A Voyage Through Our Craft

Editor’s Notes and Symposium Intros from over the Years

Rich Simon (Adapted Writings) — Introduction by William Doherty
Magazine Issue
March/April 2021
Rich speaking from behind the podium

Rich loved basketball so much that in his 60s, he hired a personal coach. He wanted to get better, to hone his craft, to understand the game more deeply. That’s how he approached his work as psychotherapy’s chronicler in chief: making the magazine’s writing sizzle like a behind-the-back pass, while spotlighting the inner world of the therapist, the outer world of the cultural landscape, and the clinical dramas where those worlds come together. One more basketball analogy for Rich’s sake: his professional range was astonishing, from pivoting layups near the basket to long-arching three pointers, and then doing a post-game press conference about the role of NBA players in the social justice movement.

There has been no one remotely like him in our field’s history. Rich didn’t have a therapy model; in fact, he hadn’t practiced therapy for 30 years. He didn’t supervise or present workshops for therapists. He never had to worry about finessing the DSM or collecting insurance fees. He had his biases: psychoanalysis and CBT were not his favorites, spirituality was not especially interesting to him, and the evidence-based therapy movement left him cold. He had a journalist’s predilection for the new and emerging over the perennial and established, though he had a knack for seeing how the timeless could be refurbished.

So how did Rich Simon come to influence the field of psychotherapy so strongly for more than four decades? By his own recounting of the origin story of the Networker, he knew that there were colorful figures and powerful stories to be brought to life through storytelling and nonacademic writing, and through engaging, case-based conference presentations. He wanted therapists to feel something when they read the magazine (not just admire an expert) and to experience energy and excitement at the Symposium (not just eat their CE spinach). And he wanted to connect all of this to what was coming down in a larger culture that was enamored of psychotherapy.

Simply put, there was a new niche ready to be filled, and Rich’s writing background, personal energy, intense interest in cultural trends, and instinctive marketing skills made him the one to fill it for decades. As I’ve heard Rich tell the story, he saw a once-in-a-generation opportunity and seized it.

But there’s something else that may not come out clearly in the collection of Rich’s Letters from the Editor and Symposium addresses showcased below. Rich built community among a number of charismatic, opinionated, and competitive psychotherapy innovators who’d otherwise not congregate in the same space, but who gladly wrote for the magazine (often doing four drafts) and presented year after year to enthusiastic audiences at the Symposium (with no compensation except airfare). Of course, there was professional visibility involved, but they signed on so faithfully because Rich would schmooze us with regular calls during the year.

During these long conversations, he built personal bonds and asked what we were up to and what we saw as fertile developments in the field. He also told us what our peers were doing that impressed him—work that might be far afield from our own. He was like a collective big brother who loved and valued us all, even if we were sometimes envious of one another. The result was that a vibrant group of psychotherapy innovators came to the Symposium each year to break bread with one another at Rich’s table and produce an experience of value for thousands of their colleagues.

This Rich-generated community of sibling leaders only became fully clear to me after his death, when we instinctively reached out to one another and gathered in Zoom groups to mourn. I, for one, am not yet reconciled to his too-soon death. This issue’s homage to Rich doesn’t heal the loss, but it does document his extraordinary legacy and unique, personalized way of chronicling our field.

My only comfort is that if he were alive, he’d never have let the embedded tributes to him get into print. Rich was old-fashioned that way: it’s about the team, not an individual star, even one who was the best and brightest of us all.

William Doherty, PhD, is a professor and director of the Minnesota Couples on the Brink Project at the University of Minnesota. He’s the cofounder of Braver Angels.


On Rediscovering Children — From July/August 1991

This weekend, while I was in search of a fresh angle for this column, my five-year-old stepdaughter, Signe, suddenly asked me to tell her about the things I’d done at her age. (Talk about kids being sensitive to their parents’ covert wishes!) At first, all I could remember from that ancient time were a few disconnected details—the little ditty my father sang to wake me every morning, the game show I switched on as soon as I came home from school for lunch (“Strike it Rich,” with host Warren Hull), the boiled chicken we always had for Friday dinner. When you’re 42, being five years old seems so terribly far away.

Then, just as all traces of that long-ago time seemed bleached clean away, I suddenly recalled the muddy-looking oil painting that had hung over the living room couch in our apartment all those years. In my mind, I saw again that framed couple, looking so dwarfed in a huge, dense forest, apparently trying to find a path home. The image brought back all the questions that picture used to stir in me: How had those people gotten there? Were they long-lost relatives who’d wandered away from the neighborhood one day? What else lived in those dark woods? If I looked at the painting long enough, would I be able to make some wood elf materialize in my Bronx living room?

There I was, back in the fantasies of my childhood. Of course, I couldn’t remember any stories about myself at five. The real action in my life back then was in the stories that played in my head as I tried to explain the mysteries going on around me, like how come my parents never got sick and what enabled adults to stride so confidently through life. There was so much I couldn’t grasp, like who was God and where did he live and what happened after you died, which adults seemed to know, even though they never explained any of it in a way I could follow. Still, I figured I’d understand later when I achieved the Olympian stature of adulthood.

So now I’ve made it to the charmed circle of the grown-ups and am myself the object of a curious five-year-old trying to solve the riddle of those giants who run the world. Signe was letting me come full circle, giving me—a first-time parent—a second encounter with the wonders and terrors of childhood.

This time around, however, what impresses me is hardly my knowingness as an adult, but rather Signe’s resourcefulness and ability to create her own niche in the world. Six months after she arrived with her mother from Denmark, not knowing a word of English, she’d mastered that new language and had her own busy schedule, filled with birthday parties and playdates. In a remarkably brief time, this small child had made a radical shift in her planetary base of operations and had managed to create a new life with a minimum of apprehension and trauma.

Certainly, her mother and I played our part in all of this. But everything family therapy has taught me about the importance of parents being “in charge” now seems so misleading. The most crucial direction came not from us, but from her—at almost every step along the way, we experienced ourselves as following Signe’s lead.

Life is filled with enough mysteries to keep all the world’s philosophers, scientists, and therapists busy round-the-clock, so every field must decide where to put its focus. The puzzles of family communication and structure and multigenerational transmission have kept family therapists occupied for more than 30 years now. Inevitably, some mysteries have been overlooked, like the way children create an identity and carve out a place for themselves in the world. That’s why this issue of the magazine is an attempt to take the reader on a voyage of rediscovery, to examine again the mystery of the small, familiar beings who, throughout history, have been the family’s primary raison d’être.


On the Language of Sex — From March/April 1993

Is there really anything new to say about sex? Now that we’ve heard from Freud, Kinsey, Masters and Johnson, Henry Miller, Playboy, Dr. Ruth, Cosmopolitan, and Madonna, what could possibly be left unsaid? With all our magazine articles and books, round-the-clock talk shows, legions of sex therapists, multitudes enrolled in 12-step programs for sex addictions, haven’t we fully managed to analyze the Great Mystery of Sex to death?

