OUT OF MY MIND

MALE OR FEMALE? VIVE LA DIFFERENCE!

After I finished reading the Sunday New York Times article on the feminization of psychotherapy (click the following – Need Therapy? A Good Man is Hard To Find), I was once again reminded of how wedded we have become, particularly in America, to the idea of equality. Don’t get me wrong, we have had to work hard to leave stereotypes behind, and advance our thinking regarding inequality in many areas-  work, pay, gender roles, – all the stuff that has been at the heart of the battle of the sexes. But, when it comes to psychotherapy, it has always seemed to me that gender can make a difference in treatment. An important difference. Good to see it in the New York Times!

It goes without saying, that a good therapist should be able to work in all areas of human behavior regardless of their gender. Furthermore, many believe that it should not make any difference whether a patient works with a woman or with a man. One’s personal dynamics will play out in the therapeutic relationship regardless. Perhaps this has come to be a commonly held belief in my profession because we like to think that as therapists, who we actually are, (including our gender) is of little consequence. What matters is how we listen, respond, who we are and become in the clinical hour. Yet, for all the hours that I have spent sitting with patients, I have always been aware of who and what I am (a woman), and the fact that this makes a very important difference to my patients, men and women alike. Sometimes a man needs a man to talk to, and sometimes only a woman will do. And vice-versa. It may have to do with the patients’ preference in regard to their need for safety and understanding. It also, may have to do with particular issues, usually to do with sexuality and identity. And it is not only patients who have gender preferences. Many a time I have received a call from a colleague, which started with, “ I am calling to refer Mr. or Ms X, I think they would benefit from working with a woman”. So it turns out that there are many of us out there, who believe that gender does make a difference, and that it should be observed in our work. In fact, the person of the therapist makes a difference. Gender is just one of the factors. Age is another factor that seems to affect the choice of therapist.

From a clinical perspective, there are various gender dependent dynamics that may be difficult to work out in same or different sex, patient-therapist dyads. Take for example, a man who struggles with his masculinity and finds other men too aggressive, or competitive, or downright frightening. He might choose to work with a woman. Or a woman, who has difficulties accepting her body and does not identify with what being female, means or implies to her. Sometimes we need our therapist to embody our experience, and this is easier to do when the therapist is the same gender we are. Granted, patients are making an assumption on the basis of sex- he will understand me better because he is a man, or she must know how this feels, because she is a woman. Such assumptions are not necessarily always true, there is the person of the therapist to consider, but they do influence the course of an analysis. Patients’ often endow their therapists with abilities that they need to believe in, in order to do their work.

As an analyst my education served to consolidate my belief that women and men work differently in the consulting room, and that they do so because of their sex and its identity defining implications. This is quite a feat in a profession that has minimized sexual difference and grew out of Freud’s notion that we should attempt to be blank screens for our patients. Aha, blank screens, that’s right. This idea always seemed a little wacky to me, even though I admit I tried it. I tried, but it never worked for me, or for my patients. We might attempt to provide a blank screen, but the original canvas it is stretched upon makes a considerable difference.

Early in my career, I developed an interest in, and explored the issue of the analyst’s gender as an important variable that can facilitate the expression of certain aspects of the patient’s experience of masculinity and femininity (click – see Ceccoli, 1999; 2000). Analytic listening is necessarily filtered through gender, and the differences between men and women reveal themselves at the level of listening.

As men and women we have very distinct and different experiences growing up. Yes, many of them are culturally determined. But many of them are biologically pre-set.  Biology is a sexed reality and is reinterpreted psychically on the basis of socio-cultural realities. Furthermore, the psychic representation of sexual difference, and the maturational unfolding of physical femininity and masculinity have particular (and different) developmental consequences for sexual subjectivity and desire. For example, sexuality and aggression are experienced in gender specific ways.

All of this to say that gender makes a difference. We cannot ignore our bodies, their sex, and developmental histories, and we cannot privilege them over our social and cultural experiences. They go hand in hand despite the tension this might create. Contemporary psychotherapy and psychoanalysis has come to address the person of the therapist as an important variable in treatment. It has begun to look at the many factors, which constitute and go into the therapeutic relationship and the facilitation of emotional growth. As such, who the analyst is, including their gender, age, level of experience and therapeutic orientation are factors to be considered in every analysis .

