The late Shirley Glass, a prominent infidelity researcher, encouraged an ideal script at the outset. Her suggestion is that when a married person notices a spark with another, it is highly advisable to discuss this spark with one’s spouse. To say something like:

“I was having coffee with Lucy today and I felt surprised that our conversation quickly became both personal and flirtatious. I was also surprised that I enjoyed it. It reminded me of how you and I used to be with one another, and I want to try to get that back. Can we work on that?”

If only more married adults chose to run this script.

Elizabeth Stroud’s latest novel, Tell Me Everything, is one of her very best. In a showcase that feels something like a finale, she allows her beloved, previously unacquainted characters from her various critically acclaimed series to intersect and collide with one another in the small town of Crosby, Maine. Set during the later part of the pandemic, the novel begins with the meek, brilliant novelist Lucy Barton having recently befriended the angsty attorney Bob Burgess. The friendship has become romantic, though Lucy and Bob remain in denial of their palpable romantic spark. They believe they are good friends and insist their frequent walks are covid-friendly and purely platonic. Quirky local fixture Olive Kitteridge (of Stroud’s Pulitzer Prize winning novel of the same name) understands the blossoming romance between Lucy and Bob and easily sees straight through their blind spots. Olive’s friendships with Lucy and Bob animate the novel as does the plot’s unfolding murder mystery.

Stroud understands that intimate life happens in the small quiet moments rather than the large romantic gestures. Lucy and Bob cherish their deep unfiltered conversations. Lucy calls Bob a sin eater because she understands that Bob has sacrificed to much for others, especially his older brother. Lucy opens up about her impoverished and abusive childhood:

“But I don’t remember feeling envious a lot, Bob, and I don’t understand that. You would think, I would think, that I would have been envious of people from the start, all these mothers who seemed to love their children as they picked them up from school, all those kids who seemed to have normal lives, but I just somehow understood: That’s not my life. And I was always inside my head, and I remember thinking: I’m glad this is my head.”

Even Bob’s bad haircut illuminates the intricacy and hilarity of the human connection. He and Lucy both agree that it makes him look like a twelve-year-old with a man’s face, and their dual experiences of this unfortunate new style represent their powerful connection and the unexpected path forward.

Bob loves his wife, the minister of their local church. And Lucy loves her ex-husband William. Lucy and William reconnected during the pandemic and are giving it another go. Despite these satisfying unions, the chemistry fueling Lucy and Bob’s conversations anchor the plot and transfix these two central characters.

Emotional repairs, infidelity, betrayal, sexual abuse, neglect, isolation, therapy and memory are all important themes explored with rich emotional intelligence. And yet, as a therapist, what stays with me most about this beautiful story is its exploration of the road not taken.

The book jacket for Diary of a Mad Housewife describes the novel as “a classic of urban women’s fiction that gave a wry voice to the nascent feminist stirrings of the 1960s.” I’m not sure how I missed it on my mother’s bookshelf while growing up in the 70s, but she confirms that it was right there all along with prominent placement. This engrossing page-turner eventually became a popular Academy Award nominated film, and is full of extremes. Both hilarious and heartbreaking, Sue Kaufman’s best-selling novel paints a portrait of city life in the 1960s that demonstrates how much has changed and how much has stayed the same.

Despite how often characters telephone local shops and charge groceries to their monthly tabs, and a 200 dollar business suit described as an obscene expense, the novel reads as remarkably current. Kaufman’s take on the challenges of motherhood, identity, marriage, and sexual intimacy withstands the test of time.

We meet the novel’s protagonist, Betina (or “Teen” as her husband Jonathan calls her), when she decides to keep a diary as a fitful attempt to cope with the escalating pressures and chaos of her life as a Manhattan housewife. Betina hopes that journaling will help her make sense of her aggressive social life and growing discomfort with the family’s superficial trajectory. She knows she needs help and she finds reading as therapeutic (and comic) as journaling. D.H. Lawrence is among her comforts, as she enjoys the satirical timing while reading as her husband readies himself for bed:

“What is more, she felt she had always really disliked him. Not hate: there was no passion in it. But a profound physical dislike. Almost it seemed to her, she married him because she disliked him, in a secret, physical sort of way. But of course, she had married him really because in a mental way he attracted her and excited her. He had seemed, in some way, her master, beyond her.” I read it three times, and was going over it a forth when Jonathan came out of the bathroom and got into bed. I sat gripping the book, waiting: it was exactly the sort of ironic moment for him to propose a Roll in the Hay. It never failed.