Yet despite advertising and entertainment industries dedicated to keeping the national id in a constant state of percolation, the private world of erotic experience remains elusive and camera shy. Technicolor images of tight-bodied sexual performers just don’t seem to tally with our personal knowledge of one of life’s most untranslatable experiences. Nor does ordinary language seem to be a sensitive enough medium for conveying the inner meaning of sexual experience. We may sputter on about nebulous abstractions like “closeness” or “intimacy,” but inside we know we’re not quite doing justice to our subject.

The problem is that sex, like music, is a language all on its own, with its own idiosyncratic vocabulary of caresses, embraces, and surging excitement. When we try to translate this private language into the neat syntax of public discourse, too often the intensely personal meaning evaporates, and we’re mouthing tired clichés or issuing marching orders to our partner.

The most sensible commentary I’ve ever heard on this linguistic tangle came from my college roommate, during a time when sex was our number-one topic of conversation. He thought the biggest obstacle to discussing sex was that the word itself confuses the issue. It attempts to yoke together too many different experiences as if they were the same thing. If the Eskimos have all those different words for snow, he argued, why do we use the same word to describe both an expeditious act of quick tension-release and a marathon of bedroom acrobatics? Why lump together an exchange that may have all the emotional weight of an obligatory handshake with the burrowing union of two souls trying to fathom each other’s very being?

Sex—is there a more loaded word in our language? It ignites a cascade of memories, images, body responses, inner injunctions, nameless anxieties, and, in a culture still struggling with its puritanical legacy, a deep undercurrent of shame. By its nature, sexuality takes us to a place where our usual controls are suspended. We put aside the carefully cultivated face we show to the world and surrender ourselves to a flow of sensation and emotion that enfolds us and temporarily erases the rest of the world. Most of us only reveal the self that emerges at those times under the veil of safety and trust. In the nakedness of our sexuality, we most firmly draw the boundary between the public and the inviolately private.

No wonder, then, that one of the most excruciating rites of passage for most young therapists is maintaining the façade of expertise the first time a client brings up some private sexual turmoil. The very mention of sex catapults the conversation into a category beyond life’s ordinary discontents. The young clinician must learn to fight all the inner cues—voyeuristic curiosity, arousal, secret identification with the clients’ fears—that would disrupt the solemn calm of therapeutic communion.

By the time one has been practicing for a while, however, one is expected to have gotten past putting up this awkward front. Clients have the right to expect their therapist’s office to be that rare place, an oasis of sexual sanity. The writers in this issue argue that even family therapists, often trained to regard sexual difficulties as something that automatically disappear once the core systemic problems are resolved, need to offer more than a formulaic reassurance or a useful technique or two. They believe that therapy should be an opportunity for honesty and straight talk and, perhaps most of all, for contact with a person comfortable with his or her own sexuality. Now, how many of us are able to provide that?


On Friendship — From July/August 1995

There’s really not much I can say about my first best friend, Robert Backofen—if that’s actually how he spelled his last name. I don’t remember a single thing we talked about or what exactly we did together. The only thing I know is that somehow he changed my life, but that’s just what your first best friend is supposed to do. Whatever else has faded from memory, I can still recall the sweet, suffocating smell of Brylcreem from when I’d press my nose up against the back of Robert’s neck as our first-grade class lined up according to size. And inside me, there’s still a trace of the thrill of bolting down the apartment building stairway by myself, making the only unescorted journey I was allowed, from my family’s cramped one-bedroom apartment on the third floor to the two-bedroom palace he presided over. But most of all, I remember the feeling that not only his family’s apartment, but his presence itself was a second home, a place of respite from the drab routine of school, family, and my own loneliness, a haven of now-forgotten games and shared fantasies, where time magically disappeared.

Those few, sketchy details may not look like the stuff of compelling psychological drama, but they do suggest what may be the fundamentals not only of first friendships, but those that sustain us through the rest of our lives. We all enter the world surrounded by people who are bigger, stronger, smarter than we are and who set the rules we’re supposed to follow. And as our families inexorably draw us into the trance of multigenerational memory, obligation, loyalty—and guilt—that may one day tax the skills of genogram-drawing therapists, it’s our friends, our partners in puniness, who give us a break from the serious business of family dysfunction. We have no say in the make-up of our families, but we do have the freedom to choose our friends and, maybe equally important, to dispose of them when it suits us. After all, they’re just friends—we don’t have to adopt or raise or marry them. And that’s part of the mysterious wonder of friendships at its best: when we’re around our buddies, life seems lighter, freer, more malleable. Our friends scale down the universe for us and make the most overwhelming challenges seem more under control. But how does this everyday miracle happen without self-help books or communication skill training or how-to-be-a-friend workshops? Ultimately, our capacity for friendship, like love, seems to be programmed into us—perhaps nothing more than a wish to move away from the boredom and deadweight of self-absorption, and a longing to sail effortlessly on the great rolling sea of play.

Maybe it’s because this connection between friendship and play is so strong that mental health professionals have, by and large, not deemed it a subject worth serious examination. Maybe it’s that in comparison with our angst-ridden families, friends don’t make enough problems for us. And besides, hasn’t it long been a standing assumption of the mental health professions that our primary emotional sustenance in life comes from our family? Isn’t depending too much on your friends an evasion of intimacy, a sign of family disloyalty, a substitute for “real” relationship?

At a time when family ties are becoming more scattered and attenuated, perhaps we should reexamine our attitudes toward friendship. It’s summer after all—time to renew old friendships, perhaps begin some new ones. The world may be in a deplorable state, but on an endless Sunday afternoon when my cranky, terminally bored nine-year-old suddenly brightens at the arrival of her friend and the two disappear giggling into her room for the rest of the afternoon, I know at least something still works. Friendship remains not only a sanctuary for children—and their parents—but the oldest way known of turning a kid’s bedroom into the entertainment capital of the world.


On Economic Insecurity — From March/April 1996

One Thursday night last month, my wife, Jette, and I invited a dozen therapist friends and colleagues over to our house to talk about what we all do for a living—what we love about it, what we hate about it, how it increasingly seems to be taking over our lives. The very fact that we were even there in the first place, cozily sinking into the living room upholstery on a prime private-practice night, flaunting the cardinal principle of this hard-driving, time-is-money age, seemed practically an act of countercultural rebellion. But we were just settling in for our first Networker Forum meeting, following in the footsteps of a thousand other therapists around the country who’ve been gathering in local discussion groups to help one another figure out what it means to be a therapist today. If this meeting was any indication, being a therapist today apparently means having intensely conflicting feelings about the work we do.

Our group seemed drawn less by a high-minded interest in sorting out clinical philosophies than the hope of seeing if anybody else had a better idea about both how to earn a reasonable living and live a reasonable life. As everybody got their chance to have their say, two things became clear: Despite managed care, most of us still found ourselves regularly awestruck that we could be paid for work that, at its best, is so meaningful and personally satisfying; yet, at the same time, with our answering machines, faxes, car phones, in-home offices, and terror at the prospect of empty blocks of appointment-book space, it’s harder than ever to create a natural boundary between home and the ceaseless demands of the workplace. And just in case the point needed to be amplified, the evening’s most absorbing soliloquy, a spirited description of one woman’s battle to create some sanctuary against the work world’s relentless invasiveness, was suddenly cut short by the sound of her own beeper.

