Trauma and Escape: A Night at the Oscars

Our movies, ourselves: The Oscars invariably reflect the American zeitgeist. This year’s ceremony is no exception, especially given its topsy-turvy ending in which the presumed winner unexpectedly loses.

La La Land had been the clear favorite of the four top contenders for best picture. It’s the type of film Hollywood always loves because it’s about—well, Hollywood. It’s also been welcomed as an escape from the dismal reality of the current political landscape. Deliverance comes through saturated colors and a love story about attractive people who don’t sing and dance all that well. La La Land embodies the American fantasy that life works out if you follow your dreams.

Hidden Figures, too, is a feel-good narrative, depicting three brilliant African-American women who endured racism and sexism at NASA in the early years of the space program. The film is a bridge between the sheer escapism of La La Land and the more depressing realities depicted in Moonlight and Manchester by the Sea. Set in the early 1960s, Hidden Figures almost tricks us into believing that individual grit matters more than institutional oppression, and that the days of rank prejudice are behind us. These wishes, too, are part of our national fantasy. But as Faulkner and the recent election remind us, “The past is never dead. It’s not even past.”

This theme is woven throughout Moonlight and Manchester by the Sea. While La La Land and Hidden Figures offer escape (and very little back story), these two films are in the clutches of trauma. Neither Chiron, of Moonlight, nor Lee, from Manchester, can escape the past.

Chiron, a sensitive young, gay, black boy born into poverty to a crack-addicted mother, grows into a hardened drug dealer. He is a broken survivor who nonetheless finds a bit of peace and tenderness.

Lee is also broken, but barely surviving. He is not born into trauma, but causes one that quickly engulfs him. Lee can escape the town—at least until his brother’s death forces him back–but not the guilt and harm he’s inflicted on himself and others.

Moonlight and Manchester by the Sea do not feel good. But they feel honest. They affirm the harder truths: Some damage cannot be undone. Triumphant Hollywood endings are rare. There is no escaping the past. Yet revisiting it and coming to terms with it—as Chiron chooses, as Lee must, as we do in our everyday lives—creates small shifts, more understanding, and perhaps a tender cradling or a little extra room where none existed before.

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Which film were you rooting for?

 

Unpredictability at the Helm

The personal is political. As we psychotherapists have seen lately, the political is also personal. According to the APA, 52 percent of Americans suffered from significant election-related stress before November 8. Since Donald Trump’s electoral victory, anxiety has escalated, at least in the Bay Area. Clients have come into our offices extremely upset about the president-elect. His bullying, bigotry, boasts about sexual assault, and denigrating remarks have triggered past traumas and intensified fresh fears. Many have experienced deep ruptures with friends and family. Their loved ones’ support for a candidate who behaves so deplorably is reminiscent of non-protective parents who turn a blind eye to abuse.

These are some of the specific wounds. Yet the damage operates on an even deeper and more pervasive level regardless of one’s personal history.  Just as families are heavily influenced by who’s in charge, so is our American family. Trump has capitalized on a yearning for a strong authority figure to take care of us and keep us safe in unsettling times. But what happens when the person most responsible for containing threats to our well-being prides himself on being uncontained and unpredictable?

Therapists know what happens in families governed by an erratic parent. Insecure, even disorganized, attachment styles generally result. Some of the most gravely injured people we treat are those who grew up not knowing from one minute to the next who they would encounter: the loving, playful father, or the impulsive sadist who destroyed through word and deed? So many of our clients were thrown off-balance by a parent sometimes dispensing favors and forgiveness, at other times exacting vengeance, and routinely playing family members off against each other.  We have witnessed these dynamics throughout Trump’s campaign and transition parade. He puts his own interest above all else, toys with the truth and with the American people, and delights in his unpredictability. Such an environment distorts reality and destroys trust, worsening a pre-existing problem of a post-factual politics that enabled Trump’s rise.

This is the stuff of insecurity, not the necessary security people—and countries–deserve. Many therapists have themselves been at a loss to respond because they, too, feel unnerved. Now more than ever, though, we will be called upon to help individuals and the collective withstand the personal and political damage of unpredictability by finding and speaking truth, fostering empowerment, building resiliency, and prevailing despite a volatile head of family—or state.

