Saturday, January 19, 2019


I am 76 years old and still growing psychologically and as a psychotherapist. Many of my patients are in their 60's and 70's and are also still experiencing themselves as growing psychologically. Including some who are experiencing profound shifts in their way-of-being-in-the-world. I and my patients also do acknowledge the physical and cognitive changes of the aging process and the full spectrum of feelings that those changes evoke. And. We feel more open to the potential for continuing to grow psychologically and spiritually until we die.
One day, a year and a half ago I was in robust health. Suddenly - without any warning - within six hours I was riding in an ambulance heading for the emergency room where I was diagnosed with pneumonia and septic shock. If my wife Jeanne had arrived home an hour later - which would have been her usual time - she probably would have found her beloved husband dead. Before this episode I was already very conscious of my aging process. Yet, this sudden physical and psychological trauma still is affecting me every day. I have become even more acutely aware of the preciousness of every day of life. I have become more conscious of how certain behavior patterns and ego attachments to some ways-of-being-in-the-world have blocked me from being more open to the flow of life. I have become more open to the flow of love between myself and others including my patients. My life is feeling fuller and richer.
One of my patients started psychotherapy at 87 at the insistence of his girlfriend who stated that their relationship would end unless he addressed his anger issues. In the initial sessions he was able to acknowledge that his lifelong pattern of explosions of anger had been so destructive to all his relationships. In subsequent sessions he was to look at his tendency toward self-sabotage that had blocked him from being more successful and really enjoying the many accomplishments of his life. As our work progressed he was able to internalize my repeated reminder, "time is running out" and has worked hard to make changes. Now at 89 his frequent refrain is "I am a lucky man." This expresses his deep appreciation for the richness of his life - the people who love him, the accomplishments (which are still happening) and his own personhood. His relationship is thriving.
Another patient, who had initiated therapy at 68 because of anxiety, was, after a year in therapy, diagnosed with early onset dementia. Because of the dementia he became unable to work and to perform many of the fix-it chores around his home. These had been his primary ways of defining himself. Initially these losses increased his anxiety, made him feel useless and diminished his already low self-worth. Gradually, as he increasingly accepted his "condition" - his Buddhist meditation practice was very helpful in that process - I and his wife witnessed significant psychological and spiritual growth. In contrast to before, when his demeanor was more serious and guarded, he seemed "softer" with a sense of lightness of being. He became more able to feel that his wife loved him for who he was not for what he did for her or their home. He trusted more the solid foundation of their love built through all the struggles they had weathered together. As they reflected upon these changes, both of them felt that somehow the memory loss and cognitive diminishments of dementia were helping the process of letting go of old ways of viewing himself and others and creating a more flexible way of being.
Another patient had initiated therapy because of the psychospiritual crisis evoked by becoming 70. Several of his close friends had recently died. Several weeks before our first session, two of his other friends had been diagnosed with early onset dementia. Early in our therapy he realized that although he had been in therapy twice before some core issues had not changed in any significant way. He wanted to delve more deeply. I have witnessed this phenomenon repeatedly with my aging patients especially when they connect to the phrase "time is running out." He was amazed when I said that I experienced him as a "very sensitive soul" and that he had probably been that way all his life. It became clear that he was still experiencing life through the lens of a very sensitive boy who grew up in the everyday atmosphere of the complex trauma of a highly dysfunctional family. It was especially helpful when I labelled that part of himself as "Little Paulie" who was very fearful and still filled with family shame. We then used the name "Big Paul" for the adult part of himself that was witnessing with compassion "Little Paulie" and protectively encouraging him to grow up. "Big Paul" conveyed the attitude, "It's safe now. I'm here for you. You're not alone anymore." He was profoundly grateful that with a lot of hard work both during and between sessions he was gradually able - even at 70 - to significantly shift his perspective on life and himself.
I feel moved to tell these stories about myself and my patients because they are hopeful and are counter to our cultural narrative. Our cultural stereotype is that old people sit around talking about their litany of body pains and aches, their cognitive and memory losses and the deaths of their friends. There is a partial truth in that stereotype. When I gather with friends those issues are often brought up first. However, someone usually changes that narrative. When one of my friends asks me "How are you?" my usual response is some version of "A year and a half ago I almost died suddenly. Because of that I am more aware of the preciousness of every day and I am grateful for and more open to the richness of my life."
As psychotherapists and counsellors we can help change the inner narratives of our aging patients/clients and the cultural narrative about the aging process. Yes, it is important for us and our clients to be able to acknowledge the full spectrum of feelings evoked by all the losses. And. It is also essential to look at and be open to the ongoing opportunity for more psychospiritual growth. Perhaps it will be helpful for your clients to internalize the mantra "time is running out" not with a sense of fear and dread, but with a sense of deep awareness of the preciousness of each day. A question for each of us to be asking is, "If my time is limited what do I want to do with it, who do I want to share it with, and how do I want to be with these people?" This means looking at how we may be blocking deeper intimacy with the people in our lives. This means looking at how some old ways-of-being-in-the world, ways of viewing myself and others that may no longer be useful in this stage of life. This means looking at whether my thought processes are too focused on projecting into the future and upon the losses, that I am missing out on the present moments of everyday life. These are the questions we can help our aging clients to address.