In this profession, we once used the term insecurity to refer primarily to the personal realm of unfinished emotional business that was presumed to be the main source of clients’ anxieties. But the chief cause of insecurity today for so many clients is a very different kind of business—the kind with downsizing payrolls. These days, between seeing clients who are working too hard and trying to offer some solace to those who fear working too little, therapists certainly have our work cut out for us.

So what do therapists have to offer a world struggling with the fallout of a global economic transformation? Before either throwing up our hands or leaping too quickly to grandiosity, we thought it might be helpful to take a look at how therapists around the country are responding to clients struggling with job-related pressures, anxieties, and uncertainties.



On Revealing Failures — From November/December 2000

As a young therapist in a residential treatment center during the late ’70s, I worked with a 15-year-old delinquent boy—incarcerated for some offense that would seem comparatively minor today—and his dysfunctional family. I was fresh out of graduate school, full of enthusiasm for my profession, entranced with the new religion of family therapy and pretty sure I could handle just about any case that ended up in my assigned cubbyhole. When the boy was 10, his father, who lived in another state, changed genders—a fact he “announced” to his young son, who’d come to visit, by putting on a dress and high heels. His mother remarried a rigidly authoritarian and moralistic man, who force-fed his troubled stepson a diet of strict discipline and finally kicked the boy out of the house for refusing to shape up.

Eventually, mother, stepdad, and son ended up in my office for what seemed like an eternity of increasingly hopeless sessions. Any one of the issues in this boy’s background—rejection by not one, but two fathers, trauma, his mother’s remarriage and implicit betrayal of him, the deep shame and fear he hid beneath a veneer of aggression—would have been more than enough for me. All of them together were like a tidal wave washing over the rickety structures of technique and theory that had impressed me so much in classes and on videotapes.

All I can remember now about those dreadful hours, besides the boy’s palpable rage, the mother’s teary-eyed confusion, the stepfather’s disgust with me for not being tougher on his stepson, was the overwhelming sense that I was completely out of my depth and sinking fast. Eventually, they dropped out of treatment and, besides the shamed feeling that I’d failed them, I have to admit I also felt relief.

For all I knew at the time, I was the only therapist who’d ever had such an experience. We inhabit a field that thrives on hearing about brilliant clinical interventions and thrilling new treatment models and therapeutic geniuses who never met a syndrome or a disorder they couldn’t cure, a client whose life they couldn’t transform. But we don’t even know how to talk about the more realistic scenarios in the practices of most clinicians, the cases that end more ambiguously, that test us to the limits and don’t really pan out quite the way we hope, not to mention those terrible cases that even years afterward have the power to make us cringe and wonder fretfully over what became of that client or family. There’s almost a taboo of silence that prevents us talking openly about troublesome cases, the ones that seem to be proof against everything we think we know about therapy.

But reading therapists’ rueful, sad, funny, embarrassed, chagrined, ever-hopeful remarks about their hardest cases inspires admiration for the writers who, by showing their “failures” reveal their generosity, creativity, integrity, their passion for the work and for the well-being of their clients. Most of us have had scores of cases like the ones in this issue, when our professional expertise has come up hard against the intransigent, obdurate, heart-breaking, mystifying reality of human life.

These cases burn us, they take us to the edge of what we know and who we are as people, they make us wonder if we’re cut out for this work at all. But, if we have enough courage, compassion, generosity, or simple stubbornness to plow on through them, they offer the possibility of teaching us the ultimate lesson that any therapist learns—that whatever clinical expertise we’ve acquired, however sophisticated our theories and methods, they will, time and again, prove inadequate to the range, complexity and sheer mystery of human experience.


On Bringing in the Body — From July/August 2004

For much of my 20s, I lived the heady, constricted existence—I won’t call it a life—of most graduate students. I trudged from class to library to dorm room to the local bar with my buddies, my physical being—to the extent that I noticed it at all—seeming no more important to me than the shell a crustacean carries around for protection. Like most of the other ambitious types around me, I’d been taught that my brain mattered, but the idea that my body might offer pathways to deep emotion, creativity, connection, or self-knowledge was a possibility to which no one had yet taken the time to alert me.

Then one summer, driven by a need to do something that would take me out of my grad-school grind, I decided to take a class in improvisational theater, led by an actress named Rebecca Rice, who could breathe life and fire into a stone. Unlike the clinicians and would-be therapists who surrounded me at school, Rebecca didn’t have much interest in the ordinary give-and-take of conversation, and she certainly distrusted talk as a vehicle to get into emotion or creativity. Instead, she tried to keep us in constant motion, playing music all the time, having us try to bypass our normal thinking processes by throwing ourselves spontaneously into unusual postures, and encouraging us to make our movements as big as we could, until, as she liked to say, we could feel the “inner life” of whatever music she was playing.

It had never occurred to me to move or listen to music that way, and I’d never before danced a step in my life, but over the course of a few weeks I underwent a metamorphosis. It was as if I were getting to know some different person who’d lived inside me all my life but had just never been allowed out before. All the implicit rules I’d been taught about what it meant to be a successful human being were switched around. Living a good, happy, meaningful life, I discovered, was more than a matter of putting my cogitating faculties in charge and letting the rest of me trail along as best it could. Nothing in the way I’d been raised or trained had ever let me in on the secret that feeling good really had something to do with actually feeling my own body and following its lead.

Like the rest of our society, the therapy profession has been enthralled with the power of words—words about emotions, about bodily feelings, about moral and spiritual dilemmas—as the one legitimate way of helping our clients improve. But during the last decade or so, we’ve learned—from brain science, from psychoneuroimmunology, from studies of the impact of exercise on depression and anxiety—that our experience of our bodies reflects and defines our mental and emotional state at least as much as our thoughts do. Clearly, as neuroscientist Antonio Damasio puts it, “No body, never mind.”

What’s happened for increasing numbers of therapists in recent years is something like what happened to me in Rebecca’s class: they’ve become more aware of their own bodies and those of their clients. It’s no longer just a matter of New Agey wishful thinking to believe that getting in touch with our bodies can help us contact undreamt-of inner resources. Therapists now are attempting to reveal the secret that the body holds—which is that, once we learn how to notice its signals, we really are much smarter and wiser than when we’re only listening to our heads.



On Community Mental Health — From July/August 2008

When I entered graduate school in something called the “Community/Clinical Psychology” program at the University of Maryland 36 years ago, I hadn’t been particularly drawn to community mental health—in fact, I wasn’t entirely sure what it was. But even as I suffered through my required classes in statistics and experimental design, I managed to pick up on an undercurrent of revolutionary fervor coming from the visionary, often flinty, department chairman who seemed to harbor loftier ambitions for his students than we had for ourselves.

Each Tuesday evening, he held an introductory seminar in his decidedly proletarian garden apartment, only slightly grander than my own grad school cubbyhole. Each week, he relentlessly prodded us to debate psychology’s social responsibility and pore over challenging books like Thomas Kuhn’s The Structure of Scientific Revolutions as if they were sacred texts, and regularly punctuated his lectures with his favorite expression—”paradigm shift.”