Differences are important. Vive la difference!

 

ON LIES AND LYING ON THE COUCH.

I have been thinking about lying, and particularly, about lying on the couch, and the possibilities of why, anyone undergoing psychoanalysis or psychotherapy might be moved to not tell the truth. Therapy is, after all, a way of understanding oneself and ones’ personal history or personal truths. So at first blush, it makes no sense at all to think about lying in this context. Or does it?

I believe it was Freud who considered lying as the first act of privacy. Think of it: that moment when we first discover, as children, that adults cannot read our minds. In that moment, we are in fact separate from them, and have our own individual thoughts, which are not immediately known to an other. WOW. As children, this must feel like magic; as if we have discovered our personal invisibility cape, which protects us from discovery and affords us some room to move, to be, well, private in our thoughts. I imagine that for some, if not all children, the first lie must feel like an omnipotent act. An act that provides immediate separateness through the establishment of an invisible boundary. So far so good. Thought of in this way, lying can be seen as a necessary developmental accomplishment. A personal achievement, which helps to establish necessary boundaries with which to navigate the interpersonal world.

But what happens when lying becomes an ongoing way of negotiating our relationship with others and the world? Here I think, we are seeking relational short cuts. The liar enters relationships with a need for control, and this leads him/her to manipulate others toward a particular understanding or experience. Ever wonder why you feel a little crazy when you discover you have been lied to? Such manipulation often interrupts the natural flow of possibilities between people, and  through the lie, such possibilities are lost, creating instead repetitive interactions that follow a predictable pattern. Lying shuts down personal vulnerability and replaces it with predictability. Thus, the person who lies habitually reinforces a state of isolation by disallowing the possibility to be known, again and again, replacing it with a rehearsed version of an acceptable persona.

So what is at the heart of lying? Fear. Often a fear that began and was nurtured in childhood, and holds relational memories of the self as wounded and vulnerable, as well as experiences that rendered the self as bad, and unacceptable to loved ones. As adults, this translates into a fear of being fully known by another through the many interpersonal possibilities that arise within relationships.  It translates into a fear that our unconscious will betray us within the matrix of relationality. That we will become known for exactly who we are.  Yikes!  And then there is shame. Shame envelops the liar in a labyrinth of secrets and silences, which serve to further isolate them from any chance of intimacy, and the complexity of authentic human interaction. Shame reinforces the pain of childhood experiences and forecloses connection.

So why lie on the couch? The opportunity to look at oneself within the context of an authentic relationship can be fraught, even when that relationship is a therapeutic one. Any discussion of lying necessarily involves addressing the truth, not as an ‘objective truth”, but as a personal narrative which defines who we are. Often our truth can be terrifying, re-awakening self states that hold pain, hurts, and the “not me” parts that do not fit in with who we want to be, and are thus temporarily (magically?) exiled through the lie. Speaking our truth(s) to another brings past and present into the room and makes it possible to address it interpersonally, and as experienced by both participants. Giving voice to our truth makes us vulnerable to another in the same experiential way that precipitated lying to begin with. And therein lies the rub: while lying begins as an act of privacy, it continues as a protective interpersonal maneuver, and the experience that it attempts to occlude has to be negotiated and addressed relationally. In vivo.

Lying can be done with words or with silence. We lie because self- experience can be too shameful, painful, frightening, overwhelming and unbearable to be spoken and dealt with, too potentially traumatizing to relive, even through the spoken word. Lying gives the illusion of safety, but at a price: it robs us of a part of our history, and a part of ourselves. It makes authentic relationships difficult if not impossible. Lying simplifies the story and reduces the meaning and complexity of human experience. Bringing lies into the open re-activates all of the feelings that necessitated them initially – perhaps this is why lying occurs on the couch as well as off the couch.

