that have multi-
ple stakeholders, work commitments
that strain one’s personal life, public
commitments that are easily framed
as distractions from doing the “real”
work of self-healing and self-care.
June, a senior family therapist
and social activist, once told me that
periodically, when she’d entered
therapy, she’d been encouraged to
see her social activism as a kind of
displacement of inner conflicts. So
she’d pull back from these com-
mitments while in therapy, only to
return again after therapy ended.
In retrospect, she resented how her
investments in a better world were
diminished in therapy that was oth-
erwise good and productive. And it
isn’t just June’s therapists. For the
most part, psychotherapy has split
the public world off from the per-
sonal world, with the consequence
that most of us don’t know how to
support our clients’ civic engage-
ment beyond its being a source
of social support for them. What
about healing the self and heal-
ing the world as twin processes,
with synergies as well as tensions
between them?
THE ROAD AHEAD
In today’s fragmented and polarized
world, the ideal of the Connected/
Committed Self must involve
engagement with community. The
link between personal healing and
giving to others who have suffered
has been well established in feminist-
informed therapies for many years,
as witnessed in Lisa Goodman’s work
with small groups of depressed, low-
income women who engage in col-
lective social-change projects as a
way to solidify and expand their
personal healing. Ramon Rojano’s
Community Family Therapy invites
those who’ve found their way above
water to receive leadership train-
ing in their communities. Jack Saul
engaged community resilience in
New York after 9/11 and more
P H OTO © B I L L W EC H T E R / ST R I N G E R
recently with the Liberian commu-
nity in Staten Island. Alcoholics
Anonymous has the 12th step of
sponsoring someone newer in recov-
ery. And of course the great religions
of the world got there a long time
before the advent of psychothera-
py: healing the self and healing the
world are deeply interconnected.
But the idea of clients as citizens of
larger communities, as contributors
to their larger world and not just as
receivers of social support, hasn’t
entered the mainstream of therapy. I
had a wakeup call on this some years
ago, when I was finishing up work
with a couple who’d found their way
back from an affair, chronic pain,
and struggles over stepfamily life.
I can’t recall how the information
came up, but I discovered that 20
years before, this couple had been
behind the creation of a major chil-
dren’s institution in our city. They’d
been sitting in their kitchen wishing
their children had an opportunity
(I’m keeping details light to protect
their privacy), and they decided that
it should be available for all the local
children. A dozen years later, with
lots of others on board, it happened.
I frequently took my own children to
participate in it. What struck me was
that despite working with this cou-
PSYCHOTHERAPYNETWORKER.ORG
ple for more than a year, I’d known
nothing about their commitment to
their community. It was deeply rele-
vant to who they were as individuals
and a couple, but it had remained
hidden from therapy because our
focus was on their personal world
and on how their near environment
(like work) affected them.
I’m sorry to say this experience
didn’t make me change how I’d work
with clients in the future. I couldn’t
see a way to bring a citizen dimen-
sion into therapy without “changing
the subject” when clients came to
sessions with personal concerns or
environmental stresses—this despite
the fact that in another part of
my career I’d been engaging fel-
low community members in social-
action projects. My therapist identity
was cut off from my civic-activist
identity. Therapy was about personal
and relational healing based on the
agendas clients brought, not about
having conversations about public
issues, unless those issues, like rac-
ism, were directly impinging on cli-
ents. And it certainly wasn’t about
how clients could make a difference
in the world.
A catchphrase of the feminist
movement was the idea that the per-
sonal is political. The election of
Donald Trump has led me to see the
connection between democracy and
therapy in a new light. Democracy,
as I’ve come to see it in my public
practice of community organizing,
is about collective agency, the abil-
ity of people to work together to
solve problems and have an impact
on their world. It’s only secondari-
ly about elections and government,
because without we-the-people hav-
ing a sense of joint efficacy, dem-
ocratic forms of government are
hollow and given to authoritarian-
ism and oligarchy. Democracy, in
John Dewey’s terms, is a way of life.
It’s about ordinary people deliber-
ating across differences and taking
responsibility for their future togeth-
er—before, during, and after elect-
ing their public officials.
C O N T I N U E D O N PA G E 6 7
31 
W
e all like certainty; we
like to think we know.
That’s as true in psycho-
therapy as in any other
field. We want to have
faith that our current
clinical approach is solid, that our
treatments work well, that our par-
ticular kind of presence in the room
Then, Now &
Tomorrow
Oral Histories of Psychotherapy
1978–2017
is healing to a client. And that may
be true—as far as we know.
But that’s the thing: we can
know only so much at any partic-
ular moment in time. The future
is the ultimate blank slate. We
have no way of knowing what vital
insight about emotional healing
we’ve missed thus far, or what new
approach might work better. The
story of psychotherapy is a chroni-
cle of this law of limited knowing—
and of the recurring appearance of
creative leaps that push us beyond
our established understandings. To
delve more deeply into our shape-
I L L U S T R AT I O N © N I C H O L A S W I LT O N
shifting history, we’ve interviewed
seven longtime leaders in a range
of clinical specialties, asking them
to tell the story of their particu-
lar realm as it's evolved over four
decades. These women and men
were there, working in the trench-
es of their fields while alert to new
possibilities. And so we asked them
about it—about the original set of
certitudes in their specialties, and
what and who challenged them over
the years, leading to the unfolding
of fresh ways of thinking about, and
doing, psychotherapy.
Change, of course, often breeds
resistance. So our storytellers don’t
flinch from describing the opposi-
tion that followed in the wake of
new therapeutic ideas as well as the
persistence and conviction of those
who fought for possibly more pow-
erful approaches. These oral his-
torians reveal the ways in which
our field has always been in fer-
PSYCHOTHERAPYNETWORKER.ORG
ment, powered by therapists who’ve
noticed overlooked problems or ele-
mental human needs that remained
unaddressed—and then have tried
to do something about it. While
we hear about exhilarating eureka
moments, our storytellers give equal
time to mistakes and misdirections.
In this way, we learn of the gritty, tri-
al-and-error work required
for meaningful new ideas
to get the field’s attention
and take hold.
The challenge each of
our oral historians has
faced has been finding a
way to operate in two plac-
es at once—both inside
the field as everyday cli-
nicians, and outside it as
critical thinkers, able to
pull back and train a wider
lens on the central ques-
tion: how can we best sup-
port emotional growth
and healing? These sto-
ries, at once social histo-
ry and memoir, attest to
how an openness to what
doesn’t work creates a space
for testing new ideas. This
steadfast self-questioning
is a big part of what makes
this field as vital as it is.
Finally, these oral histories push us
to ask ourselves: what might emerge
next in psychotherapy? Might there
be small refinements in our thera-
peutic approach, or even big leaps
of faith, that are worth exploring?
We can be sure that we have blind
spots in our operating assumptions
and methods, and plenty of alter-
native ways of serving as agents of
change and growth that haven’t
occurred to us. Not yet, anyway.
There’s always so much to reimag-
ine, to learn, and to do!
— Marian Sandmaier
33 
 BY B ESS E L VAN DER KOLK
Trauma
Retreats and Advances
Most people think the field of trau- pened after World War II, when the
ma treatment began around 1980, world quickly forgot the price that
when the diagnosis of post-traumat- we pay for sending young men (and
ic stress disorder (PTSD) was first now women) into combat. Yet all the
included in the DSM as a result of symptoms that we read about in the
a movement among Vietnam veter- newspaper—suicides, drug addic-
ans. But one could actually go back tions, family violence, homelessness,
well over a hundred years, to the and chronic unemployment—have
work of Charcot and Pierre Janet been well documented after every
at Salpêtrière in Paris. In fact, Janet war within modern memory, starting
in particular articulated most of the with the American Civil War.
relevant issues about trauma that are Nevertheless, in the 1980s, as a
being rediscovered today, such as get- result of the work of many people
ting stuck in reliving trauma, dissoci- like Charles Figley—a Marine vet
ating, and having trouble integrat- from Vietnam, who wrote a book
ing new experiences and going on called Trauma and Its Wake and
with one’s life. Janet primarily used started the International Society of
hypnosis with hospitalized trauma Traumatic Stress Studies—trauma
patients to help them put the experi- began to attract more and more
ence to rest, but his work was largely attention in mainstream psychiatry
eclipsed by that of Sigmund Freud, and psychology. Around that time,
in part because fully recognizing the Judith Herman and I began to study
devastating impact of trauma tends the relationship between borderline
to be too overwhelming for mental personality disorder and self-injuri-
health professionals and politicians ous behavior and early years of trau-
alike. For example, Freud and his ma and neglect at the hands of care-
mentor, Joseph Breuer, wrote some givers. However, in the early 1990s,
outstanding papers on the nature of just as had happened in 1902, 1917,
trauma in the 1890s, but they later and 1947, as the study of the trauma
repudiated them because suggesting movement began to gather steam,
the occurrence of incest in upstand- there came a backlash.
ing middle-class families in Vienna In this case, it came in the form of
was so disturbing to their colleagues. the false memory movement, which
Ever since, trauma has had a his- tried to discredit the stories of abuse
tory of cycling between being rec- that our clients told us by calling
ognized for the devastating, long- them the result of therapists’ system-
term role it can play in people’s atically implanting false memories in
lives and then going underground their minds. Much of this movement
in the face of resistance to that idea. was fueled by the Roman Catholic
The horror of trench warfare led to Church as it was facing innumerable
wide recognition of the symptoms charges of priests’ sexual abuse of
of shellshock during World War I, children, and by psychologists who
but in 1917 the British general staff could make a good living in foren-
put out an edict forbidding the mil- sic settings disputing the allegations
itary to use the word shellshock to by victims of sexual abuse. After the
describe the condition, because they suits against the church were settled,
assumed it would undermine the the false memory industry disap-
troops’ morale. The same thing hap- peared with it.
34 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
One of the results of the contro-
versy surrounding the false memory
backlash was that the trauma field
got bifurcated into two parallel areas
of development, with basically all the
research funding being directed to
the military and veterans. The other
area of research—child abuse and
neglect and women’s studies—was
underfunded and therefore unable
to garner enough high-quality stud-
ies to determine scientifically how
best to treat this population. As a
result, our field became one of pas-
sionate claims, but little solid scien-
tific evidence.
Nonetheless, some key develop-
ments (or, more precisely, in most
cases, rediscoveries) have advanced
trauma treatment. One has been the
recognition of the role that dissocia-
tion plays in the aftermath of trauma
and how, in various ways, treatment
must address the personality struc-
tures that can compete or alternate
with each other when someone is
traumatized. Another major advance
was the emergence of EMDR in the
1990s as the first approach that
showed that we didn’t need to rely
on drugs or the traditional talk-
ing cure to get traumatized people
to leave their traumatic memories
behind. Similarly, body psychothera-
pists have recognized that “the body
keeps the score” when it comes to
trauma and have revitalized bot-
tom-up approaches like Somatic
Experiencing, Hakomi, and senso-
rimotor psychotherapy to help shut-
down people get unstuck from the
fight/flight/freeze response.
Through neurofeedback, we’re
exploring the capacity to rewire
brains that are stuck in freeze and
terror, and our first published stud-
ies of this process show how trau-
matized children and adults can
learn to change how their brains
regulate themselves. We’ve rediscov-
ered that true change is best made
when the mind is open. Mindfulness
enables people to become atten-
tive to their body and can enable
them to feel safe. In fact, our NIMH-
funded research shows that it looks
as if yoga is more effective than any
medication for treating PTSD.
Being able to be mindful is a
necessary precondition for change.
Hypnotherapists have long known
that getting people into a trance
state can facilitate the integration
of trauma into their overall con-
sciousness. More recently, Internal
Family Systems and approaches that
use mind-altering drugs like MDMA
have demonstrated how to get peo-
ple into altered states of conscious-
ness where they can actually observe
themselves and develop a sense of
self-compassion that enables them to
integrate their dissociated self from
the past into in a calm state of mind
in the present.
While all this has been going on,
cognitive behavioral therapy (CBT)
has accumulated the most research
support, even though we know that
the whole cognitive part of the brain
shuts down when people are trauma-
tized, triggering the primitive sur-
vival part of the brain. So using CBT
with trauma is like telling somebody
with an amputated leg to take up
running. It can certainly give people
a sense of perspective on their cop-
ing options when they’re in the right
frame of mind, but it has limited val-
ue with severe trauma.
The most commonly used CBT
approach to trauma is exposure ther-
apy, which assumes that desensitizing
someone to something that used to
trigger them is the best way to help
them be less affected by their mem-
ories. The problem is that desensiti-
zation leads to a global lack of feel-
ings and engagement, so when you
get desensitized from your trauma,
you also get desensitized to joy, plea-
sure, engagement, and everything
else going on. Desensitizing people
shouldn’t be the goal of treatment:
rather, we should help traumatized
clients realize that Yes, this happened
to me years ago, but not today; today is a
different day, and I’m no longer the per-
son I was back then. That kind of inte-
gration involves a neural network
different from the neural network
of desensitization.
My hope for the field of trauma
treatment is that we learn how to
help people bring their imaginations
more fully to bear on their possibili-
ties. For example, I’m involved with
several theater programs for highly
at-risk kids so they get to experience
what it feels like to be somebody
other than the identity that they’ve
assumed. They can get the chance
to say, “Oh, this is what it feels like to
be a powerful general,” rather than
“Nobody likes me; everybody hates
me; I’m going to get hurt.”
I think theater and new tech-
niques, like neurofeedback, can
play an important role in calm-
ing the brain down and helping
it become organized and more in
touch with the body. In our culture,
we too often rely on swigging alco-
hol and taking drugs to make our-
BY
Couples
In Search of a Safe Haven
The first book to have an impact on
the field of couples therapy was The
Mirages of Marriage by Don Jackson
and William Lederer in 1968. Its
basic premise was that the problem
in distressed marriages was a failure
of the implicit quid pro quo contract
between partners when it comes to
transactions around the exchange
of rewards and positive feelings.
The therapy approaches at the time
focused on how to help people nego-
tiate these contracts with each other
from positions of self-interest, where
each person was really trying to get
the best deal for themselves as indi-
viduals. The role of the therapist was
to be a kind of super-negotiator and
problem-solver, the idea being that
negotiating the best deals for each
individual would result in the most
satisfying relationship. And to sweet-
PSYCHOTHERAPYNETWORKER.ORG
selves feel better. Perhaps the most
important contribution the therapy
world, including the field of trauma,
can make to the wider culture is to
give people greater access to their
innate self-regulatory systems—
the way that they move, breathe,
sing, interact with each other—
so they can discover their natural
resources to regulate themselves in
a different way, especially when life
gets challenging.
Bessel van der Kolk, MD, is the med-
ical director of The Trauma Center in
Boston, professor of psychiatry at Boston
University Medical School, and codirector
of the National Center for Child Traumatic
Stress Complex Trauma Network. His new-
est book is The Body Keeps the Score:
Mind, Brain, and Body in the Healing
of Trauma.
JOHN GOTTMAN
en things up, the authors encour-
aged couples to have “love days,” in
which they did especially thoughtful
things for one another.
Neil Jacobson and Gayla Margolin,
psychologists at the University
of Washington and University of
Southern California respective-
ly, were the ones who operational-
ized and researched this as a model
of couples therapy in which people
learned to be nicer to each other
through contingency contracts, com-
municating better, and improving
their conflict-resolution skills. But
this approach had a fundamental the-
oretical flaw. Game theory—brought
into psychology by Harold Kelley and
John Thibaut—suggests that the only
way you can get a really good con-
tract is to work together with mutual
trust. So each person needs to work
35 
not out of self-interest, but out of
mutual interest, where the sum of
the benefits is what the partners are
maximizing. Otherwise, it becomes
some sort of zero-sum game where
it’s a win–lose paradigm. That was
really the fundamental problem in
those early days of behavioral mari-
tal therapy, the notion that you could
work from positions of self-interest
and still get a loving contract that
really helps both people. It turns
out that most of the time, peo-
ple will sabotage that kind of a
contract because it feels like
an unacceptable compro-
mise. And not surprisingly,
when Jacobson analyzed the
results of this approach to
behavioral marital therapy,
he found very small effect
sizes and huge relapse rates.
The idea that transformed
couples therapy emerged
from attachment theory and
the belief that what’s needed in
marriage isn’t better contracts, but
looking at marriage for a safe hav-
en. That’s largely the contribution
of Susan Johnson and Emotionally
Focused Couples Therapy, which
expanded John Bowlby’s idea about
infants needing a secure base from
which to explore their environment.
Essentially, Johnson said that is what’s
often missing in couples relationships,
and she designed an approach to heal
attachment injuries through extend-
ing Rogerian concepts of expressing
emotions and paraphrasing and vali-
dating those emotions.
Beyond that, her big paradigm
shift was bringing emotion into cou-
ples therapy. Before her, influential
therapists like Murray Bowen had
insisted that emotions got in the way
of therapy. He famously said, “I don’t
want to know what you feel; I want to
know what you think.” The core con-
cept in his theory of psychological
differentiation was that at the high-
est level of development you could
control your emotions with your rea-
son. But then Johnson comes along
and says, “No, that’s wrong: you real-
ly have to express emotions and vali-
36 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
date them. Carl Rogers needs to be
brought into the couples arena.”
So by focusing on emotion and the
safe haven, Johnson wound up cre-
ating a revolution in couples ther-
apy. And even though she wasn’t
directly talking about trust, it’s essen-
tial in creating a safe haven, as is
“By focusing
on emotion and
the safe haven,
Sue Johnson wound up
creating a revolution
in couples
therapy.”
building commitment. The foremost
researcher on commitment has been
a woman named Caryl Rusbult, who
came from social psychology, not
from the psychotherapy tradition.
Her 30-year research program is the
only approach that’s ever been able
to predict sexual infidelity success-
fully. All other research on sexual
infidelity asks people to reconstruct
from memory what happened before
the act of betrayal occurred, but
Rusbult can actually predict which
couples will be sexually unfaithful.
She concluded that the basic ele-
ment of betrayal is the tendency for
partners to make negative compari-
sons. So when things get tough in a
relationship, like you have an argu-
ment or your partner is emotionally
distant, if you start to think, I can do
better with someone else, you’re nega-
tively comparing your partner to real
or imagined alternatives. She found
that when that happens, you’re going
to invest less and less in the relation-
ship and give yourself permission to
cross boundaries and start relation-
ships with other people. That’s where
commitment comes in. People don’t
recognize the enduring importance
of a relationship very deeply if they
have only a conditional investment in
it. If you’re not really building grati-
tude by cherishing what you have with
your partner, but instead are building
resentment for what’s missing, you’re
likelier to engage in an act of betrayal.
What the latest research from my
lab is telling us is that trust and
commitment are both the key
ingredients for being in love
with your partner for a life-
time, and for having your mar-
riage be a safe haven. These
are the ingredients for not
just loving your partner, but
being in love with your partner.
And here the work of Helen
Fisher is important. Fisher stud-
ies people who are in love. When
she puts them in the functional
MRI tube and they look at the face
of the person they say they’re in love
with (versus a stranger’s face), their
entire pleasure center, the part of the
brain that secretes dopamine, lights
up. People used to say, “How long
can you be in love with somebody?
It’s got to have a shelf life of maybe
18 months.” Well, she’s found people
who are still in love with their partner
two decades after the wedding and
longer. Apparently, being in love can
last forever.
While Fisher’s work doesn’t focus
on the ingredients that make that
happen, I think future research is
going to show that it’s based on build-
ing both trust and commitment. And
we already have techniques now for
doing that in couples therapy. The key
element in making those techniques
work is paying more attention to the
moment-to-moment state of clients’
physiology. To do effective couples
therapy, people really have to be calm
when they talk to one another. And
so the focus on conflict that pervaded
couples therapy in its early years needs
to be supplemented by calm, everyday
emotional connection, where people
can really talk to one another and lis-
ten and work on friendship.
Another thing we need to do is devel-
op a system of shared meaning with-
in the couple that has an existential
base. When partners aren’t compro-
mising in their essential conflicts, it’s
because they feel as if the compromise
means giving up a core part of them-
selves. Therefore, we have to get at the
meaning of each person’s position in
the conflict to resolve the majority of
relationship conflicts. It’s also neces-
sary to look at intentionally building
shared meaning to have a connection
that’s fulfilling and has some depth
to it. It comes down to having a sense
of shared purpose and meaning. For
many couples, that includes a religious
basis. William Doherty has been writ-
ing about this for decades.
Last, we need to look at the research
that shows how unsuccessful most sex
therapy is at evoking anything but
the smallest changes. We’ve learned
recently from a remarkable study—
described in a book called The Normal
Bar, which looked at 70,000 people’s
sex lives in 24 countries—that the peo-
ple who have a great sex life are doing
about a dozen concrete things differ-
ently from those whose sex life sucks.
It’s the same everywhere—in China,
in Italy, in Canada, and in the United
States—everywhere on the planet.
The people who have a great sex life
are saying “I love you” every day and
meaning it. They’re kissing their part-
ner passionately. They’re expressing
affection in public. They’re cuddling.
Research shows that only six percent
of non-cuddlers have a great sex life.
If couples don’t cuddle, they don’t
secrete oxytocin, and their sex life isn’t
fulfilling. It’s not rocket science.
John Gottman, PhD, is cofounder with
Julie Schwartz Gottman of The Gottman
Institute. He’s renowned for his work on
marital stability and divorce prediction
and has authored or coauthored more
than 41 books. His most recent book with