Betina’s diary guides readers through excessive substance use, an extramarital affair, way too many taxi rides, and a slew of raucous cocktail parties that might make certain middle-aged readers feel a little bit boring! At its most depressing, the diary is testament to how easily financial success can lead families down a superficial and dismal path. But the novel’s conclusion feels modestly hopeful and alludes to the possibility that therapy can be worthwhile, even with a substandard therapist. Reading and journaling are, indeed, therapuetic, and authentic change is possible. This cheeky novel captivated readers when published in 1967, and can be healthy bibliotherapy for mothers navigating multiple relationship challenges.

Of my pre and post-surgical reading, Sarah Polley’s Run Towards the Danger offered the most meaningful and memorable frame for navigating physical adversity. The book chronicles her fascinating career in film and television but focuses on the long-standing psychological impact of trauma and the challenges of recovering from traumatic a physical injury.

Polley is widely known throughout Canada for her childhood role as Sara Stanley in the wildly popular television series Avonlea (1990-1996). She has starred in several films including Terry Gilliam’s The Adventures of Baron Munchausen and Atom Egoyan’s The Sweet Hereafter. But it is Polley’s work as a screenwriter and director which fully showcases her astonishing talent.

She has written and directed two of the most realistic films about infidelity ever made. Away From Her (2006) won Polley the Canadian Screen Award for Best Director and demonstrates how one can forgive a spousal betrayal but may never forget it. Take This Waltz (2011) stars Michelle Williams, Luke Kirby, Seth Rogan and Sarah Silverman in a study of the human tendency to want what we don’t have. I often suggest one or both films to therapy clients who are navigating the discovery of a spousal betrayal.

Polley’s 2012 The Stories We Tell won the best film of the year award from the Toronto Film Critics Association. The film unpacks a family secret about Polley’s parents’ marriage years after her mother’s death. This unforgettable autobiographical documentary showcases the director’s depth and innate understanding of complex familial bonds and the power of denial. Interestingly, this film and its revelation are not explored in her book.

Polley also wrote a memorable New York Times article about Harvey Weinstein soon after the revelations surfaced about his predatory crimes.

Clearly, I am a fan of her work. So if Polley writes a book about how trauma shapes the body and her journey through multiple health challenges and a concussion that forced her to drop out of plans to write and direct the film Little Women, I am keen to read it regardless of my foot surgery.

Polley writes earnestly and honestly about the traumatizing underbelly of childhood stardom. Part of Polley’s appeal is that she may be the least vain, least materialistic film star with the smallest ego in entertainment history. She was breaking ground for female filmmakers way before it became a hashtag or a movement. Weinstein tried to seduce her by telling her he could make her an even bigger star, but even as a young girl, she did not want to be a star, she wanted to write and direct. This depth and resolve fuse her account of the myriad of trauma and adversity she faced as a child actor with somewhat absent parents, vicious scoliosis, dramatically lopsided breasts and chronic pain.

At times, it seems Polley may not fully appreciate the breadth of rare door openings her stardom affords her. But maybe that’s because she seems so profoundly disinterested in being a star. The book is full of powerful behind-the-scenes accounts of her experience as a young actor, as a patient hospitalized with a high-risk pregnancy, as an early member of the Me Too movement and a tireless activist. But it is her journey fighting to recover from her three-year concussion that resonates most with my therapeutic training. Polley works with multiple experts and specialists and remains largely incapacitated for several years. As the title suggests, healing comes only when she finds a doctor who insists she run toward rather than away from her pain. Diving into excruciating physical pain runs a parallel track with excavating her traumatic childhood history. The book reads as if it was necessary that she write it in order to fully heal. By running toward her danger, this strong woman comes out even stronger on the other side.

Until theaters across the country went dark, the Tony award winning musical Next to Normal was enjoying rave reviews throughout its revival tour. The generous and electric performances of the six-person cast shine a light on the question of what “normal” looks like in the realm of mental health and grief. These questions feel even more relevant during the current coronavirus crisis.