We soon absorbed the message that setting up a private little office somewhere to do individual therapy with well-heeled clients was about as socially relevant as retreating to a monastery to study medieval theology. We also imbibed a heady optimism about the power of family, school, and community inter­ventions. Who knew what marvels might come from this radical new merger of clinical know-how, systems thinking, and social idealism? We felt we were part of a “movement,” a merger of theory and activism that wasn’t just an interesting experiment, but a blueprint for the future—a new, emerging truth about the inextricability of individual psychology and social systems that had repercussions as profound as Albert Einstein’s theory of relativity.

Just in case you hadn’t noticed, this is definitively not the worldview driving the increasingly privatized mental healthcare system today. Public agencies, strapped for cash, dependent on shrinking grants, tangled in bureaucratic red tape, often just limp along, the demoralized stepchildren of the American mental healthcare establishment. Far from feeling fired up to change the world from within, most young therapists working in these agencies are there only long enough to obtain the clinical hours for their licensing requirements.

So is this issue on the lost world of community mental health just another exercise in middle-aged nostalgia? We think not. The fact is that life goes on in community mental health centers around the country, which, in addition to everything else they do, are the main source of hands-on training for most of the next generation of clinical practitioners. It’s in this demanding arena that therapists are most regularly confronted with the broader realities of what our society is all about.


On Infidelity — From July/August 2010

A few years ago, my Aunt Esther, the family historian, finally told me about a rumor that had fluttered around the edges of my family when I was a small child. My grandfather, a tall, exuberant, turn-of-the-century Russian immigrant who’d succeeded as a traveling salesman, “had women” on his business trips. Nearly 60 years after the fact, a small thrill of scandalized shock went through me as I heard this news.

Of course, growing up in that now-lost world of the 1950s Bronx, it had been absolutely inconceivable that anybody in my family or anybody I knew or ever would know would ever be unfaithful. After all, even the idea that any of the adults I knew had sex with their spouses was unthinkable!

In those days, everybody assumed that normal, God-fearing, clean-living Americans didn’t do adultery, no matter what that pervert Alfred Kinsey said (his groundbreaking studies, undertaken in the ‘40s and ‘50s, indicated that 36 percent of husbands and 25 percent of wives reported being unfaithful at some point in their marriages). If famous or eminent people had affairs, by and large nobody knew about it. Nobody knew that FDR had had a mistress, as did Ike, and JFK’s many now-notorious liaisons were carried on completely below the radar screen.

When did it all change? When did infidelity start to become as American as apple pie? Was it during the ‘60s and ‘70s, when, as an adjunct to the “sexual revolution,” we also got evangelizers of “open marriage,” arguing that you could have your cake (safe domesticity) and eat it, too (bring erotic adventure home to your own fireside!)? Was it when the shenanigans of various high-flying politicos first became a media growth industry? Of course, the spigot really opened fully with Bill Clinton’s compulsive philandering, each unedifying detail of which seemed to co-opt all other news throughout 1998 and 1999.

Now, in a world of voracious 24/7 media, no married aspiring politician or megachurch preacher can get away with so much as a lustful glance in the wrong direction without the inevitable video being picked up by The Huffington Post. But by now we’ve grown overly familiar with hearing the same plotline—secret infidelity, public disclosure, media censure, grudging admission of guilt, display of remorse, breakup of marriage (or not, as the case may be). Could it finally be time that, instead of staring at this parade of indiscretions, we grow up and begin thinking in more mature and serious ways about the nature of marriage, monogamy, and infidelity?

The therapists describing their own work in this issue certainly think so. None of them remotely suggests that couples should now become wildly libidinous, spouse-swapping swingers or join the “if it feels good, do it” school of relationship. But all question the moralistic and judgmental attitudes about infidelity that still shadow couples therapy in this country. All explore the meaning of affairs in the context of particular marriages, involving distinct and individual human beings—they present no cookie-cutter marriages or infidelity stories.

Above all, they’re asking us to question facile clinical formulations that assign a single meaning to the incident of an affair. As practitioners, we might prefer things to be neater and simpler when a troubled couple confronting an affair appears in our offices. Instead, our authors are telling us that we need to be alive to individual differences and nuance, and suspicious of easy answers and glib clinical formulas. As Esther Perel puts it succinctly, “People stray for many reasons—tainted love, revenge, unfulfilled longings, and plain old lust.” Frequently, it’s all these things at once.



On the Craft of Conversation — From September/October 2012

I grew up in the Bronx in the 1950s, a now-ancient era, when extended families spent hours visiting each other every weekend. Most of this time was filled with the low-key drone of tales about who was getting married, who was having a baby, who was scheduled for or recovering from surgery, how work was going at the store/office/practice, and, of course, who’d died. Noticeably lacking was much real conversation, at least as far as I was concerned. It was all so predictable, un­spontaneous—except for Uncle Arthur.

If conversation was a dance for which most of my family members seemed to have two left feet, Uncle Arthur was Fred Astaire. He was a dentist by profession, but his true calling was as a conversationalist. He had a gift for turning whoever was sitting next to him at family dinners, no matter how seemingly dull or stodgy, into a sparkling raconteur, with amazing adventures to recount. I remember Uncle Arthur once performing one of his conversational miracles with my doleful Uncle Jack, whose thick Eastern European accent marked him as the epitome of Old World irrelevance to my teenage self.

With Arthur’s active encouragement, Uncle Jack began recounting a tale of how he’d escaped conscription by the czar’s army in World War I by fleeing to Poland, living from hand to mouth until he accidentally met someone in a small shtetl, whom, by a remarkable coincidence, his father had befriended years earlier. This surprise benefactor wound up helping Jack emigrate to the United States and embark on the great adventure of a new life and of starting his prosperous Lower East Side pharmacy. Before my eyes—and ears—Jack was transformed from a drab background character into the star of an incandescent saga that was a mix of Fiddler on the Roof and Doctor Zhivago.

Arthur interviewed me for many years—about my friends, school rivalries, what sports I liked, my best and worst classes, what I wanted to do with my life. Throughout my teens, we talked (and argued) about books, movies, politics, society, and religion. Through all this improvised back-and-forth, he taught me about the power of conversation to bring a person’s inner self to life—he made my inner self alive to me, introducing me to the new person I was becoming but hadn’t yet started to know. He had no “method,” no training in “joining” with people, no hidden agenda about what he wanted to find out—just genuine curiosity, a gift for asking good questions, and above all, a real interest in what I had to say.

This is, of course, what good therapists do. For all the time we devote to learning techniques for handling clinical issues, the bedrock of all psychotherapy is still a conversation between therapist and client. Yet we hear very little about it in most clinical training programs. For all the mountains of books and articles and hours of classroom time spent on psychological theory and treatment models, precious little attention is given to helping therapists acquire the skills or craft of beginning a conversation and keeping it going throughout therapy.

Talking and listening to people may come naturally to most therapists (if not, we’re in the wrong profession), but it takes conscious thought and long practice to become reliably adept at engaging clients in real conversation, and not anxiously falling back on what sounds like a routinized, Saturday Night Live parody of therapyspeak. As Miles Davis once put it, “Sometimes you have to play a long time to be able to play like yourself.”