Julie is The Man’s Guide to Women:
Scientifically Proven Secrets from
the “Love Lab” about What Women
Really Want.
BY
Systems Therapy
The Art of Creating Uncertainty
What became the family therapy
movement began in the 1950s with
a group of bright and curious indi-
viduals spread out across the coun-
try who were each fascinated in
their own way in figuring out how
families functioned. Initially, it
actually had something of an anti-
family attitude, emphasizing how
families create pathology in their
members, with Gregory Bateson and
his group developing the concept
of double-bind communication as a
way of understanding how families
can produce psychosis in children.
There was also Murray Bowen at the
National Institute of Mental Health
talking about people being swal-
lowed in the family’s undifferentiat-
ed ego mass. And there were others,
like Carl Whitaker, Virginia Satir,
and Nathan Ackerman. My own early
work at the Wiltwyck School for Boys
in New York looked at how the char-
acteristics of families of the slums
led to delinquency in children. It
was only as we began to attract stu-
dents who were interested in our
work that we each encountered the
need to conceptualize what we were
doing more clearly and develop a
coherent theory of practice that we
could teach.
In 1975, when I wrote Families and
Family Therapy, I thought that all ther-
apists needed to do to translate their
interest in understanding families
into becoming effective therapists
was to develop an alphabet of skills—
how to join with families, do enact-
ments, create boundaries, and so on.
I believed that the poetry of therapy
could be derived from this alphabet.
But as I got more experience training
therapists to use these techniques, it
became clear that the techniques by
themselves weren’t all that useful. It
was therapists themselves who were
PSYCHOTHERAPYNETWORKER.ORG
SA LVA D O R MINUC HIN
the instruments of change, and to be
effective, they had to recognize the
way they were part of the system and
the process in the therapy room, not
just a neutral observer.
Unfortunately, the university train-
ing programs of today have shifted
from a focus on the self of the thera-
pist to what’s become known as core
competencies. These competencies
are concerned primarily with how to
conceptualize cases and how to struc-
ture and engage in therapy sessions.
Several competencies refer to the
therapist’s awareness of the impact
that the family is having on him, but
overwhelmingly, trainees are expect-
ed to be thinking about what to do,
rather than about who they are in
the room with their clients. The best
way I’ve found to understand this
kind of self-awareness is to envision a
therapist with a homunculus on her
left shoulder, observing her mental
processes and engaged in silent dia-
logues with her as she works.
All therapists need a range of tools
to master their craft, but tools are
just that—a means to accomplish an
objective. When the carpenter begins
with a piece of wood, he has an end
goal in mind: to change that wood
into something else. The saw, chis-
el, hammer, and nail are a means of
transforming what the carpenter first
sees into what he wants it to become.
The effective family therapist also uses
tools as means to an end, not as ends
in themselves. The craft of family ther-
apy lies in how these tools are used to
produce a difference in the family—
a useful change. An enactment on
its own doesn’t move the family, but
a therapist who understands that the
enactment is a way to view the family’s
interaction can shift the process. So
the most important tool is the thera-
pist’s use of self in guiding the process
37 
of change—and understanding how
to use that tool is the biggest obstacle
for beginning therapists. Ultimately,
learning how to use the silent dia-
logue with the homunculus on one’s
shoulder is central to mastering the
craft of family therapy.
Besides my understanding of the
craft of therapy, the related ideas of
belonging and having multiple selves
became more and more important in
my work over the years. The systems
that you belong to—that give you a
sense of who you are and make you
feel accepted—are the entryway to the
experience of multiple identities. I see
this now so clearly, both in my work and
in my own life. I grew up in a Jewish
family in a small town in Argentina
that was a kind of shtetl where, up until
the age of 12, I didn’t know anybody
who wasn’t Jewish. Then at 18, I went
to medical school, and my world grew
larger. At 20, I was put in jail for three
months with a group of other students
for protesting against Perón, and my
concept of myself changed again: I
became an Argentinian Jew who was
committed to social justice. From then
on, I was a revolutionary and a fighter
for social justice, and it seemed natural
that I should join the Israeli army, in
which I served as a doctor during the
War for Independence. Later, when
I emigrated to the United States and
was on the staff at the Wiltwyck School
for Boys, I was a cultural outsider and
found myself identifying with the poor
black people around me as I learned
to speak English. And as I came to
feel that I belonged with the staff and
children and families at Wiltwyck, I
felt I expanded even more.
My idea that we’re all multiple
selves led me to develop a thera-
py of challenge, rather than one of
being gentle with people. My goal
as a therapist wasn’t to be cautious
and empathic, but to be an interve-
nor who creates uncertainty in clients
about who they were and are and
what they’re capable of becoming. I
wasn’t interested in their “true self”:
I wanted them to experience a series
of selves and the expansion of possi-
bility that can grow from that experi-
38 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
ence. Above all, I wanted them to rec-
ognize that there were more ways of
being than what their life experience
so far, whatever it was, had made
them aware of. What I did in therapy
was say to people, “You know, belong-
ing may give you a sense of security,
protection, harmony, but it also limits
you and creates an invisible pattern
of relationship that fools you into
believing it’s the only way of being.”
So when I look back on my life, I
see a sheltered Jewish child, a rebel-
lious young adult, a revolutionary,
a soldier, a stammering, helpless
BY MARY
Family Violence
Out of the Shadows
Just before I began graduate school
in 1974, the Child Abuse Prevention
and Treatment Act was enacted—
the first authorization of fed-
eral funds to improve the states’
response to physical abuse, neglect,
and sexual abuse in families. Before
then, in many states, if you sus-
pected a child or a woman was
the victim of domestic violence, it
was unclear whom you were sup-
posed to contact. In some places,
you actually called the Humane
Society or, more likely, the police.
The idea was, “Don’t get involved
in other people’s families. It’s too
messy.” Women and children were
still looked at as property. But by
the time I got my first job as a con-
tractual in-home therapist for the
Department of Children and Family
Services in Illinois in the late ’70s,
my agency was being inundated
with phone calls, and my supervi-
sor admitted to me, “We don’t know
what to do with all these cases.”
Back then, when professionals in
the child welfare world were just
beginning to consider the idea of
immigrant, and many, many, oth-
er things. At 95, I think of myself
as having journeyed through life as
many different people, and I think
of a line from Antonio Machado,
one of my favorite Spanish poets:
“The road is not the road; you make
the road by walking.” I hope in my
own walking I’ve cleared away some
debris for those who will follow.
Salvador Minuchin, MD, is a family thera-
pist, author, and teacher. He’s the developer
of Structural Family Therapy and is consid-
ered one of the founders of family therapy.
JO BAR R ETT
therapy for abuse and neglect, the
typical course of action was a “par-
entectomy”—taking children away
from their parents and putting
them in foster care, without ever
dealing with what had been going
on in the original family. That prac-
tice evolved into the idea of finding
the least restrictive environment
possible—meaning a placement,
usually with a family friend or rela-
tive, where children wouldn’t expe-
rience the removal from parents
as a punishment or an indication
that they’d done something wrong.
But in the mid-’80s, as it became
clearer how disruptive removing
children from their homes could
be, a family-preservation movement
emerged, devoted to keeping chil-
dren with their parents if possible.
It recognized that children not only
didn’t thrive in foster care, but were
often abused and neglected there
all over again.
A tenet of the family-preservation
movement was the goal of getting the
foster parents and biological parents
to work together. Much of that work
took place in the home, not in an
office or agency. The model empha-
sized keeping the biological parents
involved, rather than cutting them
off, and helping them stabilize and
learn new parenting skills. Working
with this population, I spent much
of my time in homes talking with par-
ents about the ordinary problems of
everyday life, discussing subjects like
nutrition and even helping them
clean out their refrigerators.
When I’d check in with my con-
sultant, Carl Whitaker, he’d remind
me how crucial it was to be in the
home at the times when a frustrated
parent might lunge at a misbehav-
ing child; such times would give me
opportunities to turn angry episodes
into teachable moments. One mom
and I would watch the soap opera
All My Children each week together
and talk about how the women in
an episode were being treated or
who she thought was a good moth-
er. The discussion always led to her
own life and how I could help
her change. Whitaker taught
me not to turn off the televi-
sion, but to utilize it within
my therapeutic work.
Of course, we know
that family violence
involves a web of fac-
tors that contribute to
the abuse. But in the
’70s and ’80s, many
feminists championed
a more linear view of
abuse, emphasizing
the role of male privi-
lege and patriarchy, and
the importance of separat-
ing perpetrators of violence
from their victims. I remem-
ber being in the middle of a
workshop on family violence, incest,
and domestic abuse in the early ’80s,
when I heard loud noises in the hall.
Some therapists were passing around
flyers, yelling that my approach in
seeking to help families stay togeth-
er was dangerous to women and chil-
dren—and that I was “in bed with
perpetrators.” At that time, very few
programs treated offenders of any
type, and virtually none integrated
individual and family therapy for
offenders as well as victims.
This was a time when incest and
child sexual abuse were still taboo
subjects. The conventional wisdom
was that they occurred only rarely.
Then we began to wake up. Diana
Russell, in her 1984 book Sexual
Exploitation, reported that 16 per-
cent of women had been sexually
abused by a relative before the age of
18, and 31 percent had had at least
one experience of sexual abuse by a
nonfamily member before that age.
Researcher David Finkelhor pub-
lished A Sourcebook on Child Sexual
Abuse soon after, reporting that near-
ly 20 percent of college woman and
nearly 9 percent of college men had
been sexually abused before the age
of 18 by someone they knew.
“The
conventional
wisdom at the time
was that incest and
child sexual abuse
occurred only
rarely.”
Around this time, Laura Davis
and Ellen Bass, a survivor and her
therapist, published The Courage to
Heal, addressing the question of
what sexually abused women need-
ed to do to recover. The book was
PSYCHOTHERAPYNETWORKER.ORG
a powerful call to action, urging
abuse victims to trust their instincts
about dark memories of childhood
abuse, confront their alleged abus-
ers, take pride in their identity as a
survivors, and find therapists to help
them recover memories of abuse
that were often shrouded in uncer-
tainty. The Courage to Heal gave many
people permission to speak about
something that had been previously
unspeakable, opening the door to a
public discussion of a previously off-
limits subject.
But while The Courage to Heal
empowered survivors to voice their
experiences, most therapists had lit-
tle to no training in addressing fam-
ily violence. So many of them floun-
dered in the dark with this new type
of client, inventing and adopting
techniques that weren’t grounded
in research or accepted therapeu-
tic practices. They rebirthed clients
on the floor of their offices, or
used hypnosis to retrieve memo-
ries. They sometimes coached
their clients to write angry
letters to their parents, or
to confront them in per-
son. The result was often
irresponsible therapy,
which cast the clients
as defenseless victims
and therapists as res-
cuers. Some thera-
pist even suggested
to clients that they
write letters to peo-
ple’s employers, warn-
ing them that a sexu-
al offender was in their
midst. And survivors were
sometimes encouraged to
inform their siblings that
they too must be repressing
incidents of abuse.
Then, with the advent of the
false memory movement of the ear-
ly ’90s, it all exploded. Groups of
parents whose children had con-
fronted them about child abuse
began to fight back. Many filed law-
suits against therapists for implant-
ing memories and turning their
children against them. Aggrieved
39 
parents and their supporters pro-
tested outside therapists’ offices.
They heckled speakers at confer-
ences where therapists were trying
to learn more effective ways to deal
with child sexual abuse. Instead of
recognizing how scared and threat-
ened accused parents were and find-
ing creative ways to include the fam-
ily in a healing process, frightened
therapists just began to tell clients,
“I don’t want to talk about your sex-
ual abuse history.”
This backlash undercut the devel-
opment of effective treatment
approaches to family violence. It
also discouraged clinicians from
including family members in ther-
apy, forcing them to shy away from
more inclusive, systemic approach-
es and focus narrowly on individ-
ual survivors and their trauma his-
tory. In my view, even today, one of
the biggest obstacles to the effective
treatment of family violence is fac-
ing the challenge of involving the
offender in treatment, as well as the
rest of the family. We must recog-
nize that abuse is more than a power
imbalance of parents over children
or men over women: it involves the
attachment wounds that underlie
acts of abuse and neglect, especially
the panic that comes from feeling
both powerless and disconnected in
an intimate relationship.
Family violence remains a nation-
al health problem that few thera-
pists have been trained to deal with
and, sadly, few of us want to address.
On a good day, it’s a messy, compli-
cated business, which doesn’t bring
much financial reward or profes-
sional status. We still haven’t found
a way to apply the emotional/spiri-
tual/neuropsychological approach-
es to healing that have been inte-
grated into our models of other
types of family issues. And we con-
tinue to neglect the child welfare
world—the parents who are reliv-
ing their own trauma through the
abuse and neglect of their own chil-
dren, not to mention the men and
women for whom being abused is
a daily experience. Underfunded
40 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
and undertrained, the clinicians
who work with these clients rarely
receive much attention.
Unfortunately, the new political
climate is likely to make the victims
of family violence feel even more
powerless, out of control, and deval-
ued. But though we started out in
the ’70s not knowing what to do with
these clients, we now have a lot more
knowledge of how to help them. All
we need is the will and commitment
BY JOHN
Psychopharmacology
The Jury Is Still Out
Even though lithium was around in
the late 1940s, psychopharmaceuti-
cals really began to reshape mental
health treatment in the 1950s, when
the first antidepressants, tranquiliz-
ers, and antipsychotic medications
were discovered, mostly through
attempts to treat other kinds of ill-
nesses and accidentally finding that
some drugs had an effect on psychi-
atric conditions. These meds were
light-years ahead of treatments that
had existed before, but they had a
lot of side effects, especially the tricy-
clics and MAO inhibitors, which were
really toxic if taken in overdoses. You
could take a handful of Elavil, for
example, and kill yourself.
The big breakthrough came in
1987, when Prozac, Paxil, and Zoloft
came on the market. The major fea-
ture of this new generation of anti-
depressants was that they weren’t
as toxic. You could take a bucket of
Prozac, and it wouldn’t kill you. You
might have the worst diarrhea of
your life, but pharmaceutical com-
panies didn’t have to worry about
being sued over people using their
product to commit suicide. In effect,
this led companies to push these
meds not just to psychiatrists, but to
to apply what we’ve learned to treat-
ing this vast and underserved treat-
ment population.
Mary Jo Barrett, MSW, is the founder
and director of the Center for Contextual
Change and adjunct faculty at University
of Chicago, SSA. She’s the coauthor
of Treating Complex Trauma: A
Relational Blueprint for Collaboration
and Change and The Systemic
Treatment of Incest.
PR ESTON
primary care doctors. So in the next
five years, the stats show a fourfold
increase in prescriptions for antide-
pressant medications from primary
care doctors.
That began a revolution that
changed the landscape of the men-
tal health field over the next three
decades. In 1998, 74 percent of
depressed clients were being treat-
ed with antidepressants, and 75
percent were being treated with
psychotherapy; but by 2016, 75 per-
cent of people receiving treatment
for depression were on meds, and
only 43 percent were in psychother-
apy. All this was happening at a time
when the psychotherapies for things
like depression and anxiety disor-
ders were getting better and better.
The pharmaceutical companies—
even though they didn’t have the
research to show that the drugs were
actually more effective than psycho-
therapy—watched Prozac become
one of the most popular drugs ever,
making billions of dollars, and they
realized they had a gold mine. Then
managed care and HMOs took
advantage of this, because sending
people to primary care doctors costs
them a lot less money than sending
people to psychiatrists. Not surpris-
ingly, however, studies show that
the outcomes for people treated for
depression by primary care physi-
cians are very poor. Furthermore,
most primary care doctors don’t
refer people for psychotherapy. So
while this is a cost-saving solution
for managed care, it hasn’t been
good for the overall quality of men-
tal health treatment and psycho-
therapists’ livelihoods. Today, about
85 percent of drug prescriptions for
anxiety and depression come from
primary care doctors.
The SSRIs were touted as user-
friendly drugs, but over time,
unwanted side effects have become
apparent. All the antidepressants
except Wellbutrin have significant
effects on serotonin and can cause
sexual side effects. About 25 to 30
percent of people on SSRIs com-
plain that while they maintain the
capacity to get aroused, they can’t
easily have an orgasm, which causes
many of them to stop taking the
medication. A side effect of tak-
ing SSRIs long-term that’s even
more concerning and hasn’t got-
ten enough attention is the blunting
of affect. It usually doesn’t happen
right away, and it’s so gradual that
sometimes people can’t tell what’s
happening until they wake up one
morning and say, “You know, I just
don’t feel good.”
Two things are going on here. One
is apathy, just not having a sense
of energy to get up and do stuff or
get excited about things. The other
is feeling emotionally numbed out.
This is underscored by an inability
to cry, which is obviously an impor-
tant and healthy human emotion.
In a New Zealand study, 24 percent
of the people who responded well
to an antidepressant with reduced
suicidal ideas and depressive symp-
toms said they felt numbed out, and
another 36 percent said they felt
severely blunted. In effect, more
than half were saying, “I’m grateful
I can get out of bed every morning,
but although I’m not going to kill
myself, I just don’t feel like myself.”
In the early ’90s, another major
wave of drugs became ascendant
among prescribers. These were the
second-generation or newer antipsy-
chotic medications. They were pop-
ular because they were much less
likely to cause severe problems like
tardive dyskinesia and Parkinsonian
symptoms, and they were especial-
ly good for treating schizophrenia
as well as acute mania. But over
time it emerged that at least half of
them could create metabolic symp-
toms, changes in blood glucose lev-
els, increased rates of diabetes, and
increased cholesterol and triglyc-
erides. It doesn’t happen within
weeks or months, but the long-term
increase in heart attacks and strokes
is a serious problem.
More recently, psychotherapists,
especially in Europe and Canada,
have made big strides in integrative
treatments, which include bright-
light therapy and circadian stabili-
zation, as some people now say that
mood disorders are in part a disor-
der of circadian rhythm. There’s also
been more interest in diet and nutri-
tional approaches, which include
taking folic acid and omega-3 fatty
acids, as well as exercise.
This comes at a time when evi-
dence is increasing that conditions
like panic disorder, OCD, gener-
alized anxiety, and social anxiety
are really chronic conditions that
don’t just get better over time:
they’re lifelong disorders that ebb
and flow. We have good drugs for
them, but when most people stop
taking them, the symptoms return.
Psychotherapeutic approaches,
especially CBT and exposure ther-
apy, show better outcomes, but
they require the client to do a lot
of homework and hang in with
exposure work that can be diffi-
cult. Still, the results for more than
80 percent of those who complete
treatment can be more or less per-
manent. Despite all this, psychia-
trists almost exclusively promote
the use of medications, while non-
medical practitioners typically advo-
cate treatments that don’t involve
PSYCHOTHERAPYNETWORKER.ORG
drugs. This is an ongoing polariza-
tion within the field.
Another issue that’s gone largely
unrecognized and will profoundly
affect the future of mental health
treatment is that fewer and fewer
medical students are signing up for
psychiatry as their specialty. Over
the last 20 years, their number has
dropped by 50 percent. Currently,
about half the psychiatrists in the
United States are over 60—which
means they’re on the cusp of retire-
ment—while more primary care
doctors are prescribing meds. Young
physicians, it seems, aren’t interest-
ed in going into psychiatry because
it doesn’t pay as much as other spe-
cialties, and all you’re doing is giv-
ing out pills. I know two psychiatrists
who started their career using medi-
cine and doing psychotherapy, but
now the only thing they get reim-
bursed for is handing out drugs.
As for new approaches in psycho-
pharmacology, a couple of inter-
esting developments are focusing
on finding neurochemical targets
in the brain that are different from
those used by current meds. The
drug that’s probably gotten the
most attention is the anesthetic ket-
amine, given in very low intravenous
doses. For some people, it seems
to have a remarkable, fast-acting
effect on extremely severe depres-
sion. It doesn’t target serotonin or
norepinephrine at all, the usual sus-
pects in drug treatment. Instead,
it targets the neurotransmitter glu-
tamate. Although the issue of side
effects, especially liver problems, is a
source of concern, people are excit-
ed about the prospect of finding the
holy grail for treating anxiety and
depressive disorders with a drug that
works within hours.
One last thing that’s looking prom-
ising is the recent finding that up to
a fifth of people who have chronic
or recurring depression may have
underlying chronic inflammation.
When they’re treated with large
doses of anti-inflammatories, the
depression goes away. This is abso-
lutely experimental, but I think the
41 
cutting edge of psychopharmacology
this year will be inflammation.
Ultimately, while psychiatric drugs
do save lives, the fact remains that
integrative treatment (psychother-
apy, lifestyle changes, exercise, and
sometimes medications) works best.
It behooves us to give our clients the
best we have to offer, which involves
much more than just offering pills to
temporarily relieve symptoms. While
the economics of mental healthcare
keep oversimplifying treatment and
BY
emphasizing the power of the magi-
cal pill, research continues to show
that the most effective approaches
pull out all the stops and tackle men-
tal illness on multiple levels.
John Preston, PsyD, ABPP, a professor at
Alliant International University, is a neu-
ropsychologist. He’s the author or coauthor
of 21 books on topics such as psychophar-
macology, neurobiology, and psychotherapy,
including Handbook of Clinical
Psychopharmacology for Therapists.
KE NNE TH HAR DY
shapers of the field, and then one
by one, she thanked them by name.
As images of one white male after
another loomed over the ballroom,
the extent of the overwhelming
gender imbalance among leader-
ship roles became more and more
apparent. So albeit in a somewhat
indirect way, the feminist critique
drew attention to racial privilege
as well.
During this period, there were
certain books that succeeded in
raising consciousness about social
issues within the field. Although
Monica McGoldrick’s groundbreak-
ing Ethnicity and Family Therapy
didn’t deal with race specifically, it
succeeded in adding ethnicity and

