My patient looked me in the eye. Tears poured down her cheeks.
“It hurts so bad. Why does it have to hurt so bad?”
I often sit in a room with another person in emotional agony. It’s part of my job. I sit. I listen. I don’t interrupt. I tolerate the feelings, and do my best to understand.
“Why won’t he call me? Why doesn’t he love me?”
I told her what I knew to be true.
“This guy isn’t worth your time. He isn’t worth these tears. This isn’t about him. It’s about you. And these are old tears – the tears of a heartbroken child. Your heart was broken long before you met this guy.”
A child’s first love affair is with a parent – and a little girl’s is typically with her father. She instinctively adores this powerful man who controls the world. She would do anything to win his attention, his delight, his love.
Sometimes things go wrong.
The father might be distracted by other things – his career, his marriage, something. His baby daughter adores him. But his attention turns elsewhere.
For that child, his rejection is akin to abandonment – which is akin, for her, to death. The resulting pain is cellular, and unendurable. It is a child’s heartbreak. She thinks she is going to die.
That’s what my patient was feeling now.
We talked about how it felt, attempting to physicalize the symptoms to make them more conscious.
A cold steel ball in the gut. A choke in the throat – like a cry rising up and getting stuck. An ache at her core. She cried all the time, and couldn’t sleep.
This was heartbreak.
We returned to her childhood, to see where this hurt began.
Her father sounded awful – a swaggering bully, who verbally and physically abused his wife.
Still, when my patient was little, he became the positive focus of her life. She recalled afternoons spent sitting on his lap, being fussed over.
That ended abruptly when she was 10. Her father left with a mistress, then moved back in a year later – with the mistress in tow. After that, her childhood was a blur of drunken rages. Her father fought endlessly with both wife and mistress. The little girl got lost amid the drama. She spent most of her time alone, wounded by his rejection.
Now she was repeating the pattern. She’d found a guy like her father – a swaggering, charismatic bully who paid attention to her for a few weeks, then lost interest.
An adult doesn’t waste time on someone who doesn’t return her care. But a child loves differently – without question. The child seeks to please. If the child’s love is rejected, she locates the fault within. She must be to blame for refusing to please.
This is the formula for heartbreak – the pain of a rejected child.
My patient was pining for a someone who never existed, any more than the father who made gestures at parenting before he disappeared into his own self-fascination. Both men constituted a promise, not a reality Both appeared when they felt like it, then left. Neither deserved her love.
The first step in recovery from heartbreak is to recognize that this is a child’s pain – and address it as such. This is a cry of need that you have to answer yourself, by bringing your child the parenting she craves.
Instead of assigning importance to someone for whom you are unimportant, start treating your child as important. If you are there for yourself, you will not experience solitude as a child experiences it – as abandonment. You will feel secure in your own care.
The message for your child goes something like this:
You are good and unique and important. I love you. You deserve my love. I’m never going to put anyone else’s needs before yours, because you are mine – you belong to me – of me, and with me, and rely on me for care. You are my special love, always first in my heart.
Those are words a parent should tell a child, each and every day.
No one should ever break a child’s heart. Or let a child’s heart stay broken.
A young woman I worked with last week told me three thoughts that kept playing in her head like a tape:
I asked if she could formulate counter-voices to answer those tapes.
It begins with sitting down with yourself – just as you would with anyone else – and deciding you’re someone worth having as a friend.
Obviously, we can’t all become Lady Gaga. She’s a talented musician, dancer and performer, and most of us are not.
But you can learn to believe in yourself, and nurture and support the talents and aptitudes you have.
Maynard Solomon’s biography of Mozart quotes a delightful letter of 1778 from Mozart to his friend Gottfried von Jacquin:
But what does that really mean? The problem with mental illnesses is that they are largely invisible, at least with contemporary technology. I can’t peer down your throat or listen to your chest and diagnose you with acute depression. I have to observe your behavior. So this book, the DSM, is really a catalog of behaviors that our society has decided are indicative of a pathology.
Mozart and his friends made up silly names for themselves and had a grand time. But when other people make up silly names and impose them on you, it’s time to speak up and demand the right to self-definition. A diagnosis from your doctor should help both of you – you and him – to understand something about you.
