Granny Joy

When thinking about what I would write on the topic of joy, my mind immediately landed on my paternal grandmother. Her name is Simcha, which means Joy in Hebrew. I used to call her “Granny Joy.” She would have been 100 years old this past year if she were still here in physical form.

“[Joy] seems like an internal state that comes from our being, and it seems tied to being able to feel present in the moment.”

What strikes me as significant about my grandmother and JOY, is that she experienced tragedy and struggle in her life, yet, by the time I got to meet her, her joy seemed to be so available regardless. Granted, she had seven children, 16 grandchildren, and twenty-something great grandchildren to feel joyful about, (well, and to worry about), but there was and is something very meaningful and significant to me about my grandmother and joy.

If my grandmother were alive and I asked her what gave her the most joy, outside of her family, she hands down would have said gardening. And why gardening? Because it took her mind off of everything and brought her into the present moment with beauty, with the earth, with the roses, with the poppies, the squash, the green beans, the peach tree, the avocado tree, plum tree, and the fig tree. It brought her hands into the earth – into the soil with the seeds.

My grandmother could laugh, and she did – a lot. She laughed in conversation with others - this joyful laughter that seemed to come when she was in the company of others.

As I mentioned, she experienced loss and heartache and pain, just like the rest of us, yet this didn’t seem to interfere with her ability to feel joy. Yes, during those times of great suffering, I imagine it absolutely interfered. But in her life, in general, there was this ability to find the joy again and again by doing things that spoke to her soul, to her being. Gardening and family were those things for her. She didn’t seem to need to chase the joy, she seemed to connect to what she loved and the joy would start coming through her.

In thinking about my grandmother, how I experience joy, and how my friends have described their experiences with it to me, it seems like an internal state that comes from our being, and it seems tied to being able to feel present in the moment.

The safety, security and feeling of love I feel when I think of my Granny Joy, of Simcha, feels deeply rooted in her love for her family, her ability to nurture us and her own ability to connect to the JOY that she could bring through her. There is something safe and nurturing about joy - something that feels organic, authentic, deeply alive, and available to everyone.

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Michelle Levy, PhD, is a Registered Psychological Assistant #PSB94024010 working under the supervision of Gabrielle Taylor, PhD. Dr. Levy’s clinical interests focus on parenting practices, attachment, child mental health and developmental concerns, as well as the effects of trauma on youth, families and communities. 

Women of Style: Frida Kahlo

“At the end of the day, we can endure much more than we think we can.”

— Frida Kahlo

Frida Kahlo was a woman who endured - physical pain, gender discrimination, heartache, family dysfunction, and civil war. She is perhaps most known for her evocative self-portraits and tumultuous marriage to Diego Rivera, but it is her fierce spirit that connected me to her years ago. As a fellow woman who has endured, I found deep strength in Frida's story. 

It is said that for Frida's first exhibition in Mexico she was ordered by her doctor to stay in bed due to severe illness. She was devastated at the prospect of missing the first show in her home country, so she had herself driven to her exhibition in an ambulance and carried in on her signature bed. As someone who has experienced limitations, it is easy to succumb to barriers and setbacks, but Frida reminds me to transcend my limitations and to engage my pain and allow it to radically change me. 

Frida's story is not one with a happy ending, nor is it a blue print for emotion regulation and containment, but rather it reveals an authentically messy human who fought for her dreams. Frida was unabashedly Frida, and her fierce endurance serves as a reminder to me to courageously persevere. 

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Give! Visit our Dressember page and make a donation. It's that simple and no sum is too small. Truly.

Follow! Be sure to follow us on Instagram and our blog throughout the month of December. 

Share!  Help us spread the word. You can do this by sharing our social media posts or links to our Dressember fundraising page.

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Abigail (Abby) Wambaugh, M.S., is a Marriage and Family Therapist Intern, IMF #94231, working under the professional supervision of Michelle Harwell, Psy.D., MFT 50732. She specializes in treating relationship difficulties, trauma, and sexual issues.

Women of Style: Ruth Bader Ginsburg

“I don’t sit in the back.”

— Ruth Bader Ginsburg

To my mind, a lady of style can be very much herself, while making room for the people around her to be themselves, too. 

I admire this trait in Ruth Bader Ginsburg. She’s a lady with an opinion, and a whole lot of passion. She has enough skill that she’s landed in the highest court of our country. And yet, in all of the strength with which she holds herself, she is not consumed by the power of her own voice. I see this in the way she cultivated a rich friendship with the late Justice Scalia, whom she often fiercely opposed professionally. I see this in her humor in the midst of such serious work, such as her habit of wearing a “dissent collar,” the same glass bead necklace that she dons whenever offering an opposing opinion. 