Race Matters culture to the list of contextual fac-

How Far Have We Come?
In the late 1970s, I was a black kid address issues of racial inequality
from Philadelphia enrolled in the and racism, even though by pointing
family therapy graduate program out how family therapy privileged
at Florida State, an institution that males, it also exposed the privilege
had graduated its first black grad enjoyed by white people. Just like
student only in the mid-’60s. I was women, people of color were mar-
the only black student in the pro- ginalized. Seeing how the field’s fem-
gram, and there were no black fac- inist leaders pushed boundaries and
ulty. Issues of race as a factor in peo- withstood the firestorm of criticism
ple’s lives rarely came up in class. If they received from the influential
I brought it up with my supervisors, men in the field was both inspiring
they responded, “If you want to be and a little frightening for therapists
a good clinician, just learn the rudi- of color. I remember thinking that if
ments of family therapy and then whites could so viciously attack each
apply them to whatever family you other over their differences about
see. Don’t make race a special issue.” gender issues, what would happen
The entire emphasis was about gen- to people of color who dared talk
eralized treatment methods without openly about race and racism.
paying attention to race, class, or One moment at an American
gender issues. Association of Marriage and Family
Then, through the early 1980s, the Therapists (AAMFT) national con-
feminist critique began to expose ference in 1984 stands out for me as
the rampant gender-based inequi- especially powerful. Feminist thera-
ties and sexism inherent in the field pist Marianne Walters, in her keynote
and the way family therapy perpetu- address, called attention to both the
ated mother-blaming in its explana- issues of sexism and racism by flash-
tion of family interactional patterns. ing on a big screen the pictures of all
It made what had been previous- the keynote speakers and members
ly invisible impossible to ignore. of the AAMFT board of directors.
Nevertheless, largely advanced by She began by saying that she wanted
white women, it didn’t directly to pay homage to the thinkers and
tors that should be considered when
working with families. Unlike the
feminist critique, the topic of eth-
nicity was easy for everyone to dis-
cuss, because it didn’t call attention
to structural inequities, power, and
privilege. Even more importantly,
Nancy Boyd Franklin’s book Black
Families in Therapy marked a crucial
milestone for the field by focusing
on the special challenges black fam-
ilies face in a racist society. And it
was practical to boot, providing tips
and tools for effectively engaging
and treating black families.
Nevertheless, it was still hard to
get material about race into academ-
ic journals because reviewers found
it too inflammatory. I remember
conference organizers discouraging
me from focusing directly on race
in my talks and strongly encourag-
ing me to instead use the less threat-
ening term multiculturalism. After
all, the major power brokers of the
field at the time were white: all the
editors of family therapy journals (a
fact that remains true today), all the
officers of the major family therapy
organizations, the plenary speakers,
the field’s most charismatic gurus.
For people of color, forcing a con-
versation about race seemed like
committing professional suicide. So
some of us took a more strategic
approach. I remember publishing

42 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/FE BR U AR Y 2 01 7
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a paper called “The Theoretical
Myth of Sameness: A Critical Issue
in Family Therapy Treatment and
Training” as a safe way to examine
the potentially explosive issue of race
in a more general discussion about
“sameness and difference.” I was
opening a door without sounding
too confrontational.
In the climate of the times, even
giving a workshop explicitly on
race and racism seemed like a
big step forward. One year,
I offered a session called
“Breaking the Silence”
that gave voice to the
sense of stifling frustra-
tion, deep disappoint-
ment, and race-related
pain that many people
of color felt unable to
workshop explicitly on
openly express to their
white colleagues. For
race and racism seemed
people in the minor-
ity community, it was
as close to an open act
of defiance as many of us
had come: no more walking
on eggshells regarding issues
of race, no more apologies for
acknowledging when and how we
saw racism in the field. For my own
part, I’d learned a lesson or two from
my feminist friends about the cour-
age it took to be outspoken about
“divisive issues,” and the importance
of taking good care of yourself in the
face of the inevitable pushback that
comes from pointing out differences
in power and privilege that are built
not only into society, but the mental
health profession as well.
Throughout the 1990s, my pro-
cess of becoming more transpar-
ent about the struggles of being a
black therapist in the field contin-
ued. I published an article in the
Networker called “War of the Worlds,”
in which I talked openly for the first
time about the compromises people
of color in the field have to make
to be deemed acceptable by their
white counterparts. To date, noth-
ing I’ve written for the Networker, or
any other publication, has generat-
ed more personal letters—strongly
44 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
supportive as well as scathingly criti-
cal—than this one. Then in 1996,
I gave a keynote at the Networker
Symposium. It was the first time
that a nonwhite clinician had deliv-
ered a major plenary address at a
“In the
climate of the
times, even giving a
like a big step
forward.”
national family therapy meeting of
such a size.
Pleased as I was to receive the
invitation, I also felt the tremen-
dous burden of responsibility as I
began my talk extemporaneously
by describing all the voices of black
people for whom I felt I was a rep-
resentative. It was a very emotion-
al experience for me. Designed to
engage the broadest possible audi-
ence, my theme was the sense of
“psychological homelessness” that
so many people of color struggle
with as they try to fit into different,
mutually exclusive worlds, leaving
them without a safe place, a true
home. Women, gays and lesbians,
immigrants, estranged daughters
and sons, and emotionally cut-off
parents could all relate to what I was
saying as a black person about the
depth of my need to feel safe, val-
ued, and connected to others. In
the years that followed, it was grati-
fying to start seeing other people of
color become more prominent at
those kinds of forums.
By the late ’90s, an increasing
number of training programs began
developing curricula that specifi-
cally addressed issues of race and
social justice. This was instrumen-
tal in attracting more trainees
of color to family therapy
programs. The Couple and
Family Therapy Program
at Drexel University in
Philadelphia has been
a leader in graduat-
ing a large number
of family therapists of
color. The Ackerman
Institute for the Family
in New York City
developed a minority
social-work program.
Monica McGoldrick’s
Multicultural Family
Institute in New Jersey
and Nancy Boyd Franklin’s
Psychology Program at
Rutgers University in New Jersey
have also produced a large group
of skilled therapists of color over
the years.
But while there’s been a posi-
tive shift in our awareness of race,
the discomfort and awkwardness
in addressing it is still prevalent.
Regardless of the venue or the par-
ticipants, conversations about race
are difficult to facilitate. People of
color fear being judged as race-
obsessed, angry, and hypersensitive.
And whites often fear being mis-
understood, perceived as a racist,
or saying something that will trig-
ger the anger of people of color.
For the most part, a fundamental
attitude of mutual mistrust under-
lies discussions of race between
blacks and whites, making mean-
ingful interactions across the great
divide of race hard to achieve. It
takes both will and skill to address
the issue of race, and even though
the will has generally increased, the
skill is still lagging behind.
 Over the years that I’ve been If ever there were a critical
facilitating these kinds of interac- moment for constructive and cou-
tions, I’ve realized that the most rageous conversations about race,
successful ones must start with the power, and privilege in our practic-
soul work of seeing, being, and doing. es, communities, and the broader
Seeing is about our increasing abil- society, this is it. Personally, I feel
ity to recognize how much the col- affirmed in the credo that whatev-
or of our skin defines our day-to-day er our training or orientation, our
experience. The next step is being work as clinicians should ultimate-
able to engage in a process of self- ly be devoted to healing the world,
awareness about what it means to even if it means addressing that
be white or a person of color and huge task in 50-minute intervals at
what role we choose to play in a time.
addressing the racial inequities we
see around us. The final step is, Kenneth Hardy, PhD, is director of the
of course, the most difficult—to Eikenberg Institute for Relationships and
actively engage in doing something professor of marriage and family therapy at
about them. Drexel University.
BY DA NI E L S IEGEL
Neuroscience and
Therapy
The Craft of Rewiring the Brain
In 1978, when the Psychotherapy cognitive science, anthropology, soci-
Networker was born, I was just begin- ology—that might advance the craft
ning medical school. Back then, of psychotherapy.
little was known about the work- At that time, we were taught that
ings of the living, dynamic brain, the brain was fully formed by adult-
but by the mid-’80s, technology in hood. But if this were true, what in
the form of CAT scans and MRIs the world could we do as psycho-
enabled us to see some aspects of therapists that might lead to last-
neural structure and function inside ing changes in our clients’ brains?
our previously opaque skull. Still, The orthodox teaching in neuro-
as I started my training, first in biology also asserted that certain
pediatrics and then in adult, ado- regions “gave rise” to specific men-
lescent, and child psychiatry, I strug- tal functions, like memory, mood,
gled to find a way to combine my and language. If this were true, then
fascination with science with what a malfunctioning mind was due to
I was learning as a psychotherapy dysfunction in a particular region—
student. What I sampled from the and short of giving a pill, what
smorgasbord of therapeutic modali- could a therapist do to improve that
ties—from family and couples ther- region’s functioning? Luckily, these
apy to psychodynamic methods and two axioms would soon be over-
cognitive-behavioral approaches— thrown, as we learned that the brain
seemed to inhabit a world separate responds to experience throughout
from important developments in the the lifespan by changing its function
broader scientific community—in and structure, and that you could
fields like neurobiology, child devel- look to the connections of regions—
opment, evolutionary psychology, and grow those connections—to
PSYCHOTHERAPYNETWORKER.ORG
understand how to move clients
from dysfunction to function, even
in adulthood.
But yet another obstacle was get-
ting in the way of our recognizing
the fresh possibilities that were open-
ing up. We still believed in some-
thing Hippocrates had asserted 2,500
years ago: the “mind is what the
brain does.” Could our mental lives—
our emotions, thoughts, memories,
and meaning-making narratives—be
nothing more than simply neurons
firing off in our head? If our mind was
only a brain, we were left with a self-
contained, single-skull view of mental
life—which implied that our relation-
ship with others, all the richness of
human connection, was superfluous
to mental functioning. Deep down,
unsupported by much scientific evi-
dence to the contrary, many thera-
pists sensed that this simply couldn’t
be the whole story of the mind.
Then came the 1990s—“The
Decade of the Brain,” as dubbed
by President George H. W. Bush—
which brought us a new perspective
on the brain as self-renewing, with
capacities to rewire itself in response
to changing circumstances. This
went well beyond old assumptions
about our innate, hardwired limita-
tions. New findings about neuroplas-
ticity took us beyond anecdotes and
metaphors and vague theories into a
more measurable science of human
nature, incorporating both the bio-
logical and the personal.
For me, one of the first steps in
a new, science-based view of psy-
chotherapy came with the work on
attachment theory by people like
John Bowlby, Mary Ainsworth, and
Mary Main. Together, the differ-
ent threads of their work not only
showed how early experiences shape
our personalities, but in a finding
with vast implications for psychother-
apy, revealed the central importance
of a coherent narrative in people’s
grasp of their own lives. Mary Main
showed how if adults could cre-
ate reflective, coherent, and emo-
tionally rich narratives about their
C O N T I N U E D O N PA G E 6 8
45 
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I
n 1978, The Family Schtick—a little
newsletter intended to connect
and coordinate the scattered
tribe of family therapists in the
Washington, DC area—made its
debut. A few years later, when
it was renamed The Family Therapy
Networker and became a full-fledged
magazine, it was still pretty humble,
Turns IN THE

as magazines go: 38 pages cover-to-

cover, black-and-white illustrations
(some distinctly, um, amateurish),
on clearly economical low-gloss
paper. But even so, there was some-
thing even then about the magazine
that fundamentally distinguished it
from virtually all other psychology
Highlights from the
and psychotherapy journals—and
has unto the present day.
In what academic journal, for
Networker Journey
example, could you find thera-
pists describing their own fears
and fascinations, triumphs and
failures, as they work with par-
ticular clients? Where else
would you read how it feels to
witness a real psychological
breakthrough in a client, or
to stumble into a clinical blun-
der—and then figure out, on
the fly, how to repair it, perhaps
even deviating from standard
clinical practice? What jour-
nal article could describe times
when the therapist’s own per-
sonal life story makes itself uncom-
O is co
fortably felt in the presence of a September/October 2013

client with a particular, resonating

issue? In this sense, the readers of
the Networker are much like an entire
crowd of flies on the wall, listening
and watching in perfect anonymity
as individual therapists, much like
THE
Selling
themselves, give their all for their cli-
ents and never stop worrying about
Psyc
whether or not they’ve done enough.
Such stories from the point of view
of the individual therapist—curious,
enlightening, often moving, some-
times thrilling—have always been the
lifeblood of our magazine.
From the beginning, we’ve consid-
ered our writers—no less than our
readers—part of the community, the
Networker tribe, the extended family,
or maybe even a very large group

