Machiavellian Therapy


I bet you never expected to hear someone say that one of their role models is Machiavelli, a man who has come to represent deceit and lack of scruples, but here you are. I admire him because he was the first proponent of Reality Therapy.

If you look it up, William Glasser gets all the credit for inventing Reality Therapy. He was a psychiatrist who lived five hundred years after Machiavelli. Glasser didn’t believe in reaching into a person’s psychological insides to root around for what was wrong like the Freudians do. He thought problems arise when the person is not getting her needs met. He preferred helping people discover what they really want and showing them how to behave in a way that leads to success.

Nowadays, you don’t hear much about William Glasser or Reality Therapy. You heard it from me because, being a reflective eclectic, I possess a vast storehouse of unfashionable therapeutic methods. Glasser’s ideas have become mainstream, after having mated with others and evolved into present day forms of CBT, ACT, and DBT, which you may heard of, if you traffic in therapeutic methods.

Glasser probably did not realize how Machiavellian his ideas were. Niccolò Machiavelli is not often associated with therapy. We don’t study him in shrink school. His very name conjures up images of bare-knuckled political realism, duplicitous bad faith, and self-centered expediency. There’s even a theory that the Devil is called Old Nick in reference to him. But Machiavelli was a counselor, a counselor to princes.

As a counselor to princes, Machiavelli did what I like to do with my clients. He got them grounded. I don’t mean grounded in the sense of meditate-on-your-breath-till-your-thoughts-stop-racing type grounding; I mean grounded in reality: the basic knowledge of what is. You see, if we don’t pay attention to reality, we’re not going to know how to thrive within it. Continue reading

Telehealth Psychotherapy


A man I talked to the other day seldom looked me in the eye. His gestures were not in rhythm with the things he was saying. At times, he skipped half the words in a sentence. Once, he disappeared entirely and went on talking as if we were still together. He seemed oblivious to many things I said to him. His face froze. Reactions were delayed. Was this a bizarre psychotic I was talking to? An individual with autism? Someone with something to hide? No, it was just an ordinary day in an extraordinary time of social distancing. It was what’s called a psychotherapy session thanks to the wonders of telehealth technology.

I’ve got to assume I was just as peculiar to him as he was to me. Continue reading →


The Therapeutic Milieu


Some milieux (the plural form of a fancy French word for social settings) are therapeutic, meaning they bring out the best in people; others bring out the worst. If you need an example of those that consistently bring out the worst, think of a maximum-security prison, a busy highway, the cafeteria of a middle school, or the parents’ bleachers at a basketball game. I wish I could give you a list of settings that consistently bring out the best in people, but I can’t. A home, a marriage, a gathering of friends, a workplace, or a church are all places that could be therapeutic, but often aren’t.

If you want to enjoy the therapeutic properties of a well-functioning milieu, you either have to be very lucky to find yourself in one, or you must create it, yourself. Fortunately, I’ve had a hand in creating a therapeutic milieu or two in my day, so I can tell you how it’s done. For many years, I worked in a program where almost two hundred people with serious mental illnesses and intense addictions came to spend the day together, every day. If we could make that kind of gathering therapeutic, then you should have no problem with yours. Pay attention to the following factors. Continue reading

Eleanor Oliphant Might Be Completely Fine But Using Therapists to Resolve Your Plot Isn’t


Ordinarily, I avoid reading books and watching movies that portray head shrinking because I’m careful to maintain a work/life balance. But I couldn’t ignore Eleanor Oliphant. Too many people recommended the novel as a delightful portrayal of someone with serious troubles.

I soon saw they were right, and so was I. Eleanor is truly delightful, but the book did remind me of work. Over my years as a therapist, I’ve sat with dozens of Eleanors and many of them were delightful, too. By Eleanors, I mean disturbed and painfully lonely young women, awkward around people, scarred by horrifying secrets. The world is full of Eleanors. Continue reading

Evidence-Based Therapy


In the peculiar land of shrinks, evidence-based therapy is a phrase we use a lot. It’s supposed to refer to therapy that’s backed by scientific evidence. But what they call evidence-based therapy is not evidence-based therapy. It’s a term for a standardized, manualized, commoditized therapy protocol. It’s not necessarily the best therapy for you. Continue reading

Turning Black by Turning White


My twenty years as a ghetto shrink made me a guest in the world of inner-city Blacks. I miss parts of that world. I admired the rhythm of my clients’ speech, the words they had for things, and the stories they told. They got me started writing fiction because writing fiction is a way of living more than one life at a time. I wanted to sound like them. I wanted to tell stories the way they told them. Turning White was one short story I wrote, back in 2000. It was my way of turning Black.

I submitted Turning White to a literary magazine called New York Stories, published out of LaGuardia Community College, in the heart of it all. The kids at the college said I got it right. Somehow, they thought I captured the experience of an inner-city Black without being anything but White and without my ever setting foot in a Bed-Sty project. It was one of the nicest things anyone has ever said about me.

The story got nominated for the Pushcart Prize, which is the thing to win if you’re a writer of short stories. It didn’t win, but the encouragement of it all kept me going with my writing.

I have re-published the tale on Medium. You can read it here.



In my earliest memory of my mother, I must have been around three. We were at the beach. She had spread a towel out on the sand and was sitting there, doing whatever it was adults did when they sat on the beach in those days.

I didn’t pay much attention to what adults did back then.

I suspect my Aunt Cosette was there because she often was around whenever my mother did fun things. There was probably a transistor radio playing. It was 1960 or 1961, so imagine some early Rock. Seagulls were flying. A horseshoe crab, straight out of the Pleistocene was flipped over and getting an examination by kids. I had a plastic pail and was doing something with it and the sand.

I waded into the water.

This beach was on Long Island Sound. There are no big waves there. It’s a very safe place, as long as a kid doesn’t go out too deep. It’s like a wading pool.

I must have tripped or slipped or just totteled under the water. I had gone out too far, so I went under. When I went under, I saw my hand holding the pail. They looked the same, but strangely different through the water. I looked up towards the sun and I saw the light coming through. They looked different, too. And then there were the bubbles. These bubbles were the last of the air coming out of my lungs. I had never seen bubbles like that before and they were gorgeous. Continue reading