Wednesday, September 5, 2018


My contemplative walks in the woods and to a local pond are essential to my taking care of myself. My work as a psychotherapist, which requires deep compassionate listening and my being in the energy field of so much pain and suffering, can sometimes be very depleting. These twice a week walks enable me to recharge my psychological batteries. I have recommended this practice in other blogs(e.g. Recharging). From the feedback that I've received that suggestion has been helpful. These sojourns into nature also create a psycho-spiritual space of openness and receptivity wherein I connect to: God, to my personal Higher Self, to other realms of consciousness and to the non-human beings who live in those nature places. As a result of many years of these walks I have developed a deep love and attachment to these places. They have become sanctuaries for me.

I live in a small town in western Massachusetts so I have not yet experienced some of the catastrophic effects of climate change that have occurred in other parts of the world. What I have witnessed have been more subtle, but I can project over the next decade(s).

► What will happen to our beloved forests and to the creatures that live in them that are genetically
adapted to New England winters?
► What will happen as there is much less snow to those families that rely on the income generated by
those who enjoy winter activities?
► What health issues will be produced by the rising horde of disease-bearing ticks and increased air pollution?
At 76 I do not expect to witness these more severe effects. But the younger members of my community will.
And my sons and their families who live in New York, New Jersey, Maine and New Hampshire will.
► What will they experience?
► What will the impact be over the next few decades upon other people all over the world and upon
the non-human beings who are our companions on this planet?
► What changes have you observed in your beloved local nature places? What do you project will happen
there in the next few decades?
► What about the places where your children and grandchildren live?
► What about friends,family members and colleagues?

From my perspective it is important that the words "climate change" not be an abstract notion. By personalizing it and focusing on what we are witnessing now locally and projecting it forward we will connect more deeply with our feelings. Sadness. Fear/terror. Anger/rage. Powerlessness. Hopelessness. Of course, these feelings are difficult to hold and to be more conscious of. For me what has arisen more strongly alongside these feelings is a greater need to DO SOMETHING and
to be part of a group of people who are trying to DO SOMETHING.

For years before this I have contributed money to environmental organizations, invested in companies working on these issues, gone to protests etc. But this feels different - for me it is activating an intention to devote time and energy to be part of a collective effort towards a solution.

What "solution" I have chosen is to be involved in my local chapter of a national and international organization called Citizens Climate Lobby. Citizens Climate Lobby is focused on passing the legislative solution that climate scientists and economists of both political parties agree is the best legislative first step to reduce greenhouse gasses and the likelihood of catastrophic climate change - carbon fee and dividend. Simply, a fee is charged to the fossil fuel company at the point of origin(the coal mine, oil or natural gas oil well). All the money collected is held in a fund and returned to each American citizen in the form of a monthly check. One of the major impacts of CCL efforts thus far has been the formation and significant expansion of a bipartisan Climate Solutions Caucus in the US House of Representatives. I would strongly encourage you to learn more about carbon fee and dividend and the Citizens Climate Lobby
(VISIT - support this work.

My primary purpose in writing this blog is to encourage you to "DO SOMETHING' and to help your clients to deal with their sense of being overwhelmed and powerless by also DOING SOMETHING. What is essential is that whatever you decide to do resonates with you personally. This heartfelt and soulful motivation coupled with being part of a collective will be what sustains us in our efforts to deal with this huge issue. If Citizens Climate lobby does not resonate with you as what you personally want to do, please support our efforts, and also take a look at the book "Drawdown" by Paul Hawken which offers a number of other "solutions". I'm sure that you will find something that connects with you. We need to utilize many approaches to confront this problem.