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Originally published in NCSPP’s Impulse

Persuasion

A metal toggle switch with plate reading Listen and Ignore, symbolizing how we choose to pay attention to certain messages

Recently I shared an article on Facebook by a Bernie-supporting Hillary skeptic who articulated his reasons for voting for her. He’d decided the volatile political climate and the increasing unreliability of polls made it too risky–even in “safe” states–to stay home or to vote for a third-party candidate.

I had not heard this argument before, and wanted to inject this thoughtful piece into a discourse largely dominated by bashing from both sides of the political divide.

Right away a Facebook friend I haven’t seen since college commented: “Don’t you think that incessantly hectoring people might have the effect opposite to that desired?”

I was taken aback. My posting rate on Facebook hardly qualifies as incessant. Besides, there was nothing remotely hectoring about this article. Still, there’s no denying that my motivation in sharing it was to persuade reluctant voters to choose Hillary.

I decided to engage with rather than ignore my friend. He immediately replied that he didn’t mean me personally, “but that the daily attacks on the folk who are not gung-ho for HRC, including the accusation that we are women-haters, are really counterproductive.” He likened well-meaning attempts at political persuasion to the noxious proselytizing meant to convert people from one religion to another. Besides, it made him think that Hillary’s supporters lacked the faith that she should and could win, and found their apocalyptic pronouncements about not voting for the Un-Trump unhelpful.

His response reminded me of a party I attended right before the 2004 election. Amid a dozen or so Chardonnay-sipping liberals eternally bitter over the selection of W four years earlier was one lone Nader supporter. Unrepentant, he planned to vote for Nader again.

“How COULD you?” everyone exploded in unison. As we all moved in for the oh-so-persuasive kill, I could see this man’s jaw tighten, his posture stiffen. You can probably guess who he voted for.

I’ve learned a lot since that encounter—if you want to preach outside the choir, it’s better not to screech or beseech. Still, there are reasons to try. Or was my Facebook friend a case in point that such attempts invariably backfire?

Recently I’ve had many conversations with my friend Linda (who also doesn’t like Hillary but who will vote for her). She has been talking with her son and his friends, most of them young, fervent Bernie supporters who care deeply about racial justice. They now feel totally disillusioned by the political process, seeing little difference between the parties and no point in voting. Linda has a lot of empathy for this viewpoint, and mostly listens. But when she does talk, whatever she has to say doesn’t only fall on deaf ears—it closes those ears further.

Periodically I send things with a fresh or compelling perspective to Linda, saying, “What about this? Could this help?” One was a recent column by Charles Blow. Linda was almost persuaded until the last paragraph:

Protest voting or not voting at all isn’t principled. It’s dumb, and childish, and self-immolating. I know you’re young, but grow up!

With those words, Blow blew it. Of course, Linda never forwarded the article to her son, and has wisely stopped talking to him about the election altogether.

Years ago Republican pollster Frank Luntz quipped, “The trouble with Hillary is she reminds everyone of their first wife.” She also reminds people of their mothers. There are legitimate reasons to be skeptical of Hillary, but this unconscious association has gotten short shrift in understanding the level of antipathy generated by the candidacy of the first woman who has a shot at the presidency. Often what mothers say, no matter how wise and well-intended, has the effect of generating resistance. You should listen to your mother, but do you really want to? Middle-aged mothers like me who are trying to persuade others, especially young people, may only be perpetuating the maternal nag problem.

Is it possible to change people’s minds? We are now inundated with 24/7 information and misinformation, and live in silos that reinforce our worldview while keeping out other perspectives. Social science research demonstrates that when people are shown evidence contradicting their firmly held beliefs, they don’t reconsider; instead, they double down.

If one person’s persuasion is another’s hectoring, what’s a mother to do? What’s a concerned citizen to do?

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 Have you tried to influence anyone’s vote in this election season? Has anyone tried to influence yours? What works and doesn’t work?

 

 

Mental Health and Presidential Politics

presidents-mental-illnessWith all the furor over the presidential candidates’ physical and mental health, I found myself wondering not about the ethics of armchair analysis or the quality and timing of the information released so far, but another question: What would happen if the medical records of someone running for president revealed any current or past treatment for mental health issues?