But back to the play for a moment. Rachel Bay Jones won the Tony Award for her role as the angst filled mom Heidi in Dear Evan Hansen. In Next to Normal, Jones plays Heidi, the doting mother of two who seems full of life and spirit and energy until she doesn’t. The play opens with Heidi enjoying an exchange with her charismatic teenage son. But it soon becomes clear that Heidi’s energy is a deceptive and fleeting burst of mania. It also turns out that one of the two children she dotes on so lovingly has been dead for well over a decade. Her enthralling performance toys with the idea of what it really means to be or feel normal. Can doctors or mental health practitioners or even family members dictate what normal looks like in the face of loss? Can we place a yardstick up against the arch of grief and hold anyone to a clear-cut standard?

Next to Normal’s rhythmic and provocative study challenging these questions has stayed with me as I continue to work with therapy clients both virtually and in person. Each of us has a list of pressing concerns and a list of current losses. Deserted schools, virtual classrooms, canceled travel, worry for parents and grandparents, longing for life to return to “normal”. We are all wondering what “normal” will look like in our future.

The play emphasizes the power of human connection and the complex reality that humans process grief in unusual and unpredictable ways. Our collective communities will eventually acclimate and find a new “normal”. As we alter our social patterns and practice physical distancing, the ability to create intimacy through words, honesty and acts of kindness may be the best medicine.

The book begins with Gottlieb’s unexpected and devastating breakup with a symbolic character known mostly as “boyfriend” and occasionally as “the child hater”. Readers are thrust behind the scenes of the therapeutic process to delve into the dilemmas of practicing as a therapist, helping patients navigate their relationships, if the clinician’s world is simultaneously falling apart. Gottlieb is exquisitely self-deprecating. The day following the breakup with “boyfriend” she admits to discovering, after a full day of office hours, that she accidentally wore a pajama top to work stating “Namaste in Bed”. It’s her clever patient, Julie, who points this out. The colorful passages of the therapy patients intersperse Gottlieb’s personal quest to enter therapy and process her breakup. There’s Rita, a sixty-nine year old woman who has had multiple marriages and divorces and whose children won’t speak with her. There’s Julie who is dying of cancer. And John, a savvy television producer with insomnia who is convinced that the world is full of “idiots.” There are others, but these three memorable characters shape the plot and mirror Gottlieb’s personal and professional journey.

Gottlieb weaves theoretical definitions and insights through heartbreaking and inspiring tales, referencing Sigmund Freud, Viktor Frankl, Erik Erikson and several other pioneering leaders in psychology and literature. I especially enjoyed her exploration of Frankl’s quest for “meaning” and probing of Frankl’s words: “Between stimulus and response there is space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Gottlieb acknowledges that the patients are fabricated, but their tales do bring to life the slow but steady process through which individuals change and evolve through self-reflection. Therapy patients don’t create new selves or get personality transplants. They learn to respond differently to life stressors and adversity. They smooth off their rough edges and create a healthy degree of emotional space to access their more mature selves.

I wish readers collected a deeper view into Gottlieb’s decision to use a sperm donor to conceive and what it meant to practice as a therapist while raising a son as a single mother. So many people seek therapy to delve deep into their romantic relationship patterns, and Gottlieb seems to gloss over this despite the fact that her therapeutic journey is triggered by a breakup. But maybe that’s the point. Perhaps Gottlieb is intentional in her neglect to give voice to her romantic choices. Maybe she chooses to emphasize the individual self over the relationship self to fully celebrate her individuality and her remarkably independent voice. As she grows and discovers deeper meaning in her life and her work, she becomes a more fulfilled woman and a more grounded clinician. The book is best suited for readers who are interested in psychology or for individuals going through adversity, but it is an entertaining read for anyone interested in the human connection.

Steve Carell convincingly plays David, a thoughtful writer who is cool enough to smoke a joint with his son Nic. (Maybe he is too cool?) David is obviously bonded with Nic and they seem to have carved out a delightful, artistic existence in the Marin County, California. Timothee Chalemet plays Nic, David’s creative, lovable son who applied to seven colleges and is accepted to them all. Nic seems well adjusted to his parent’s divorce and genuinely happily connected to his stepmother and his two half-siblings. It’s Nic’s idea to smoke the joint to celebrate his college acceptances. David is clueless to the secret that the joint is merely a light appetizer warming Nic up to an extensive smorgasbord of other drugs.