I also admire that RBG is able to be herself, even when that falls outside of what others would expect. For example, even in her 60s and 70s, she was found parasailing and whitewater rafting. She’s quoted as saying, “I don’t sit in the back,” when encouraged to ride in the safer seat on one such boat ride. 

Now that’s style. 

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HERE'S HOW YOU CAN PARTICIPATE IN DRESSEMBER WITH US:

Give! Visit our Dressember page and make a donation. It's that simple and no sum is too small. Truly.

Follow! Be sure to follow us on Instagram and our blog throughout the month of December. 

Share!  Help us spread the word. You can do this by sharing our social media posts or links to our Dressember fundraising page.

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Allison (Allie) Ramsey is a Marriage and Family Therapist Intern, IMF #94391, working under the professional supervision of Michelle Harwell, PsyD, MFT 50732. Allie works with individuals on a broad range of issues, including anxiety, depression, relational challenges, faith integration, divorce, and aging. 

Imperfect Parenting Group - New Members Welcome

When my son was two years old I joined a playgroup through a community outreach organization. The goal of this organization was to bring mothers and children of the same age, living in the same community, together for a weekly play date. Although the mothers and toddlers had community in common, we were diverse in many ways. Reflecting back, our ability to embrace and honor each others' differences created a safe space to parent with authenticity.  Feelings of overwhelm, confusion and frustration as a parent were met with understanding - there was no pressure to be “perfect.” As our children played, we shared parenting tips and explored how are own emotional process challenged or supported our parenting. We utilized each other’s knowledge and strengths and leaned on each other for support.

“...our ability to embrace and honor each others’ differences created a safe space to parent with authenticity. Feelings of overwhelm, confusion and frustration as a parent were met with understanding - there was no pressure to be ‘perfect.’”

Through the preschool years, we build memories together at local parks, children’s museums and backyard visits. We delivered meals when siblings were born and celebrated our children’s milestones together. We had successfully created a village.

Several years later, members have moved, children have gone to different schools and a couple of friendships remain a valuable part of my present life. Looking back, that special group of women reinforced that we are all imperfect parents seeking community, connection and acceptance.

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Laura MacRae-Serpa, MFTI, CCLS has special interests in supporting children and families navigating adoption and the challenges of chronic illness.

Clothed in Authenticity

Authenticity. For some reason, this word made me think of clothing. Maybe it's because I'm from Washington state, and I find myself breathe a little deeper when I land back in the Seattle airport and see all of my frumpy-looking kin. Clothes are a big deal, here in Los Angeles. And while I at first poo-pooed this, it's actually caused me to reflect on the value that clothing choices can have.

Clothing can be used as a mask, something we hide behind. It can be used as a dream, something we use to believe in ourselves a little more (“Dress for the job you want!”). It can be used to communicate something to others or ourselves.

I think this is especially clear in adolescence. In adolescence, we sometimes use clothing to “try on” different parts of ourselves in different seasons. Perhaps this year, I'm going to try on my ability to take social causes seriously. Or perhaps, I'm going to try on the dark feelings I have – reveal my ability to feel the sorrow and heaviness of being on this earth. Or maybe clothing isn't much of a conscious decision for me at all this year, and that's a way I can try on a part of me as well.

I asked Ron Ben, Art Director, about this, and he comments, “I have always believed that clothes reflect your emotions or where you're at in life. Some people don't care what they wear, some people care greatly, but if you take a look at both you can see where they are in their life.”

So, thanks, LA. You've taught me that clothes go a little more than skin deep.  

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Allison (Allie) Ramsey is a Marriage and Family Therapist Intern, IMF #94391, working under the professional supervision of Michelle Harwell, MFT 50732. Allie works with individuals on a broad range of issues, including anxiety, depression, relational challenges, faith integration, divorce, and aging. 

Authentic Encounters: An Interview with Dr. Gil Spielberg

Authentic Encounters: An Interview with Dr. Gil Spielberg, Clinical Psychologist & Psychoanalyst

Vanessa Spooner: Alright, good morning Gil Spielberg!

Gil Spielberg: Good morning Vanessa.

VS: So, my name is Vanessa Spooner and I am interviewing Gil for this month’s Michelle Harwell Therapy Newsletter. So to warm us up a little bit Gil can you just give us a quick two-minute background on yourself, your practice, your approach to your work as a therapist?