On a Broader Look at Depression — From November/December 2014

More than two decades ago, on the opening page of the book We’ve Had a Hundred Years of Psychotherapy—And the World’s Getting Worse, psychologist James Hillman told his coauthor, writer Michael Ventura, why he thought psychotherapy was—already, back then!—at a dead end. “We’re working on our relationships constantly, and our feelings and reflections, but look what’s left out of that . . . a deteriorating world. . . . By removing the soul from the world and not recognizing that the soul is also in the world, psychotherapy can’t do its job anymore. The buildings are sick, the institutions are sick, the banking system is sick, the schools, the streets—the sickness is out there.”

I’m half-inclined to stop right there, since what Hillman was saying is still true today—except that it’s so much truer now than it was even then. If the world’s mental health was “getting worse” in 1992, it’s gone catastrophically downhill since. The numbers cited in Jonathan Rottenberg’s cover article in this issue are stunning. Depression is expected to produce more death and disability by 2030 than war, accidents, cancer, stroke, and heart disease. This is in spite of the fact that antidepressant use has increased 400 percent since 1988—not to mention the vast industry of self-help books published since then! Depression is becoming the most important public health issue in the world.

Furthermore, as Hillman suggested way back then, depression doesn’t happen in a social vacuum. It may be our civilization itself, our high living standards, but also the stresses and strains of modern life and our relentless competition and unflagging desire for more—more money, more status, more power, more stuff, more happiness—that create the conditions for chronic low mood.

And yet, in spite of profound historical changes that make us more vulnerable to depression, the entire mental health establishment still regards the condition much as it did more than two decades ago—as an individual problem, confined within an individual skull, best approached with individual therapies or nostrums. In the face of massive evidence that “individual” depression is really a vast social and cultural problem inextricably linked to the habits, mores, and expectations of our era, our tunnel vision is remarkably unchanged. So why do we continue to use a relentlessly individualized remedy to fight a socially mediated disorder?

Therapy’s individual focus can be a weakness, certainly, but that focus is also its glory. A particular kind of personal, individual (to use those “bad” words) relationship is what makes it work, what helps people, including depressed people, get better. And it hardly needs mentioning that people experiencing suicidal despair won’t be helped much by getting a lecture on the downsides of 21st-century civilization.

Still, it seems reasonable to ask whether as therapists we don’t have a public health responsibility to educate people about the role played by our society in generating unprecedented levels of depression. We should be aware—and make our clients aware—that they’re not in some way abnormal or deficient because they’re depressed. Just the opposite. If we accept Rottenberg’s persuasive account of the evolutionary impulses of our brains—that depression and anxiety are built into our genome—and we live in a time that specifically evokes them, being depressed is, sadly, a pretty normal way to be!

While this issue of the Networker offers no Big Answers to what we can do as a field to address the growing problem of depression, at the very least it proposes that we begin to bring a broader social consciousness into our work than simply assigning DSM labels to the clients who pass through our offices.



On Compassion — From September/October 2015

Over the course of their careers, most psychotherapists discover that to be genuinely helpful they must learn to do something more than simply wield a set of highly specialized professional skills. But what exactly is this “something” that’s both the bedrock of therapy and the energy that propels it forward? In the now-standard tropes of our profession, we usually maintain that therapeutic attunement, healing connection, and therapeutic alliance are central to the whole therapy process. But what if we called this key ingredient compassion? The word reflects the Latin prefix com (with) and verb pati (to suffer), meaning, literally, to suffer with. No human society can be imagined without compassion as its fundamental bonding agent.

But to extend true compassion to others, we also need to learn how to extend it to ourselves. And there’s the rub. In the atmosphere of assembly-line efficiency that’s increasingly come to dominate our profession, we no longer put an emphasis on encouraging therapists to explore their own suffering with, yes, compassion, along with the clear understanding that this exercise in self-knowledge (or self-compassion, as we’re calling it in this issue) is the sine qua non of becoming a good therapist. After all, what’s to learn? Isn’t compassion just the innate human ability to express full-hearted solace to a fellow being in need? And yet these simple gestures of extending ourselves to others often seem like more than we can manage. Navigating the pathway to compassion and self-compassion is often not such an easy journey.

Recently, an old friend stopped by to see me. I’d never seen him look so stressed and unhappy as he told me about the life-threatening medical problem of somebody dear to him—and his own trouble dealing with it, and even thinking about it. As he spoke, I felt my own helplessness and resistance rise like a stone wall between us. I didn’t really want to hear his miserable story—it brought up too many of my own fears about illness, aging, death, and loss—and I felt I had no great words of wisdom to utter that would magically lighten his burden.

But perhaps inspired by the fact that I’d spent the last few months immersed in working on this issue of the Networker, I did something quite uncharacteristic. I took a deep breath and let myself just listen—not say anything, not try to “fix” anything—just be there as fully as I could in the presence of his suffering. And in those few moments, something fundamental shifted between us. Where there’d been fear and resistance, now I only felt kindness and friendship for him, sorrow for his pain, and a sense of an almost palpable current passing between us. Because I had no words to offer, I just hugged him—not something that’s usually high on my list of things to do when confronted with the intense pain of people around me.

For however long—two minutes? 20 minutes?—we stood there in an embrace. When we finally disengaged, the heaviness of the air had lifted, as if freed of something dark, brooding, and fearsome that had been hovering over us. Now we could be open and free with each other, look at the world afresh—at least for that evening. In fact, we went out to dinner and had one of the best times ever in our long friendship, talking without reserve or shyness or self-censorship.

That’s the great thing about compassion: as an investment in human connection, it pays far higher dividends than obtained by even the deftest hedge-fund trader.


On Why We Do the Work We Do — From January/February 2020

Once upon a time, clinicians relied less on their own therapeutic instincts than on the received wisdom of a handful of revered psychotherapy gurus. In the 1970s and ’80s, the likes of Salvador Minuchin, Virginia Satir, Carl Whitaker, and Murray Bowen worked their magic in workshops and videos that transfixed tens of thousands of clinicians.

I was as starstruck as anyone. Way back in 1976, when we launched a precursor to the Networker called The Family Schtick, I imagined it as mainly a showcase for the work of these super-sages. But over time, not content to sit at the feet of masters, the field became bolder and confident enough to shed the hero-worship thing and, well, grow up. Clinicians began to incorporate other intriguing new models, follow research on what actually worked in the treatment room, and especially pay attention to and trust their own on-the-ground experience.

This issue of the magazine homes in on this third element of the therapist’s craft—curiosity about, and willingness to act on, our own deepest instincts, personal gifts, and creativity. Few clinicians are merely followers, unswerving disciples of the wizards of psychotherapy and the therapeutic schools they created. But more and more, we’re charting our own journeys and making our own discoveries, while becoming increasingly aware that the best way to contribute to the field is often by listening to our deepest selves and seeing where that exploration takes us.