48 PSYCHOTHERAPY NETWORKER
 therapy collective. In fact, the edi-
tor–writer relationship sometimes
bears more than a passing resem-
blance to the therapist–client rela-
tionship, as the first-time writer—an
accomplished, self-confident clinical
expert in his or her other life—sud-
denly discovers just how unexpect-
edly difficult, not to say miserable, it
is to put words to paper in a coher-
ent, interesting, readable way. It is,
to put it as delicately as possible, a
process between editor and writer,
one not always free of sharp differ-
ences of opinion and hurt feelings.
But in the overwhelming majority
of cases, not only has the process
resulted in fine work, but the result-
ing article has been a revelation to
the author, who uncovers—just as
in good therapy—valuable insights
about the way he or she works and
thinks that can now be handed over
to readers.
In addition, the Networker has always
done, as interestingly as possible, its
official duty to follow closely various
new approaches, advances, and per-
spectives in the field—paradoxical
therapies, narrative therapies, brief
solution-focused therapies, mind-
body therapies, trauma therapies,
attachment-centered therapies, neu-
robiologically informed therapies,
to name a few. And we’ve cov-
ered our share of brilliant,
ming so0n!
new instant-cure methods
See page 42
$6.00 U.S./$6.00 Canada
that eventually proved not
quite so brilliant and instan-
taneous, after all. But that’s
what happens when you
g OF
make an effort to let a thou-
sand flowers bloom in your
ychotherapy
What are the
magazine—some are bound
to be weeds.
rules in today’s
consumer-driven
market? Just as valuable, and often
more immediately compel-
ling, were the sometimes bit-
ter controversies we covered
that periodically roiled the
field, perhaps none as rancorous as
the so-called “false memory” debate,
in which therapists were widely
accused of implanting entirely bogus
memories of childhood abuse in
their clients’ minds. That most ther-
apists did no such thing made little
difference at a time (mid-’90s) when
therapy’s reputation was at some-
thing of a low point—as therapists
were accused en masse of purvey-
ing simplistic, feel-good solutions to
life’s complexities, coddling whiners
and malcontents, and generally cre-
ating a culture of victimology. But
the field recovered nicely, perhaps
helped by our contributors’ shining
an honest light on the field’s foibles
and missteps, as well as its triumphs.
Even when their opinions seemed
irreverent, sometimes widely unpop-
ular, they broadened perspectives by
encouraging important debates.
Over the past 40 years, it’s become
very obvious—if it was ever truly in
doubt—that the supposedly sacro-
sanct boundary between the private
space of the consulting room and
the larger outside world is a myth.
All clients, all therapists, bring into
every therapy session their experi-
ence of race, ethnicity, culture, class,
gender, and sexual orientation—
and the way those identities are per-
ceived by the world at large. From
the beginning, Networker writers have
sought to explore how these socially
constructed identities affect the way
both clients and therapists experi-
ence themselves, their relationships,
and their interaction in the therapy
room. Similarly, taking its cue from
the family therapy movement’s capa-
cious view of human “systems,” we’ve
taken into account not just the cli-
ent’s personal psychology (family
therapy’s pioneering theorists could,
it’s true, be a little dismissive of
as retrograde an idea as individu-
al selfhood), but also the intergen-
erational family constellation, the
community, and the society in which
all clients are embedded.
Thus, it was perfectly within the
mandate of this magazine to include
searching articles about the traumat-
ic impact of war on military vets, the
unexpected prevalence of domes-
tic violence, the role of poverty in
defining family life, the vast destruc-
tive power of the AIDs epidemic
(and the popular homophobia that
PSYCHOTHERAPYNETWORKER.ORG
made it worse), the changing roles
of men and women in society, the
“second family” of teen culture that
threatened to entirely supplant fami-
ly authority, and of course, the digital
revolution, which, even now, seems
to be fundamentally transforming
culture in a way the old geezers
(including many of us!) could never
have dreamed. One day, a thousand
years from now—should the human
race survive—maybe humanoids will
pick up ancient, preserved copies
of the Networker to decipher the
astonishing, marvelous, and perfect-
ly terrible rules, conventions, and
folkways surrounding the cusp of
the 21st century.
Meanwhile, back in our own lit-
tle corner of the known universe,
the process of making this maga-
zine goes on pretty much as it always
has, barring some amazingly useful
technical changes (no more hauling
huge layout sheets across town to the
printer!). Certainly, we owe much of
our evolution over the past four
decades, to our large, often frac-
tious, but ultimately mutually com-
mitted and, for the most part, loving
and loyal family of subscribers. As
in all families, we have our quarrels,
and from time to time, certain fam-
ily members get mad and go off in a
huff (often making their grievance
known in Letters to the Editor). But
that’s all to the good. We may be a
tribe, a clan, a family, but we’re a
family comprising many thousands
of distinct voices, rugged individu-
alists every one—though, of course,
individualists who are always, or
almost always, wise, empathic, com-
passionate, and attuned to the feel-
ings of other people. We are, after
all, therapists.
And with that, we extend to you
an assortment of Networker high-
lights from our archives that show-
case what we consider to be at the
heart of what we do. The following
are excerpts from much longer arti-
cles. We’ve posted the full versions
on our website and in the digital edi-
tion of this issue on our app.
— Mary Sykes Wylie
49 
 PERSONALITIES
SEPTEMBER/OCTOBER 1985
Take It or Leave It
The Therapy of Carl Whitaker
Carl Whitaker was family therapy’s master of the absurd. This Networker profile
described him in action demonstrating his belief that the unsocialized inner world
of fantasy and impulse is a source of creativity to be defended against society’s
abnormal normality.
Cal Whitaker is being
crazy again. At a week-
long summer workshop,
he’s set aside one morn-
ing to be interviewed
alongside a 24-year-old
man, once diagnosed
as schizophrenic, whose
family Whitaker saw in
therapy for five years.
With hands clasped tightly in his
lap, Eric, his rail-thin former patient,
addresses the floor as he’s questioned
by a therapist chosen from the work-
shop audience. Asked about his strug-
gle to support himself and separate
from his family, Eric explains that
“adaption is a horrible word” to him
and insists that his inability to hold a
job is a result of his refusal to accept
his various employers’ shady ethics.
Whitaker, who has earlier described
schizophrenia as a “disease of patho-
logical integrity,” announces to the
therapist that “Eric is the me that
I wished had happened.” Turning
to the young man, Whitaker says,
“I want to talk to you about the sac-
rifice you’re making in fighting so
intently for your growth.” He begins
to muse about his own isolated ado-
lescence and his belief that he was
a schizophrenic throughout high
school. “But I became a trickster
and social robot in order to make
my way in society,” says Whitaker. “I
am very admiring of you for having
To read the full articles in this section, visit our website.
50 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
& PROFILES
the kind of guts I didn’t have.”
The young man, who has been
sitting on the edge of his chair as
if expecting some gigantic foot to
descend suddenly and squash him,
begins to fidget, offering a modest
protest to his distinguished admir-
er’s praise. “Please don’t . . . ” he
begins, groping for the right word.
“Idolize you?” ways Whitaker. The
young man nods his head warily, still
mesmerized by the carpet.
It’s the kind of odd encoun-
ter Carl Whitaker has become
renowned for over the past 40 years.
As Lynn Hoffman put it in her book
Foundations of Family Therapy, he “spe-
cializes in pushing the unthinkable
to the edge of the unimaginable.”
During his long career, he’s out-
“Whitaker specializes
in pushing the unthinkable to the
edge of the unimaginable.”
raged and fascinated the world of
therapy with his belief that what he
calls “craziness,” the inner world of
fantasy and unsocialized impulse, is
a source of creativity and selfhood to
be resolutely defended against civili-
zation’s abnormal normality. Guided
by an unrelenting confidence in his
own craziness, Whitaker has chal-
lenged all the rules and conventions
of therapy. At various stages of his
career he’s bottle-fed his patients,
arm-wrestled with them, refused to
allow them to talk, even fallen asleep
on them. All this in the interests of
righting a balance he believes soci-
ety has upset, allowing people to
acknowledge the unacceptable twists
of their inner life, to find some way
to hold onto their craziness without
“getting their throat cut.”
Whitaker’s colleagues haven’t
always shared his confidence in his
own intuition. As one senior fam-
ily therapist says, “I don’t think
there’s anything curative in having
an encounter with a crazy man.” But
Atlanta psychiatrist Thomas Malone,
who spent 20 years in close collabo-
ration with Whitaker, believes that
such criticism is inevitable. “Carl is
about as right brain as you can get,”
says Malone. “In a goal-oriented,
left-brain culture, he’s an oddity. But
you can’t make judgements about
Whitaker from the context of the left
brain. That would be like a grammar-
ian doing an analysis of James Joyce.”
Today, the 73-year-old Whitaker
is still someone whose work elicits
extreme reactions, but he’s become
such a beloved, grandfatherly figure
that it’s a bit jarring to hear about
him once being denounced as a
dangerous figure.
— Richard Simon
SEPTEMBER/OCTOBER 1987
Good-Bye Paradox,
Hello Invariant Prescription
Palazzoli and the Family Game
After Italian psychiatrist Mara Selvini Palazzoli became celebrated for her work with
therapeutic paradox in the 1970s, she stunned the family therapy world with an
even more flamboyant intervention—the invariant prescription.
Parents mildly cha-
grined at their rebel-
lious teenagers, cou-
ples vaguely aware
of something miss-
ing in their marriage,
families who think it
would be a nice idea
to learn how to com-
municate better—
steer clear. Milan’s Nuovo Centro per
lo Studio della Famiglia is not for you.
This isn’t a center for your run-of-
the-mill family problems; it’s for the
cases most therapists would consider
impossible, like that of the Santinis.
It’s hard to imagine that Mr. and
Mrs. Santini, both sourly avoiding
each other’s gaze right now, ever
cared very much for each other.
Nevertheless, they’ve stayed married
for over 30 years, even though most
of the time they live in separate
residences. Of their five children,
two are former heroin addicts and
a third, 19-year-old Rudolpho, has
had auditory hallucinations for the
past year and insists his older sister
speaks to him through the TV set.
In their first session, 60-year-old Mr.
Santini accused 20-year-old Paolo,
a handsome university student, of
sleeping with the family maid. It was
soon revealed, however, that it was
actually Mr. Santini who was sleeping
with her. Mrs. Santini is now threat-
ening to get a divorce. After the sec-
ond session, Paolo called the Center
to report that his brother Rudolpho
had propositioned him and told
him, “I want to have your baby.”
It’s now the middle of the third ses-
sion and the family’s therapist, Mara
Selvini Palazzoli, a small woman with
an enormous, electric smile, is keep-
ing up an almost constant barrage
of what she calls “terrible questions,”
her method for quickly penetrating
to the family’s emotional core. She’s
asked Mrs. Santini why her husband
cheated on her in her own home,
inquired of Paolo whether he thinks
Rudolpho’s homosexual proposition
“To deal with help-seekers who
resist help, we must be change agents who
argue against change.”
was a message to his mother or to his
father, and requested Rudolpho’s
help in understanding why his father
sleeps with maids. Meanwhile, the
Santinis sit, almost motionless, as if
mesmerized. Despite Palazzoli’s pro-
vocative questioning, they appear
fascinated by what’s going on, as
fascinated with Palazzoli as she is
with them. Whatever terrible things
she may be asking, her rapt atten-
tion, her expansive gestures, and
that blazing smile keep saying to the
family, “However uncomfortable this
may make you, you can trust me.
Nothing you can say will throw me
off.” But there’s more than that—
a kind of delight she takes in the
whole process.
Readers who associate Palazzoli
with Paradox and Counterparadox, the
PSYCHOTHERAPYNETWORKER.ORG
celebrated book she cowrote with
Luigi Boscolo, Gianfranco Cecchin,
and Giuliana Prata, may at this
point be wondering what she’s up
to. That book proposed that client
families enter treatment with both
a request and a warning, a double-
level, paradoxical message that goes
something like, “Please change us/
Don’t you dare change us!” To deal
with help-seekers who resist help,
Palazzoli and her colleagues argued,
therapists must be change agents
who argue against change. At the
heart of their paradoxical approach
was an unswerving commitment to
clinical neutrality and “positive con-
notation,” a way of explaining to the
family how even the most trouble-
some symptom was ultimately in the
service of family harmony.
But whatever happened to pos-
itive connotation and neutrality?
And when is she going to advise
the Santinis against change? Well,
Palazzoli’s ideas about treatment
have changed dramatically since the
days of Paradox and Counterparadox.
Right now with the Santinis, she’s
confronting what she calls the “dirty
games,” the maneuvers family mem-
bers use to hide their coalitions and
strategies for controlling each oth-
er. It’s Palazzoli’s controversial con-
tention that schizophrenia always
begins as a child’s attempt to take
sides in the stalemated relationship
between parents. And what’s even
more controversial is she believes
that she’s developed an “invariant
prescription” that can shake up the
whole family game and, in the pro-
cess, cure schizophrenia.
— Richard Simon
51 
 PERSONALITIES & PROFILES
NOVEMBER/DECEMBER 1994
Panning for Gold
Michael White and the Promise of Narrative
Australian narrative therapist Michael White captured the imagination
of the therapy world by introducing the method of “externalization,” a way of
personifying and concretizing clients’ everyday struggles, giving them a
larger-than-life, often heroic dimension.
According to Australian
therapist Michael White,
a disconcerting effect of
his new celebrity on the
international therapy
conference circuit is the
recurrent experience of
getting off a plane and
being told something
like, “We sure have a real
humdinger of a family for your live
consultation. Oh, and about 500
people have signed up to watch.”
Whereupon White, the most vis-
ible representative of what’s loose-
ly called the “narrative method” of
therapy, is plunked down in front
of an impossible situation while
the audience waits breathlessly for
a therapeutic miracle. But White
denies that there’s anything magical
about what he does. He says he’s just
very “thorough.”
During sessions, he hunches down
over his notepad and seems almost
to recede from view. He almost nev-
er asserts anything, rarely utters a
declarative sentence, and patiently
asks questions, hundreds of ques-
tions. Like an archaeologist, White
sifts through the undifferentiat-
ed debris of experience for minus-
cule traces of meaning—the tiny,
precious shards of struggle, defeat,
and victory that reveal a life—all
the while doggedly taking notes.
Indeed, there’s a startling tenacity
about the process, a kind of polite
but unshakable insistence on partici-
pation, a refusal to let people off the
hook, even after hours and days of
long silences, embarrassed shrugs,
52 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/FE BR U AR Y 2 01 7
continued
parrot-like reiterations of “I don’t
know.” White will not allow the peo-
ple who consult him to slip away into
the sad night of their misery. He sim-
ply won’t give up.
In one session, the parents of a
deeply shy and isolated preado-
lescent girl are trying to coax her
away from her perch in front of
the TV and go walking with her
father. But the girl’s reluctance is
such that even when she does con-
sent, she dawdles so that her father
must then take a second walk in
order to get any exercise for him-
self. He’s disheartened and won-
ders if the effort is worth it. Trying
to get a statement of feeling from
the girl herself is uphill work. White
asks, “Do you have different paces
of walking? A snail’s pace? A tor-
toise’s pace? Are you faster or slow-
er when you go walking with your
dad?” After a long pause, she mur-
murs, “Probably slower.” “Probably
slower,” volleys White. “That means
you do have more than one gear.
Do you walk more slowly because
you don’t want to go walking with
him?” “I don’t want to do it,” she
says finally.
Ignoring this response, he asks
her how she could help her dad fig-
ure out whether to abandon their
walks together or persist. She yawns
hugely. Building on a microscopi-
cally tiny advance that emerged
earlier in the session (when he’d
elicited from her a barely spoken
acknowledgement that she might
like to be “taking more initiative
in life”), White asks, “What would
you like to do with your dad that
would fit with this new direction
of yours?”—a “new direction” that
would’ve been invisible to anyone
but White. She mumbles, “Go walk-
ing.” “Going walking would fit this
new direction?” he pushes. “Fits,”
she barely murmurs. “It does fit,”
White continues enthusiastically,
“so would you like him to keep on
trying to go walking, or would you
like him to stop?” “Hmmm,” she
replies. “You have to say what you’d
like,” says White—the closest he
comes to making a demand. “Keep
on walking,” she finally answers.
By the end of a later session, while
she doesn’t exactly seem chirpy and
communicative, she’s clearly much
more engaged. She looks at him out
of the corner of her eye and smiles
shyly, even producing some whole,
unequivocal answers (short ones)
to his questions, obviously delight-
ing her parents. Their daughter,
who’d rarely been able to iden-
tify any of her own likes, dislikes,
desires, or interests, who’d rarely
even talked to anybody, has begun,
however hesitantly and timidly, to
say out loud what she wants for
her life.
This kind of work may look to
some practitioners like cutting
grass blade by blade, but it’s prob-
ably more like panning for gold in
an overworked stream long aban-
doned by other prospectors. Slowly,
meticulously, steadfastly, White sifts
through the sandy deposit, patient-
ly extracting almost invisible flakes
until, by imperceptible increments,
he’s amassed an astonishing mound
of precious metal. Clearly, White’s
reputation rests less on therapeu-
tic bravura than on the extraordi-
nary, transfiguring moments that
occur in his practice—epipha-
nies that take place with people
most therapists would write off
as hopeless.
— Mary Sykes Wylie
NOVEMBER/DECEMBER 1997
Fearless Foursome
The Women’s Project Prepares to Pass the Torch
For two decades, the members of the Women’s Project in Family Therapy were
the outspoken feminist conscience of psychotherapy and, with their humor and
warm camaraderie, became beloved role models in a field that had long been
dominated by male leaders.
Despite its monumen- ly into the consulting room, they
tal-sounding name, sought nothing less than to trans-
the Women’s Project form the very picture of family life
in Family Therapy that undergirded the classic family
owns no real estate therapy approaches.
and doesn’t even have When they looked at Gregory
a listing in the phone Bateson and Jay Haley’s double-bind
book. In the 20 years hypothesis, or Murray Bowen’s the-
that it’s been in exis- ory of differentiation, or Salvador
tence, it’s produced Minuchin’s concept of enmesh-
only a handful of monographs, pre- ment, they saw not so much a revo-
sented a few dozen public work- lutionary new way of thinking about
shops, and published one book that human behavior, but more of the
sold all of 24,000 copies. Why, then, same old sexism done up in fan-
do so many people in the field cy terminology. However abstract
believe that without the Women’s and evenhanded the theory sound-
Project the development of fam- ed, they claimed that, again and
ily therapy over the past 20 years is again, in practice, the family dys-
practically unthinkable? function was balanced on the back
Perhaps, in part, the Women’s of the mother. Rather than offer-
Project owes its paradoxical suc- ing an eye-opening perspective on
cess to the high-voltage friendship the inner workings of the family,
between four of family therapy’s they argued, family therapists were
most commanding and savvy practi- too often guilty of perpetuating the
tioners—Betty Carter, Peggy Papp, same cultural myths about men and
Olga Silverstein, and Marianne women that got families in trouble
Walters, who took time off from in the first place.
their individual careers as clini- When the Women’s Project first
cians and teachers to moonlight strode onto center stage, fam-
together as the field’s longest-run- ily therapists still aspired to the
ning think tank cum road show removed calm of astronomers peer-
cum social protest rally. As gender ing through a telescope. In con-
became the hottest, most divisive trast, Carter, Papp, Silverstein, and
issue in family therapy in the ear- Walters, all of whom knew firsthand
ly ’80s, they became both revered the life of the traditional homemak-
and reviled as feminist sheroes, er in prefeminist, post-World War II
bold and brassy women unafraid America, talked of the family from
of ruffling feathers, who openly the inside out. And early on, they
and publicly challenged the field’s developed their own ritual for plan-
patriarchy and its convention- ning workshops, collapsing the per-
al wisdom. Bringing the ideology sonal into the professional. Camped
of the women’s movement direct- out in Silverstein’s Manhattan apart-
PSYCHOTHERAPYNETWORKER.ORG
ment, with its panoramic view of the
Upper East Side, the women would
schedule two days for themselves
and devote the first day entirely to
updating one another on their lives
and travails. “We talked about every-
thing,” says Silverstein, “our hus-
bands, our divorces, our kids. As
we talked, we saw the connection
between what we did as parents and
wives and friends and what we did
as therapists. We saw that all those
roles weren’t something that inter-
fered with your professionalism;
they made you more of an expert
on families.”
Their book, The Invisible Web, pub-
lished in 1988, went beyond dissect-
ing the sexism of traditional therapy
to offering practical, nuts-and-bolts
approaches to the issues of gender
and power in ordinary practice. But
the women’s broader achievement
has been their role in persuading
the field to move beyond the inte-
rior of the family to incorporate
social and cultural issues into main-
stream clinical thinking.
Of course, they could be scath-
ing and combative at times, but the
Women’s Project never fit the ste-
reotype of grim feminist crusaders.
When they talked in their work-
shops about the impossible impera-
tives to be both the perfect mother
and the successful career woman,
their tone was more knowing and
ironic than angry. Somehow they
managed to embody the voice of
time-weathered clinical wisdom and
the wise-cracking spirit of sorority
sisters, teasing one another about
their clothes, trading one-liners.
Once at a workshop, a participant
remarked, “The four of you seem
so at ease with yourselves. What
do you do when you’re anxious
or uptight?” Before anyone else
could respond, Walters grabbed
the microphone and replied,
“We eat!”
— Richard Simon
53 
 CHALLENGES & CHANGES
JANUARY/FEBRUARY 1991