GS: That’s in two minutes?

VS: Maybe three minutes?

GS: How about two hours? In two hours I could do that.

VS: [laughs]

GS: Let's see. I have a doctorate in Clinical Psychology, then I have my analytic training from the Institute for the Study of Subjectivity in New York. That was my individual analytic training. My group analytic training was from the Center for Group Studies, also in New York. And I have taught group therapy in a variety of places over the past 30 years. Currently my practice is group-oriented, but not exclusively, I see individuals, some individuals both in group and individually, some patients just in psychoanalysis, either once a week or more often, and couples. And then I also do supervision at a place called Beit T’Shuvah, which is a Jewish rehab center and in terms of authenticity that is a wonderful example of a place to be.

VS: And so Gil, you touched on what we are going to be talking about today, which is authenticity. What comes to mind for you when you are thinking about Beit T’Shuvah and authenticity?

GS: Well, the thing about Beit T’Shuvah that I really like is that it is the goal of the staff and for those patients who are really willing to engage is to live more authentic lives. Because for addicts in particular, there was a lot of hiding – from themselves and from others – a great deal of deception. So for those people who come in and are allowing themselves to fully engage in the program, they are learning to figure out how to present themselves honestly to themselves and to the world. But the part of this that is particularly meaningful to me is that the staff mirrors that. So the staff also tries to communicate authentically with one another and with the patients. You don’t have much of a sense of hierarchy; you have more of a sense of people trying to find ways of creatively and constructively relating to one another. Which means it becomes a more complicated institution at times, but much more fulfilling for all who sort of enjoy that kind of environment and can tolerate it.

VS: And is that where you come in, when things get more complicated, when you are providing supervision?

GS: I provide supervision in a couple of ways. In sort of the basic aspect of teaching people the craft of psychotherapy, helping them locate where they want to be in terms of their theory and who they are. And then for the organization itself, as well as the individuals, I help them sort of navigate trying to find themselves therapeutically and cooperating in a very complex emotional environment.

VS: And does that guidance you provide them kind of mirror how you are as a leader in your therapy groups?

GS: Not entirely. Partly. It does to the extent that I am always trying to use myself and my experience to help me understand what’s going on. And to figure out what other people want and need from the situation. But in my therapy groups I am much more aware of how to make use of something like transference than I am in a consulting situation, where that is not sort of a guiding task. I have a different task, so I use myself differently.

VS: I could imagine that with transference it can feel a little tricky, because on the one hand it is a very authentic experience between you and someone else, but at the same time there are pieces of it that are repetitive from someone’s past, and so it might be a little less authentic in the present. What do you think about that?

GS: Well, some of this goes back to Freud who would say that within transference the relationship is never fully authentic, because the patient is not really seeing you fully, they are seeing someone else. They may be presenting themselves as honestly as they can, but the relationship is not fully authentic, because they are not totally in the present. And for me, since I’m not fully presenting all of my thoughts and feelings and trying to be transparent as possible, I’m not fully authentic. I’m using my authentic experience, but I may not be presenting it.

VS: So the way that you present it is more filtered, depending on the person.

GS: More…filtered is probably correct, but it is more…um…what is a better word?

VS: Like selective?

GS: Yeah, maybe selective is a better word, if I can think of a better word I’ll tell you better. But we can go with that for now.

VS: So what’s the big deal with authenticity? Why is it so important?

GS: That’s a great question. It actually didn’t start out being important. You know, originally when the field was much more medicalized, which was in the beginning of psychotherapy and psychoanalysis, authenticity was nowhere on the map. What was on the map were symptoms and neuroses. I don’t think it was until the Humanists like Carl Rogers came on the scene where they began to change the point of view of psychotherapy to not just relieve symptoms, but to live a different kind of life. And at that point, what was emphasized was the patient becoming more of themselves, sort of getting rid of the shackles of what they were supposed to be. And the therapists presenting more of him or herself. Carl Rogers I think one of his first papers was The Necessary Sufficient Conditions for Psychotherapy (or for Change), I can’t get the exact title of it. One of the things that he talked about was that the therapist needs to present, be genuine, have positive regard and be respectful. But that was new to the field to begin to understand what the therapist had to do as well. So that way the therapist was modeling for the patient to live and talk and relate authentically. And I think within psychoanalysis Heinz Kohut took that over when he talked about having relationships that work true to the self. When he put the sense of self, a vigorous and vital self, in the center of what needs to happen in psychoanalysis. When he did that and moved that into the center, what he did was also to say to privilege living authentically with one’s self and with one’s important relationships. And that had been picked up by the Relationalists and some of the other Intersubjectivists within Self Psychology, who now stress relating more authentically with the patient and with the patient relating more authentically with them. Now in order to relate authentically, a person has to be congruent with their speech, body and mind. And then from there, as a platform, he or she can engage in an authentic relationship.