For More Information:
Visit Citizens Climate Lobby

Thursday, July 5, 2018


Did your training as a psychotherapist or counsellor emphasize the importance of being a caring therapeutic presence? Did your training discuss how to cultivate and enhance your therapeutic presence? My training certainly did not. If course theories and techniques of psychotherapy are also important. However, over 40 years of experience in private practice have taught me that cultivating and being a caring therapeutic presence is essential. Without that our theories and techniques are much less effective. It is important for us to remember that the literature on effective psychotherapy consistently has reported that when clients are asked, "What was most helpful to you?" their response is some version of: "My therapist genuinely cared about me as a person"; "My therapist was really there for me,not just using techniques."
It is not easy to find adequate words to describe therapeutic presence. A vital aspect of it is our intention to have our whole self engaged in the session as much as possible on that day with that person. It means physically being there not exhausted or distracted by other objects in the room. It means cognitively discerning what therapeutic perspective and technique will be most responsive to the needs of this person today. It means being emotionally engaged with an open heart trying to sustain an empathic compassionate connection. It means being spiritually open trying to access guidance and wisdom from our own personal Higher Self and whatever other sources of assistance that might be available.
To be that kind of caring presence for many hours each day with a wide range of clients over many years is a profound challenge. Perfection is not possible. However, there is lots of good news for those of us who are trying to be that kind of presence. First of all, brain research has indicated that taking the time before each session to have the intention to do so activates the neocortex which then aligns other parts of the brain so that the probability of deep presence occurring is enhanced. Second, brain research has also validated my experience of over 40 years of doing this work. The more you cultivate therapeutic presence the more brain patterns develop and then get strengthened over time. So gradually the capacity to be that kind of presence becomes easier to access and then you also have a deeper reservoir to draw upon.
Cultivating and accessing a caring therapeutic presence is the work of a lifetime. There are several helpful pathways for each of us to explore. Because this is a brief blog I will just mention some of them and then describe one in more detail. For a thorough elucidation of this topic I would suggest reading, "Therapeutic Presence: A Mindful Approach to Effective Therapy" by Shari Geller and Leslie Greenberg(2012). That work inspired and informed this blog, broadened my understanding particularly of the brain research,and validated my years of experience.
Our own personal psychotherapy is an essential pathway that will help us become more conscious of our personal issues that might be triggered by our clients and are reducing our effectiveness. Also being attentive to our own self-care is vital so that we are not tired from or distracted by the responsibilities of the multiple roles of our lives. Because we are often not good at taking care of ourselves I have written elsewhere(see blog and book chapter on Recharging) on what are some of the psychological blocks that you may have to good self-care. In addition we need to work on developing more compassion - particularly self-compassion - so that we can be more open-heartedly compassionate towards our clients. We may also need to cultivate being a more compassionate presence in our everyday lives. An important question for each of us to explore is: "To what extent am I more present to my clients than I am to other people in my life?" I am not saying that we should be therapists with our family and friends. Rather I am saying there are probably many brief moments in each day when we could be a more compassionate human being. Why that is important is that the brain research indicates that the more that we cultivate presence throughout our lives the stronger those brain patterns become. We then have a deeper reservoir to draw upon during sessions.
I now want to share several practices that I have incorporated into my life that have helped me to develop and deepen a more caring therapeutic presence. Five minutes before I begin my morning or afternoon's work I sit in my therapist's chair and ask my Higher Self and other sources of guidance for help in fulfilling my intention for my clients to be a source of compassion, peacefulness and strength. I follow that with meditational breathing imagining with the out breath that I am letting go of whatever might be blocking me from being present that day. For a few minutes between clients I do the same. This is a practice I have been doing for many years. It is a way of acknowledging to myself that I am consciously moving from the ego realm of ordinary life into a different level of consciousness where my therapeutic self resides. It is fascinating for me recently to learn that brain research is now validating the importance of taking the time to set my attention which then calls into alignment other brain patterns.
In my meditational practice I have developed a relationship with certain nature places that have helped deepen my capacity to be present to my clients. This was certainly not my original intention in developing that aspect of my spiritual practice. However, it has evolved in such a way that is helpful to my work. Often I sit in meditation with my back up against an old ash tree with its thick roots exposed above the ground. For me the tree symbolically represents strength, stability, rootedness. That individual tree has become a living connection to the archetypal "Tree of Life". I also have a poster of a giant redwood in my office. When I look at the poster it reminds me of my local ash tree - and my actual experience of having meditated inside a redwood tree - and connects me at that moment to my intention to be a reliable source of rooted strength for my clients.
I also sit near a local pond and meditate. For me that pond symbolically represents stillness, peacefulness, equanimity. When I sit there I am trying to cultivate those qualities in my own consciousness not only for myself,but also so that I can project - perhaps even transmit - the energy of those feeling states for the people in my life. I have a painting of a pond in my office. When I look at it before I begin my work and during sessions it connects me to my intention to be a source of peacefulness.
I am extraordinarily blessed to have a small brook that is thirty feet behind our home and flows through our property. When I stand or sit by it I ask the brook to help me more connect to the flow of life. There is so much to learn about what the Taoists refer to as "the watercourse way" that is relevant for the human journey. Increasingly, witnessing the ways of the brook have helped me to be more in the flow of a session with each particular client on that day. To be able to let go of my need to control, influence or even know what's going on in a session and simply trust the process. What a challenge for my ego! Yet the brook is a good teacher. Having spent so many hours in the presence of that old tree, the pond and the brook have helped me to cultivate those qualities of a rooted strength, peacefulness and trust in the flow of life. I am then able to offer the presence of those qualities to my clients.