The screenplay is adapted from two different books – one written by David Scheff, the other written by his son Nic — and it toggles between the past and the present. Belgian Director and screenwriter Felix Van Groeningen also made the exquisite film about loss and addiction The Broken Circle Breakdown that was nominated for an Academy Award for Best Foreign Language Film in 2014.

David learns the basic principles and tag lines of substance abuse treatment. “Relapse is a part of recovery.” “Call your sponsor.” Through each relapse episode and subsequent rehab stint, David continues his determined mission to discover why this addiction is so tough to beat. He reads brain studies. He takes other addicts out to lunch. He even tries the drug himself! He listens with a weeping furrowed brow as Nic explains that his first meth high delivered an experience of euphoria so strong that it filled an underlying void. But we never quite learn is what the void is about. This feels a bit frustrating and leaves viewers imagining that the void relates to Nic’s parent’s divorce. Several flashbacks focus on Nic’s trips from one parent to the other. In one flashback, a sullen young Nic boards a flight back to his mother in Los Angeles, and David assures him that he loves him more than everything. The phrase “everything” becomes an ongoing spoken reference code to their connection. Nic’s mother acknowledges that there was a phase of the addiction that she couldn’t handle. But still, we do not gain much clarity about the void.

Perhaps this unanswered question is intentional and implies the possibility that methamphetamine addiction has no “why”. Perhaps the “why” is as random as making one bad choice on one teenage night out blowing off steam. Or, the “why” might involve choosing a friend who turns out to be an addict who convinces others, in a moment of weakness, to give it a try. Regardless of the answer to this difficult question, the film is worth viewing with teenagers to discuss the perils of addiction and the gravity of this current American epidemic.

Lady Gaga and Bradley Cooper’s tremendous remake of the classic love story A Star is Born explores these complicated questions. The plot begins with expected, alluring romance. A charismatic hunky rock star named Jackson Maine stumbles into a drag bar and hears a struggling waitress with fake eyebrows and fabulous costume named Ally belt out La Vie en Rose. Jackson is smitten and the couples’ starry-eyed chemistry is organic.

Gaga’s supernatural voice and Cooper’s impeccable acting play off of each other with circular harmony. The two are so improbably perfect together. It seems as if director, Cooper, knew that Gaga would teach him how to convincingly sing and that he would complement her musical magic through teaching her how to act at his level. These master lessons appear to happen more through osmosis or magic than through craft.

Ally is ultimately discovered in her own right and her star begins to shine. Jackson’s alcohol abuse is obvious from the film’s first moments. Tragically, he begins to drown in Ally’s stardom.

A Star is Born is an important mental health narrative. The plot honestly explores the relationship between alcohol, intimacy and creativity. Each tempts the other, and appears to assist the other. Jackson and Ally’s union begins with an alluring flow of liquor, physicality and song. But this seductive cycle is deceiving and masks the sobering reality that alcohol abuse ultimately destroys intimacy and stunts creativity. The film pushes further through unveiling the risks and vulnerability of sobriety and recovery.

This beautiful, unsettling, honest love story does not shy away from the difficult reality that we can never fully assume the mental wellbeing of another, and we can never know for sure who is and who is not safe from harm.

“Do you drink alcohol and, if so, approximately how many drinks a week?”

“Do you smoke cigarettes? If so, how many cigarettes a day?”

“Do you use any other substances? If so, which ones and how often?”

Depending on the answers, clinicians are trained to refer therapy clients to substance abuse programs. But clinicians cannot expect immediately honest answers to questions about substance abuse. There’s a general consensus in the therapy field that clients admit to about half of the number of drinks per week that they actually consume. Clients tend to be even less truthful about cigarette smoking and the usage of other substances.

Duncan Macmillan’s bold play People, Places & Things shines a bright, unflattering light on the complex dynamics of substance abuse and the grueling journey that treatment involves. Emma is an addict who uses with abandon: pills, booze, cigarettes and a healthy regular dose of denial. She activates her gifts as a professional stage actor to lie to others with authority and ease. She manipulates anyone who gets close to her, and manages to make herself the ongoing center of attention.