VS: Can you say a little more about what being congruent looks like?

GS: It’s not just what it looks like, it’s what is feels like.

VS: What it feels like.

GS: The person is…what they are feeling and thinking inside is available fully to them and eventually they can present that transparently to another and that is sort of their contribution to an authentic relationship.  So their feelings can be sensed by themselves or another, their thoughts reflect their feelings, and their body reflects their thoughts and feelings. They’re all sort of working together, they’re in congruence with one another. I think that they are people you may have noticed who, who may have a feeling, even a strong feeling, but you can’t tell what they are feeling, they can hardly tell what they’re feeling. And their body may be in some kind state of tension, but it doesn’t come through easily in what they’re saying. So they are confusing to talk to, and it is not clear what really they are experiencing. So that would be a state of incongruence.

VS: I have definitely experienced that where someone is either confusing, or they wind up, at least to me, like feeling very flat. And I am not sure where the flatness is coming from and what is underneath the flatness.

GS: How do you tend to handle it?

VS: If it’s someone that I’ve been working with for a while, I will definitely try to pay attention to their body and see if there are any signs there that kind of help. If it’s someone that I haven’t been working with for a while, I might try to change the subject or notice when there are any little periods where I notice like a little bit of spark, a little bit of feeling that comes through and I might try to center in on that a little more. But definitely in the beginning it is more of a mystery and I’m noticing it and I’m trying to figure out what to make of it.

GS: Well I tell you, to the extent you can treat it as a mystery and have sort of interest and curiosity, that’s terrific. I think some people get involved in breaking through that defense and it’s too overwhelming for the patient and you lose the experience of being just curious about who that person is and how they got to be that way. And curiosity is such a main part of what we do, maybe one of the most important traits. You can probably get away with a lot of mistakes if you are truly curious and the patient senses it. But that’s another topic.

VS: Well I do feel like that relates back to authenticity in terms of we’re kind of curious about others and if we don’t feel a sense of authenticity from them, then we don’t feel like we can actually get to know them.

GS: Well you get to know the part of them that is defending against it, defending against some other parts of them. You’re still getting to know them, you’re just getting to know more about how they have protect themselves than what they could experience if they weren’t as emotionally protected. But if they can sense your authentic curiosity, that goes a long way.

VS: Does that go a long way in terms of why you think we need authenticity or why we crave it?

GS: I think authenticity has the potential to be extraordinarily nourishing in relationships. It is a way of the self being nourished by the interactions with another. Even if your circumstances don’t change, the fact that you’re having an interaction with someone who you are feeling nourished and they are feeling nourished by you, that is going to change your present experience and your mood and some aspect of the self over time. So it is REALLY important. The sense of curiosity is sort of the foundational attitude that one really needs to have to do this work well. And if you really embody that, people will sense it from you and it is really beckoning for them to be more open with you and themselves. I’m not even sure I’m answering these questions correctly.

VS: You’re not sure if you’re authentically answering them? [laughs]

GS: No, no, I’m sure I’m authentically answering them, I just have no idea if this is really what you are asking for.

VS: You’re doing great. How do you notice the difference between how this authenticity feeds the self in individual versus your groups?

GS: Well in group my goal is to set a culture where people can have as many authentic relationships as they can tolerate and even take risks to do something a little bit uncomfortable. Now sometimes I’ll model an authentic relationship with someone in that I will be fully transparent. Sometimes my interventions are more towards the culture of the group to help the group to step into more authentic and transparent relationships with themselves and others. Sometimes I will point out what is getting in the way. So, it all depends on how I use myself. But basically it is to set the culture of the group, that will help people find themselves and find more authentic relationships with others in the group. Because that is where the growth is, or what is termed in psychoanalysis these days as the leading edge of risk and growth.

“I think authenticity has the potential to be extraordinarily nourishing in relationships. It is a way of the self being nourished by the interactions with another.”

VS: And maybe in group there is more opportunity for risk and growth since there are more people involved versus individual.

