Empathy is the connective tissue of good therapy. It's what enables us to establish bonds of trust with clients, and to meet them with our hearts as well as our minds. Empathy enhances our insights, sharpens our hunches, and, at times, seems to allow us to "read" a client's mind. I first recognized the physical force of empathy as a college student. When I copied the swaggering gait of a cocky young man, for example, I'd momentarily feel more confident---even happier---than before. I found this secret street life fascinating and fun, but I didn't think much about it until a few years later, when I started practicing clinical social work.

For decades, most clinicians who had a choice avoided borderline clients, while agency staff (who couldn't) went through the motions with a sense of futility. Therapy consisted of guarding against "manipulation" and mining the borderline's reactions to the therapist for clues to her fragmented inner world. It was hard on clients---and on therapists as well. Then, in 1991, a behavioral psychologist and Zen student at the University of Washington named Marsha Linehan introduced an alternative. Her treatment was called Dialectical Behavior Therapy, or DBT.

While at first glance, 21st-century adolescents appear impossibly cool---cooler than we could have ever been ourselves---teens today are running hot with cultural forces that have redefined the nature of their consciousness and experience of selfhood. Therapy with adolescents needs to change fundamentally. We may not have the power to alter the techno-pop culture that defines so much of teen experience today, but by focusing treatment squarely on how to engage adolescents in a vital relationship, we can make an enormous difference in their lives.

I believe that some elements of our ethical codes have become so needlessly stringent and rigid that they can undermine effective therapy. Take, for example, the almost universal taboo on "dual relationships," which discourages any connection outside the "boundaries" of the therapeutic relationship, such as lunching or socializing. These "boundary crossings," are rarely harmful and may even enhance the therapeutic connection. My experience with Mark and Sally was one such boundary crossing.

How can it be that—despite all the efforts aimed at understanding, treating, and educating the public about depression—the number of people suffering from depression continues to rise? Why have our treatments plateaued in their effectiveness, and why does the stigma associated with this condition remain very much with us? Depression has clearly been a tough nut to crack, but we haven’t focused much on what’s at the center of that nut: mood.

My year treating high school boys taught me a lesson that still guides my work: if words are the currency of most interpersonal exchange, many boys are on the verge of social bankruptcy. When it comes to communication challenges, gender discrepancies are staggering. Boys make up 75 percent of special-education classes, are far more frequently diagnosed with syndromes ranging from ADHD to autism that involve social-learning problems, and account for nearly 80 percent of children identified as emotionally troubled. Our world is increasingly driven by communication and the need for emotional intelligence---attributes that generally don't come easily for boys---and they're clearly falling behind. In spite of the still-potent icon of the silent male in the American psyche, there are far fewer life options today---whether academic, career, or relational---that can accommodate a boy (or man) of few words.

I will never forget the Correys, who were referred to me by their family doctor in western Nebraska. Every other week for a year, I saw them, during which time I tried pretty much every trick in my therapeutic arsenal. I spent hours discussing their case with trusted colleagues and read up on their particular problems. I don't know how many nights' sleep I lost worrying about how to get these folks on the right track. And in spite of all my efforts, the Correys were one of my most spectacular failures.

Over the past decade, Michael White has developed a worldwide following of both senior therapists and neophytes on several continents who insist he has something vitally important to say that the field needs to hear. But watching him in session is a far cry from seeing one of the recognized lions of clinical performance sweep grandly into the middle of a dysfunctional family circle and in one session transform it into a little kingdom of love and harmony, while being wildly entertaining in the process. Far from it. His pace is measured, even monotonous. Some find it maddeningly slow, the therapeutic persona respectful, solicitous, inquisitive, slightly donnish, almost deferential, the circuitous language an eccentric mix of the folksy and the politically correct.

The provocative core of new research is this: each of us approaches our erotic encounters already primed by a premixed neurochemical and hormonal "cocktail" that influences both the strength and staying power of sexual passion. Having delved into this new biological evidence and observed its impact in my own couples therapy practice, I’m convinced that as long as our clients remain unaware of these bodily processes, they’re at high risk for making disastrous decisions about their intimate commitments.

Many of us enter the bedroom now as if we have been told we are about to play a high-stakes game. There is no rule book, or else it's been hidden. Everyone else, we think, knows how to play. We charge down the field. We pass the ball. A whistle blows. The rules have changed. We are given five different rule books and told to choose one that suits us. (We have no idea what book the other team is playing from.) Bleeding from the shin, we strap on our battered equipment again and once more run down the field.