Despite Emma’s classic attempts to resist, group therapy breaks through her defiance. The play scripts an honest reflection of the humbling and powerful group therapy process. Irish acting powerhouse Denise Gough gives a soul-stirring rendition and becomes an addict her audience will remember. Performed in the chic, minimalist St. Anne’s Warehouse Theater in Brooklyn, following a sold-out and critically acclaimed run in the United Kingdom, audience members face one another in well-lit seating areas, creating a greater mirror to the group process. Early in the first act, the audience is surprised to discover a sudden spotlight shining on fellow audience members across the stage. This structural twist incorporates viewers into the set, metaphorically morphing each audience member into a larger group.

Most therapy clients do not seek professional help with the intention of joining a group. In my practice, I feel honored when a client trusts our work enough to try a group. I don’t run groups to suit the comfort zone of therapy clients; I run groups because they are effective. Group process speeds up the rate of clinical change. The group itself structures a laboratory where members can practice new behaviors and forms of communication.

Emma’s resolute resistance to group work is not surprising. She rejects and mocks her group and its methodical honesty. She makes fun of members who celebrate their days of sobriety. She makes up stories to mock their process of sharing. Nevertheless, the group triumphs.

Why is group therapy so effective? Think of group as a room of mirrors and windows. Mirrors into the parts of one’s self that are painful to face but much more visible and surprisingly more palatable when reflected through the words and honesty of another group member. Group is also a room of windows into the perspectives of our loved ones whose viewpoints are tough to swallow, but become more accessible when viewed through the words of another. Group members have a manufactured degree of emotional distance from one another, and this necessary psychological space sets the clinical stage for change.

One of the most interesting facets of the play’s dialogue involves a comparison between acting and group therapy. Is the group a performance? Is it real? Emma admits that acting gives her the same therapeutic boost as therapy. She magically explores the way theater and therapy compliment and collide.

If you or a loved one have struggled with addiction, this magnificent play and Gough’s electric performance are well worth the trip to Dumbo (Down Under the Manhattan Bridge) to experience this memorable and meaningful artistic work.

A projective identification, in its truest, most psychologically sophisticated sense, is an unconscious contract between two people through which they agree that a particular trait or grouping of traits will be transferred from one person to another. With such an agreement, one person therefore internalizes the pathology of another, and agrees to hold it for them to relieve their pain and emotional burden. For example, when an alcoholic whose primary conflict is marital intimacy enters treatment, their spouse might begin taking pills to ensure that some form of mind-altering substance remains between them, as a buffer to their marital intimacy. I have also noticed this phenomenon among military spouses who experience post-traumatic stress in the place of their husbands who serve. The couple might unconsciously agree that the soldier cannot afford the tremendous anxiety, so the wife takes it on.

Tender is the Night tells the colorful tale of the exceedingly glamorous couple Nicole and Dick Diver, whom the reader first encounters through the naive and adoring eyes of Rosemary Hoyt, a young American starlet on the brink of fame. Rosemary is vacationing with her mother in the late 1920s on the French Riviera when she discovers the Divers on the beach. Their collective aura is captivating and seductive, as she finds herself drawn to them both. It turns out that the couple has a secret: Dick was once a promising young psychiatrist and Nicole was his wealthy, institutionalized patient. Dr. Diver fell for the young heiress while treating her, and has found himself in a dual role — part psychiatrist, part husband.

Fitzgerald wrote Tender is the Night after he spent time at a psychiatric institution where his wife Zelda was a patient diagnosed with schizophrenia. As Fitzgerald writes of Dr. Diver’s work with young Nicole, Fitzgerald seems to driven to work through his own experience:

Dick tried to rest – the struggle would come presently at home and he might have to sit a long time, restating the universe for her. A “schizophrene” is well named as a split personality – Nicole was alternatively a person to whom nothing need be explained and one to whom nothing could be explained. It was necessary to treat he with active and affirmative insistence, keeping he road to reality always open, making the road to escape harder going. But the brilliance, the versatility of madness is akin to the resourcefulness of water seeping through, over and around a dike. It requires the united front of many people to work against it.

