When Problems Take Over a Relationship

Even when people are firing on all cylinders, relationships can be tricky. When there’s a persistent problem, like an illness or an addiction in the mix, they can be impossible. Persistent problems can be the source of much harm. The alcoholic you can’t rely on. The gambler you can’t trust with money. The depressive who won’t do anything. The phobic who won’t go anywhere. The narcissist who makes everything about her. The guy who can’t seem to keep his dick in his pants. When problems like alcoholism, compulsive gambling, depression, phobias, narcissism, or compulsive sex take over, it takes hard work to eradicate them and eternal vigilance to keep them away. Relapse can be expected. When we’re talking about addiction, it takes an average of seven real attempts before recovery feels solid and, even then, you won’t know if he’s going to need eight. Mental illness also tends to be episodic, and, if nothing is done about it, each new episode is worse than the last. People who have succumbed once to the allure of violence, sexual recklessness, self harm, suicide attempts, or self-pity are more likely to do it again. Moreover, problems will often go into hiding when they feel threatened, so that what appears to be recovery is really a more pernicious hidden phase of the same problem that caused so much trouble before. Continue reading →

Boundaries and Trust

Think of your Self as a house.

There are some people in your life who you never have to trust. They’re like people who never come in to your house. You pass them on the street and go by. You see them all the time, but they don’t know you.

Others, you trust in some small way. Waiters, shopkeepers, clerks, and customer service workers are like delivery people who leave things on the porch of that house, ring the bell, and leave. They have contact with you as a house, but it is very brief and task oriented. You trust your waiter to bring you your soup, but you examine it before you eat it.

Others come to visit you on the porch. You’re friendly and spend some time with them, but never really let them in. The porch of your Self has a little bit of you in it, but it’s a public part of you. Most of you is kept private from them and safe. Continue reading →

Detect Dreams

When you’re stuck at an impasse.

You find yourself gridlocked. You want children; she doesn’t. He wants you to go to church, but you’re an atheist. She likes to stay home; you’re always ready to party. There doesn’t seem to be any solution. There’s no way to compromise. You’re ready to call it quits. What do you do?

Step away from the problem.

Look at the big picture. Understand the different points of view. Not just your perspectives on the immediate issue, but what lies behind them. Behind every position is a dream or a value that you and your partner find essential. Acknowledging and respecting these deepest, most personal hopes and dreams is the key to getting past the impasse. Continue reading →

Don’t Force It

Especially when trying to bring about change

My father was a car mechanic. When I was a kid, he tried to teach me all about cars, but I wasn’t very interested. After a while, he might have thought he was wasting his time, but one of his lessons stuck with me. I think about it every day.

“Don’t force it,” he often said. Continue reading →

Why Can’t We Turn Away?

The fascinating and appalling state called abjection

There’s a psychological mechanism that isn’t very well known, yet it’s involved behind the scenes in many emotions. It plays a part in disgust, revulsion, repugnance, aversion, distaste, nausea, abhorrence, loathing, detestation, horror, contempt, weird, outrage, terror, fear, fright, panic, dread, trepidation, hatred, hate, abomination, execration, odium, antipathy, dislike, hostility, animosity, ill feeling, bad feeling, malice, animus, enmity, aversion, shame, humiliation, mortification, chagrin, ignominy, embarrassment, indignity, discomfort and repugnance, among others. Really, just about any negative emotion has this mechanism involved.

What is this mysterious power behind the curtain of so many intense, uncomfortable emotions? It’s called abjection. Abjection is what happens when there is a breakdown of the distinction between self and other. It’s necessary for your development into an independent, functioning human being. Continue reading →

Announcement

After more than fifteen months of pandemic, I am fully vaccinated and will be ready to see clients in-person after June 1, 2021 at a new location. I’ll be in the office for in-person sessions two days a week. I will still be counseling by telehealth five days a week.

The New Location

My new office is at the Harvard Street Integrated Wellness Center, 18 Harvard St, Rochester, NY 14607, a residential street in the Park Avenue area of the city of Rochester. Also in the building are other therapists, a psychiatrist, a physical therapist, a nutritionist, and a couple massage therapists.

In-Person Counseling

I will be at the new office for in-person sessions two days each week.

Tuesdays, 9am to 2pm and Thursdays, 3pm to 8pm

If you chose in-person counseling, you should be fully vaccinated and wear a mask while entering the building and sitting in the waiting room. We will be able to take the masks off once we get settled in my office.

Telehealth

Because so many people have found telehealth to be more convenient, I will continue to offer counseling by phone or video for all the hours of operation.

Mondays, 3pm to 8pm
Tuesdays, 9am to 2pm
Wednesdays, 9am to 4pm
Thursdays, 3pm to 8pm
Fridays, 11am to 4pm

How to Schedule an Appointment

To schedule an appointment, please use this link and, if I have seen you before, enter your email address. You will get a link to that address from simplepractice.com. Open it up, select request an appointment, and chose the type, whether an initial evaluation or individual or couple’s counseling. On the next screen, you will have a chance to select a location, either telehealth or in person at 18 Harvard St. You will then see the openings I have in my calendar. Select one and you are done.

If you would like to meet regularly and your schedule is tight, I recommend setting up several appointments at once, so you know you can get the time you want. We can always change them if we need to.

Afterwards, I will most likely confirm the appointment. I may send you a request to fill out some paperwork beforehand so that I have up to date contact and insurance information.

I hope to see you soon.

Keith

Shame

We have no emotion that’s not useful in some way. Everything is there for a purpose, even an emotion that undermines its purpose.

I’m talking about shame. Its purpose seems to be to help us fit in with others. Shame, and its milder version, embarrassment, comes up when you violate a social norm which might get you expelled from the group or, at least lower your status. Continue reading →

Some Strange Ideas about the Strange Situation

And stranger ideas about attachment

A mother enters a room with her eighteen-month-old child. Neither have been there before. There’s a few toys on the floor. The mother leaves the child with a stranger for a few minutes. The mother returns. White-coated researchers are standing behind a one-way mirror with clipboards, recording everything that happens.

The experiment has been called the Strange Situation, but it’s not a strange situation at all. It happens all the time in the natural world. Nonetheless, it’s been a very important experiment in the history of psychology. Out of it has arisen theories of attachment. Continue reading →