In 1972, Democratic Vice Presidential nominee Thomas Eagleton had to step down when news surfaced about his prior hospitalizations and electroshock treatment for depression. What would happen today if there was a notation about ECT, Prozac, Lithium, addiction, or the like in a candidate’s chart? Would it be disqualifying? Should it be?

Given the stigma and discrimination that still surround mental illness, it’s not surprising that very few politicians and no presidential candidates admit to struggling with or seeking treatment for psychological problems. This does not mean there haven’t been plenty of afflicted presidents; a 2006 study found that nearly half of 37 presidents whose historical records were reviewed met the criteria for psychiatric diagnoses. Some, like Lincoln, rank among our greatest presidents.

It’s a shame that stigma and discrimination discourage proactive and responsible responses to many treatable conditions. It’s not the presence or absence of a mental illness (or life circumstance) that counts, but how someone deals with it. As any therapist knows, what’s worrisome is not the person who knows something is wrong and seeks help, but the person who doesn’t.

Not all mental illnesses are the same. Nor are all jobs. Military personnel and commercial airline pilots routinely face the quandary that acknowledging significant psychological distress may derail their careers not only because of stigma, but due to legitimate concerns about risk to self and others.

What about the presidency, a high-stress, high-responsibility job if ever there was one? People often quip that you’d have to be crazy to want to be president. It’s no joking matter, though: for decades there have been serious proposals for an independent and impartial evaluation of the physical and mental health of all presidential candidates. Assuming we could find such examiners and eliminate stigma, though, diagnosis is an imperfect art and poorly predictive of performance. (Thomas Eagleton, for example, went on to have a long and distinguished career in the Senate and academia.)

Anti-social personality disorder, malignant narcissism, and paranoia have been commonly cited as conditions that ought to raise alarm, if not disqualify someone from the presidency. There is often a partisan slant to these opinions. But even if an official and impartial diagnosis could be made, why would it be persuasive when the traits and behaviors in question are already perfectly obvious for all to see? Besides, such characteristics may or may not have anything to do with a candidate’s mental health.

Perhaps we should be more concerned about the ill state of the body politic: We are too often split into polarized camps, divorced from reality, and suffering from anxiety, paranoia, withdrawal, and despair.

These problems are much more difficult to diagnose and treat.

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What are your thoughts about this?

 

Political Rupture

woman burning in hell (2)At a rally for Hillary Clinton, Madeleine Albright declared, “There’s a special place in hell for women who don’t help each other.” A fierce debate about gender, the generational divide, and feminism in presidential politics ensued. There’s a fundamental psychological dynamic at play as well: the idealization of female solidarity and the corollary difficulties women often experience when differences emerge.

Women are celebrated for their emotional intimacy. Statements like, “We get one another completely”; the sharing of secrets, clothes, and gossip; even jokes about women going en masse to the bathroom make clear how much women prize connection.  This “urge to merge” can be viewed as an aspect of female identity formation and the longed-for return to the blissful state of maternal-infant union. Nothing is quite as delicious.

But it’s also a set up. When women are not supposed to feel, let alone talk, about their differences, there’s no room for conflict, and no vocabulary or practice for resolving it. Difficulties go underground, leaking out in ways that often lead to rupture. Thus differentiation is experienced as betrayal, and standing apart from the group risks social suicide. My daughter discovered this in college when, tired of looking for housing with eight (!) other women, she considered leaving the group. The anger and accusations of disloyalty quickly convinced her otherwise. It turned out that none of the women really wanted to live in such a large household, but no one knew how to say so without hurting anyone’s feelings or being seen as a traitor.

This loyalty/betrayal split is now being played out in presidential politics. Albright’s remarks typify idealized notions of female connection that make no room for difference. She reminds us of the dangers women face if they stray from the fold. (Never mind that the halcyon days of blissful union have never really existed: the very women’s movement Albright exalts was itself torn apart by conflict.)

Predictably, when Albright consigned to hell women who disagree with her, all hell broke loose. As long as those who differ are seen as traitors, with only a narrow range of women’s emotions and choices deemed acceptable, all hell will continue to break loose.