So why do we do the work we do? As therapists, our job is to help people reflect on their lives and choices. But what about our own? Life moves fast, relentlessly so, and the pace of our daily schedules can make it hard to glance up and notice the bigger picture: Why, actually, are we doing this thing called therapy? What drew us to the field in the first place? Over time, has our quest changed?

Of course, new questions, reassessments, and opportunities emerge at all stages of life, some that are of our own making and some that just get dumped in our laps, like a surprise pet for one’s birthday. At these junctures, we may find ourselves jolted into an appreciation of our deeper relationship to our work—whether we experience it as a worthwhile job or as something more, a kind of calling. That thing we were meant to do, despite everything.



On Wisdom — From Symposium 2012

If we try to tap the irreducible core of why, year after year, so many clinicians make a pilgrimage to the Symposium, I’d say it has to do with our field’s endless fascination with that mysterious, but utterly indispensable, quality of any good therapist: wisdom.

Wisdom is undoubtedly helpful in just about any line of work, but in what other profession is it the single most important quality? After all, where do people generally go when they need somebody to help them negotiate the messiest, most personally difficult passages of life? Deep in the throes of great loss and pain, who are they going to consult? An investment banker? A politician? Their dentist? Or—however much we may admire their gifts—Brad Pitt? Lady Gaga? Basketball prodigy Jeremy Lin?

Let’s face it, in our Secular Age, the traditional wisdom dispensers—priests, ministers, rabbis, etc.—just don’t have the caseloads they once did. Meanwhile, therapists, with our ongoing explorations of the brain and the connections among mind, body, and spirit, seem to be actually adding to our store of human wisdom.

When the Symposium first got underway decades ago, we were pretty sure we knew where we could find wisdom. It resided, like eye or hair color, within certain, larger-than-life individuals. A wise person was Obi-Wan Kenobi in Star Wars or Atticus Finch in To Kill a Mockingbird. Fictional characters like these leave such a strong impression because we so want people like them in the world—calm, saintly, infinitely compassionate figures, who’ll help us understand what we should do in life, and who’ll never let us down. It may be a childish fantasy, but it’s a universal one. It’s no accident that our field ascribed the same quality of superhuman wisdom to many of the great progenitors of psychotherapy—Freud, Jung, Rogers, Sullivan. And, of course, the less we actually knew about them, the deeper their ascribed wisdom.

But then, in the 1970s and ’80s, a bunch of charismatic iconoclasts inspired lots of us to knock these deities off their pedestals and replace them with new gods of family therapy. In the early ’80s, we knew for a fact that the founders of family therapy—Ackerman, Whitaker, Satir, Bowen, Minuchin—possessed wisdom in spades. They emanated sagacity from their very pores. We knew they were wise because . . . well . . . they knew they were wise. They, and we, believed that their clinical wisdom would reconstitute families, cure schizophrenia, end poverty, and transform history. We loved their pithy pronouncements, the more gnomic and elusive the better. One famous family therapist liked to periodically announce, “Wet birds fly at night.” Whenever he did so, his students would puzzle and buzz about what grand key to fundamental knowledge might be encapsulated in this cryptic nugget.

Well, part of growing up is being disappointed sooner or later in our gods, discovering that our iconic heroes are merely human after all, just like the rest of us. Should we, then, be skeptics about the possibility of wisdom? Disillusioned with our heroes for not having sufficient quantities of it? Of course not. The problem isn’t with wisdom, but with where we’ve always looked for it. In our highly individualistic country, we’ve assumed that wisdom is a kind of magic substance that certain people carry around inside them—maybe in little wisdom packets located somewhere in the vicinity of the spleen, or possibly among the neural circuits of the anterior cingulate gyrus or the medulla oblongata. And you can quote me on that.

No. The truth is—and maybe we’re just beginning to get this—the best way to approach the great mystery of human wisdom is to recognize that wisdom resides in the community, and especially in a certain kind of generative community conversation that taps into the gifts of every participant. For our species, with all our miraculous talents as well as our many lamentable blind spots and Stone Age emotional reflexes, genuine wisdom is best considered a collective project, in which we gradually achieve most of whatever limited wisdom we have through, with, and from other people.

Many of us go through our lives yearning for something like wall-to-wall wisdom—a flawless, intricately patterned carpet (think antique Persian silk) extending through our lives, manifesting in every particular. Anchored in all this sagacity, we don’t yell at our spouses or kids; we don’t seethe with anger and resentment; we don’t churn with envy and greed; we perpetually feel genuine loving-kindness for all creatures. We’re fonts of sound judgment, selfless generosity, farsighted vision, and penetrating insight. Plus, we have a great sense of humor.

But as we grow older, reality intrudes. Wall-to-wall wisdom has eluded us entirely. We feel lucky if we’ve garnered a small throw rug, a frayed placemat, or even a gummy postage stamp–sized piece of true wisdom. Fortunately, even the humblest and most misguided of us have our little wisdom patches of various sizes, shapes, and colors, ranging across different subjects and arenas of life. Most of the time, they’re substantial enough to sustain us—as long as we don’t try to step too far outside our customary boundaries.

The problem is that staying within these narrow boundaries can get a bit boring, even claustrophobic. Nor are we much help to anybody else if we’re focused only on balancing precariously on our own little placemat of wisdom. If we could somehow find a way to step from mat to throw rug to runner, or even weave together these different floor coverings, we could actually traverse the floor of life without getting our feet chewed up by all the nasty pebbles and glass shards along its path. Creating this combination wisdom rug is a collective enterprise, and the product is rarely neat and tidy.

At the Psychotherapy Networker, you can be sure that there are no geniuses or Old Testament prophets in our editorial offices. In fact, you could say that we specialize in being experts at not being expert. Our true specialty is ignorance, albeit ignorance seasoned with a healthy dose of curiosity and openness to learning. In putting out the magazine, and in trying to assemble a crazy quilt of a conference each year, we venture forth armed not so much with great knowledge, but with inquiring minds, a willingness to ask questions—even ones that may sound dumb—and a real desire to hear the answers. Through the contributions of experts, practitioners, and creative minds from a wide array of disciplines, our goal is to partner with each other, pool our insights, and cobble together some collective wisdom.



On the Therapist’s Craft — From Symposium 2013

Every year at Symposium time, we at the Networker find ourselves asking the same fundamental question: What is therapy, anyway? Is it an art or a science? Are we any closer to unraveling its mysteries than when Dr. Freud first moved that old chaise lounge from his attic to his office and, soon thereafter, became the first therapist ever to complain about his clients’ “resistance”?

Some would argue that we’ve come a long way since Freud. They believe that therapy is becoming an increasingly rigorous scientific enterprise. Yet, as more and more metanalyses are done of widely varying clinical approaches, something disconcerting to lovers of scientific predictability keeps turning up. There is, it seems, surprisingly little difference between therapy models in producing clinical success. So what is it that predicts effectiveness? With apologies to James Carville and his crew, it’s the relationship, stupid!

Despite the fancy credentials we like to use on our business cards, the Symposium is best thought of as a gathering of craftspeople. We may not be adept at knitting or pottery-making, but we’re experts in the highly interactive craft of healing conversation—the kind of conversation that, when repeated over and over, builds a relationship that can itself lead to a subtle, but real, transformation in our clients’ lives.