In the consulting room, we are always in interaction with many truths and un-truths about remembered and lived experience. What we can count on, as therapists, is our experience of the other and the various and multiple ways in which we relate to each other and each others’ emotional and cognitive states regarding particular events.  I think of these moments as relational experiential truths: they are felt even before they are fully understood and put into words. The truth that we seek to encounter and make available in treatment, is one in which there is the space and room to consider many possibilities, including the ones that may lead to a lie or omission, and make choices that free our patients to become real and in sync with who they are and how they want to live. This is necessarily an ongoing process that is mutually negotiated.

The essence of the psychotherapeutic relationship and its potential for cure lies in our ability to continually refine and redefine the personal truths that are spoken, experienced and lived at any one moment. Psychoanalysts and psychotherapists are knowledgeable travelers in the terrain of conscious and unconscious experience, and most of us are committed to going the hard way with our patients, the way that is feared and perhaps not yet known, but moves within the possibilities of human relationship and connection.

 

LET’S GET PHYSICAL.

Really? Yes. Or as physical as one can get in a blog, and as a psychoanalyst. Lets talk about bodies. Our bodies. How they speak and what they say. This is an area that has been largely ignored, or relegated to second place in psychoanalysis. Mostly, because as psychotherapists we have grown more comfortable with minds and less so with bodies. It is an area that many of us are trying to put back on the psychoanalytic map because it deserves as much of our attention as our psyche does. Psyche and soma, hand in hand, in constant interaction. To wit: what do our bodies say and how do they speak?

Developmental research tells us that early experience is registered physically. No thought there, just feeling. It tells us that there is a sensori-motoric organization which precedes, and is vital to the life of the mind. Thus, our bodies are the first instruments in the experiential knowing and understanding of who we are, and who we are in relation to others and the world. We feel first (and think later), and this experience begins to be translated to us through our physical interaction with our caretakers. As we develop a profusion of sensory and physical experiences, we begin to experience ourselves as engaged with, and able to engage others. We feel our way through and in relationship to another. Over time, and as we develop the ability to use language, to think and speak, we begin to assign meaning to our physical and embodied experience. We begin to connect our sense of ourselves with thoughts and actions. This is how experience becomes signified and acquires meaning.

Early relational ruptures, traumas, and illness, greatly impact the body and are absorbed within it, inscribed in its physicality. These corporeal inscriptions become the precursors and repositories of our internal experience and mentalized world. While as therapists we attempt to put words to experience that has been incorporated in this way, the body does not speak in words. It speaks through sensations, feelings and movement. It speaks in an older and more primary language, particular to the body in question. The body holds and assimilates all of our experience, and the mind is always a tad behind in the translation of that experience. Often times more than a tad. Our mind can entertain many possibilities, it plays with them. But the body never lies, it just is. And it remembers.

The body speaks through sensation: a feeling that unfolds from the inside through our senses, sometimes dizzying, painful, deadened, fiery, alert, you name it, but before you name it you feel it. Somatic experience speaks directly through our physicality, and only then do we go about trying to figure out what it means. Despite our reliance on our psyche, it is the body that speaks first.

Our bodies are key players in the development of our sexuality and the ongoing elaboration of our identity. The mind, our psyche, gathers much of this information and begins to translate bodily states and internal sensations, which are filtered through cultural and social norms, into thoughts and internalized experience. Consider this: it is the body with its experiential, somatic reservoir that fuels, feeds, and shapes the mind. It literally maps out who we are to become.

When I sit with a patient in my office, I am usually aware of the way that they carry themselves. How do they walk in, sit, recline? Do they look at me when they speak? When do they look away? Do they smile, laugh, cry? Is their movement easy, fluid, or labored and slow? I am also aware of my body and how it feels. Given the fact that I often sit for hours at a time, I try to intersperse movement in my day. Let my body move a little so that it can be open to listening and feeling the particular movement  and aesthetic of the patients I sit with. Receptive to the body of the other. Despite the imposed mind-body binary that psychoanalysis has reified, many of us are attuned to both what is said and not said in the room as well as what the body does or does not do. Communication and meaning is thus multiply determined through our various languages: emotional, affective, intellectual and physical.

It is no coincidence that activities which involve physical movement, such as Yoga, Tai Chi, Karate, and dance, to name but a few, carry potential mind benefits with them. It is often movement, through its disciplined motion and action that releases what is held in the body. The movement becoming a language form for the articulation of somatically held experience. Or like a colleague recently told me: “Good yoga is like good therapy, it accesses important experience and brings it to the fore.”