But perhaps there’s hope. As younger women reap the benefits of their foremothers and are able to speak up, speak their minds, and stand apart, strong feelings and disagreements won’t be quite so likely to go underground, then erupt. Instead, polarization might give way to dealing directly and respectfully with the differences that enrich women’s complex and very human experiences.

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What have your experiences been with female solidarity and its discontents?

 

 

The Paradox of Hope

HopeAt a recent storytelling event ushering in the New Year, audience members were asked about their resolutions: “To give up hope only to regain it,” one woman said.

This echoed something I’d heard just weeks before at a clinical meeting I facilitate, when I asked the staff to share something they were doing for self-care. A colleague who unfailingly sees the best in everyone surprised us all by saying she had given up hope, and was thus no longer so prone to disappointment.

Hope, we are told, springs eternal, so such dissents from the cultural imperative to uphold it are rare. Nowadays it often seems the more difficult things become, the more we are forbidden to feel hopeless. We are urged to look on the bright side, keep gratitude journals, embrace the lessons of hardship. And no wonder: It is difficult to live in despair.

Exercises cultivating resilience and hope can bring genuine relief, broaden perspective, even pull one back from the brink. They can also preserve relationships. Being around someone who despairs is also difficult, and in lieu of outright fleeing, it is tempting to extend a lifeline. Yet who really escapes—the person feeling hopeless, or the person who cannot bear to listen? Those who are unable or unwilling to be coaxed out of sorrow might soon find themselves alone.

Our clients know this (or at least the lucky ones do). They worry about burdening or alienating others, fear wallowing in hopelessness. So they bravely try to focus on the positive, often with felicitous results. Yet the more people feel compelled through internal or external expectations to disguise despair, the more pinched they become. It is as if they squeeze themselves into emotional Spanx to keep everything contained and looking good.

Psychotherapy offers the relief that comes from shedding such constraints, breathing freely, and being one’s natural self. The terrain of hope and despair is tricky, though: therapists must help clients navigate the depths of unbearable pain without stranding them there. Often we see ourselves as the guardians of hope. Yet we must never impose it. We would do well to remember the famous story of a patient in analysis who said that the only time he felt hope was when his analyst agreed with him that it was hopeless, but that they would carry on together anyway.

It is when we make room for hopelessness that hope, too, might find a little space.

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What are your thoughts on the balance between hope and hopelessness?
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Originally published in Impulse, an online publication of the Northern California Society for Psychoanalytic Psychotherapy

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The Illusion of Invincibility

safety_pin_crp1When my daughter was little, my husband and I tried to safeguard her against people who might do her harm. “It’s OK to kick and scream,” we told Emma. “You don’t have to be nice if someone tries to hurt you. Not everyone is a good person.”

“Those bad guys better watch out!” Emma replied. “I’m gonna have safety pins with me, and if they try to get me, I’m just gonna take out my pins and stab them!”

I loved my daughter’s confidence in her strength, her ability to quell her fears by standing up to danger. No matter that her plan for protection was childish folly.

We’re now seeing a similar impulse play out on a national scale.

The New York Times reports that in the wake of the latest mass shootings here and in Paris, Americans are rushing to arm themselves. When something frightening happens, people want to feel safe and in control. Their fear of becoming a victim is transformed by the illusion of invincibility.

The gun lobby and its political minions masterfully exploit this psychological dynamic by stoking fear, then offering a reassuring (though false) “solution” like the one promulgated after 20 six-year-olds were gunned down at Sandy Hook three years ago today. “The only thing that stops a bad guy with a gun is a good guy with a gun,” proclaimed NRA spokesman Wayne LaPierre in response to that horrific massacre.

This sentiment has been echoed by the Republican Presidential contenders in response to more recent mass shootings. The day after the San Bernardino massacre, Ted Cruz proclaimed at a gun rights rally, “you don’t stop bad guys by taking away our guns, you stop bad guys by using our guns.” A couple of months before, Ben Carson essentially blamed the victims of a heavily armed gunman at Umpqua Community College by saying, “I would not just stand there and let him shoot me.”

