Category: Issues

Inwardness, Marital Discord, and Porn

A positive, nurturing, etc. upbringing psychologically prepares a person to successfully meet the challenges that inevitably arise in an intimate relationship. I say inevitable because there will always be some friction at times between two people, no matter how well suited they are for each other. The other person in a relationship is another person, with his/her own needs, values, perspective, trigger points, moods, idiosyncrasies, foibles, quirks, blind spots, and so on. No one’s needs, wants, etc. are fulfilled 100% of the time by one’s partner or spouse. Thus all relationships are challenging in certain ways and degree. Read more

Is Porn Bad For You?

Is Porn Bad For You? I’m talking about the videos you watch on the internet. I’m not interested here in examining what distinguishes artistic rendering or examination of human sexuality from porn or in examining if porn is simply a term of disapproval on the part of someone for something that another person does not find objectionable. Again, I’m talking about what you watch online that is commonly understood as porn.

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Why do people keep on drinking after the first few?

Why do people keep on drinking after the first few? The answer shouldn’t be circular or tautological, as in ‘That’s what alcoholics do.’ The answer should actually shed some light on the matter. I’ve asked myself this question many times in the course of doing therapy with problem drinkers. I’ve asked them, too. This seems to be one of those questions that the person doing the activity in question has a hard time answering. Read more

To What Extent is the Addict Responsible?

Freud once commented that we are responsible for our dreams because well, who else could be responsible? This is Jewish humor, as I well know. Are we really responsible for our dreams? What actually are we responsible for and why? This is a pressing question for both husband and wife after (typically) the husband’s infidelity of one or more sorts has emerged (I must say many of the men I see have been strikingly lax in trying to cover their tracks). Is the husband bad or sick or both or something else or what?
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Whose Interests Really Matter?

One cannot be precise about the figures, but it is all too apparent that many people grow up having to endure very serious adversity within their own family. In 1962, in a landmark article appearing in Journal of the American Medical Association, a group of emergency room physicians implored medical colleagues across the country to stop covering up parental battering of infants and young children.Maltreatment of children within the family is not a pleasant topic, but it will not do to make believe it does not happen or that it is rare. Read more

Your Adult Relationship With Your Parents Could Be Your Most Consequential Adult Challenge

Time passes; you get older and become an adult. You have gone to college or not, you have a job, you make money, perhaps you are very successful, you get married and have children. You still have parents. They are, if this is the case, the toxic parents you grew up with. They have changed little if at all as you grew from childhood to adulthood. You have a life of your own as an adult, but your parents are still part of your life, still in your life. Read more

What’s the matter? (Diagnosis)

Based on persistent distress and so on, people ask about themselves or others ‘What’s the matter?’

Over the past 31 years (that is, since the 1980 publication of the American Psychiatric Association’s third edition of its Diagnostic and Statistical Manual, the DSM for short), American psychiatry has trained not only the mental health industry but also the public at large to think and speak in the language of DSM disorder categories. Read more

Addiction as a Marker of the problem

The title refers to a perennial disagreement among people who treat addictions of all sorts, namely whether to think of addiction (to alcohol or sex or anything else) as the problem (disease, disorder’) itself, or whether to think of addiction as one sign (and not the only one) of a problem that actually generates the addiction (as well as other signs, if one looks carefully).
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What Stands Out about Addicts

First the usual caveat about ‘addiction’: It does not lend itself to precise definition. It is really is a term indicating use (substance or activity) on the part of someone that has come to stand out to others or the user him/herself as damaging well-being and which resists efforts to eliminate or modulate. It is consequential for treatment if the person using does not really (as opposed to lip service) see his/her use as ‘over the line’ in terms of self-harm.
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Why is Change so Difficult?

Perhaps therapists see a biased sample. Perhaps there are people who recognize a need to change something important about the way they live and execute change in a timely manner. But I must admit that what stands out to me as a therapist as well as through informal (non-therapy) relationships is how hard most people find it to change any well-entrenched aspect of how they face the world or live in the world day to day, regardless of how desirable it might seem to let us say ‘upgrade’ how they go about living life. Read more

How Does Change Occur in Psychotherapy?

I think it will be helpful to me and to prospective and beginning clients to try to provide an overview of how I think about …

Make-Believe in the Addiction Treatment Industry

Therapists shouldn’t be in the business of make-believe. There is a great deal of make-believe in the addiction treatment …

Magical Thinking About Drinking

Most of the people I see who have serious drinking problems express the hope that they can over time acquire the ability …