Confronting Homophobia didn’t really matter—I was gay, and

in the Therapy Room
Are We Still in the Dark?
Back in the therapeutic Dark Ages of the 1990s, many clinicians, like the rest of
the population, were still just beginning to confront their own discomfort with
gender and sexual nonconformity. Today—when an “unstraight” client might be
transgender, gender fluid, agender, gender dysphoric, or genderqueer—this article
on homophobia, which seemed daring 25 years ago, may strike some readers as an
almost quaint reflection of a simpler time.
Thirty years ago, the agen-
da for therapists working
with homosexuals, stated
or otherwise, was likely
to be conversion to het-
erosexuality. Whether
through confrontation,
subtle persuasion, explo-
ration of childhood trau-
ma, or even electroshock,
the goal was to reclaim the homosex-
ual from the ranks of social misfits.
Not surprisingly, gays and lesbians
were, at best, reluctant consumers of
the therapies of that era.
In 1969, the Stonewall riot, a spon-
taneous protest triggered by a police
raid of a gay and lesbian bar in
Greenwich Village, marked the begin-
ning of the fight for gay and lesbian
civil rights and the move out of the
closet for millions in the United States.
By 1973, the American Psychiatric
Association had struck homosexual-
ity from its DSM II, ending sanctioned
prejudice by mental health profes-
sionals and finally conceding there
was no more pathology in gays and
lesbians than heterosexuals. But while
homosexuality was depathologized,
therapists were given no guidance as
to how to think about or work with
their gay and lesbian clients.
This is still largely the case. Within
the field of family therapy, for exam-
ple, there’s little or no discussion of
gay and lesbian treatment issues at
conferences or in the mainstream
literature. Those who do participate
in workshops on these issues, or who
write about and study them, are almost
always homosexual themselves. Few
graduate programs include required
reading on same-sex couples or
how to deal with homophobia—not
just the blatant form, but the qui-
eter, more subtle type that might
sneak into therapy sessions when our
unthinking assumptions about sexu-
“While homosexuality was depathologized,
therapists were given no guidance on how to work
with gay and lesbian clients.”
al identities get jostled. We may not
go on the attack when we feel these
stirrings, but despite our best inten-
tions, our anxiety, fear, and discom-
fort often spew out.
Assumptions about homosexuality
are usually based on a lack of infor-
mation or outright false notions, and
most people, including mental health
professionals, aren’t sensitized to rec-
ognizing these errors. At one end, a
faulty assumption is that, whatever
the presenting complaint, homosexu-
ality is the fundamental problem. “I
went to therapy after I’d been out in
most areas of my life for 15 years,” says
one 55-year-old man. “We spent the
first session arguing about whether
homosexuality is biologically or socio-
logically based. Finally, I told him it
that was a fact. I’d come to therapy to
deal with my anger toward my alco-
holic father who was close to dying.
He asked me if I’d come out to him
and I said no, our relationship had
never been so good, and there were
so many other problems between us
that I didn’t want to add another. The
therapist told me that until I came out
to my dad, I wouldn’t be able to have
an equal relationship with him. I was
frustrated—he was missing the point.
It was like knowing I was gay was a
clinical buoy the therapist could cling
to, that somehow everything in my life
was going to be about my sexuality.”
At the other extreme, a therapist
might believe that homosexual pref-
erence makes absolutely no differ-
ence at all, so why make a big deal
about it? “I was miserable because it
was another Christmas and my fam-
ily hadn’t invited my lover home
with me for the holiday,” remembers
32-year-old Heidi, a graphic artist.
“I’d been out to them for a few years,
and they were civil to Becky, but they
never really acknowledged our rela-
tionship. Invitations to family events
never included her. I felt angry and
asked my therapist what to do. She
seemed surprised, and said she
thought I was used to the arrange-
ment by now, and wondered why I
was so upset. When I said I thought
my parents were being homophobic,
she asked me, ‘Don’t you think they
might want to have just family for the
holidays? After all, Christmas is tradi-
tionally a family-only holiday.’ When
I told her that Becky was my family,
she asked me why I was taking such a
belligerent stance.”
— Laura Markowitz

54 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
SEPTEMBER/OCTOBER 1991
Welcome to the Postmodern World
Tired of Your Old Reality? There Are Plenty
More to Choose From
Over the past four decades, a new word entered our lexicon—postmodernism—
the awareness of the multiplicity of many possible realities and belief systems, along
with the increasing difficulty of believing in the importance of any one. Therapists,
as usual, had a front-row seat on the psychological uncertainty of living in a
“postmodern society.”
Jerry feels over-
whelmed, anxious,
fragmented, and con-
fused. He disagrees
with people he used
to agree with and
aligns himself with
people he used to
argue with. He ques-
tions his sense of real-
ity and frequently asks himself what
it all means. He’s had all kinds of
therapeutic and growth experienc-
es: gestalt, rebirthing, Jungian anal-
ysis, holotrophic breathwork, bio-
energetics, the Course in Miracles,
12-step recovery groups, Zen medi-
tation, Ericksonian hypnosis. He’s
been to sweat lodges, the Rajneesh
ashram in Poona, the Wicca festi-
val in Devon. He’s in analysis again,
this time with a self-psychologist.
Although he’s endlessly on the look-
out for new ideas and experiences,
he keeps saying that he wishes he
could simplify his life. He talks about
buying land in Oregon. He loved
Dances with Wolves.
Jerry is like so many well-educat-
ed professionals who come in for
psychotherapy these days. But he’s
not quite the typical client: he’s a
well-established psychotherapist. He
conducts stress-reduction workshops
nationwide; his current foray into
To read the full articles in this section, visit our website.
self-psychology analysis is another
attempt to find some conceptual
coherence for his own work—and of
course, for his own life.
Today, people are shoppers in the
great marketplace of realities that
the contemporary Western world
has become: here a religion, there
an ideology, over there a lifestyle.
They browse among a vast array
of possibilities and in the process,
change not only their beliefs, but
their beliefs about belief—their
ideas about what truth is and where
it’s found. They change not only
their identities (I’m a woman, I’m a
Jew, I’m a Jungian, I’m a liberal, I’m
a Libra), but their ideas about what
identity means. Some enjoy the free-
dom that can be found in this, some
try to escape from the freedom,
and some are nearly destroyed by it.
Meanwhile, new products keep arriv-
ing at the marketplace. If old-time
religion doesn’t do the job for you,
perhaps Deep Ecology will.
Without quite noticing it, we’ve
moved into a new world, one creat-
ed by the cumulative effect of plural-
ism, democracy, religious freedom,
consumerism, mobility, and increas-
ing access to news and entertain-
ment. This is the world described as
“postmodern” to denote its differ-
ence from the modern world most
PSYCHOTHERAPYNETWORKER.ORG
of us were born into. A new social
consciousness is emerging in this
new world and touching the lives of
all kinds of people who aren’t the
least bit interested in having a new
kind of social consciousness. We’re
all being forced to see that there
are many beliefs, multiple realities,
an exhilarating but daunting profu-
sion of worldviews to suit every taste.
We can choose among these, but we
can’t choose not to make choices.
Frequently these cultural/ideo-
logical/religious consumer choic-
es become the “problems” of
psychotherapy. They underlie fam-
ily conflicts and identity crises; they
generate deep uncertainties about
what—if anything—is real. This
shopping for The Truth among the
postmodern smorgasbord of belief
systems is playful for some, deadly
serious for others. Confused by the
staggering variety from which they
may choose, clients come to thera-
py hoping for some sure guidelines.
But frequently the therapist is as
confused as they are.
As such, most of Jerry’s profes-
sional life has been spent pursuing
the therapist’s equivalent of the holy
grail: a universally true psychologi-
cal theory and practice in which he
can find himself—his true self—mir-
rored. He’s spent tens of thousands
of dollars searching for an approach
that he can trust unreservedly and
that dependably meets the needs of
his clients. Yet it seems to Jerry and
to many others like him that the
longer he searches for therapeutic
certainty, the farther away he gets
from it.
— Maureen O’Hara and
Walter Truett Anderson
55 
 CHALLENGES & CHANGES continued

MAY/JUNE 1996

The Second Family ily alone is rarely powerful enough

to effect change in the life of a
troubled teenager.
The Decline and Fall of Parental Authority The disintegration of the first
family, for decades bleakly appar-
When family therapist Ron Taffel wrote this article, an explosive upsurge of ent in urban populations, has final-
youth pop culture was calling into question the very idea that parents must ly become palpable at all socioeco-
reestablish firm authority over teens. With the advent of smartphones and nomic levels. As we all recognize
instant, constant access to peers, this cornerstone of family systems theory has by now, divorce (50 percent of
crumbled even further. The central question Taffel asks is even more urgent marriages), mobility (up to 20
now: if pop culture reigns, and teens are firmly embedded in a peer-driven percent of the population moves
“second family,” what role, if any, can parents play in providing guidance to every year), and economic pres-
troubled adolescents? sures that generally require both
spouses to work ever-longer hours
When his family was TV, Nintendo, Sega Genesis, CDs, have undermined the old stability
referred to me, 13-year- and comic books. Friends came of the family. Time-squeezed par-
old Jimmy was on the to hang out, but his parents knew ents have few moments to spend
verge of being expelled none of them, except for brief sight- with their children. As MIT eco-
from eighth grade ings as they slunk from the front nomics professor Lester Thurow
because of his obvious, door to Jimmy’s inner sanctum and wrote in The New York Times, two
but heatedly denied, out again. million children under 13 have
pot-smoking. To his par- The other therapists had been no adult supervision either before
ents’ horror, he also partially correct—there was no or after school. Furthermore, the
intended to have his meaningful authority or hierar- family’s informal support systems—
ear, eyebrow, and lip pierced. His chy in Jimmy’s family. More to the the extended kin networks, church
parents seemed to agree with the point, however, there was little and community organizations,
unanimous diagnosis presented by significant connection in the fam- PTAs, and neighborhood ties—
his various therapists and counsel- ily. Insidiously, without his parents that buttressed family life have
ors. The boy’s problems, they’d all quite noticing, Jimmy had, over the gradually disintegrated.
said, could be traced to classical- years, been completely engulfed by Into the void left by the withering
ly dysfunctional family dynamics: a voracious, commercially driven away of adult community life has
father was distant and insufficiently youth culture. Beginning in pre- rushed the vast wave of adolescent
involved with his son, mother tend- adolescence and certainly by now, peer groups and pop culture. Their
ed to be overindulgent and intru- the “second” family of his peers influence has been hugely expand-
sive. In short, Jimmy suffered from had, in fact, become his primary ed and energized by a technological
an archetypal inadequacy in the family, the one that really mattered explosion that’s proven its power to
family hierarchy. to him. blast into every home. Two-year-
Since Jimmy had grown disen- Unquestionably, Jimmy’s parents old children, without developed
gaged from his parents some time needed help, but what use would language ability, can recite the
ago, I asked who’d been the signifi- classic family therapy interventions McDonald’s jingle; researchers
cant adults in his life, his role mod- be when the fundamental assump- have found that 18-month-old kids
els, confidants, friends, or advis- tion upon which they were based— are already capable of brand-name
ers. It soon became obvious that the parents’ central importance to recognition. At a time when exter-
Jimmy hadn’t experienced any sig- the child’s life—hadn’t been true nal systemic forces—peer groups
nificant connection with a grown- for quite some time? When it comes and mass culture—are at least as
up, including his parents, since to millions of kids like Jimmy, fam- powerful in defining the adoles-
middle childhood. Beginning in ily therapy hasn’t kept pace with cent’s world as the internal fam-
about the third or fourth grade, several decades of massive social ily system, we can no longer focus
he’d almost completely drifted upheaval. The world of an adoles- only on the first family in the ther-
away from the adult world into the cent is now so powerfully defined apy room. It isn’t enough—and it
closed society of the kid pop cul- by systemic forces other than doesn’t work.
ture—communing mostly with his home that working with the fam- — Ron Taffel

56 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y / FE BR U AR Y 2 01 7
SEPTEMBER/OCTOBER 2005

Alice in Neuroland its clockworks invisible, as it was

to Sigmund Freud, Carl Jung, and
the seminal thinkers and clinicians
Can Machines Teach Us to Be More Human? who have shaped 20th-century psy-
chotherapy. For the past decade,
As neuroscience was becoming the topic du jour of the therapy field, we sent in well-funded university neurosci-
Senior Editor Katy Butler to MIT on a mission. The result was, literally, a ence laboratories from Boston to
mind-expanding article that thrust readers into the brave new world of Madison to San Francisco, the black
behavioral neuroscience. Nominated for a National Magazine Award for box of the skull has been opening
Feature Writing, this piece conveys both the excitement and eerie strangeness and spilling out diamonds. And in
of therapists’ plunge into a “new rabbit hole into the psyche.” offices across the country, therapists
today are struggling to make sense
It’s a rainy morning cortical relays, frequency reward of this treasure.
in early March. I’m bands, and inhibitory postsynaptic Here, in this rented room, the
in a hotel confer- potentials. I feel like a student at demarcations between the psycho-
ence room near the beauty school run by the Bride logical and the neurological are
MIT in Cambridge, of Frankenstein. melting. With the help of a $5,000
Massachusetts, run- Consulting my wig-head, I move computer program, Marcia Lipsky’s
ning a dressmaker’s my finger to a point on Marcia’s skull is thinning like an eggshell
tape measure through scalp about two and a half inches before our eyes—sensitive, vulner-
the reddish blonde above her right ear. In the spot below able, semitransparent. But we’re
locks of a mildly anx- my finger, beneath a quarter-inch of doing more than just looking into
ious physician named Marcia Lipski. bone, lies a cluster of 20,000 pyrami- Marcia’s brain—we’re resetting its
At tables all around us, assorted dal neurons stacked three deep on inner clockworks. Neurons close
psychotherapists, MDs, and speech the outer layer of her brain’s senso- to the surface of her skull will, we
pathologists are clustered in groups rimotor strip, which governs body hope, come to fire in slower, calm-
of three, with laptop computers, sensation and movement. I smear a er rhythms. They, in turn, should
electrical wires, plastic tubes of unfa- chickpea-sized lump of clear, viscous entrain other neurons deeper in
miliar goop, and white Styrofoam wax onto an electrode—it looks like her brain, relaying their calming
heads bought from a wig-supply a tiny, gold cokespoon with a long, influence from her cortex to her
house and pasted with orange stick- yellow, electrical wire attached—and thalamus, which helps govern physi-
on dots denoting various parts of press it onto the freshly cleaned spot ological regulation.
the brain. on Marcia’s scalp. Like a stethoscope The fleeting, repeated, bio-elec-
We’re in the midst of a train- pressed against a wall to eavesdrop tro-chemical patterns of neural func-
ing presented by EEG Spectrum on a party, this little spoon is capa- tioning that Marcia calls mild anxi-
and accredited by the Biofeedback ble of “hearing” faint electrical sig- ety—once thought to be hardwired
Certification Institute of America nals pulsing from neuron to neuron by temperament, early childhood
in the fundamentals of neurofeed- beneath the bone. development, and fate—are turn-
back: a hybrid of biofeedback, old- We clip earring-like electrodes ing out to be malleable after all. On
fashioned counseling, and cutting- to Marcia’s ears, run a few elec- the basis of a 14-page questionnaire
edge brain science. Attendance is tronic tests, and plug the electrode she filled out, we’re thinking of her
restricted, on the whole, to health- wires into a small amplifier lead- as “overaroused” and are trying to
care professionals. ing to a laptop. On the screen, four teach her brain to reregulate itself at
The clinicians around me are squiggly lines, like tracings from its most basic, cellular level. But our
attempting to integrate their 20th- an earthquake-monitoring machine, healing technology isn’t the imper-
century therapeutic skills with 21st- dance grayly across a dark field. fect body and soul of a therapist or
century electroencephalography It’s Marcia’s EEG—a display of the meditation master, both of whom,
(EEG) and affective neuroscience. electrical activity occurring in about in slow, time-tested ways, attempt
Those who once aspired to be sag- one-millionth of the total of 20 to to teach the psyche self-regulation.
es, healers, and wise women will 40 billion neurons in her brain. We’re diving down a new rabbit hole
struggle over the next few days to It’s magic. into the psyche.
make sense of hertzes, thalamo- No longer is the skull a black box, — Katy Butler

PSYCHOTHERAPYNETWORKER.ORG 57 
 CONTROVERSIES & DEBATES
JANUARY/FEBRUARY 1992

It’s not My Fault!

