Does severe remorse require a specialist?

In her recent New Yorker article, “The Sorrow and the Shame of the Accidental Killer,” author Alice Gregory claims there are no self-help books for anyone who has accidentally killed another person. Nor published research, therapeutic protocols, publicly listed support groups, nor therapists who specialize in their treatment. She profiles several such tormented souls who […]

Choose your actions, not your feelings

Again and again in therapy I find myself emphasizing the distinction between feeling an emotion and acting on it. Many patients, and non-patients too, take undue responsibility for their emotions, as though feelings were volitional behaviors, the result of a choice. Often there is a stated or implied should: “I should feel this, not that.” […]

Behavioral science versus moral judgment

George S. Patton, Jr. commanded the Seventh United States Army, and later the Third Army, in the European Theater of World War II. General Patton, a brilliant strategist as well as larger-than-life fount of harsh words and strong opinions, was also infamous for confronting two soldiers diagnosed with “combat fatigue” — now known as post-traumatic […]

“Have you seen a therapist yourself?”

Recently a patient asked whether I’d ever been in therapy myself. Without answering his question directly (see my post on psychotherapist disclosure and privacy), I replied that many of us have, and asked what it meant to him. It would be a bad sign: “How can you help if you need help too?” We went […]

If I accused you of being a Martian...

Cross-posted from “Sacramento Street Psychiatry“.

In dynamic psychotherapy, patients often say how hurt and victimized they feel as a result of unkind judgments or criticisms by others:

“My coworker called me a hypocrite!”

“My mother told me I neglect her by not visiting enough.”

“My husband complains I’m too self-centered.”

Although sharing such complaints with […]