Several parts of this blog have been inspired or influenced by my recent reading of: Therapeutic Presence: A Mindful Approach to Effective Therapy by Shari Geller and Leslie Greenberg.

Wednesday, January 24, 2018


As I reflect upon my over 40 years as a psychotherapist I can now see there were stages in my evolution. I have also witnessed similar patterns in the therapists I have supervised and in colleagues that I've known for many years.The evolution has not been completely linear. There were certainly moments of creativity during my imitation period and there continue to be moments of imitation during the this later more authentic epoch.
In my earliest years as a psychotherapist I usually simply imitated what my therapist had done with me.At times it was pure mimicry - using the same words, gestures and tone of voice. My first therapist was a psychoanalyst. When I realized that I needed more training and supervision I went for four years of point-doctoral study to the same institute where he had trained. For those four years I read extensively and almost exclusively the writings of Freud, his followers and the neo-Freudians of the next generations of psychoanalysts. I immersed myself in that tradition.
If Freud witnessed how I worked now he would probably turn over in his grave or more likely excommunicate me for betraying him, the psychoanalytic tradition and my teachers. Yet I strongly feel that period of imitation and immersion was essential for the foundation of my lifework as a psychotherapist. I also acknowledge that I still use some of those concepts and techniques - they are now expressed through the unique synthesis that is my more authentic self.
Imitating our therapist or supervisor or favorite author was not a negative, it was necessary. We read extensively or entered a training program and assimilated ideas and techniques within a particular theoretical framework that we were initially drawn to or exposed to. It was important to immerse ourselves so that a solid foundation got built through practicing certain techniques and internalizing ideas within that paradigm.
Perhaps it might be fitting to describe that initial stage as an apprenticeship.
During this early period of our development some of our initial expressions of creativity and movement toward a more authentic self often show up as acts of rebellion or subversion. My second therapist was the head of this analytic institute. In therapy with him I refused to lie on the couch. In the atmosphere of that psychoanalytic institute that was a very rebellious act - an early signal that I was going to follow my own path.
With some of my early patients who were adult children of alcoholics I went against what was then a cardinal rule of psychoanalysis - to remain neutral and not disclose yourself. I revealed that my father too was an alcoholic. My patients deeply appreciated that empathic linkage. I took a further step and submitted an article describing my unorthodox ways of working with that population of patients. Somewhat to my surprise it was accepted by a respected psychoanalytic journal.
As we practice the techniques that we have assimilated we learn: what works for some clients and not others; what ideas explain issues that our clients are struggling with and what does not; what ways of working are a good fit for our personality and what feels inauthentic.
In order to further evolve in the craft of psychotherapist it then becomes essential to intentionally expose ourselves to other theoretical perspectives and to expand our repertoire of techniques and strategies. This stretches us in that we are not rigidly adhering to a particular framework and broadens what we can offer our clients. As we explore and incorporate these other pathways what occurs - often unconsciously - is an internal reorganization of theoretical perspectives and a synthesis into a new therapeutic self. I explored Jungian,humanistic, cognitive-behavioral, psychosynthesis and many other perspectives. Increasingly we then find it hard to answer the frequently asked question,"Are you a Jungian, cognitive-behaviorist, Freudian...? What would you call yourself?"
Many therapists over a number of years are able to develop a high level of mastery of the craft of psychotherapist. They expand what they can offer their clients by synthesizing the ideas and techniques of these other approaches. Yet they tend to stay within the boundaries of the known and familiar rarely breaking out to try something radically new, something that is their own unique insight or technique.
From my perspective it is important in the later stage of our evolution as a psychotherapists to consistently take more risks - to say or do more things with our clients that are authentically our own, that we have not consciously heard or read about others doing. To be more creative. This is not to say that we haven't been creative before or that these ideas are not influenced by others.
Sometimes these creative movements emerge from a personal life experience. For example, my ideas and strategies for helping my patients with self-forgiveness evolved from an identity crisis precipitated by my initiating a divorce. Nothing in my professional experience provided a clue how to forgive myself for the overwhelming guilt I felt for causing so much pain to people that I loved. I then developed ways of helping my patients to forgive themselves that were inspired by my personal journey.
Another, the technique of The Council, emerged from a weekend retreat in an isolated cabin that I took when I was turning 60. I had decided to imagine that the different parts of my personality were on this retreat and were addressing the question,"What is happening in my inner life as I enter my 60's?" I took a yellow legal pad - the same kind that I am writing on now to compose this blog - and unexpectedly I wrote pages and pages of thoughts and feelings. That led to the concept of The Council - a very effective tool that I now utilize when patients are facing a major life decision or entering a transitional moment in their lives.
Two medical crises, one was a very aggressive cancer in my mid-60's and the other seven months ago shortly after my 75th birthday, wherein I almost died liberated me to be more self-disclosing in unexpected ways. My patients dealing with their own medical crises or issues of aging and dying have been profoundly grateful for these moments of empathic connecting.
At other times these creative moments just spontaneously arise during a session where we suddenly find ourselves saying something to or doing something with a client that we've never thought of or done before. And its on the mark! It's exactly right for that person and that moment. Afterwards we find ourselves wondering,"What just happened? Where did that come from?" It is our creative and courageous - going beyond the boundaries of what is familiar and known - response to that moment.
These moments off letting go and being receptive to "something" flowing through me have increased since about ten years ago I started to more actively cultivate my relationship with my own personal Higher Self.In addition to my conscious efforts to engage my Higher Self during my contemplative walks in nature I started a practice of meditational preparation before starting work. Before I begin seeing my first patient I spend at least five minutes in meditational breathing and asking my Higher Self, "Please help me to be a vehicle of compassion and heart wisdom." Also, "Help me to connect to other sources of wisdom and healing beyond myself. Help me to be open to the assistance of the Higher Self of my patients." During sessions, particularly at moments when I feel uncertain what to say or confused by what is happening or overwhelmed by the amount of emotion that my patient is expressing, I ask my Higher Self for help. These "prayers" have helped to create a receptive space in my ordinary consciousness so that these creative moments of inspiration from multiple sources of consciousness can occur. At these times I feel more fully alive and authentically present to the moment.

Many of the ideas expressed in this blog have been influenced and inspired by writings about creativity in Oliver Sacks recent posthumous book,"The River Of Consciousness."

