Substance Use
Can spouses gage one another’s mental health? Can therapists and metal health professionals rest assured that a client who appears to be functioning well is safe and stable? Can we take responsibility for the emotional well being of people we love and heal their psychological pain? Lady Gaga and Bradley Cooper’s tremendous remake of the…
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The previews and early promotion of I, Tonya inspired memories about Tonya Harding and her scandalous role in the 1994 attack on Nancy Kerrigan. I felt conflicted about revisiting that infamous incident and the popular cultural drama that followed. I assumed that I would enjoy learning more about the competitive world of figure skating, but…
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The slippery criteria that define substance abuse are notoriously difficult to distinguish in a client’s behavior. Sometimes the signs are obvious. But often, therapy clients hesitate to report the full extent of their usage. Practicing therapists must ask the right questions, usually more than once. I was trained to begin therapy asking several background inquiries…
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Deepak Chopra famously said: “When you blame and criticize others, you are avoiding some truth about yourself.” The tendency to focus on the flaws of others in order to deny scary or painful dimensions of the self comes up often in therapy. Sigmund Freud described this process as projective identification. Projective identification — often called…
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“I don’t believe in epiphanies. I don’t believe in transformative moments, as transformation is harder than a moment. I’ve seen far too many people awash in a genuine desire to change only to lose their mettle when they realized just how difficult change actually is.” What factors facilitate authentic change? And what traits of character…
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Discovering infidelity is a common reason that couples seek therapy. Infidelity is much more frequent than one might expect, and the popular culture tends to equate infidelity with a loveless or passionless marriage. In my work as a couples therapist, I often discover marriages that have experienced infidelity but that clash with this popular conception.…
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Parents of teenagers are bound to struggle to communicate and connect with their kids. It’s hard enough to lure a teen out of their bedroom, let alone to convince them to engage in an authentic conversation. One strategy to connect with teens is to create scenarios that set the stage for conversation. Driving to and…
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The sensations and experience of grief are a shocking departure from other states of existing. And we, as a society, often shy away from exploring or understanding the grieving process. Sensations can feel heightened, while orientation is often confused. For those who have never been through it, and even for those who have, a traumatic…
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Annie Grace opens her 2015 self-help book about alcohol use by asking a provocative question: “What if, by reversing years of unconscious conditioning, you could return to the perspective of a non-drinker?” Grace proceeds to talk readers through her strategy to return to a mental state where the desire for a drink disappears. She blends…
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During post-graduate training in couples, family and sex therapy, I was taught the importance of asking new clients about alcohol and substance use during the first session. There is a controversial but widely accepted understanding in the therapeutic field that if someone is actively abusing a substance, traditional psychotherapy will have limited benefit unless a…
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