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.