I can’t seem to locate the exact quote, but I recall seeing a documentary somewhere in which Clinton discussed his unique status in the music industry. He said something like “Yeah, now I’m considered a visionary genius…but back when I got started I was just ‘that crazy mother-f-er.'”
A reader wrote recently to ask about the effect of multiple moves on a child.
The word resonates so strongly that real estate listings often use “home” instead of “house” to describe a property for sale. They’d rather market a concept – something we all long for – than the thing itself, a heap of wood and brick, cinder block and glass.
As a child, you long for stability – a regular schedule, predictable places and events. A child savors routines that would bore an adult to tears: watching the same dvd over and over again, having the same book read to him over and over again, eating the same meal (chicken nuggets or pizza) over and over again. A child wants to stay put and feel safe. Familiarity is like food – he gobbles it up.
So you turn vagabond – and search for a new home, elsewhere.
You cannot build a home with someone else until you feel secure in yourself. No other person can make you feel secure in your life, and partners cannot run to one another for something they both lack.
Always there, always ready to offer love, security and safety. For yourself.
My patient was upset. Another girl had dumped him when everything seemed to be going well.
And that’s what E=mc squared means. Matter at the speed of light becomes pure energy. (Apologies to my physicist older brother, Dr. David D. Meyerhofer, if this isn’t exactly, precisely absolutely correct – but I think he’ll agree it’s pretty close.)
Maybe the speed of light is as fast as you can go. Maybe a ruler can stretch or shrink and time can run faster and slower, depending on how fast you’re moving.
Sometimes I feel like I might be the greatest therapist in the world.
It isn’t easy to overcome the fear and take that leap. Certain elements in our society are committed to keeping gay people from telling their truth, and to achieve that end they do their best to scold, frighten and intimidate LGBT people into hiding the beauty of their authentic souls.
But that’s their job. They have a gay person in their lives, and they need to learn more about gay people.
Towards the end of a session a while back, one of my patients, who was African-American, laughed out loud, like he was sharing a personal joke.
I take pride in showing off my bits of cultural competence. I enjoyed greeting a Chinese patient from Hong Kong the other day with “Please come in!” in Cantonese. Last month I shared a laugh with a Dominican patient when we realized we both have little half-Dominican nieces who call us “Tio.”
The first researchers to observe chimpanzees in the wild were left with an idyllic impression of our close ape cousins. They appeared to be a peaceful tribe of vegetarians, who cuddled and groomed and cared for one another in extended family units, sharing fruit and showering their young with affection.
Chimpanzees are gentle, loving and family-oriented within their own territorial mating group. But with chimps from outside that circle, they can turn vicious.
An album of photos was made public in 2008 containing photographs taken by members of the SS who worked at Auschwitz. These pictures are not what you would expect. Dating from 1944, they show laughing, singing, smiling people reveling at Solahütte, an SS recreation home located just outside the death camp.
There’s even a shot of an SS officer lighting the Auschwitz Christmas tree only a few miles from the place where millions were being starved, beaten and gassed.
Freud watched Hitler march into Austria during the Anschluss in 1938, as the powerful Roman Catholic church stood by offering no resistance whatsoever. As Peter Gay describes it:
Another way to ostracize a group is to link them to disease. When Glenn Beck calls Progressivism a “cancer” in America, he implies that Progressives, those people like myself who believe in Progressive causes, are the embodiment of that cancer. He is borrowing a page from Adolf Hitler’s playbook. One of the Fuehrer’s favorite tropes was to compare Jews to tuberculosis bacilli infecting the German nation.
Still another way to justify dehumanizing a group of people is to isolate them because they have a different ethnic background, or physical appearance. This country began as a slave colony, based on the firm notion that people with dark skin could be beaten, abused, tortured, murdered, and bought and sold as chattel because they weren’t really “human” at all – they were more like animals. This is another example of in-group/out-group psychology at work.
The Tea Party movement lends itself to in-group/out-group psychology because it is a homogenous population – an excellent candidate for an in-group. According to a CNN poll, active supporters of the Tea Party, those who have attended a rally or donated money, are much more likely to be wealthy, male, have graduated from college and reside in rural areas that are already GOP and conservative strongholds. According to a Quinnipiac University poll, 88% of the Tea Partiers are white. They are also almost entirely Republican. It’s a fair guess that most of them are Christian, too, and probably fundamentalist.