Political Correctness vs. Therapeutic Correctness
When Networker film critic and in-house provocateur Frank Pittman wrote this
piece 25 years ago, the concept of “political correctness” was just beginning to seep
into our national consciousness. With an iconoclast’s passion and a dash of dry
wit, he cataloged the hazards of PC thinking for the field of psychotherapy—and
for the souls of therapists themselves.
Years ago, at a national
meeting, I interviewed a
black family with over-
whelming problems.
The audience wanted to
talk about racism, but
after a while I interrupt-
ed with, “Racism is soci-
ety’s problem, and we
may not solve it in time
to help these people, and they don’t
have the luxury to postpone their
lives until we do. These people are
black in a racist society, and they
can’t afford to treat that as a social
problem. For them, it’s an individ-
ual problem, and we have to help
them on that basis.” While the fam-
ily appreciated what I was saying, it
set off a furor in the audience, which
was PC and believed it was unfair to
let the disenfranchised solve their
problems, since that took society
and the enfranchised off the hook.
I worry about how political cor-
rectness affects the practice of fam-
ily therapy. We therapists encour-
age, maybe even require, people to
rethink their sense of themselves
and of the universe. By every word
we say or don’t say, by every move-
ment we make or don’t make, we’re
transmitting our values and our
world view, and if therapy is work-
ing well, we transfer our sanity, or
lack of it, to the patients. We can’t
risk doing therapy unless we regu-
larly rethink our views about gen-
der, class, race and ethnicity, and
religion, because our prejudices will
affect everything we do and every-
one we see. But is political correct-
ness therapeutic?
Those of us who are battling for
gender egalitarianism, for instance,
find ourselves bumping into a PC
sensitivity regarding ethnicity. I once
saw a family that had immigrat-
ed from Iran during a revolution.
Abdul was a physician who’d worked
his way up from humble origins.
Fatima, his wife, was an aristocrat.
Abdul practiced in Chattanooga, an
hour and a half away, where he was
licensed. Fatima stayed in Atlanta
where she had relatives. The couple
had two daughters, both physicians,
and Abdul wanted them to join
him in his practice. But the daugh-
ters couldn’t move to Chattanooga
because unmarried women shouldn’t
live apart from their mothers. And
they couldn’t commute, since Fatima
didn’t believe it was theologically
correct for women to drive. But she
had a pothead young, male cousin
in Atlanta. So this stoned, 15-year-
old boy drove the two physician
daughters around, though Abdul
ranted and raved to no avail. The
daughters rebelled and demanded
family therapy.
Therapy was directed toward
Fatima’s sense of powerlessness in
the face of this overwhelming new
culture. Fatima was hard to empow-
er because she insisted she should
be powerless, as befitted a Muslim
woman. She refused to acknowledge
having any power of her own, except
to interpret the dictates of her reli-
gion. In therapy, it was a struggle to
keep the daughters from rejecting
their mother as they freed them-
selves from the powerful bonds of
her powerlessness. I wonder whether
it was PC of me to impose my egali-
tarian values on these people from
an incompatible culture. When gen-
der and culture collide, I have no
idea how to do the PC thing and still
solve the problem.
I’m also concerned about the
effect of all this political correct-
ness on the practitioners themselves.
Taking offense at so many things, all
the time, must wither the soul and
do terrible things to the sense of
humor. I keep thinking of a tomb-
stone I saw in Dorchester Abbey
near London. The rather roman-
tic tombstone of Sarah Fletcher,
who departed this life at the age
of 29 in 1799, read: “If thou hast a
heart famed for tenderness and pity,
contemplate this spot in which are
deposited the remains of a young
lady whose artless beauty, innocence
of mind, and gentle manners once
obtained her love and esteem of all
who knew her. But when nerves were
too delicately spun to bear the rude
shakes and jostlings which we meet
with in this transitory world, Nature
gave way. She sunk and died a martyr
to excessive sensibility.”
— Frank Pittman

To read the full articles in this section, visit our website.

