Today was typical and atypical for a Wednesday. It usually starts with heavy breathing and lots of sweat but my personal trainer was out of commission, having undergone reconstructive knee surgery for the second time in 6 months because of basketball-related injuries (or should I say injuries due to delusions of immortality). So I slept in – and loved it. Yesterday had been a seven-client day and I had gone to bed exhausted from lugging projections from session to session. Sometimes you can leave it in the office and other times, it gets in you and stays in you. Even my yoga class the night before had been only mildly restorative. At times, the breath is no match for seven hours of potent and unsavory unconscious attributions. I was told once that the key to being a good therapist is finding a way, when you’re getting covered in shit during a session, to keep one eye open so you can see where the shit’s coming from. Certainly some days smell sweeter than others, but there does seem to be truth in that advice.


So once I did rise and shine, I appreciated having a bit more time and energy to direct toward preparing for an upcoming workshop that my group practice was sponsoring in two weeks. My colleague, close-friend, and group co-therapist, Claudia, will be presenting on mindfulness, meditation, neuroscience, and psychotherapy and I had offered to provide administrative support. In another life, I think I was a copy editor so I was happy to bring those skills to bear in creating materials to both market the workshop and our practice to the broader DC community. Plus, Claudia is essentially my “second wife” – co-therapy is really just another form of life partnership – so I knew my help would mean a great deal to her and to us.

Now for the actual face-to-face. My first client of the day was a very successful lawyer with full-blown OCD that manifests in hours of “checking” and “thinking”.  She gushes about therapy but doesn’t seem to get much better, which poses a dilemma. Is her praise of me and our work a distraction from the “real work”? Is she growing in ways that I can’t see? Is change just really, really, really slow? (the answer to that last question, of course, is always yes) When I’m feeling “half-full”, I’m comforted by the fact that our work does seem to be deepening – meaning we’re more in the moment with each other, looking closely at our relationship, the ways that intensity ebbs and flows between us, how she filters in sessions, measures her degree of need and exposure. I trust more and more these days that the road to growth and healing leads through the “here-and-now”. Presence is essential – it’s what makes the work so energizing and intimate and what makes it so difficult and demanding.

Next was a supervision session with a clinical psych doctoral student in her first year of providing therapy.  Supervising has always been one of my greatest professional joys. I’m good at giving students permission to make mistakes and helping them see therapy as a play space where mess is not just allowed but unavoidable and integral to the process.

After supervision, a phone call with another colleague to discuss our progress toward organizing a two-day conference on the Art of Clinical Supervision. I’m co-chairing this conference for the second year in a row and can’t wait for it to be over. I like the topic but not the task. I’d rather be teaching or treating or eating or sleeping. Only a month to go.

So much more to the day but this isn’t supposed to be a dissertation so I’ll keep it relatively short. Three more individual clients, all showing signs of growth: 1) a middle-aged man who was very suicidal 6 months ago but just this week told me he joined Facebook, bought hazard insurance for his house, and started looking for a job. All very good signs for him – connections to the world – a big deal for someone who used to smoke in his garage to avoid being seen by neighbors. Makes me tearful thinking he might want to live, 2) a young woman who pulls out her hair and worries incessantly but who came to therapy today giddy because she allowed herself to eat lunch during the workday and leave work early to come to our session. I liked seeing her smile and smiling back, and 3) another man I’ve seen for 5 years who just found the courage to enter sex therapy with his wife and face the lack of intimacy between them. I feel lucky when signs of progress are so obvious. They mostly aren’t.

The day ended with Group – really, it’s a therapy group for men and women of various psychological shapes and sizes working to figure themselves out in relationships – but I just call it Group. I love it. We meet weekly. Claudia and I co-lead. It’s been going on for 6 years and I rarely leave a session without feeling energized. I just became a Certified Group Psychotherapist and if there’s any area of my professional practice about which I’m unambivalent and aspire to expand, it would be Group. Not particularly lucrative, but it makes me feel rich.

When I got home around 9pm, my wife was still out. She takes horse-back riding lessons on Wednesday night. It just occurred to me that we both often come home on Wednesday night covered in our respective shit. Laughing is good at the end of a day.