This might explain their obsession with attempting to prove that Barack Obama, the President of the United States, was somehow not born here or is somehow not American.
The latest example of in-group/out-group psychology at work has appeared in the form of threats of violence by radical Right-wingers against Democratic politicians who supported the healthcare bill and voted it into law last week. Black and gay politicians have had nasty names shouted at them. One Democratic congressman was called “baby killer” by his Republican colleague on the floor of the US House of Representatives. There have been death threats and acts of vandalism.
But the Republicans still need to learn a basic lesson in citizenship.
I write a lot about unconscious regression – mostly how to prevent it.
You also need to play. Perhaps that’s what dreams are – the play of the unconscious mind.
Adults do just the opposite. When you play as an adult, you regress back to childhood activities. You might occupy yourself with sports, vegetate with a video game or disappear into a novel or a movie. You might sit on the beach, look at a palm tree and think about the world.
The German philosopher, Friedrich Nietzsche, wrote that a man who transcends the conventional thinking of his time “must be accustomed to living on mountain tops.”
But for a few days I’ll let my child take over.
Remember when you were a kid, and you got caught doing something you shouldn’t, and a big cloud formed over your head?
I wrote a column a few weeks back on Prince William and Kate Middleton.
That’s because the British royal family are treated like children. And you want to be treated like a child, too.
William and Kate exist in a similar world. They can’t go swimming without a paparazzo recording each stroke through a telephoto lens.
You never basked in one ten-thousandth the attention – or the adoration – to which William and Kate are subjected on a daily basis.
Your anger is expressed as an aggressive sense of entitlement. You are entitled to photos of them swimming. You are entitled to juicy bits of gossip about their personal lives. Fair’s fair – isn’t it?
No harm in fantasizing about being the royals – the most pampered children of all – so long as it doesn’t become an obsession that occupies your every waking moment. (For most of us that isn’t an issue – it’s just a hobby.)
One of the hard parts of psychotherapy – and the unavoidable realities – is remorse. Inevitably, once you become more aware of who you are, and how you’re living your life…you wish you’d done so sooner.
The second monk laboriously scales the wall and is also soon hidden amid the plants and trees.
Watching the most recent Oscars ceremony was a healthy reminder of the most fundamental instinct in human nature – the desire to please.
Perhaps it was her putting it so bluntly – telling the audience that they liked her – that made them flinch, and change their minds, and switch to making fun of her.
I was working this morning with a patient I’ve been seeing for a few months. At the end of our session I suggested he join one of my psychotherapy groups that meet once a week in the evenings.
Myth #3. For a group to work, everyone has to share a common life experience. 
My patient sounded bewildered.
You’ve probably heard of “Pavlov’s dogs.”
My patient was developing an observing ego. He kept having “deja vu” moments. He’d been down this path before, and he knew it.
When gay people come out of the closet, they usually run into some variation of the “but that’s unnatural” argument. This is the apparently sensible claim that it doesn’t make sense to be gay. Isn’t sex for procreation? Why would two males or two females become romantically involved if they can’t have a child together?
You can breed a chihuahua that weighs 2 pounds. Or you can breed an Old English Mastiff that weighs 300 pounds.
I mean raise other people’s children.
That’s why, throughout the world, gays are the unofficial backbone of the adoption system. Without them, many children would suffer terribly, never finding wiling, dedicated adoptive parents.
Inevitably, a few times a year, a new patient refers to me as “doctor.”
First, you shake some bamboo sticks from a cup. The ones that fall to the ground have numbers written on them. Those numbers somehow guide the work of the fortune teller, who sits in the back of the temple in a special booth (there may be many fortune tellers working in a large temple.)
I had the clear sense that this “fortune teller” – an old man in a silk jacket at a Taoist temple – was a colleague. Clearly a skillful psychotherapist, he was working in a different modality, but essentially doing what I do – observing, listening, and offering insights intended to create awareness.
Last October, a law school placement director friend of mine forwarded me an email with a juicy piece of big law gossip. A former associate at Sullivan & Cromwell had offed himself. He was 39.
Gerald Lucas, a psychotherapist who runs an institute in New York City, used to tell his patients he regretted he couldn’t make the world a better place – he could only make them better able to handle it the way it is.
The People's Therapist 