GS: I can’t say there is more opportunity; it sort of depends on what people need. Some people really need the individual experience for various reasons and that is where at different points in their life they will find the maximum benefit. Although my other sense is that most everybody at some point can make great use of a good group experience. The other thing about group though that is most interesting is that you have a lot of personalities and characters in group who are not primarily there to listen well to you and respond to what you as a patient developmentally need. They are there to over time find themselves and so that is very different. As a patient in group you are going to rub up against people that are very similar that you fit with really well and those you don’t fit with really well. And you can learn from both. And that is the magic of group. No one is there primarily there to meet your needs. So right away that is a harsh reality. One that becomes ultimately very very growth-full. Most people pick their therapist because they feel in some way akin or comfortable and the therapist will go out of his or her way to make sure the patient feel comfortable, which is fine, but that means the kind of relationships that they can have is somewhat limited because they have this basic comfort between them. And aspects of each other that might be very problematic let’s say in the patient’s life might not be triggered. It is very hard to have a sibling kind of transference with the therapist. And sibling experiences are very, very important to people’s lives. They’re more important than we tend to give them credit for. And those are much more easily accessible in group.

VS: Can you say a little bit more about why sibling relationships or transferences are so important?

GS: They are underemphasized. We emphasize in the literature the relationship to the parents. And that’s fine. And especially in the early years that’s important. But if you ask people about their lives, invariably what comes up are people’s relationships to their siblings. And if they got along, if they were good mentors and friends to each other, where they fit in the family. Siblings are important and they determine a lot about how we relate to our peers. So the group is a much more natural place to have those kinds of relationships. And in addition, you will find aspects of a parent that you really liked or disliked that may not have been available to you in the individual relationship. And people have all kinds of experiences that come not only from their family, but being in school with friends that are very impactful in their lives and they are likely to find that in group much more easily than individual. Individual they can remember them and in group of course they get to re-experience them.

VS: And it sounds like that re-experiencing can be filled with a lot of growth, but it can also be filled with a lot of discomfort at times.

GS: It is filled with a lot of discomfort, so a good deal of what you do in individual therapy, and especially group, is find ways to help the group tolerate the discomfort. That is very, very important. Because when groups or patients cannot tolerate much discomfort, there’s not going to be a great deal of growth. And one of the larger sources of discomfort is how they feels towards one another when they are in the midst of aspects of their prior experiences that have been difficult. It’s one thing to talk about one’s relationships to a sibling or parent and sort of talk about it in absentia and it’s quite another thing to talk about that as it’s being played out here and now in the room and understanding what you as the patient bring to that experience, how you help to train someone else to be a part of your early drama.

VS: Your job as the leader then is to find a balance between making it tolerable enough for the group to hold those feelings, while at the same time trying to increase the authenticity in the room so that these things can be talked about and felt more.

GS: I think that’s a very good way of putting it. I’m going to help the group figure out how to make that tolerable. I don’t make it tolerable for them, I help the group engage in the process where we can over time find a way to make it tolerable or not.

VS: What happens if it is not tolerable?

GS: Well if it’s not tolerable and it’s not being talked about, people will either begin to shut down and you will have a group that has come to a halt, sometimes called a status quo resistance, or you will find that people will begin to act out a lot of aggression behaviorally: lateness, absences, people wanting to leave the group. Sometimes the leader picks this up because they are uncomfortable in the group – they begin to dislike coming to the group, they are not enjoying themselves, they are finding desires to get rid of the group or get rid of people in the group. And that is one pathway, that through the leader’s willingness to be authentically attached to themselves, they begin to realize that there’s something happening in the group that really needs to be attended to.

VS: And in those types of situations…

GS: By the way, I’m glad you’re following me because I’m just sort of free associating. So I’m glad you’re following.

VS: Oh yeah, I am right here with you. So in those instances in group where you might be feeling some of those feelings, is that something that you are sharing with the group or is that something that you are just using as a way to make a “group as a whole” interpretation?

GS: It sort of depends on the group, where they are at developmentally, what I think their relationships are like, what they can tolerate. Let's see if I can think of a good example that would be great. Let’s see if I have an example [pauses]. I don’t have one at the moment, but maybe I will think of one.

VS: That’s fine. But yeah it sounds like depending on what the group can tolerate developmentally you may be sharing more of your authenticity in terms of how you’re feeling or you might limit it a little bit more so that they can tolerate it and process it.