If only it were that easy!

Yet the research—not to mention law enforcement and military personnel–overwhelmingly contradict this simplistic notion. “Good guys” unloading their weapons against an active shooter in a public space would likely result in greater mayhem and casualties. Guns on alcohol-infused campuses are a recipe for disaster.  The risk of gun deaths from homicide, suicide, or accidental shootings is much higher when there’s a gun in the home. And guns, in the heat of the moment, can turn a “good guy” into a killer instantaneously. More guns mean more gun deaths.

Yet reason doesn’t seem to stand a chance against fear and its exploitation. In the three years since Sandy Hook, Congress has done nothing to enact gun-safety legislation. Although some states have tightened restrictions on guns, many more have actually made it easier to purchase and carry guns.

It’s one thing for my young daughter to fantasize about wielding her safety-pins for protection. But it’s quite another to arm ourselves to stay safe from gun violence. As adults, we should know better.

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Had enough? One of the reasons we have failed to enact more common-sense gun-safety laws is that those who support such measures don’t speak out. You can bet gun- rights advocates don’t make that mistake. Contact your representatives. Rally. Sign petitions. Vote your principles. And check out these organizations that are working hard to make a difference:

Everytown for Gun Safety

Moms Demand Action for Gun Sense in America

Newtown Action Alliance

Suicide by Gun

Means Matter logo

Once again, America is transfixed by a mass shooting. No doubt the list of massacres will grow to encompass other shattered towns and families, evoking fear and horror every time.

Yet almost two-thirds of gun deaths do not make national headlines. These are the more than 21,000 people–many of them teenagers— who every year kill themselves with a gun.

As someone who has worked in the field of suicide prevention for decades, I know that the best way to prevent these tragedies is to restrict access to guns. Current research contradicts the commonly held but false belief that suicidal individuals will just find some other way to kill themselves. In fact, self-destructive feelings are often impulsive and fleeting, dissipating as the crisis passes. Ninety percent of those who survive an attempt never go on to die by suicide. But when guns are involved, the crisis can quickly escalate, precluding safe resolution. Fast and deadly equals no second chances.

According to the Harvard School of Public Health, those states with the highest rate of gun ownership also have the highest rates of suicide. Access to lethal means is a far greater risk factor than mental illness. Although some promote the fallacy that a gun in the home makes you safer, the opposite is true. The risk of suicide is two to five times greater for all household members in gun-owning homes. In one study, 82 percent of children 17 and under who shot themselves to death used a gun belonging to a family member. Homes without guns have the lowest suicide rates, but even in homes where firearms are present, risk decreases if they’re properly stored—unloaded and under lock and key.

When it comes to preventing suicide, means matter. We always ask why people kill themselves. But we’re better off focusing on how so many people die.

It’s the guns. If we really want to save lives, restricting easy access to such lethal means is our best approach.

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The statistics cited here are from these sources, which provide a wealth of additional information:

http://www.nytimes.com/2015/03/10/health/blocking-the-paths-to-suicide.html

http://www.hsph.harvard.edu/means-matter/

http://actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/Reducing%20a%20Suicidal%20Persons%20Access%20to%20Lethal.pdf

 

 

 

 

Out of the (Gratitude) Closet

Gratitude closet

I love my colleague Tina for many things, but especially because she drinks her coffee from a mug that announces, “I Don’t Do Perky.” False Positive is the title of an article I wrote for psychotherapists about the downside of positive thinking. And a humorous essay of mine begins, “This gratitude craze bugs the shit out of me.”

So it may come as a surprise that I’ve recently begun keeping a gratitude journal.

Call me a hypocrite. I prefer to think of it as similar to the time I went from being a person who doesn’t much like dogs to owning one. I could really relate to canine-indifferent friends who couldn’t express an enthusiasm they did not feel for such lovable behaviors as tail-wagging and that (not so, to them) endearing doggy lean-in.