Thursday, October 19, 2017


My wife Jeanne and I recently returned from a much-needed eight day vacation in the town of Wellfleet on Cape Cod in Massachusetts. That section of Cap Cod is only three miles wide. On one side is the Atlantic Ocean and on the other is the bay. Every day we walked on the beaches at the water's edge. We focused on what it felt like to walk in the moist sand, to hear the comings and goings of the waves, to feel on our bodies the warmth of the sun and the coolness of the onshore breeze, to smell the salt air. We sat on the sand and did our meditation taking it all in physically, psychologically and spiritually.
It was so restorative. The cumulative tiredness and depletion of the effects of my recent medical crisis and the many months of our work as psychotherapists gradually ebbed away. We felt nourished by this immersion in the natural world, our dormant and depleted life energy was being replenished. It was a reminder to both of us that whenever we have experienced a physical/psychological/spiritual crisis spending concentrated time in nature has been the most reliable source of reconnecting to the life force both within and outside of us.
Who knows why spending that kind of time by the ocean is so restorative. Certainly there is something primordial about being at the ocean's edge. Is there some resonance with our reptilian brain that reminds us of the origins of our species? Is there some connecting with the primal memories of being in the nourishing waters of the womb? Is there something about the intake of negative ions that affects us at a cellular level? Is the unending ebb and flow of the tidal waters connecting our spirits with some feelings about eternal life? Maybe all of the above.
As psychotherapists and counsellors it is essential for all of us to have ways of restoring ourselves. We all spend many hours each week in the energy field of the suffering and struggles of our clients. Each of our clients needs us to be an open-hearted compassionate presence. After work when we return home our partners and children also need us to be emotionally available. How do we sustain that level of presence and not become exhausted, overwhelmed, emotionally distant, resentful and numb?
In order to sustain that level of empathic connection which is necessary for our most optimal work each of us needs to find our ways of restoring ourselves that uniquely fit us. From over 40 years of experience in private practice I have learned that a primary pathway is to regularly spend solitary time in some local nature setting. Whenever I sit, stand or walk alongside the brook that is behind my home or the water flowing at the bottom of the small gorge several miles away or at a local pond I feel reenergized. My psychological and spiritual batteries are being recharged. Standing or sitting by the water, acknowledging this felt sense of the presence of life giving energy, I take some meditational breaths. With the inhale I say "Water of life" and with the exhale breath I release the feelings of depletion.
When I am in the office in the psychological energy field of my patient's strong feelings, that sometimes can be overwhelming, I look at the painting of a pond that I placed on the wall behind my patient. Using that image to tap into the memory of the feeling state of being by the water I quietly do a few meditational breaths. With the inhale breath I imagine myself accessing the felt sense of being by the water and with exhale breath releasing the feelings of anxiety about being overwhelmed by the power of my patient's feelings. Gradually I begin to feel that some larger source of life is sustaining me at that moment. I am again able to be fully present with an open heart.

For more about this topic I encourage you to read another blog entitled "A Walk In the Woods" and the youtube video called "Recharging"

Thursday, July 13, 2017


Two months ago, while home alone, suddenly without warning my body was wracked with chills. Then for the next four hours I had alternating bouts of vomiting and diarrhea. When my wife Jeanne arrived home she found me in this depleted state and called my physician who fortunately picked up the call and said go to the emergency room. In the ambulance my body temperature was 105 and my blood pressure was plummeting to dangerously low levels. The emergency room team treated me aggressively with antibiotics, intravenous fluids and norenephrenine to regulate my blood pressure. I was in the intensive care unit for five days with a diagnosis of streptococcal pneumonia and severe septic shock made worse by the fact I have no spleen because it was removed twelve years ago as a result of very aggressive lymphoma. On the third day of my stay in intensive care, as my body was recovering unexpectedly quickly, the RN revealed that when I arrived I was the sickest person on the unit. At that moment I became increasingly aware that if everyone(Jeanne, my physician, the ER team) had not acted in such a timely way I would have died.