 

Tic-Tac-Tic-Tac: On TIME.

While talking with a patient about her sense that she never has enough time to do what she wants to do, she told me the following story. She had heard an interview with the actress Laura Linney on NPR, in which she was talking about having three weeks to rehearse her role in a play, and her feeling that there was very little time to learn it. The director called the cast together and told them “there is much to do so we have to slow down and take our time”.

Slow down so as to have time. A paradox that turns out to be true. When we slow down and attend to what we have to do, we find that there is plenty of time for everything. How can this be?

I have been thinking about time. How we use it, and think about it, or not. Whether we are aware of it or not.  Whether we act with deliberate attention to time, or whether we feel as if it escapes us and just happens. What is our relationship to time, and how does it come about?

Time is something that some of us are very aware of, and others are not. Some of us are always on time. Then there are those of us who are always late. And then there are those of us who are always running around, rushing like the white rabbit in Alice in Wonderland. Oh, and then there are also those of us who are always early. How we manage our time says a lot about how we manage in the world. Clues about us and our relationship to our life, as exhibited through our use of time.

Our relationship to time is rooted in how we manage ourselves in relation to the outside world. How we go about taking care of ourselves, locating ourselves in our lives. It is a part of our system of self- care, internalized as we grow up and take in how we were treated and cared for as children. Like much of our personal history, time and how we think of it and use it is one of the many elements that determine our relationship to ourselves and others.

While culture impacts our sense and use of time greatly, we filter its pressure through our internal experience. Our perception of time is influenced and dictated by our moods and affects. Depression, anxiety, and physical illness, to name a few, will alter our relationship to time and our experience of it. For the depressed person, time can stretch out in long blurs, where days turn into weeks and are lost. For people who suffer from depression, time is always lost, something that has passed them by and they have not lived, or have no experience of living. Something they mourn, feeling that they have lost so much time and that it is “too late”. For someone who is anxious, time becomes a formidable tormentor, adding angst to every potential appointment, due date, schedule. For the anxious soul, there is never enough time, they are always chasing after it and it always eludes them. For someone who is ill, time can go either way: it can threaten to run out, moving fast and robbing one of the ability to do and be. Or, it can move at a snails pace, highlighting pain and discomfort. All examples of how our internal experience, our senses and feelings, determine our awareness of time and the various meanings we assign to it.

“There is much to do so we have to slow down and take our time”. Wise words that have been at the core of meditation practices- as we stop, and slow ourselves down we recover the time to attend to what is happening within and without. We recover time and our sense of the present. In many ways, psychotherapy asks us to do the same: to stop and consider our lives thus far, to sit in the present and re-consider what has happened, what is past, and what is now.

 

ON SPEAKING AND FINDING OUR VOICE.

 

Much of the psychotherapeutic hour is based on dialogue. On putting our experience into words, as an attempt to communicate to another what has happened, what we feel, what we remember. The interchange that ensues in each clinical hour is particular to the experience of each patient and their analysts’ experience of them. Each clinical moment is constructed on this dual, shared experience and each participant’s ability to find the words to communicate it. As such, our speech is performative: an articulated action meant to make contact with another person, as an invitation to be known.

As I have written in other blogs and professional papers, it is often the case that words fail us. That they are not enough to convey the complex and deep meaning of our experience. At such times, we may convey meaning and experience through silence, or a look, a movement, or by acting in a particular way that invites the other into an experience that is known through its shared feeling, but has yet to be articulated and understood. All of these pertain to the psychoanalytic situation, in which it falls within the analysts’ purview to find words that are adequate enough to capture the multiple, layered meanings of personal experience, and lead to some mutual understanding. We always come back to words, to narrative, to dialogue as a way of connecting to others and elaborating ourselves – as a way of being known and understood.