A craft is basically the conscious, intentional pursuit of certain, often complex skills and their practical application with a specific end in mind. In that sense, all artists and even scientists are craftspeople. Their expertise isn’t magic, nor is it simply a matter of learning a manualized procedure. A craft requires a number of interacting qualities—both skill and awareness, both routine behaviors and imaginative power, both proficiency and intuition.

This truth has been brought home to me over the last couple of years through my own late-life learning of a new craft—or rather, learning an old craft better. I was always reasonably competent at basketball, even without any real coaching, though LeBron James definitely had nothing to fear from me. At this stage of my life, however, as my wife Jette will readily tell you, I probably shouldn’t be playing the game at all, out of respect for my aging joints and other increasingly creaky body parts.

Nonetheless, a couple of years ago, I fell in love with the Dallas Mavericks during the NBA playoffs. In my new starry-eyed adoration of this team, I got to thinking that maybe even I could become a better basketball player. And, of course, I heard the underlying drumbeat of so many things in my life these days: if not now, when? So I submitted myself to a 26-year-old, wise-beyond-his-years coach named Andrew.

In our transference-rich relationship, Andrew became both my part-time son and part-time father figure. More than anything else, he showed me that playing basketball well was largely a matter of learning and practicing a constellation of highly specific skills that no one had ever taught me. I’d always had a solid, familiar way of playing, and my moves had a long pedigree, going back to P.S. 79 in the Bronx. However, in basketball—at least as Andrew taught it—it’s not enough just to rely on the same old stuff. He expected me to practice new footwork and other skills that I’d never tried before. Far from depending on intuition or innate artistry, learning a skill actually depends on tolerating excruciating levels of awkwardness and discomfort. It’s a matter of trying and failing, trying and failing, trying and—maybe by the 30th time—failing a little less badly.

Take the afternoon that Andrew decided to teach me how to execute a tricky, between-the-legs crossover dribble. The first times I tried it, I felt hideously un-Michael Jordan-like. But there was enough blind, stubborn will in me to make me grit my teeth and keep doing it, ignoring the inner voice that sneered, “You childish idiot! Why are you doing this at all?” I practiced this move hour after hour, fumbling the ball, losing my dribble, finding new, even more comically grotesque ways to dribble it off my leg again and again, making mistake after mistake.

And then, one day, I just got it!

The connection between this experience and therapy is obvious—right? Well, let me say it anyway. When you keep honing your craft, practicing new skills, and trying systematically and purposefully to get better at what you do, you don’t just become more helpful to your clients. The better you get at doing something you want to do, the more you love it, the more inspiring and fascinating it becomes to you. And, of course, the circle completes itself: the more joy and satisfaction you get from work, the better you’ll be at it, and the greater your desire will be to keep on improving.

But let’s face it: there are no shortcuts. Teaching and practicing a craft take lots of time. The truth is, our theory-heavy professional training hasn’t focused much on the actual nuts-and-bolts of the therapy craft. But we know, now, that we can’t improve our therapy skills or outcomes just by reading about theory. Nor do we get better just by continuing to do what we’re doing in the hope that, somehow, just adding more years of “experience” will make us more clinically effective. To become a better craftsperson requires sustained, focused, systematic effort, often in precisely those areas we’re not so good at and find least enjoyable.

So who wants to do that? I suspect that the reason there’s such a huge amount of self-help literature out there is that so little of it actually gets used. People keep buying the books, reading them alone at home, trying to follow the advice, getting discouraged early on, then buying a new book, and then another, searching for the one that’ll help them make big, important changes in their lives—effortlessly.

Constitutionally, most of us human beings are kind of lazy. Why should we work that long and hard on the next thing? To stay on course, we need the prospect of some reward, some fresh inspiration, to make significant gains in knowledge and skill. And the key to experiencing that drive to succeed is to feel connected to something larger than yourself. To feel that zing, there’s nothing like joining up with a band of sisters and brothers who share a similar vision.

Whatever drew us into psychotherapy in the first place—a fascination with relationships and the process of human change, a desire to be genuinely helpful to people in pain, even the hope of making the world a bit better—we’re sure not in it for the prestige or the power or the money. We need the energy, excitement, and inspiration of our colleagues to help us renew our commitment to this incredibly demanding, at times discouraging, yet enduringly fascinating, deeply rewarding profession.


On the Future of PsychotherapyFrom Symposium 2015

One of the main reasons for our record turnout at this year’s Symposium is the theme—The Colors of Tomorrow. Who can resist a glimpse into the crystal ball? Americans in particular have always put great stock in the future. Isn’t that what the American Dream is all about? But lately, I think we all could agree, assurances about the rosiest of futures don’t seem all that assured anymore. We’ve become increasingly aware of just how complicated the world is and how hard it is to predict what lurks around the corner.

And the profession of psychotherapy is no exception. There may have been times in the history of the field—kinder, simpler times—when we psychotherapists thought we knew where we were going. It was a time when insurance companies still reimbursed 80 percent for therapy, when our chief rivals were other therapists in our neighborhood and not the internet or the pharmacist at the local CVS, and when the phrase “wealthy psychotherapist” wasn’t an oxymoron.

In those days of Peace and Plenty in the Gentle Kingdom—at least that’s my nostalgic, dim recollection—it seemed that we knew who we were and how our profession was ushering in a new age of psychological enlightenment. We might even have entertained fevered dreams that therapy could actually change the world. It didn’t seem completely insane to think that if everybody just got in touch with their inner wounds, and every family learned to detriangulate, differentiate, and realign their subsystems—who knew? We could see the end of intolerance, poverty, and war. The lion would learn to control his emotional reactivity, come to understand the lamb’s point of view, and develop a vegetarian palate.

In reality, of course, I suspect there’s always been a deep undercurrent of uncertainty in our practice of therapy. Certainly, DSM notwithstanding, we can’t argue that psychotherapy is even a remotely “medical” intervention. So what is it, and what are we doing when we do it? Who do we think we are, anyway? Here’s where it gets really interesting. Whatever it is that we do, there seems to be something so alluring about our profession these days that it defies the basic laws of economics. Even as surveys tell us that we’re losing ground in the marketplace to Big Pharma and yoga classes and apps that chart our moods on our iPhones, somehow large numbers of new therapists continue to flock into this field. Why is that?

I think it’s because the satisfactions of doing this work, at least on a good day, run so deep. You all know what I’m talking about. You’ve had a really good session. The client’s had what looks like some sort of breakthrough and leaves your office with a fresh glow of insight and clarity. You allow yourself a tiny pat on the back—maybe you really are the wise, skillful, exemplary healer you like to think you are. What could be a more meaningful way to earn your daily bread?

But then, just to make sure that you don’t get too full of yourself, the universe steps in.

Next week, the same client stomps in and grumbles that the session you thought was so great was not quite as life-changing as you’d imagined. It’s like that Seinfeld episode when George gets all sweaty again right after taking a shower at his gym and complains frantically to Elaine—as only George can—that, for some reason, the shower “didn’t take.” A version of this about-face unfolds in the wake of some of our most dramatic therapy sessions. The client returns all discouraged again and tells you he’s not sure he should even continue with you. In fact, he has a friend who has a therapist with a powerful new approach—neurodynamic, attachment-oriented water ballet—which sounds like just the ticket.

