Romantically infatuated with the idea of psychological revelation—aka the therapeutic “breakthrough”—therapists too often ignore the fact that a life’s worth of habitual behavior often trumps, for good or ill, all the insights and emotional fireworks that we like to see as the key to therapeutic “progress.”

Changes in the habitual attitudes and behaviors that shape our lives rarely happen as the result of psychological epiphanies or emotional catharsis. Most therapeutic progress comes from the painstaking process of continual practice that reinforces some behaviors while actively discouraging others.

Some people can drink to excess for years without experiencing the negative consequences that can destroy their lives. So when does someone cross the tenuous line from habit into addiction? And what’s the difference between the two anyway?

When routines and habits become as lifeless as the manner in which one brushes one’s teeth, when the choreography of one’s existence resembles a blindfolded slog through quicksand—rather than the Jets and Sharks leaping across the streets of the Upper West Side—something must be done.

Most clients have automatic habits of thinking, feeling, and verbalizing experiences that imprison them in a world of gray sameness. How do we help them escape? The most immediate way is to ditch your logical analysis and help them experience a felt sense.

Making yourself profoundly unhappy takes tenacity and creativity. But the real art of it is to behave in ways that allow you to claim yourself to be an innocent victim, ideally of the very people from whom you’re forcibly extracting compassion and pity.

How do you help 200 teenagers who’ve had to flee their country find a path to peace in a new place? A psychiatrist who’s traveled across the world to help traumatized refugees from Tibet guides them to a source of wisdom and hope within themselves.

Garry Cooper and Kathleen Smith

Although the idea that the mind and body are inextricably linked is widely accepted in our field, many clinicians remain too focused on words to hear the truths that their clients’ bodies have to offer.

Raising the issue of race in therapy can help African American clients connect their personal struggles to an enduring cultural legacy that many insist isn’t supposed to matter anymore.

David Kessler has spent his career helping people all over the world deal with death. In the process, he’s learned that—as much as we may resist experiencing it—grief is a gift that helps us heal.

Pilgrim's Wilderness

A new book examines how one man, under the guise of religious faith, kept his family isolated in a world of abuse and brutality, and how another family broke boundaries to help them escape.

A woman discovers that giving someone permission to sleep can be a deep expression of love.