We rely not just on words, but on the way that they are spoken, and here, it is our voice that takes center stage. Our voice, with all of its dense inflections, tones, rhythms and accents, adds color to our words or neutralizes them altogether. It provides a direct experiential link between emotion and feeling and thought. It bathes words with affective expression, which bestows diverse meanings and alters the strict definition of words. This is something that music and vocalists have always known – alter the harmony and it changes the meaning of the melody, alter the rhythm and you shift the emphasis, add coloratura and you create an individual thrust  and intensity,  sing a duet and you enter into a musical conversation or argument. Vocalists can modulate their voice to convey different intentions, which reach inward and affect us deeply, calling forth our own, personal experience. Musicians do this through their instruments and their interpretation of the score. The pliancy and elasticity of our voice changes and shifts the meaning of words so as to make them capable of expressing a myriad of  messages and implications. It is our voice which carries the emotion and rounds out the sharp and constricitve edges of language.

The human voice is a complete, amazing and powerful personal instrument. Through the use of our voice we add emotional texture and expand the potential of words and what they can convey. With our voice we fill in the area of language that is porous, in which the possibilities are literally endless since they involve the full spectrum of emotional life and experience. Psychotherapy provides a space where one’s voice can develop and change, where it can resonate with the different meanings of  personal history and life experience and its echo in the present. Often, finding our voice when in dialogue with another, ushers in new possibilities for being and a new understanding of our history and past.

Our voice is like our calling card. Hello world, (it says), here I am, and this is how I make myself known, this is how I want you to know me, this is what I want you to understand about me. Our voice moves our personal aesthetic forward toward others, engaging them in different ways. It provides the means for the elucidation of who we are and what we are about. We can use our voice to clarify meaning, alter it, or obfuscate it. Furthermore, with our voice we can draw attention to or away from specific situations and information, as well as engage others intimately or keep them at a distance. Our voice is ultimately, the carrier of emotion and the bridge from our internal experience outward, into the world and into our relationships with others.

Hmmm….It certainly underscores the meaning of  the saying: “it ain’t what you say, it’s how you say it”.

 

 

WHY WE NEED ART.

Several weeks ago I wrote a blog about language and its limitations. I was essentially addressing the area of our experience that is not language bound, or if it is, it is bound to a language of affective experience and emotion, which cannot be captured in words, and often, disrupts logic and our sense of self-cohesiveness. The power of feelings to agitate and overwhelm us lies in the fact that they are a communication which contains a relational memory trace within it, embedded in the very fabric of the emotion. Or put another way, we learn to experience our feelings in relation to another, and we learn to understand them and navigate them within that relationship. Thus, the meaning(s) that we assign to a particular emotion, and the words that we chose to talk about it all come about through and within a relationship. Because affective experience has its own language (feelings) and its own logic (relationship based) words are often not enough to capture it. And this is where art, in all its manifestations, comes in.

Art provides us with a form of aesthetic communication that bypasses language while accessing personal experience. It dwells in an area of experience where words are not enough yet deep meaning is present. The aesthetic experience that art captures and translates for us speaks through rhythms, tones, and traces that are not yet coded through spoken language but are perceivable through colors and frequencies, a register of the senses, that is yet to be defined by language and defies a particular meaning. Think of how deeply a particular painting can touch you, or how transporting a novel or poem can be, stirring our imagination and our hearts. Or music, which is capable of providing an extra dimension to reason, rationality, logic and language by filling in for what words alone cannot possibly capture. Think of Opera as an example of bringing emotion into dialogue musically, the harmony changing the meaning of the melody, the rhythm varying its intensity.

The first inkling I had regarding the power of art to access and elaborate emotion came to me early on, through my studies in music. It was through various classical composers that I learned about the depth of my own feelings and how easily accessed they were depending on what I was listening to or playing.  Artists know this well, and they communicate and speak through art so that the rest of us can be stirred and touched through their aesthetic movement to our own. Perhaps this is one of the reasons we all have our personal, favorite composers, painters, choreographers- our individual interpreters of the movement of our own aesthetic sensibility. Bottom line: emotions and the language of affect are better apprehended and expressed through art in all of its various forms. We need art and artists to capture and interpret internal experience and shape it into a corporeal state that speaks to us directly and from the inside.

In my previous blog (I Do, I Do…) I wrote about relationships as involving a deep exchange between people which reveals intimate and previously unelaborated self-states about both partners. I invite you to click on the following link, and experience what I wrote about through the choreography of Mats Ek, in a three-part piece called Smoke. It says so much more through its movement than I could possibly capture in words. Enjoy.

