One of the things that I truly love about my job is that I get to think. In my head, I visualize each patient as a complicated puzzle with at least 10,000 pieces. Over the course of several sessions, I begin to assemble the pieces to understand how this unique individual functions, what elements of his/her environment and history have shaped thinking patterns and emotional reactions, how the particular aspects of biology and physiology have formed the basis for the environment, and how I can help. It is a great honor that many times I can find ways to help, and to touch the lives of individuals who learn to trust my care, and my thinking.


Mind and Spirit

“There is no coming to consciousness without pain. People will do anything, no matter how absurd, in order to avoid facing their own soul. One does not become enlightened by imagining figures of light, but by making the darkness conscious.” Carl Jung

Typically, when someone calls me for an appointment, it is because he or she is experiencing some high degree of distress. Often there is a wish for immediate relief from that inner pain. Sometimes it is important to ease the intensity of the emotions by reassuring the patient that there is some normalcy in the reaction. Ultimately, however, for true change to occur, one must embrace the darkness and dig into the inner aspects of the self to find what needs to grow. Probably the hardest emotion for most people to talk about is shame. My patients could tell you that I call shame “the final frontier” of therapy because it is so very difficult to reveal to anyone, even a therapist. When we stop running from our dark emotions, however, we find that they are not so toxic as we had feared. We are only human after all.


Topics in Psychotherapy


Autobiography in Five Short Chapters

by Portia Nelson


I walk down the street

     There is a deep hole in the sidewalk.

     I fall in

     I am lost…I am helpless

It isn’t my fault.

It takes forever to find a way out.


I walk down the same street,

There is a deep hole in the sidewalk.

I pretend I don’t see it.

I fall in again.

I can’t believe I am in the same place.

But it isn’t my fault.

It still takes a long time to get out.


I walk down the same street

There is a deep hole in the sidewalk.

I see it is there.

I still fall in…it’s a habit.

My eyes are open.

I know where I am.

It is my fault.

I get out immediately.


I walk down the same street.

There is a deep hole in the sidewalk.

I walk around it.


I walk down another street.


One of the discussions I often have with my patients is about why we, as human beings, continue to make the same mistakes in life over and over again. This simple poem illustrates what, for me, is an explanation for the learning process we have to engage in order to train our brains to respond differently to situations that trigger our emotional responses. If it was easy to do this, I would not have a job. Part of the difficulty is that we tend to be very unforgiving of ourselves and part is just an automatic response that keeps us from seeing how our own behavior gets us into the same predicaments. We can retrain the brain and teach ourselves to understand our reactions and responses, rehearsing a more appropriate response in preparation for the next “hole in the sidewalk”.