Over the years, many of us learn that a big part of our job is to sigh inwardly, put aside our fantasies of being therapeutic magicians, and patiently begin rolling the boulder up the hill again.

But whatever it is we do, there are few enterprises that are so fundamentally linked to a sense of hope and possibility for the future—even to people’s very sense that they have a future. To choose to see a therapist is in itself a step toward hope, a declaration, no matter how muted and buried in despair, that says, “However much my life may feel like a complete train wreck, in some tiny corner of my being, I believe things could get better.” And that possibility, the chance of a finer tomorrow, is the fundamental currency of therapy. If therapists were bakers, hope would be the yeast in their dough: the bread wouldn’t rise without it. In a sense, we’re a passageway into the future for our clients, helping them find their own way to seeing the colors of their tomorrows.

So what’s ahead for psychotherapy as a profession? Most therapists today still inhabit a largely mom-and-pop business world, an old-fashioned brick-and-mortar kind of place, in which word of mouth is still the primary way we broadcast our services. But our challenge is to not mistake the outer forms of what we do with the essence of our craft. We need to resist the temptation to keep on practicing just the way we always have and overlooking all the ways the world beyond our consulting rooms is changing. Above all, we need to avoid the fatal mistake of asking a digitally tuned-in generation to communicate with us via the equivalent of quill pen on parchment.

And yet, while we undoubtedly need to rethink many of our hallowed ways of working, I believe this younger generation that’s grown up in a digital world craves human connection and guidance as much as any past generation. When they feel stuck in their lives, embedded in a kind of psychic cement, they still want and need somebody, somewhere, somehow, not just to give them information and easy answers that fit into a haiku-ish tweet. They want someone to comprehend who they are, grasp their particular way of seeing the world, and understand what they long for in their lives. In short, they want help in envisioning the tomorrow they wish to step into.

I know that in today’s hypercompetitive world, the word hope has a bad reputation; it can suggest a kind of passivity, a lack of fortitude, too little get-up-and-go. But hope for the future is the driving force of most human activity, the reason we try anything new. It requires at least a modicum of hope to negotiate life’s important challenges—getting on a tricycle for the first time, going out for the basketball team, asking somebody for a date, going off to college, starting a new job, getting married, deciding to have a child, or even making an appointment with a hair stylist. They’re all fueled by the belief that taking this or that step will, somehow, make tomorrow a brighter, more inviting place.

The biggest obstacle our profession faces today isn’t the paucity of new methods and models of practicing our craft, but a crisis of imagination in the way we think of ourselves and how we’ll maintain the relevance of our profession. We need to recognize that we live in a world in which people are far more reluctant than patients of the past to sign up for a person-to-person appointment once a week for 50 minutes for the next two or three years. Exactly how we’ll adapt to our new, attention-challenged world is up for grabs. But however we may morph to meet the times, the through-line will be constant: we will continue to be vital agents of hope.


On the Courage to Connect — From Symposium 2017

To put it bluntly, there’s something about this conference of therapists, even about being a therapist in the first place, that seems deeply incongruous with this strange second decade of the 21st century. After all, this Symposium is premised on the belief that ongoing, intimate, face-to-face dialogue—carried on in real time and real physical space between real people who trust and respect each other—is actually important for emotional healing and human well-being. Not only do we believe this odd conviction, but we somehow manage to make entire careers based on it. 

How totally reactionary and out of step with the “real world” is that? Everybody today knows that all communication between earthlings should be instantaneous and involve no direct contact, the current preferred modes being Twitter, Snapchat, WhatsApp, Instagram, WeChat, HeyTell, to name a few. Any interaction that takes more than a minute or two—long enough to text somebody and to read a reply—strains the outer limits of our 21st-century attention span. Besides, who has the time to focus on a single, boring, ordinary, human when an infinite proliferation of enticing, ever-new and ever-changing voices and images are just a few clicks or thumb presses away?


This all-pervasive digital culture has enormous power to shape our consciousness and connections with each other, without our even being aware of it. Take the way our leaders communicate with us. In the 1930s and early ’40s, Franklin Roosevelt gave his famous fireside chats—live, informal radio talks about the important issues of the day. Families gathered together around radios all across America—the citizens of the whole country, basically, listening to this single, calm, reassuring voice, talking candidly about the state of the nation and the policies he was pursuing. Even during the worst days of the Depression and World War II, people were reminded not to succumb to fear, not to give up hope, but to retain confidence both in the country and in themselves as Americans. Above all, he unified people with his message: We’re all in this together. In fact, as he put it, “the basic idea of society and of the nation itself [is] that people acting in a group can accomplish things which no individual acting alone could even hope to bring about.”

The novelist Saul Bellow recalled hearing, as a young man, a fireside chat while walking in Chicago one summer evening. “The drivers had pulled over, parking bumper to bumper, and turned on their radios to hear Roosevelt. They had rolled down the windows and opened the car doors. Everywhere was the same voice, with its odd, patrician Eastern accent, which in anyone else would’ve irritated Midwesterners. You could follow without missing a single word as you strolled by. You felt joined to these unknown drivers, men and women smoking their cigarettes in silence, not so much considering the President’s words as affirming the rightness of his tone and taking assurance from it.”

Now, 80-odd years later, our current president tweets in the middle of the night, releasing off-the-cuff, 140-character messages that explode like incendiary devices, leaving social and political firestorms in their wake. But what could be more characteristic of our time than these out-of-the-blue tweet-storms? They reflect a culture geared to speed, isolation, and social and emotional detachment, all of it undergirded by free-floating anxiety, yearning, depression, and sheer boredom, which often gets expressed in spontaneous online “flame wars” among people who may not even know each other.

Of course, one reason FDR’s voice had so much resonance—he was like a therapist for the masses—was that it was just about the only public voice that everybody could listen to at one time. Americans of the 1930s didn’t live their lives in cyberspace. They didn’t have access to news and infotainment—real news, fake news, celebrity news, lifestyle news, sports news, crime news, business news, health news, news ad infinitum.

But this explosion of media culture is antithetical to what you might call the Therapist Culture. You could say that we’re so old-hat, so outdated, so out of touch, that we actually like to meet people in the flesh and talk to them in person. We like making conversation—the more the better! In a sense, this is our job description: we make a living by talking to other people. And this conference testifies to the fact that even when we’re not at work, we go to some effort and expense to talk and listen to our colleagues, in person. Look at us: many of us fly across the country just to engage in this weird behavior.

And while we’re here, we engage in even more weirdness. We sit in lined-up chairs, or on the floor in some cases, just so we can listen quietly while another colleague stands on a stage to talk to us about talking and listening to people. If so moved, we may ask thoughtful questions, listen to answers, and engage in more conversation about conversation, always mindful that we’re part of a tribe that places special value on talking and listening, especially with people with whom we disagree. It is, we believe, a fundamental expression of our humanity.