[youtube width=”690″ height=”558″]http://www.youtube.com/watch?v=hik5QkWz0fc[/youtube]

[youtube width=”690″ height=”558″]http://www.youtube.com/watch?v=RTaFQlGJbWA[/youtube]

[youtube width=”690″ height=”558″]http://www.youtube.com/watch?v=PapxE1xTWM0[/youtube]

 

I DO I DO! On relationships and commitment.

What does it mean to make a commitment to another, to be in an intimate  relationship with another? Beyond the vows that we make, the intentions that we have in our heart, the passion and attachment that we may feel, what is commitment really about?

Our culture tells us that relationship and commitment are something to aspire to, and are about love, trust, communication, partnership, and companionship. Ok, so far so good, who would not want that? But as a psychoanalyst I know, that relationships, and our ability to make a commitment to another, involve more than the elements that might make for  good relations. And furthermore, that the ability to commit to another and stay committed, turns out to be a real test of character, but not in the way that you might think.

When we commit to another, we commit to knowing them deeply, from the inside. Relationships involve an ongoing, intimate exchange between two people, who come to know each other and themselves through their experience of each other within the relationship. When we are involved with another, we not only come to know them, we also come to know parts of ourselves and our character through our partners’ experience of them. And this is the dirty little secret about relationships: they put us in touch with parts of ourselves that we might otherwise never know. Most often, this surprises us; through our relating to another we may find out that we are many things we do not like about ourselves, or want to be –impatient, bossy, critical, mean, etc.- aspects of our selves that are only activated within ongoing intimacy and may seldom, if ever, make an appearance in other situations and/or less intimate relations. Features of ourselves that may be saturated with shame and kept out of awareness, but return within the dance of intimacy as parts of our early relational language. After all, our blueprint for intimacy becomes established in infancy through our interactions with our caretakers. When we enter an intimate relationship in adult life, we bring with us many early intimacies that will likely become activated in our relationship with a significant other.

When we commit to another, we commit to bearing their character and the many articulations of their very being, through our experience of it.  We commit to our processing of the particular aesthetic of the other through our experience and interaction with them. We in fact say to our partners: this is what you are like. The truth is, that we are also known and elaborated, through the others’ experience of us. It is our partners that can tell us a great deal about who we are in relationship to them. And this is what accounts for rupture in commitment: who we become to the other and what it says about us, may not be who we want to be. There is such a thing as a bad match: individual characters relating to each other and foreclosing possibilities for the recognition and elaboration of each other, playing out a version of intimacy based on the past and their history. This is also why bad relationships can wreak havoc with our sense of self: they validate our worst fears and entrap us in repetitive interactions.

There is an old Freudian saying that we tend to marry our parents. The modern version of this, is that we are drawn to what is familiar and known at some deep, intimate level. In this sense, the character of our partners (and friends) will affect which parts of us are engaged and how – celebrating and supporting our personal aesthetic or foreclosing it. Even “good” relationships are a strain to bear, because they necessarily involve us in a deep, experiential character exchange where we come to know ourselves through the other and in relationship to them, and vice-versa. The ability to stay committed to another involves a process of mutual recognition, as well as a continuous elaboration of each other, that is capable of repairing interpersonal ruptures and validating individual experience. Ultimately , it boils down to who we want to be in relation.

TAKE A PAUSE.

We are inclined to move, to think on our feet, to react, to keep pace with the world around us. We are invited to multi-task, a word that did not join the English dictionary and vocabulary until recently (at least not as related to human activity) to accommodate our cultural need to do. And to do many things at once. The more the better, as proof of our ability to be productive. This in the name of efficiency, but at what cost?

From a psychoanalytic viewpoint this is all wrong. While we can attend to many things at the same time, we cannot engage fully with all of them. From my chair, it is one thing at a time, with full attention to the person, and as many dynamic elements in our interaction as possible, as well as my experience of them. Being conscious, and staying attuned to our thoughts and emotions, as much and as often as possible, helps us engage fully in the world. So that we can be present. Every moment a new opportunity to do so.