Ultimately, Nicole is cured and Dick – whose career is in shambles and whose alcohol use is extreme – descends into a state of madness. Though they do not discuss nor seem consciously aware of the acute transaction, Nicole essentially hands her illness over to her doctor/ husband, who internalizes the illness in this final act of his treatment before they part ways:

Nicole relaxed and felt new and happy; her thoughts were clear as good bells – she had a sense of being cured and in a new way. Her ego began blooming like a great rich rose as she scrambled back along the labyrinths in which she had wandered for years. She hated the beach, resented the places where she had played planet to Dick’s sun. “Why, I’m almost complete,” she thought, “I’m practically standing alone, without him. And like a happy child, wanting the completion as soon as possible, and knowing vaguely that Dick had planned for her to have it, she lay on her bed as soon as she got home and wrote Tommy Barban in Nice a short provocative letter.”

Tender is the Night is, of course, much more than a window thrown open to illuminate the psychological complexity of projective identification within marriage. Fitzgerald is among the most important American writers, and the trajectory of his own struggles, and his wife’s, make the book even more absorbing. The Divers and the Fitzgeralds share a magnetic aura, volatility, and additional parallel details including a wife’s shocking attempt to drive her husband off the road. Readers who are curious about how unconscious marital transactions unfold will be riveted by this remarkable novel.

(Henry King’s 1962 film by the same name, starring Jason Robards as Dick, Jennifer Jones as Nicole and Jill St. John as Rosemary is also worth a view!)

How can couples who want to make their marriage work regain the loving feelings from earlier years?  This is a question asked by many clients in couples therapy and obviously an excellent one.  One challenge is that the whirlwind passionate experience of falling in love is magical — in part — due to its departure from and in some ways its rejection of day-to-day real life.

In his bestselling self help book, “The 5 Love Languages: The Secret to Love that Lasts”, anthropologist and marriage counselor Gary Chapman writes:

“We cannot take credit for the kind and generous things we do while under the influence of “the obsession.”  We are pushed and carried along by an instinctual force that goes beyond our normal behavior patters.  But if, once we return to the real world of human choice, we choose to be kind and generous, that is real love.”

Chapman proposes that people tend to fall into one of 5 distinct categories with respect for what makes them feel loved.  Words of Affirmation, Quality Time, Receiving Gifts, Acts of Service and Physical Touch comprise the categories.  Once the pixie dust of infatuation settles and couples embark on real life together, the challenge becomes that couples often do not speak or respond to the same love language.  In other words, we tend to express love in the way we want to feel loved.  But, all too often, one spouse feels love most acutely when love is expressed through the means of a category that may not be intuitive to his or her partner.

This no-nonsense, practical guide to marriage breaks down the five languages in a way that is easy to follow and can resonate well even with the most discouraged of couples.  What is interesting in terms of the advice is that rather than a continuous series of compromises, Chapman urges readers to move past the idea that their love language is superior.  In other words, whatever language your partner speaks is the one that you should use in order to make sure that they feel loved.  If they respond to quality time, then it is essential to be willing to sometimes (or often) put your busy schedule on the back burner and make quality time your number one priority.  If they respond to gifts, make sure you give them even if you find this approach superficial.

This strategy feels very much in concert to some basic communication advice I often give to clients:  sometimes the best way to “win” and argument is to “lose” it.  By this I mean that you can go on and on about the millions of reasons you may be “right” and likely get nowhere in terms of resolution.  However, if you simply focus on where you are at fault and what you should have done differently, your partner will typically do the same.  (And if genuinely owning your part of the problem does not generate a positive shift in the communications dynamic, this gives you some important information about the over-all relationship.)

Chapman’s Love Language advice is similarly self-focused and therefore effective.  Rather than trying to prove to someone that they should feel satisfied because of all of the love you show in YOUR way, learn the ins and outs of their love language and become fluent in its dialect.

Chapman uses simple exercises and direct questions to help readers unsure of their language to determine which one resonates best.  And the many case studies of couples he has helped in the past work as inspiring templates for those feeling stuck in a marital rut.  Many of my clients have used this book as a complimentary tool alongside couples therapy.  If “your love tank” is running on empty and you want to make your romantic relationship work, “The 5 Love Languages” is certainly a worthwhile, upbeat, enlightening read.