58 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y / FE BR U AR Y 2 01 7
SEPTEMBER/OCTOBER 1993
The Shadow of a Doubt
The False Memory Debate Strikes at the Heart
of Our Belief in a Just World
For many clinicians, the false memory debate of the 1990s was a chilling
experience, rife with accusations that therapists had “implanted” fictitious
memories of child sexual abuse in the minds of clients. This piece, part of an
issue nominated for a National Magazine Award for General Excellence, plunged
us into the many dimensions of this debate—the bizarre, the dreadful, the
bewildering, and the deeply sad.
On a pleasant Friday tells a companion that her 46-year-
morning in early old daughter has cut off all family
spring, a group of contact with her parents, charging
well-dressed, pros- that during her childhood they’d
perous-looking men engaged in satanic ritual abuse that
and women, most in included rape, murder, torture, and
their 50’s and 60’s, mutilation. “We wanted her to go to
gather for a confer- the Mayo Clinic for psychiatric test-
ence at a large con- ing,” said the woman, “but she said
vention hotel in the her therapist had told her that the
manicured suburbs of Philadelphia, Mayo staff was made up of Satanists
not far from the rolling greensward who’d get control of her mind.”
of Valley Forge Historical Park. From Across the room, a Minnesota wom-
the subdued, convivial roar of the
600-plus voices, these people sipping
coffee and peering at one another’s “In a psychotherapeutically
name badges might be here for a
conference of senior sales represen- inspired double-bind, denial itself is
tatives or real estate agents.
That is, until unnerving snatches evidence of . . . denial.”
of their conversation are overheard.
“My daughter has accused me of an, elegantly dressed in a tweed
raping her from the time she was 7 suit and looking younger than her
until the time she was 17,” says one 61 years, starts weeping quietly as
grey-haired man from Wisconsin, in she talks about her 33-year-old son,
the slightly amazed tone of someone who’s accused his father of sodom-
who can’t get used to making this izing him when he was a child. One
statement. In another small group, sister believes him; the other hasn’t
an Ohio woman, about 50, reports taken a stand. “At least one is neu-
that her daughter—a Harvard MA tral,” she says forlornly. She looks
in public policy—convinced the around, suddenly embarrassed. “Am
state police to dig up a public park I the only one here crying?” she asks.
in search of the bodies of many Every one of the parents gath-
young boys who, the young wom- ered here can tell a similar story of
an claimed, her father and moth- adult children suddenly, and with-
er had sexually abused, murdered, out warning, turning on them with
and buried there. A woman in her accusations as horrible and fantastic
70’s, standing in line to register, as they are incomprehensible. Every
PSYCHOTHERAPYNETWORKER.ORG
parent here talks about the abso-
lute shock and horror of hearing
their children make these accusa-
tions, and every parent here vehe-
mently denies the charges. Often,
they say, they don’t even know what
the alleged details are, or exactly
when and where the abuse was sup-
posed to have occurred—the son or
daughter levels general allegations
and then refuses to disclose partic-
ulars, saying something like, “You
know what you did. I don’t have to
tell you.”
It’s not hard to identify with these
parents—in this post-Kafkaesque
era, who can’t imagine the helpless
bafflement of being charged with
terrible but unremembered crimes,
assumed guilty, and condemned
without hearing? Furthermore, in a
psychotherapeutically inspired dou-
ble-bind typical of our times, denial
itself is evidence of . . . denial, the
pathological indicator that makes
declarations of innocence virtual
proof of guilt.
It’s this strange commonality of
experience that brings these fami-
lies together for the first meeting
of the False Memory Syndrome
Foundation, a support and advocacy
organization formed in March 1992,
comprising the parents of 4,000 fam-
ilies who say they’ve been falsely
accused of sexually abusing their
children. Some stand accused of
committing even more heinous and
sadistic acts—emerging in cultish
orgies of animal sacrifice, rape, tor-
ture, mutilation, forced abortions
on preadolescent girls, murder,
and cannibalism.
— Mary Sykes Wylie
59 
 CONTROVERSIES & DEBATES
J U LY/AUGUST 2 0 03
The End of Innocence
Reconsidering Our Concepts of Victimhood
Part personal story and part social critique, this article argued that in its treatment
of survivors, the therapeutic pendulum had swung from complete denial to an
overfocus on the wounded inner child. It asked: how can we help clients establish
a delicate balance that fully acknowledges the pain of a traumatic past while not
being identified by it?
As a systems therapist,
incest survivor, and recov-
ering alcoholic, I’ve lived
through several stages of
our culture’s attempt to
come to terms with child
sexual abuse—as a victim
in the silent ’50s; as a ther-
apy client in the oblivi-
ous ’60s and ’70s; and
as a psychotherapist in the ’80s and
’90s, when once-dismissed accounts
of abuse filled my therapy prac-
tice (and my television screen) only
to be partly discredited within the
decade during another swing of the
cultural pendulum.
We clinicians are still feeling our
way toward a middle path, one that
avoids the extremes of disempower-
ing pity and “buck-up” denial. Our
clients (and if we’re survivors, we
ourselves) still struggle to negoti-
ate what sociologist Ervin Goffman
called “spoiled identity”: the isolat-
ing experience of being cast outside
the circle of “normal” life. Helping
a client move from subjugation by
the worst thing that ever happened to me
to a nuanced and effective life has
turned out to be more complex—
and oddly enough, more common-
place—than I imagined when I first
sought help.
I’m now close to 60—a middle-
class, middle-aged professional liv-
ing in Northampton, Massachusetts,
where I occasionally see women in
town with teddy bears in their back-
packs and buttons reading, “It’s
never too late to have a happy child-
60 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
continued
hood.” I want to tell them that
their button is wrong: it is too late.
Time is a river that runs in only
one direction. Trauma survivors—be
they Vietnam veterans, Cambodians,
Holocaust survivors, sexually vic-
timized women, or firefighters who
escaped from the World Trade
Center—never become people to
whom trauma didn’t happen. But
the ripples that flow outward from
every traumatic event don’t have
“We're still finding a middle path
that avoids the extremes of disempowering pity
and ‘buck-up’ denial.”
to sink us, define us, or assign us a
single identity. Victim, I want to tell
them, describes a specific moment
in time, not a permanent self-defini-
tion. This is a comforting aspect of
the impermanence that transforms
every emotional state.
As a culture, we’re only just wak-
ing from sleep. It’s long been easier
to blame people covertly for their
reactions to childhood abuse than
to face what happened to them. We
pay staggering public health bills
for the addicted and traumatized,
but we balk at spending on prevent-
ing that trauma in the first place.
Protective workers charged with
investigating crimes against chil-
dren, for example, make less than
half what we pay the police officers
who investigate adult crimes.
There are a few hopeful signs that
this may change. In the wake of the
priest scandals and the collective
public wounding of the September
2001 attacks, words like victim and
trauma have enlarged their mean-
ings beyond the mostly female
holders of this particular spoiled
identity. The psychic damage suf-
fered by the firemen and construc-
tion workers of Ground Zero made
it clear that not only Vietnam vet-
erans and sexual-abuse survivors
suffer from PTSD. Nobody’s yet
suggested that the heroes of 9/11
are part of a culture of complaint.
As Jack Rosenthal put it in the
New York Times Sunday Magazine,
“Before 9/11, trauma often referred
to the horrible physical injuries
seen on ER. Now the psychiatric
use of the term may just as like-
ly be referring to the time bombs
that 9/11 lodged in the minds
of thousands.”
These days, I sometimes think
back 30 years to the desper-
ate, unconscious, distrustful, and
enraged young woman I was when,
three days drunk and covered with
self-inflicted cuts, I was shot full
of Thorazine and bundled off to a
state hospital in Connecticut. She’d
be both contemptuous and amazed
to see who she’s become: a physi-
cally healthy professional woman
who works inside the system without
ever quite joining it. And although
I still hold in my heart that wild
young woman and understand how
she came to be, the river of life has
flowed a long way since then, and
she’s now only part of me.
— Dusty Miller
M A RC H /A P R I L 2 0 14
The Cult of DSM
Ending Our Allegiance to the Great Gazoo
Written just after the release of DSM-5, this masterfully sardonic look at the diagnostic
charade many practitioners play argued that it was finally time to take the dissatisfaction
with DSM seriously and find an alternative to an increasingly empty ritual.
A client comes to see
you. Let’s call him
Fred. He tells you he
has a dream job, one
in which he’s mostly
left alone to do what
he loves. But there’s
a hitch: in order to
get paid (which he
does, and well), he
has to stand in front of a video cam-
era once every hour, raise his left
hand, stand on his right foot, and
say, “I declare obeisance to the Great
Gazoo.” He tells you that he knows
the Great Gazoo doesn’t exist. He
tells you that he, and all his cowork-
ers, think the ritual is stupid and
undignified, and that he’s appalled
at himself, at the ease with which he
engages in a pointless exercise pure-
ly for the sake of money and then
drives awareness of his bad faith out
of his mind.
At first, the complaint seems rich,
intriguing, even piquant. It provides
fodder for conversation about his
expectation that the world will con-
form to his needs, his disappoint-
ment at finding out that it won’t. It
gives rise to meaningful talk about
the fear of poverty, the cruelties of
capitalism. You discuss alternatives
with him: finding a different job,
refusing to participate in the ritual,
organizing a protest with his cowork-
ers. Sometimes he leaves your office
determined never again to declare
allegiance to the Great Gazoo, only
to come back a week later, sheepish
and forlorn, with a story about how
he just couldn’t follow through.
After months of this, both of you
are becoming impatient. Fred’s sta-
sis now strikes him as failure and
cowardice, which means he’s unhap-
pier than when he began. For you,
the intriguing conversations have
become boring. You’re ready to throw
in the towel—or, as therapists call it,
to reframe the discussion. The new
therapeutic task is to push the ritual
into the background, to accept it as
part of reality—like death and tax-
es and the inevitability of loss. And,
you tell yourself, the ritual isn’t such
a bad thing: it doesn’t harm anyone
and only takes about 30 seconds, and
besides, its crosslaterality is probably
good for Fred’s brain. You and Fred
agree on a new goal: to stop worrying
and learn to love the Great Gazoo.
You’re feeling pretty good about
this outcome as he leaves your office
and you sit down to make your ses-
sion notes. To sign the note, how-
ever, you have to provide a diagno-
sis. You’ll probably use the same
one you entered when you first saw
Fred: 309.28 (adjustment disorder
with mixed emotional features), or
perhaps 300.02 (generalized anxiety
disorder), or any of the other of the
handful of diagnoses whose codes
you’ve memorized. You probably
think this is an innocuous enough
diagnosis, not likely to impede his
access to life insurance or to become
an issue should he decide to seek a
security clearance.
And it is, except for one thing, or
more accurately, three things. First,
you know that the only reason you’re
entering that diagnosis is that Fred’s
insurer isn’t going to pay you to sit
around with Fred and figure out the
PSYCHOTHERAPYNETWORKER.ORG
meaning of his life. It’ll pay for ther-
apy only if he has a medical disor-
der, which is why you shelled out a
hundred bucks for your copy of the
DSM in the first place.
Second, you know, or at least you
should, that there’s no such thing as
adjustment disorder or generalized
anxiety disorder or any of the other
200 or so diagnoses in the DSM—at
least not in the same way that there’s
such a thing as strep throat or diabe-
tes. Although it’s debatable wheth-
er the DSM provides an accurate
anthropology of suffering, a work-
ing catalog of our common miseries,
its status as scientific medicine isn’t
in doubt.
Third, you know that your diagno-
sis isn’t helping you figure out how
to treat Fred. It’s not really for his
benefit (other than that it helps him
pay for it), and ultimately, it’s not
even for your benefit, but for the
benefit of a mental healthcare deliv-
ery system that increasingly demands
a kind of accountability that has lit-
tle to do with mental health.
If you’ve ever felt guilty about this,
you might take comfort in the fact
that after a couple of years spent
talking to virtually every prominent
psychiatric nosologist in the coun-
try, I can report that finding some-
one who will say that the DSM is of
clinical value is like walking around
Athens with a lamp lit in the daylight
looking for an honest man.
For everyone, from lunchbucket
therapists like me to the nation’s
psychiatrist-in-chief, making a DSM
diagnosis is the ritual you have to
perform to get the system to work. It
may not be quite as silly as Fred’s ritu-
al at work, at least not on the surface,
but we therapists have responded to
it just as Fred did. We’ve engaged in
all sorts of evasions and subterfug-
es to avoid the glaring and simple
truth: the DSM is our Great Gazoo.
Invoke it, and the cash rolls in.
— Gary Greenberg
61 
 SEX, MARRIAGE
M A RC H /A P R I L 1 9 8 8
The Facts of Life
Of Sex and Loss
This piece started out as a reportorial piece on sex therapy, but nontherapist Fred
Wistow soon blew past that assignment to investigate the ways in which our terror
of intimacy can subvert the fragile magic of sexual contact. Here, he lyrically
conveys both the thrill of genuine lovemaking and the terrible losses we sustain
when we run from it.
I’m barreling out of the
city, driving north. A rela-
tionship with a woman,
yet another, has just end-
ed. I’m anxious to get
away from that hurricane
of self-doubt and pain
that marks the end of a
love affair, the collapse
of a world. Maybe the
wind whizzing by will blow it all away.
But the past will not rest. Moments
of closeness jostle against flashes of
betrayals and rejections. Issues of
character and trust seem paramount
in understanding why we broke up;
sex, surprisingly, is secondary. Yet sex
is at the core of the loss: if we hadn’t
been physically connected, the pain
wouldn’t have been this acute; if we
had been more connected physical-
ly, I painfully consider, perhaps we
might not have broken up.
As memories of recent and more
distant pasts line up for inspection,
certain moments stand out in such
bold relief that they seem to be of
another order than the rest. And
it’s then I realize that I’ve made love
no more than five or six times in
my life.
My mind stops. Does the num-
ber merit gratitude or more self-
pity? From the vantage point of a
rest stop, all the other times start to
resemble masturbation, except that
whatever woman I was with substi-
tuted for my genitals, as I did, hers.
During sex, even with someone I
love, it seems that in spite of every-
thing I know or want or feel, I too
62 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
& PARENTHOOD
often wind up in a mutual manipu-
lation whose only ultimately under-
standable aim is orgasm. Touching
and being touched, kissing and
being kissed, sighs, smells, sights—
the intimate murmuring presence of
otherness, the excitement of differ-
ence—all of that wonder inevitably
seems to boil down to the question,
stated or not: “Did you come?” Two
people become two objects.
I make her come. She makes me
come. Our job is done. I’ve been
macho enough to break through her
wall of not-coming, to overpower
her not-coming state, thereby prov-
ing my manhood and the wizardry
of my technique. She’s reconfirmed
her own desirability through my
erection and ejaculation. Through
coming, our anxieties about not
coming—of not pleasing and being
pleased—ease. Relaxed, we can each
feel protective of the other. And pro-
tected: some private part of us has
not been touched; some hidden part
has remained hidden.
I feel like an imposter.
Then, the few havens in the heart
of my memory rush forward, the
half-dozen times when love and the
transcendence of shame overshad-
owed the orgasms and power trips.
Those few times something broke,
something very strong and ever-pres-
ent, yet so invisible I’m never aware
of it—or what’s behind it—except
when it’s broken. It’s a wall behind
which hides a self, adamantine in
its refusal to emerge, a private self
which seeks protection in remaining
unseen. It’s primal, needy, and desir-
ing, and most of all, ashamed and
oh so fearful of the pain it might
encounter if, in revealing its need, it
should be spurned.
The few times I’ve been brave
enough to peer out from behind the
wall, a woman always showed me the
way. Through a word or gesture she
let a terribly private part of her be
seen and I followed.
On those few occasions when the
wall has broken, I’ve felt myself
spill into another person. It’s a me
I rarely see, the trusting desiring
child-me. The threat, the competi-
tion—the ability to hurt—that oth-
er people represent, ceased need-
ing to be defended against and I,
I who was liquid—semen, sweat,
sometimes tears—flowed without
restraint. And she at those times
became not just a doll to touch
and rub in order to make come,
but instead, a tender welcoming,
resonating bowl who in the course
of holding me I held, her own pri-
vate trembling self revealed, by me
embraced. The magic of discovery,
disclosure, and acceptance. Mutual
acceptance of secret selves. We were
separate yet entwined.
Looking back, I realize I shouldn’t
complain: I shared one such mag-
ic experience with my most recent
lost love. But we’re living a con-
nect-the-dots game. The dots are
moments of contact, special inti-
mate moments when we see our-
selves and others see us, too. Most
of our lives is spent in the pas-
sage of time between the dots. But
when we recall what’s meaningful
about our lives, we remember the
dots, forget our lines. Sex, the great-
est opportunity for contact, makes
for the boldest dots. It can also
afford the most complex labyrinths
in which to hide. The few times I
hadn’t hidden myself, something
magical happened.
— Fred Wistow
SEPTEMBER/OCTOBER 1989
The Mother Journey
Traveling on an Unmarked Road
Before Molly Layton became a mother, she was a graduate student who pondered
philosophy and allowed herself some existential angst. But becoming a first-time
mother rocked her to the core, forcing her to confront the awesome responsibility of
parenthood—not just in the wailing, diaper-changing present moment, but forever.
When I was a 23-year-
old graduate student
and finishing up notes
for an oral report
on the Philosophical
Investigations of
Wittgenstein, I went
into labor. My hus-
band, Charles, and I
dropped the paper
off at a friend’s house so he could
present it in my stead at a philoso-
phy seminar. Then we drove through
Austin’s balmy November twilight to
the local hospital, where David, six
pounds and so-many ounces, was
born early the next morning.
It was the ordinariness of becom-
ing a mother that first struck me
with a hot blast of wonder. Women
had babies all the time, and yet in
the great novels I’d read, no one
ever talked about the experience
of becoming a mother, nor about
the sticky details of birthing and
nursing. As a person accustomed
to research, I found even the most
practical information hard to come
by. This was in 1966, and I had to
send off to France for a book about
the new Lamaze method of child-
birth. Because of the popularity of
bottles, even the informal lore of
breastfeeding, handed down from
older to younger women, had been
lost. It seemed I’d landed at the cen-
ter of human life and, surprisingly,
To read the full articles in this section, visit our website.
found myself alone, engulfed in an
inchoate and banal silence. How
bewildering that a process as grand
and scary and tedious as becoming
a mother should be so unremarkable,
literally not worthy of remark.
I myself was adrift in immaturity,
about as unformed and malleable
as my own small baby, who, I was
now genuinely startled to discover,
needed my intense concentration.
Before he was born, the fetal David
was a rosy abstraction in a blithely
comfortable pregnancy. I glowed, I
thrived, I brushed aside the caution-
ary tales. Not until I saw Rosemary’s
Baby much later did I conscious-
ly recognize the dark side there all
along—the baby as parasite, the sin-
ister “other” placed within the soul
self by strange and alien powers, the
invasive fetus vanquishing the help-
less mother. This isn’t merely the
baby of horror stories and psychotic
nightmares: this is the shadow side
of symbiosis.
Truly the infant David over-
whelmed me. In his presence, I could
neither read nor write. Eventually, I
abandoned my training in philoso-
phy to study instead this small, will-
ful, and physically beautiful person.
I had to push away my books and my
thoughts so that I could hear his tiny
demands. David was the person who
made me pay attention to the world
outside myself, to boiled eggs and
PSYCHOTHERAPYNETWORKER.ORG
washed sheets and flirty babies.
In remembering the early days of
motherhood, I feel again that first
shock of my own responsibility for
this tiny fragile person, the clear and
compelling demand that I harden
into a self, a definite persona, that
I come out of the mists of gradu-
ate study. Because we stubbornly
identify with the helpless infants, we
human beings find it hard to accept
the frail and tenuous humanity of
the mother. We easily and senti-
mentally resonate to the emotional
nurturance that we as infants need
from mothers. Our infant-selves are
masters of longing, and masters too
in imagining the mother’s unlim-
ited strength and unlimited sup-
ply of love. The mother soon learns
what’s required to support the life
of her child. Then she just does it.
Whatever she thinks the child needs,
that’s what she does.
Specifically, the mother’s motiva-
tion arises from her discovery of a
terrible truth: she must keep and
hold someone who’s perilously frag-
ile in a world now suddenly filled
with danger. This demand—the
demand to preserve—is so clear and
so penetrating that it forces even
the most philosophical among us to
abandon our relativism and shuck
off our existential blues.
It was the bald inescapability of
my new identity that shocked me the
most, sometimes making me proud
of myself, sometimes guilty and con-
fused, sometimes just exhausted. But
of course, I had to stay in role: my
baby held me as I held him. Until
then, I’d never been so located in
time and space.
— Molly Layton
63 
 SEX, MARRIAGE & PARENTHOOD
MAY/JUNE 1998
Bringing up Father
How My Children Taught Me the Secret of Fatherhood
When author Frank Pittman became a father, he discovered that the childhood absence
of his own father left him with no idea how to relate to his kids. This piece plumbs
many men’s difficulties in connecting with their kids, and suggests how therapists can
best help “amateur dads” learn the vital lessons for raising their children.
Mother taught me that
fathering was the most
noble of man’s call-
ings. Her own father—
a judge, senator, poet,
and editor—had died
when she was two, but
she brightened my child-
hood with her glorious
fantasies about what he
would’ve done had he lived and how
wonderful her life would’ve been as
a result. In Mother’s fantasy, hap-
piness was a father who would just
hang out with you and talk about the
nature of the world and the mean-
ing of life. I fell in love with this
heroic myth of father as the man
who knew all the secrets of life and
sat around telling them to you.
Even though I knew I wanted
to be a father when I grew up, I
didn’t know exactly what skills were
required. I needed a model of a
father, a real live one who could talk
to me about what the profession was
really like, and how it might differ
from my mother’s fantasies. That
shouldn’t have been too difficult a
job. My mother had thoughtfully
provided me with a fine father, and
it would seem natural for me to have
talked to him. But that wasn’t the
way it worked out—for me, for my
friends, or for just about any other
man growing up in my generation.
We of the ’40s and ’50s grew up
with fathers who were off at war or
at work, and who weren’t part of
the family even when they were at
home. We were essentially father-
less. When we had children, we
64 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
continued
became fatherless fathers. We either
had no concept of what fathers
were for, or some glorified fantasy
of the paternal ideal. Lost and con-
fused, we waited for somebody to
tell us what we were supposed to do.
Some of us assumed that our wives
knew what fathers were about, for-
getting that our wives hadn’t had
fathers either.
Fatherless men may go through
life in a childlike position. Having
been raised by women, they assume
that women are supposed to take
care of men and children. But they
may not know what men are sup-
“I continue to believe that expertise
at living is more helpful for a therapist than
expertise at therapy.”
posed to do in return after they get
the women to take care of them.
Some of these fatherless men have
never known a grown man well
enough to know how to act when
they themselves become grown men.
Men who’ve been raised without
fathers can’t help but be amateur
parents, and may even be amateur
human beings.
I was wrong when I thought that
being a therapist would help me as
a parent. I’ve tried all the tricks, but
none of them worked with my kids.
They’d mastered paradox by the sec-
ond grade, and made clear that they
like enmeshment, as long as it was
on their terms. As parents, we can’t
get by with mouthing truths the way
we can as therapists. We have to
embody them. We can’t kid our kids.
They know what we do, not just what
we say. We can’t erect boundaries
against our children. Parent–child
relationships are mutually intrusive.
Our children may not pay very much
attention to what we say, but they’re
studying us, and absorbing us. I’d
always seen much of my mother in
me, and much of me in both my
daughters. I’m gradually becoming
my father, much as I might resist it,
and my son is rapidly becoming me,
now that I’ve given up on forcing
him to do so.
I continue to believe that exper-
tise at living is more helpful for
a therapist than expertise at ther-
apy. But then I assume that peo-
ple, whether they be patients, par-
ents, or children, are generally
well intentioned, but misinformed.
I don’t understand those theorists
who think that families want noth-
ing more in life than to defeat the
therapists, or who believe that par-
ents are out to destroy children, for
unconscious or conscious reasons.
I just assume that people are ama-
teurs at life—this is their first time
doing it, and they’re just muddling
though the best they can with what-
ever they’ve learned in their own
families from their own amateur
parents. Our job is to respect their
good intentions and amateur status,
and provide our professional exper-
tise in identifying and correcting
their misinformation.
— Frank Pittman
MAY/JUNE 2003
Erotic Intelligence
Reconciling Sensuality and Domesticity
It’s been said that “sex without sin is like an egg without salt.” In this piece,
couples therapist Esther Perel outraged some readers by arguing that the therapeutic
ideal of egalitarianism in the bedroom may actually dampen sexual pleasure, and
that couples therapists would do well to revamp their definition of healthy sexuality.
A few years ago, I
attended a presen-
tation at a national
conference, demon-
strating work with a
couple who’d come
to therapy in part
because of a sharp
decline in their sexu-
al activity. Previously,
the couple had engaged in light sado-
masochism; now, following the birth
of their second child, the wife wanted
more conventional sex. But the hus-
band was attached to their old style of
lovemaking, so they were stuck.
The presenter took the approach
that resolving the couple’s sexu-
al difficulty first required working
through the emotional dynamics
of their marriage and new status as
parents. But the discussion after-
ward indicated that the audience
was far less interested in the cou-
ple’s overall relationship than in
the issue of sadomasochistic sex.
What pathology, several question-
ers wanted to know, might underlie
the man’s need to sexually objec-
tify his wife and her desire for
bondage in the first place? Perhaps,
some people speculated, mother-
hood had restored her sense of
dignity, so that now she refused to
be so demeaned. Some suggested
the impasse reflected long-stand-
ing gender differences: men tended
to pursue separateness, power, and
control, while women yearned for
loving affiliation and connection.
Still others were certain that cou-
ples like this needed more empath-
ic connection to counteract their
tendency to engage in an implicitly
abusive, power-driven relationship.
After two hours of talking about
sex, the group hadn’t once men-
tioned the words pleasure or eroticism,
so I finally spoke up. Was I alone in
my surprise at this omission? I asked.
Their form of sex had been entire-
ly consensual, after all. Maybe the
woman no longer wanted to be tied
up by her husband because she now
had a baby constantly attached to
her breasts, binding her more effec-
tively than ropes ever could. Didn’t
people in the audience have their
own sexual preferences, preferenc-
es they didn’t feel the need to inter-
pret or justify? Why automatically
assume that there had to be some-
thing degrading and pathological
about this couple’s sex play?
More to the point, I wondered,
was a woman’s ready participation
in S&M too great a challenge for
the politically correct? Was it too
threatening to conceive of a strong,
secure woman enjoying acting out
sexual fantasies of submission?
Perhaps conference participants
were afraid that if women did reveal
such desires, they’d somehow sanc-
tion male dominance everywhere—
in business, professional life, poli-
tics, economics? Maybe, in this era,
the very ideas of sexual dominance
and submission, conquest and sub-
jugation, aggression and surrender
(regardless of which partner plays
which part) couldn’t be squared
with the ideals of fairness, compro-
mise, and equality that undergird
PSYCHOTHERAPYNETWORKER.ORG
American marital therapy today.
As an outsider to American soci-
ety—I grew up in Europe and have
lived and worked in many coun-
tries—I wondered if the attitudes I
saw in this meeting reflected deep
cultural differences. I couldn’t help
wondering whether the clinicians in
the room believed that the couple’s
sexual preferences—even though
consensual and completely non-
violent—were too wild and “kinky,”
therefore inappropriate and irre-
sponsible, for the ponderously
serious business of maintaining a
marriage and raising a family. It
was as if sexual pleasure and eroti-
cism that strayed onto slightly outré
paths of fantasy and play—particu-
larly games involving aggression and
power—must be stricken from the
repertoire of responsible adults in
intimate, committed relationships.
After the conference, I engaged in
many intense conversations with oth-
er European friends and therapists,
as well as Brazilian and Israeli col-
leagues who’d been at the meeting.
We realized that we all felt somewhat
out of step with the sexual attitudes
of our American colleagues.
Ironically, some of America’s best
features—the belief in democracy,
equality, consensus-building, com-
promise, fairness, and mutual toler-
ance—can, when carried too punc-
tiliously into the bedroom, result
in very boring sex. Sexual desire
doesn’t play by the same rules of
good citizenship that maintain
peace and contentment in the social
relations between partners. Sexual
excitement is politically incorrect,
often thriving on power plays, role
reversals, unfair advantages, imperi-
ous demands, seductive manipula-
tions, and subtle cruelties. American
couples therapists, shaped by the
legacy of egalitarian ideals, often
find themselves challenged by
these contradictions.
— Esther Perel
65 
 Talk Is Not Enough
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Doherty F R O M PA G E 3 1
I see two core links between psy-
chotherapy and democracy. The
first is that personal agency, which
is necessary for collective agency,
is at the heart of psychotherapy—
we help people create meanings
and act in accord with their aspira-
tions and values. People without a
sense of efficacy in their personal
lives will have trouble maintaining
a democracy. The second link goes
in the other direction. Outside of
free democratic society, therapists’
ability to foster personal agency is
severely compromised, as I discov-
ered when my graduate students
returned to countries like China
and Vietnam, where they had to be
careful about how they encouraged
their clients to speak and act in
the community. (One therapist led
youth-support groups in the woods
so as to avoid attention from local
authorities.) And of course in the
US there have always been antidem-
ocratic, agency-squashing practices
(think Jim Crow and more recent
civil rights abuses).
The link between psychotherapy
and the public domain, I now real-
ize, is through seeing therapy as a
form of democratic practice that
starts in the consulting room. Our
clinical work prepares people to
be active shapers of their person-
al lives and also, if they choose, to
join with others—in the Hebrew
phrase, tikkun olam—to repair
the world.
In truth, this work can be anxi-
ety-producing for therapists, so we
need a lot more therapists develop-
ing the craft of these personal/pub-
lic conversations in therapy. When
is it therapeutic, and when does it
become a way to avoid real work?
How and when does the therapist
share personal views and reactions
to public issues? What happens when
the therapist gets triggered by a cli-
ent’s polar opposite—or even offen-
sive—public views? What resources
can therapists provide clients who
want to engage in civic action? Since
most therapists are on the liberal/
progressive side of the spectrum,
how do we avoid letting therapy be
seen as part of a partisan political
agenda? How do we avoid sending
messages to clients that our regard
for them depends on whether they
agree with us politically?
On one hand, all of this reminds
me of other big shifts in what we
do in the therapy room: at first
they seem antitherapeutic, maybe
even unethical, as when therapists
began to treat marital distress by
having both spouses in the same
room. On the other hand, feminist
therapists and other social-justice
therapists have been pushing this
envelope in therapy for decades,
so it’s not really new. Maybe what is
new is the democracy theme, which
assumes that everyone has a stake in
the public domain, can be affect-
ed the public stress (Trump sup-
porters included), and can be part
of the solution through personal
action (such as talking about issues
in their social network) and collec-
tive action (by joining with others
to work on change).
The realm of public concerns of
clients in today’s world is likely to
be far ranging if we invite them to
share what’s on their minds and in
their hearts. These concerns could
include local public schools, com-
munity safety, the lack of insurance
support for mental health treat-
ment, local police practices, threats
to the planet, or the influence of
the internet and social media on
children. Note that these can cut
across traditional liberal and con-
servative lines, but I predict that
one of the main public stresses that
therapists will be dealing with now is
the Trump presidency: how will we
deal with the Trump effect on our
clients, and how will we address the
larger threat to the public mental
health and our democracy? Clearly,
we have work to do. Each of us will
need to decide how far we’re willing
to extend ourselves into the world
beyond our consulting room.
What’s next for me? After being
PSYCHOTHERAPYNETWORKER.ORG
prodded and challenged by my
therapist daughter not to aim low
or think small (as therapists have
often done since we lost our cul-
tural mojo), I’ve decided to launch
Citizen Therapists for Democracy,
which I envision as an association
of therapists developing and spread-
ing transformative ways to practice
therapy with a public dimension,
rebuilding democratic capacity in
communities, and resisting anti-
democratic ideologies and practic-
es wherever they arise. (Okay, a bit
daunting, but why not dream big?)
It’s for colleagues who are attract-
ed to the idea of the Connected/
Commitment Self in personal and
civic life and who want to find ways
to bridge the divide between the
personal and the public dimensions
of life in the therapy room and
the community.
Though tempered by age and
experience, and not expecting cul-
tural transformation in my lifetime,
I’m fired up for a new leg of my pil-
grim journey. Our world needs what
therapists have to offer. We’re con-
nectors, glue makers. We under-
stand the complexity of the human
spirit. We know that embracing dif-
ferences is difficult but life enhanc-
ing. If we raise our sights and keep
in mind that we’re in this culture
and not above it, our profession can
contribute to a flourishing democ-
racy, where people can be agents
of their own lives and builders of
the commonwealth.
William Doherty, PhD, is a professor
and director of the Minnesota Couples
on the Brink Project and the Citizen
Professional Center at the University
of Minnesota. He is founder of Citizen
Therapists for Democracy. His books
include Take Back Your Marriage and
Medical Family Therapy with Susan
McDaniel and Jeri Hepworth. Contact:
bdoherty@umn.edu.
Tell us what you think about this article
by emailing letters@psychnetworker.org.
Want to earn CE hours for reading it? Visit our
website and take the Networker CE Quiz.
67 