Pema Chodron, a Buddhist monk with a gift for making difficult issues and emotions understandable and workable, speaks about the need to take a pause in our lives. She has turned the ability to pause into the art of reflection. Chodron counsels us to take a pause often. Particularly when what we want to do is react. Specifically when we are overwhelmed by our emotions. She advocates pausing, stopping and taking a breath. Taking a moment to consider. When we stop, we have the opportunity to consider and reflect. We take notice of ourselves and our reactions, as well as the situation surrounding us. Consciousness and our ability to connect to it, is in the pause. When we pause we have access to our consciousness. When we pause we have choices. When we pause we can choose a direction, we can create a conscious path of action. We can change what we do and what we think.

The psychoanalytic situation is built around the idea of making space and taking time to attend, to listen, to get to know, and to consider our history and the circumstances of our lives. Most of us enter psychotherapy because we are in pain, and we are looking for a way to change. The journey that psychotherapy involves is about self-knowledge and understanding, and about using that knowledge to reconsider our lives and create change. To find new ways of being and experiencing ourselves and the world. Often this involves observing ourselves in interaction with others, and reflecting on our behavior. It involves attending to our emotions and our thoughts. Over time, it is the practice of reflection on our behavior that allows us to change it. A prolonged pause if you will, that gives us time to reconsider who we are and who we want to be. But one need not be in therapy to practice the art of reflection. Pausing before we act or react gives us the opportunity to change direction, to think before acting or speaking, to include what we know and use that knowledge, along with our feelings, to consider the situation anew and perhaps act differently.

When we pause we have the opportunity to attend to the details that often get lost in the big picture. And details are important to all of us. In fact, when we do not attend to the details we run the risk of making mistakes, and worse, of hurting others and ourselves. Pausing allows us to consider the details as well as the overall picture. It is a simple practice that yields big results.

ON DREAMS – And Making Movies.

Dreams are a type of self- communication. In some cultures, they are a communication from unknown parts of the universe, and as such they are shared in town meetings and included in community decisions. The Raramundi of Northern Mexico plan their sleeping arrangements to facilitate waking and discussing their dreams. The Ashanti of West Africa, believe in dreams as actual expressions of feelings and behavior and will bring legal action against another on the basis of the content of the dreams. The Iroquis hold an annual festival of dream sharing through pantomime and story telling, which then becomes part of their community lore. In ancient Greece, dreams were believed to be messages form the Gods. In the modern Western world, Freud considered dreams to be the “royal road to the unconscious”. Freud’s theory of dreams, along with the concept of the unconscious remains one of his most important contributions to a theory of mind.

My own interest and experience with dreams began at my grandmothers’ knee. We would sit and eat breakfast together in the kitchen, and she would begin my day by asking me what I had dreamt the night before. We developed this morning routine in which she taught me how to be curious about my dreams.  Many years have passed since then, and her interest in dreams deeply influenced me,  even before I became a psychoanalyst. I have always kept a special place in my thinking for dreams, and what they are about. While I approach them playfully, I take them very seriously.

Since dreams are your own production, we could think of your unconscious as the production company and major studio behind the show. Dreams are like your own movie: You are the director, scriptwriter, set designer, costume designer, editor, cameraperson, etc. You provide all the special effects. Dreams are hatched and incubated in your unconscious, and derive their story line from your personal data center. Often dreams are amalgamations of daily experience, situations that trouble us or stress us, wishes that are held dear or sometimes in abeyance, and rehearsal areas for new behavior. Dreams can also provide a narrative in which we try to resolve something, and/or re-live a past experience or trauma. Dreams are internal communications that may speak to us of personal work that has to be done, redone, initiated or completed.  They are based on our history and experience, and on material that remains unformulated in our unconscious. The stuff that is known deep inside but has yet to be put into words.

The story, narrative,  or content of a dream comes directly from your unconscious and bypasses the sequential logic of consciousness. This accounts for why dreams are often nonsensical and fantastical: the language of the unconscious utilizes sensual experience: sounds, sights, smells, colors, textures, and feelings.  The unconscious has a logic of its own. Dreams also dissolve time- they bring together events from the past,  present and future, as well as events that have never happened or will. Dreams are direct communication with our own stories and how we experienced them, or pieces of them. Experiences come back to us through dreams in movie like, Technicolor precision. If there were an advert for our dreams upon waking it would say: pay attention to this, be curious, what was that about? Give it some thought. This is about something in you. It is your own, uncensored, uncut production.