In the ambulance en route to the hospital, in the emergency room and throughout my five day stay in the intensive care unit I frequently asked my Higher Self, "Please carry me." And it did. My dear wife Jeanne, who was fully with me throughout this major medical crisis - including sleeping on a couch in my room every night - said it was amazing to witness that my consciousness was present during the whole experience. My primary care physician, who is a dear friend, visited me at home two days after I returned from the hospital and asked,"Were you freaking out at times?" I was perplexed by her very understandable question. After a while I realized that at no time in this ordeal did I feel fearful or anxious. WOW!
My Higher Self carried me through what one of the RN's described as "the most massive stress test that your body could ever experience." That transcendent part of my consciousness helped me to be fully present so the I could: collaborate with the medical staff, be unafraid so that fear did not interfere with my treatments and recovery, and most importantly to feel deeply that I was going to be "OK."
This is profound for me. It has deepened my faith that no matter what happens in my life, including my dying, my Higher Self will be present as my companion,as a source of strength and equanimity to carry me through. WOW!!! For many years I have cultivated a personal relationship with my Higher Self - whom I call Wiseheart. This medical crisis bore to me the fruits of that ongoing work. With my psychotherapy patients I encourage them also to develop that ongoing relationship and teach them how to access their Higher Self in everyday life. This experience has affirmed the importance of that work. I encourage you too to cultivate an ongoing relationship to your personal Higher Self.
There are no adequate words to describe the level of gratefulness that I feel to my body, to the medical staff at Cooley Dickinson Hospital in Northampton Massachusetts, and to all the people whose presence, love and prayers helped me through this ordeal. Coexisting alongside these feelings of immense gratefulness I was also carrying and contemplating - for several weeks after my return home - this unanswerable psychospiritual question "What is it like to not exist in this form?"
About a month after my hospital stay Jeanne and I felt we needed some time away and we went for three days to a town an hour and a half from our home. Our first night over pizza and beer we were discussing again all the thoughts and feelings we were each having while I was in the hospital. Then a man walked up to our table and said, "Do you remember me?" I looked up and said "Yes,but I don't know from where." He said,"I'm Matt. I was your nurse at the hospital." Both Jeanne and I got up, hugged him and expressed our great gratitude. I said," I can't imagine any hospital in the world giving me any better care than you and the rest of the staff at Cooley Dickinson gave me." He introduced his wife and son and we expressed our feelings to them. After he left Jeanne and I expressed our awe at this moment of synchronicity. What are the odds that at the moment we were talking about the hospital Matt - who lives two and a half hours from this pizzeria - would be there with his family.
Later that night,lying in bed while Jeanne was asleep, I began to have flashbacks of being in the hospital. After a while something inside me said "You are alive." Then it shifted to "I am alive' and then became a robust "I AM ALIVE." To affirm this statement I decided to do two things that I could not do in the hospital: one,get up and walk around; two, open a window and breathe outside air. Since that moment I say aloud robustly several times each day "I AM ALIVE." I do this to strengthen that inner feeling and to respond to the call to be more fully alive. The earlier question,"What is it like not to exist in this form" has receded. It is as if that synchronistic moment of Matt's appearance acted as a psychospiritual bridge to move me along from my thoughts that I almost died and ruminations about non-existence to a way-of being-in-the-world more connected to the life force. WOW!!!