Likewise, I understand why someone who is suffering can feel even worse when asked to embrace positive emotions. It’s not that I’m a depressive ingrate by nature (at least not most of the time). But I’m wary of efforts to sanitize thought and speech. Too often, expressions of negativity are met with rebuke instead of empathy, and I’ve seen the damage this causes, personally and professionally.  I thus try to champion all those nasty feelings we feel pressure to squelch: anger, sorrow, bitterness, envy, vengeance. Superimposed gratitude is like a thin coat of whitewash that seals in the toxins.

And yet, stubborn resistance is equally problematic.

So during a hard time this summer, I relinquished my protestations and started a gratitude journal, figuring that it couldn’t hurt.

It’s nothing fancy, just an old 5×7” Reporter’s Notebook covered with my daughter’s grade-school scribbles . Every night I write the date and “I am grateful for/that . . . “ Then I list 3-5 things. I try not to repeat myself (though our latest addiction, the TV series Nashville, has made it into several days, and there’s a sprinkling of entries that say “RAIN! RAIN! RAIN!”).

Here are some of the things I’ve jotted down recently:

(And although this isn’t a current event, I’m grateful to my daughters, whose persistent dog lobbying brought Button into our lives for 15 years.)

Button

Two weeks into my gratitude journal, one of the things I wrote was “Feeling way less depressed.” Though the ritual of giving thanks surely helped, there were other things at play as well: I’d resumed weekly therapy after cutting back; the post-cancer scans that always make me nervous were clear; I finally followed through on my intention to volunteer; my weight finally started heading in the right direction; things started to go better for the Democrats; the summer drought of movies yielded to a fresh crop of Oscar worthies; our actual drought yielded (a little) to rain and the promise of more to come.

There is always more to come.  Assuming El Nino delivers on its promise, I look forward to jotting down my gratitude for SUN! SUN! SUN!

That’s how it goes, the chiaroscuro of darkness and light that makes up life’s full spectrum.

I’m grateful for it all.

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Ever felt (or promoted) the prohibition on negative feelings? How’d it go? What are you grateful for?

Talking Cure

Conversation

Sherry Turkle, a sociologist and psychologist who studies the impact of technology on relationships, wrote recently about the need for face-to-face conversation in a world increasingly dominated by texting and smartphones. It is through this “talking cure” that we build empathy, intimacy, and self-reflection, coming to know ourselves and others deeply.

Turkle wasn’t talking about Freud, but she was describing the mainstay of psychotherapy.

Soon after Turkle’s essay appeared, new research questioning the efficacy of talk therapy in treating depression made headlines. That same day, I listened to a podcast about Dr. James O’Connell, who has been providing healthcare to Boston’s homeless population since 1985.

O’Connell’s approach is more art than science.  He described having to unlearn the techniques and arrogance he’d perfected as an ER doctor when he took a job at a homeless shelter. The nurses, unimpressed with his skills, advised him to keep quiet about his medical expertise. They instructed O’Connell to spend his first two months doing nothing but soaking the feet of those living on the street.

“Don’t judge, these people have been through hell,” the nurses told him. “You will not gain anyone’s trust without being present.”

O’Connell spoke of the profound isolation and loneliness as well as the tremendous courage and resourcefulness of the men and women he came to know in his decades on the street. He believes the adversity they experienced would have broken him. This knowledge is fundamental to engaging in such hard work:

“We’re all broken in our own way,” O’Connell says. “It’s a connection with that brokenness that actually keeps us going.”

O’Connell’s words took me back to what inspired me to become a therapist: volunteering at a crisis hotline.

I had never before encountered the level of adversity our callers faced—poverty, abuse, addiction, chronic mental illness. Like O’Connell, I was awed by the courage and dignity of those whose lives were unimaginably precarious. The work was hard, but I loved it—the listening, the immediacy of the connection, feeling that my presence made a difference. Nothing much changed in anyone’s life, mine or theirs. Yet everything changed because we mattered to one another.

This is the essence of therapy. Our work is a modest endeavor–a conversation, a space of undivided, unhurried attention and exploration. The talking cure depends on humility and presence. These are the ineffable, unmeasurable things that matter—on the streets, in conversation, and in psychotherapy.

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 How do you preserve conversation in a technology-obsessed world? What is the essence of presence for you?

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(Originally published in Impulse, the electronic newsletter of the Northern California Society for Psychoanalytic Psychology)