No wonder Freud saw it as the “royal road” to the unconscious: our individual yellow brick road to our very own Oz.

ON BOUNDARIES – And Internal Architecture.

Boundaries are something that we do not often think about, at least not consciously, until we find ourselves in an uncomfortable situation, usually an interpersonal one. Yet, it is boundaries that provide us with a sense of personal safety. Boundaries delineate where we stop and another begins. Think of it as a geographical frontier: a line that demarcates where one nation begins and another ends. That line also connects the two. Boundaries both separate us and unite us. They provide an area that both contains us and allows us to connect with another. Boundaries are not always clear, in fact, interpersonally they can become quite blurred- and there is the rub, boundaries are part of our relational make up, and are constantly re-negotiated in relation to another.

Psychoanalysts are usually aware of how a person negotiates their space, and their position vis a vis another. Most often, when we get entangled with others, we have lost sight of our boundaries and the personal space that offers us safety in interpersonal interactions. I like to think of boundaries architecturally: how is the use of space negotiated? Which structures delineate a finite object and its space? Where are the doors, entryways, locks, windows, etc? The thickness of the walls usually equals the need to feel safe, and the inability to negotiate contact with another easily. For some, boundaries are impenetrable walls with elaborate defense systems built into them.  Think of beautiful castles with moats surrounding them, complete with drawbridges and towers. For others, boundaries can be as fragile and permeable as the thinnest of silks. And for yet others, boundaries can be so porous, that the person may constantly shift positions and even identities. Think about it, what makes you feel safe? What kind of personal space constitutes safety? Where do you draw the line?

In the psychoanalytic situation, boundaries are firmly set and agreed upon in terms of appointment times, fees, cancellation policies, emergency procedures and the like. It is the setting of these boundaries that delineates a safe space where everything and anything can be talked about and explored. Without these boundaries the intensity and depth of personal work could not be accomplished. While daily life cannot be set up in such a way, it is our personal boundaries that help us navigate complex and difficult situations with a sense of safety.

Personal boundaries are, well personal. They are like psychic envelopes that develop through our relational history and our interpersonal experience. They shift with us as we grow up and continue to experience the world and our relationship to it. Our boundaries develop in response to our experience of ourselves in relation to others. They thus determine how comfortable we are with others, and with ourselves.

The truth is, in the beginning, when we are infants, we know nothing about our boundaries.  The world is ours, and begins to be interpreted for us through our mother. We begin to learn about them in our first relationship to our caretaker. We are omnipotent at first.  At one with all and everything. We know not what we can and cannot do. Boundaries come about through our relationship to our parents and their attitudes. The first “no” occurs in relation to real dangers. Our first brush with reality. We learn, for example, what is dangerous (stay away from the stove), potentially pain inflicting, rude, complicated, what makes us sad, angry, happy, etc. We learn our physical limitations, sometimes painfully, and we begin to establish a sense of interior boundaries as we move into the world (mine, yours, ours). Through our interactions with the world as translated by our early caretakers, we begin to develop a sense of ourselves and a sense of otherness. Our first boundary: Me and her (mom). Through our first relationship, our interaction with another, and the quality of that relationship, for better or for worse, we are launched into the world. And the need for boundaries hits us hard at first. The reality principle- I am not omnipotent, I have limits, I can be hurt, I can hurt others- tests the boundaries that contain and protect us, as well as allow us to interact in the world and with others. The internal structure that boundaries provide takes hold early on and continues to structure our character throughout our lifetime.

Ultimately, the psychic envelope that develops through our use of personal boundaries is the foundation upon which we build a sense of security and safety. When we act within our boundaries, and ask others to respect them, the conditions for a trusting relationship abound.  Nothing tests our boundaries as much as our intimate relationships. Our boundaries sustain our ability for intimacy. So boundaries turn out to be a key, structural element in the architecture of personal safety, security and trust.