Thursday, February 2, 2017


One of my patients gave me a copy of "The Book of Joy". It describes a series of conversations between two of the most respected contemporary psychospiritual teachers - the Dalai Lama and Desmond Tutu. Thee two men - now both in their 80's - share their thoughts about how to experience joy amidst all the pain and suffering and conflict in the world.
Among the myriad insights of the book one notion presented by the Dalai Lama inspired me to write this blog. He raised the question: since we emphasize the importance of having a strong physical immune system why don't we also encourage people to develop a strong mental immune system? "Of course" I thought,"that makes sense. As psychotherapists and counsellors we can help our clients to do that." Some of what follows flows out of their discussions and some emanates from my own work with patients.
The central concept is that by developing our psychological immune system we are taking a proactive preventative approach. As with physical illness is it not wiser to try to prevent problems rather than wait until an illness occurs? When we have a strong psychological immune system negative emotions(fear/anxiety, powerlessness/helplessness etc.) usually arrive in an attenuated form and are not overwhelming. Also when a large stressor does occur we have more internal resources to deal with the situation.
All of what follows will involve active work by our clients between their sessions with us. Or as some of my patients describe it - homework. The active work is necessary because so many of our usual psychological patterns are deeply engrained and have been reinforced repeatedly over our lifetimes. And - it is important to remember - are physiologically wired through brain patterning. A plethora of brain research in the last decade confirms this neurological patterning - including the important insight that our brains are "wired for negativity." The concurrent hopeful news is that the research results are also reporting that it is possible to change these patterns through active effort.
I teach all of my patients a simple breathing technique as a tool for dealing with anxiety and for releasing negative thought patterns. I say to them,"Physiologically with your in-breath your body takes in what it needs (oxygen) and with your out-breath it gets rid of what is not good for it(noxious gases). Let us now imagine that with your in-breath you are taking in what you need psychologically(peacefulness, relaxation,positive thoughts/energy etc.) and with your out-breath you are releasing what is not good for you(anxiety/fear, helplessness/powerlessness, self-criticism etc.)" We practice this in the office for ten minutes. The enables my clients to experience the process, give feedback and to receive from me individualized tweaking of the technique. Then I encourage them to do this for ten minutes each day until our next session. At the next visit, and periodically in the following months, I inquire about their efforts. We discuss difficulties in the mechanics of the technique and any psychological/practical resistances to incorporating this tool into their lives.
I also recommend that during their everyday life whenever they are feeling anxious or being overly self-critical to take a few minutes to do the breathing technique. Each time that they do that they are strengthening a new psychological and brain pattern.
Of course there are a number of my clients who already have some form of a meditational practice that involves breathing(e.g. mindfulness) or an active practice(yoga,tai chi etc.) that incorporates breathing. For these folks I encourage them to bring these practices more into their daily life utilizing mini meditational moments throughout each day to release noxious emotions. I also now say,"The more you do this practice the stronger your psychological immune system becomes."

