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Couples Therapy for Moving Past Affairs

For several years, I’ve been contacting couples I’ve treated to find out more about the long-term impact of the infidelity that brought them to therapy. With those couples who’ve remained together in the intervening years, I offered a free, follow-up interview to discuss how they regard the infidelity retrospectively, and how they integrated the experience into the ongoing narrative of their relationship. Specificities notwithstanding, I identified three basic patterns in the way couples reorganize themselves after an infidelity—they never really get past the affair, they pull themselves up by the bootstraps and let it go, or they leave it far behind.

Avoiding Burnout in Your Therapy Practice

An entire industry has sprung up to address the problem of compassion fatigue, but research indicates that the most commonly proposed answer, improved self-care, doesn’t work. In fact, the study of the most highly effective clinicians suggests that burnout isn’t related to caring too much, but continuing to care ineffectively.

How to Market Your Therapy Practice Online

As a practice-building coach for the last seven years, I’ve met a lot of therapists who are working hard to implement marketing strategies that just don’t work in today’s therapy environment, although they worked well in the past. So what’s changed? One word: the Internet. If the Internet continues to grow in importance as a communication and information medium, as it almost certainly will, it’ll increasingly be the most effective way for you to attract clients. So how do you create a web presence? Here are a few possibilities.

Coping with a Genetic Disposition for Depression

My family is haunted by depression. My mother can trace it back in her family at least six generations and it’s in my father’s family, too. When it hits, it hits hard. Understanding the legacy of depression in a family requires more than genetic mapping, family diagrams, or symptom checklists. Each of us is the product of a complex weaving of genes and expectations, biochemistry and family myths, and the configuration of our family’s strengths, as well as its vulnerabilities. To truly appreciate the complexity of the weave, we have to sort out the contributions of individual threads to the overall design.

Customizing Cognitive Behavioral Therapy for the OCD Child

Maria was 9 years old when she heard a TV news item about an outbreak of hepatitis that originated at a local bakery. Long after the alarm had subsided, she couldn’t stop worrying about it. At first, she feared that …

Therapy Enters the Digital Age

More and more clinicians today are adapting to meet the demands of the digital world and fit into the schedules and lifestyles of clients no longer willing to follow the traditional pattern of once-a-week sessions in a therapist’s office. In a consumer-driven mental health marketplace, individuals with anxiety disorders want services from the comfort of their homes. For veterans living in rural areas, remote group and individual psychotherapy for trauma offers treatment possibilities that weren’t available even a few years ago. But although telehealth has been around for decades, many clinicians are still unsure about the clinical, ethical, and legal issues that emerge as distance therapy becomes a more accepted practice.

Giving Therapy Clients a Little Push for Big Change

What first made me fall in love with being a therapist was the idea that I could make a living by having conversations that cut through everyday pretenses, got directly to the heart of the matter, and helped people change their lives. That was then, and this is now. Today as a profession—and as a society—we’re much more fearbound and rule conscious than we used to be. Yet the sacred space of the therapy room is the ideal place to really exercise your creativity. It’s taken me more than 30 years to realize that it’s the combination of two strange bedfellows—imagination and repetition—that holds the key to change.

Connecting Body Awareness and Couples Therapy

If we can bring awareness into our own pulsing bodies, we get a chance to explore the hidden well of physical discomfort caused by our memories and emotions and our crazy defenses against that discomfort. The body, you might argue, is the unconscious. No one welcomes discomfort, but the fear of becoming overwhelmed, the fear of unleashing strange forces, of “wallowing” in negativity, can funnel our energies away from tolerating even the mildest turbulence of our felt experience. In my therapy practice, I’ve learned that being present to the rich physical substrate of the body can be especially useful in couples work.

Two Guidelines for Keeping Your Therapy Business Afloat

Money is an underdiscussed topic in graduate programs, supervision and peer groups, yet every therapist I know has felt the awkwardness of seeming mercenary when insisting to a client who has fallen behind that he or she needs to pay. Unfortunately, most therapists were never coached about how to reconcile the closeness of the therapeutic encounter with the fact that therapy is also a business. These days, I run into the problem of clients who don’t pay far less frequently than I used to. I attribute this to two changes I’ve made.

Mindfulness Practices for the Skeptical Client

Clinicians often make a variety of mistakes while trying to introduce mindfulness, and in my 30 years of trying to figure it out, I’ve made all of them. So let me share some of my bloopers with you in the hopes that you can avoid them. After all, meditation teachers often say, “This practice is simple, but it isn’t easy.” Perhaps the best piece of advice for helping people stay with mindfulness is to have them find something enjoyable in the practice. And above all, do your best to make sure that the practice fits the patient.

How Psychotherapy Helps Us Recover the Beauty in Our Lives

Many walk into the therapist’s consulting room exactly at the moment that they have been stripped to the core of their being. While not at the physical meeting-point of life and death, they are often at its emotional and spiritual equivalent. One element they seek and are desperate for is beauty; they present a situation that’s cut them off from experiencing beauty. All of which leaves us facing one piercing question: What is beautiful in your life? The therapist-client relationship is just about the last functioning shared space in this country where this question can be asked and, more important, heard. Which is why it’s so crucial that therapists find a way to ask it.

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