Siegel F R O M PA G E 4 5
childhoods, their own children were
likely to form a good, secure relation-
ship with them, no matter what type
of attachment they themselves had
had when growing up. It wasn’t what
had happened to them as children,
but how they’d come to make sense
of what had happened to them that
predicted their emotional availabil-
ity as adults and the kind of parents
they’d be.
An equally important discovery
with powerful implications for psy-
chotherapy was the discovery of the
role of the horn-shaped hippocam-
pus and how it created the difference
between implicit and explicit memo-
ry. Implicit memory is a form of emo-
tional, sensory, or behavioral memory
that doesn’t include recalled facts or
place inner experience on a timeline
from the past. Trauma can flood the
amygdala to create intense implicit
memories but shut off the hippocam-
pus so that the horrible sensations of
life-threatening events are blocked
from becoming explicit memories.
That’s why people with PTSD experi-
ence their memories in the here and
now, without having the sensation of
remembering them. They find them-
selves overwhelmed by the retrieval
of powerful sensations drawn from
pure implicit memory that lacks a
sense of something coming from the
past. This process makes PTSD sur-
vivors vulnerable to flashbacks and
dissociation. It also reveals how dis-
tinguishing a past memory from pres-
ent life can enable clients to move
forward into the future without the
fear that the past will continue to
haunt them. The key is the neural
integration between differentiated
areas of the brain, allowing the past
event to become no more and no less
than an aspect of an autobiographi-
cal story that makes sense of life.
By the mid-’90s, together with a
group of colleagues at UCLA from a
range of scientific disciplines, I began
to explore the relationship between
the mind and the brain. Along with
others in clinical fields, we explored
68 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
ways that integrating brain func-
tions might be therapeutically bene-
ficial for clients, especially those who
had an impoverished sense of their
own past and couldn’t really feel or
express emotion. We found that lots
of clients who usually intellectual-
ized their way through talk therapy
responded well to guided imagery,
sensate body focusing, and practice
in using and picking up on nonver-
bal cues. Inspired by the work being
done on neuroplasticity, we began
to look at how therapy can catalyze
neural growth to create long-lasting
change. Could it be that the way you
think can actually change your brain?
In the first decade of the new mil-
lennium, interest in mindfulness was
beginning to burgeon in the field,
offering new evidence, now measur-
able through advances in technology,
that the way we focus attention with-
in awareness can change our brain.
Neural firing changes neural con-
nection, and if we intentionally pay
attention, this can transform the very
structure of the brain. Mindfulness,
we learned, promotes the integra-
tive function of the various regions
of the brain, including the prefron-
tal cortex. It allows brain circuits to
fire together that perhaps have never
fired in this coordinated way before,
giving people a sensation of inner
awareness that they may never have
had. It can open the pathway to neu-
ral integration—the linkage of differ-
ent parts of the brain—and enhance
powers of self-regulation.
Almost every mental health prob-
lem—anxiety, depression, eating dis-
orders, personality disorders, thinking
disorders—are issues of self-regula-
tion. Ultimately, the goal of therapy is
to optimize self-regulation, the coor-
dinated flow of energy and informa-
tion through the major systems of
the brain—brain stem, limbic circuits
neocortex, autonomic nervous—and
then between one brain and another.
When we’re in this secure, stable state
of mind-brain-body equilibrium, we
can face life’s vicissitudes with some
measure of emotionally calm flexibil-
ity, self-awareness, and reason.
As we broaden our appreciation of
what science can teach us about the
complexity of human functioning, it
becomes clear that clinicians serve as
transformative attachment experts,
whose job it is, in effect, to help
rewire unintegrated neural connec-
tions, to reintegrate (or sometimes
integrate for the first time) different
areas and functions of the brain—
implicit and explicit memory, right
and left hemisphere, neocortex with
limbic system and brain stem.
The past 40 years have given us
a view of the mind that encom-
passes an emergent, self-organizing,
embodied, and relational process
that regulates the flow of energy
and information. We now know that
where attention goes, neural firing
flows, and neural connection grows.
We’re finally equipped to embrace
the wide array of sciences to see the
myriad ways therapy can focus atten-
tion to stimulate the coordination
and balance of neural firing that
leads to the growth of neural inte-
gration and optimal health.
Helping people develop more
integration goes beyond reduc-
ing symptoms: it helps them thrive.
And integration also has its mor-
al dimensions, pointing us in the
direction of being kind and com-
passionate to ourselves and others.
So now, more than ever, we as men-
tal health practitioners need to be
aware of the crucial importance
of integration in human function-
ing and find ways to harness the
power of psychotherapy to create a
kinder, more compassionate, and
integrated world.
Daniel Siegel, MD, is a clinical professor of
psychiatry at the UCLA School of Medicine,
founding codirector of the UCLA Mindful
Awareness Research Center, and executive
director of the Mindsight Institute. His
latest book is Mind: A Journey to the
Heart of Being Human.
Tell us what you think about this article by
emailing letters@psychnetworker.org. Want
to earn CE hours for reading it? Visit our
website and take the Networker CE Quiz.

 

 

 
 
 

the future of psychotherapy:

from fragmentation to
unification  
 
 
 
"If you understand deep, lasting change in
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being a fragmented, confusing situation
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rich repertoire of ways to guide this
innate core process." — Bruce Ecker
 
 
 
Memory reconsolidation
is a research-based, universal key to
transformational change and psychotherapy integration.
 
Case studies of transformational change in widely different therapies
have been shown to contain the memory reconsolidation process:
AEDP, Alexander Technique, Coherence Therapy, EMDR, Emotion-
Focused Therapy, IPNB, NLP, Progressive Counting and Tapping
 
 
 
 
 

 
 
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We offer a curated selection of
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for healthy living, just for you!
www.cambridgenaturals.com
 TREATMENT PROGRAMS &
RESOURCES
■■ Options Behavioral
Health System At Options in
Indianapolis, IN, we are dedi-
cated to providing the highest
quality of service both to the
individuals who are entrusted
into our care, and to their fami-
lies. In addition to identifying
and addressing the issues with
which our patients are strug-
gling, we are also committed
to working with each patient’s
family to help them understand
what their loved one is experi-
encing and preparing them for
challenges that may occur in
the future. www.options
behavioralhealthsystem.com
■■ Recovery Village at Palmer
Lake Our leading drug and
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Colorado provides thorough
treatment in a safe environ-
ment, led by professionals who
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Everyone’s struggle with addic-
tion is unique. Our team works
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cess is tailored for each patient
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■■ Desert Milagros in beautiful
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ity care through our treatment
programs for disordered eating,
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health issues including anxi-
ety, depression, and self-harm
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vices with separate programs
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At Desert Milagros the focus is
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oring the strength, spirit, and
inner knowledge within each
person. www.desertmilagros.net
INNS, VILLAS, AND RETREATS
■■ Ghost Ranch It’s time to
slow down, connect with the
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■■ Blue Mountain is a privately
owned Retreat Center located
on 27 acres of mostly forested
land, in the beautiful Blue Ridge
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exist to facilitate truly produc-
tive planning meetings, trans-
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ties, re-energizing retreats, and
celebrations of success - all
at reasonable rates. When you
host a workshop here, expect
healthful organic food, quiet
but efficient staff support, and
low-key notices of how your
stay is environmentally friendly.
You'll leave feeling refreshed
and happy knowing you have
contributed to keeping our
planet green.
www.bluemtnretreat.org
■■ The Lodge at Wakulla
Springs Surrounded by 6,000
acres of pristine forest, the
Lodge at Wakulla Springs is
North Florida's castle. Built in
1937 by industrialist Edward
Ball, the Lodge is not only one
of the most beautiful buildings
of its period, but also one of the
few where you can stay over-
night. Located in the middle of
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Lodge's 27 rooms overlook one
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Whether you enjoy fine dining
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cream at the world's longest
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Lodge's timeless beauty sur-
rounds you. Nature, luxury, his-
tory, and comfort—all can
be found at the Lodge at
Wakulla Springs.
www.wakullaspringslodge.com
GIFT ITEMS
■■ Gifts With Humanity is a
brand of Global Crafts. Our
mission is to offer income-gen-
erating opportunities to crafts-
people in developing countries
by following fair trade practices
including paying in advance
at least the market price for
items, ensuring that crafts-
people receive payment, and
ensuring that the craftspeople
work in fair working conditions.
We work directly with artisans,
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groups to achieve these goals
and hopefully help improve the
lives of some of the people with
whom we share this planet.
www.giftswithhumanity.com
■■NeuView Glasses Can
your sunglasses lower your
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and lower your golf score?
NeuView's can! Visit us at:
www.neuviewglasses.com
■■ Taraluna We offer a wonder-
ful selection of some of the
best there is in fair trade prod-
ucts and gifts. We mostly buy
from non-profits and NGO's
that work directly with artisans,
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Many of our products have
informational tags that tell
about the producer of your pur-
chase. All of our fair trade items
come from businesses that
meet the rigorous Fair Trade
Federation policies and are
members of the FTF or Trans
Fair. www.taraluna.com
■■ Organic Bouquet Our flower
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gourmet cookies, plants and
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In addition, our flowers provide
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outstanding resources for farm
workers and artisans.
www.organicbouquet.com
CONTESTS
■■ Short Story Award for New
Writers A prize of $2,500, pub-
lication in Glimmer Train Stories,
and 20 author copies is given
three times a year for a short
story by a writer whose fiction
has not appeared in a print
publication with a circulation
over 5,000. Using the online
submission system, submit
a story of 1,000 to 12,000
words with an $18 entry fee
by February 28.
www.glimmertrain.com
■■ 2017 Editors’ Awards The
Florida Review is pleased to
announce the guidelines for the
2017 Editors' Awards in fiction,
essay, and poetry. For prose,
submit up to 25 pages (double-
spaced word doc or pdf). For
poetry, submit up to 5 poems
(word doc or pdf). The entry fee
of $15 includes a one-year sub-
scription to The Florida Review.
First Place winner in each genre
are awarded publication and
$1000. One or more finalists in
each genre will also be published.
www.floridareview.cah.ucf.edu
■■ International Poetry
Competition A prize of $1,000
and publication in Atlanta Review
is given annually for a poem.
Submit up to two poems of any
length with an $11 entry fee ($16
for up to four poems) by March 1.
www.atlantareview.com
■■ James Jones First Novel
Fellowship A prize of $10,000
is given annually for a novel-
in-progress by a U.S. writer
who has not published a novel.
A selection from the win-
ning work will be published in
Provincetown Arts. Runners-
up will each receive $1,000.
Submit the first 50 pages of a
novel-in-progress and a two-
page outline with a $30 entry
fee ($33 for electronic submis-
sions) by March 15. www.wilkes.
edu/pages/1159.asp
77 
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F mily M tters
F R O M PA G E 8 0
of the one-on-one encounters with
opponents, the grunting impact of
occasional collision, the darkening
sky that’s sometimes penetrated by
a white moon, and the opportunity
to bear witness to the splendid ath-
leticism of the younger players. It’s
occurred to me that, approaching
the end of my sixth decade of life,
I’m not going to get any better at
soccer—or much of anything that’s
physical in nature, for that matter.
Sure, from time to time I fantasize
that I’ll join a soccer clinic or make
some time to practice in between
games, but I never do, and I’m pret-
ty much certain that I never will.
The unshakable reality is that not
only is everyone on the field young-
er than me, but almost everyone on
the field is better than me, and it’s
going to remain that way as long as
I’m able to play. This would’ve been
an intolerable thought in my young-
er days. Now, I’m not so sure. After
all, week after week, year after year,
I continue to play, even as my physi-
cal capabilities gradually diminish.
So on this early April evening, I
find myself playing in a cool, feeble
drizzle. The clouds obscure the stars
and lie low above the trees that sur-
round the park, and the wet, green
turf glistens brightly in the white
floodlights that line the field. I’m
managing a little better than usu-
al this evening: one pass of mine
crisply arrives as planned right at
the intended player’s feet, and at
another point, I deftly poke the
ball away from an opponent, pre-
venting what would’ve been a shot
on goal. But then I clumsily muff
a crossing pass that skitters slickly
toward me and that might’ve led to
a score if I’d only been able to meet
it cleanly and punch it forward—not
an easy shot, especially in the rain,
but hardly unachievable for a more
adept player.
With a discouraged sigh, I turn to
head in the other direction, hoping,
as usual, to redeem myself by quickly
getting back on defense. Yards ahead
of me at midfield, Mara darts sud-
denly from the sideline in front of
the enemy dribbler and steals the
ball away from him, sending play
back in my direction. I turn once
again and clear out to the side to
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capable longing for an irretrievable www.stepfamily.org
past? What became of the man I once
was and never again will be? Are we
truly most human when we falter,
or do we just tell ourselves that to Writing
A Book?
escape the hard truths of our aging?
The rain is falling harder now, the
breeze picking up, and I run hard
toward the goal, my stubborn heart
Marian Sandmaier,
fluttering with wistfulness, with want- award-winning writer
ing, and with a whisper—something and Networker editor,
about the inevitable sorrow of grow- can help you to
ing old mixed with the sheer joy of
feeling alive.
clarify your vision
Brad Sachs, PhD, is a family psycholo- engage your readers
gist in private practice and the author of
numerous books. His most recent publica- polish your writing
tions are Family-Centered Treatment
with Struggling Young Adults and “I’ve published over 20 books
Why Am I Telling You This? Poems and still use Marian as an editor.
from Psychotherapy. Contact: drsachs@ Her kind and gentle hand always
drbradsachs.com.
makes my writing better.”
Tell us what you think about this article by —B I L L O’H A N L O N
emailing letters@psychnetworker.org.
For a free consultation, visit
Want to submit a Family Matters piece for www.mariansandmaier.com
an upcoming issue? Please see Submission mariansandmaier@gmail.com
Guidelines on our website.
PSYCHOTHERAPYNETWORKER.ORG 79 
 F milyy M tters
BY BRAD SACHS
The Oldest Guy on the Team
RUNNING FOR YOUR LIFE
M
y teammate, Mara, is the
picture of youthful vitality,
especially tonight, as the
other players maneuver through the
rain during our coed soccer league
game. Now in my late 50’s, I’m the
oldest member of the team and
surely the only grandparent on the
field. Mara, still in her mid-20’s
I’d guess, is probably the youngest.
Swift, fierce, and determined, she
tirelessly whips from one end of the
field to other, zipping off sharp pass-
es along the way with an uncanny
ability to get her foot on the ball,
wherever it may be.
I played goalie on my high school
team. In fact, my junior year I set a
county record with six consecutive
shutouts. But while I was good, with
quick reflexes and a sure grip, I was
never great—and I was never going
to be great, because I was never fear-
80 P S Y C H O T H E R A P Y N E T W O R K E R n JA NUA R Y/ FE BR U AR Y 2 01 7
less. The thought of taking a cleat in
the jaw or a knee in the groin kept
me from sprinting out of the box
and bravely disrupting developing
plays. On more than one occasion,
I was a sitting duck, left to watch
the ball, untouched by my human
hands, whir past me into the back
of the net.
I consoled myself by noting that
there were advantages to staying put
and patiently reading the onrush-
ing action. And often there were:
one of my defenders would sweep
by to stymie the attacker, or a shot
would wind up arriving right where
I’d strategically positioned myself.
In these moments, with the ball cra-
dled securely to my thumping chest,
I’d silently pat myself on the back
for my restraint. But deep inside,
I knew that self-preservation mat-
tered more to me than heroic self-
sacrifice, and not surprisingly, my
serious playing career ended after
one demoralizing day of college try-
outs when I quickly realized that I
was out of my league.
Many years later, however, I took
deep satisfaction in coaching my
two sons and daughter on their
youth teams, and I continued coach-
ing until my youngest reached a
level of play that surpassed the lim-
its of my instructional aptitude. It
was only when she graduated from
high school and our nest had emp-
tied of children that I took up play-
ing soccer again, invited by a young-
er acquaintance to join his team
in an over-25 league, almost 40
years after I’d played my final high
school game.
My agreement with myself was that
I’d play in the field, not in the goal,
because one of the main reasons to
return to the pitch was to find anoth-
er way to stay in shape and work up
a good sweat. The problem? While
my stamina was still solid and my
feel for the flow of the game acute,
never having developed any foot
skills, my moves with the ball were
easy to read and my shots unlike-
ly to instill any fear in an oppos-
ing keeper. Even now, despite my
decent speed, I’m dismayed at how
quickly I’m overtaken by opponents
on those rare occasions when I find
myself breaking into the clear and
dribbling downfield. Players seem
to appear out of nowhere and strip
me of the ball, leaving me to dog-
gedly follow the play back upfield
with a hint of anger and some der-
elict muttering.
Nevertheless, I greatly enjoy the
games—the camaraderie, the intensity
C O N T I N U E D O N PA G E 7 9
I L L U S T R AT I O N B Y A D A M N I K L E W I C Z
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