Both the Dalai Lama and Desmond Tutu place a strong emphasis on cultivating compassion. Since the need for connection with others is a fundamental part of our humanity they emphasize that it is essential that we develop a greater sense of concern for the well-being of others. Interestingly evolutionary scientists see cooperation(including empathy,compassion and generosity) as fundamental to our species survival. There is additional research that indicates that the reward centers of the brain are activated when we feel compassion and do something for others. Psychologically each time we do something for someone who is suffering we expand our heart's capacity for compassion.
Often when our patients are describing their own pain they will also report that they are aware that there are people in the world who are suffering more than they are. Not infrequently this makes them feel less entitled to their own pain. My response is"I have a different perspective. Whether your pain is greater or lesser than others is not the issue. It is not a competition. Our common pain is one of the things that connect us to others. Imagine that your current pain is part of the universal pain and that our hearts go out to each other." Another common comment by my clients when they are reporting the losses or big life trauma of someone else,"I cannot imagine what it would be like to lose your...or to have that kind of trauma." My usual response is,"I have a different perspective. Even though to do so is hard I think that it is important to take the time to try to imagine what it would be like to be them experiencing that pain. It will increase your compassion for them. Both of you will benefit. You will feel closer to them and they will feel the energy of your compassion. They will feel less alone."
Whenever my patients are overly critical of themselves I say to them,"It is important to be compassionate towards yourself." After they have heard this phrase from me a number of times they gradually internalize it and begin to say it to themselves. Developing self-compassion significantly increases our resiliency to stress because we are no longer attacking ourselves.
Many of my clients have difficulty taking in praise from others and in genuinely feeling good about their own accomplishments. Some of this difficulty is personal and related to their life narrative.(Please refer to the chapter entitled "Love Blocks" in my book "Working From the Heart" or an earlier blog also entitled Love Blocks" for an in-depth discussion of this issue). Some of this difficulty is cultural in that there is an overemphasis in our society on constantly striving and being productive. For many people this contributes to self-criticalness and unrealistic self-expectations. The resultant diminished self-esteem is not good for our psychological immune system. It leaves us with a sense of less inner strength to deal with life's stressors. I try to counteract this personal and cultural pattern whenever possible. When one of my patients reports some moment of psychological growth I stop the flow of the session to acknowledge the accomplishment. Then I encourage him or her at that moment to use their in-breath to take in more deeply the sense of accomplishment and with the out-breath to release some of the inner feelings of low self-worth. For some bigger moments I extend a "high-five"; for even bigger moments I will give a "double high-five" or a hug at the end of the session. These moments during the session are also a modeling. I encourage my clients as "homework" to take a few moments during their everyday life to use the breathing technique to acknowledge, celebrate and take in more deeply their daily accomplishments.

One of the areas that Desmond Tutu and the Dalai Lama emphasize in order to experience more joy is to encourage us to cultivate gratefulness. They discussed how our competitive culture focuses on the accumulation of things, success/failure and external measurements of status. I also witness how often my patients focus on what is missing or insufficient in their lives. As a Buddhist the Dalai Lama has practiced for over seventy years non-attachment to externals and cultivating gratitude for life. He expressed his delight about the research that grateful people report more positive emotions, better physical health,vitality and life satisfaction combined with lower levels of depression and stress.
Introducing a more grateful attitude into our life does not mean we deny or minimize our pain and struggle. What it means is that we are acknowledging that coexisting with our current suffering are things and people in our life for whom we are grateful. To help cultivate gratefulness I teach my patients to use the word "and". For example,,"I am really struggling right now and I am grateful for friends who really care about me." I also think that ritual can be helpful in cultivating gratefulness. For example, at the end of my meditation I always spend several minutes thinking about the people now and in the past who have contributed to my growth including those who have caused me problems and forced me to grow. Several years ago I also started another ritual. After I have seen my last patient for the day I kneel down in my office and give thanks for the patients who came to me that day who by opening themselves to me sustain my work and my life. I am also grateful for all the sources,known and unknown, who have provided guidance that day so that I could help my patients. As these practices have evolved my life has felt increasingly rich and full.
In conclusion I would like to reiterate that all of these ways of developing and strengthening our psychological immune system inquire conscious effort and hard work. We are often going against the patterns of a lifetime that are psychologically engrained and neurologically wired. The results,however,are worth the work.