GS: Something like that. So I had a group where there were a number of people who were quite disruptive in the group, so I remember one time coming in and saying: “I found myself coming in to this group with a lot of tension today. Who’s tension am I picking up?” So I remember using it once that way. I can remember some other time thinking about how much competition there was in the room so I sort of primed myself based upon my own sort of fantasies that were coming to me, I was thinking a lot about being a kid and playing baseball and how competitive that was. I came into the room and someone in the group who I thought was most triggered by the degree of competition and I asked him if they thought there was any competition in the group that we weren’t talking about. So sometimes that will happen.

VS: So it sounds like you use your feelings as a way to try to hone in on someone in the group or to have the group kind of wonder about where these feelings might lie in the group, whether it is in the group-as-a-whole, or particularly resonating with one of the members.

GS: Exactly. Beautifully said. I think I will interview you. Good job!

VS: We can swap roles next time. [laughs]. One final question: How has your definition of authenticity changed over the years? Whether it is through various trainings or just through your own view of the world, how have you noticed it changing?

GS: Well, I will put it in two ways, in terms of my sense of authenticity and what I am looking for with patients. In terms of my sense, my original training was more classically analytic so there was absolutely no emphasis on the therapist/analyst being authentic to the patient at all. That radically shifted, I actually trained at times with Carl Rogers and in Gestalt therapy. So that really changed things around for me and I began to appreciate how important the therapist’s authenticity was. Then by the time I got back into analytic training the field had changed and it was now being valued to a very different degree. So that has allowed me to have a lot more presence and enjoyment in my work. It really wasn’t enjoyable keeping so much of me apart, it was sort of deadening for me. At the same time, I find it more enlivening and not scary in the way that it would have been 20 or 25 years ago to have those authentic moments and spontaneous moments with people. Both in group and individually. But those moments in group are sort of a life blood of what happens in group. It’s inherently a less predictable place. And it needs to be. Once it gets predictable, it’s sort of game over.

VS: Is that what you were mentioning before when you were talking about the status quo?

GS: Yeah. That’s one of the things. Yes. When the group becomes predictable and routinized, it is a level of communication, you have a system that no longer has any perturbations in it. It is never shaken up and therefore everyone is not shaking themselves up and not shaking others up. So it is a shark dying, not moving in the water. The authentic encounters in group are what keeps it going and the ability of the therapist to tolerate all the intense feeling that occur within the authentic encounter is what is more anxiety provoking in people, but what is ultimately the most fun and the most enlivening. Over time I have been able to tolerate more of that, so my groups have more of that. And that part is terrific.

VS: And it sounds like then the patients are able to experience, if they are able to, a wider range of authenticity if you are able to tolerate a wider range.

GS: Exactly. So there’s often as much laughter as there are tears in my group. Because that’s the range of human experience.

VS: I think that is a wonderful note to end on, people in group being able to share as many laughs as good cries. I think sometimes people think that therapy is always supposed to be this painful daunting emotionally wrenching thing and that’s not as authentic.

GS: No, it’s not.

VS: There’s a wider range of experiences and you really encourage your group members to delve into that if they are ready.

GS: Absolutely.

VS: Wonderful. Well thank you Gil for being available this morning for the interview. We’re very excited to kind of mull over these thoughts that you have provided us about authenticity, especially as we are thinking about the new year and how we all at Michelle Harwell Therapy want to help our clients to become more authentic as they are beginning a new year and maybe a new chapter for themselves.

GS: Well you know, it gave me the opportunity to do more thinking more about it. I myself am in a consultation group with people around the country. So I ran this past my group, and that was a great experience and we all had an interesting time talking about it. So actually I have enjoyed the process.

VS: Wonderful. That’s wonderful to hear. 

Gil Spielberg, PhD, ABPP, is a clinical psychologist and psychoanalyst who maintains a private practice in Los Angeles, California. His specialty is group therapy, a form of therapy in which a small number of people meet together under the guidance of a therapist to help themselves and one another by developing, exploring, and examining interpersonal relationships within the group.

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Vanessa Spooner, PsyD, is a licensed clinical psychologist who specializes in helping adults work through anxiety, depression, grief, and eating disorders. Dr. Spooner also has extensive training and experience in group therapy and is currently president of the Group Psychotherapy Association of Los Angeles (GPALA). 

The Rhythm of Candor

Candor is synonymous with truthfulness, honesty, frankness and bluntness. I tend to surf candor as oppose to always deep diving. Why is that? I value candor in specific contexts such as, health care and academics. When the stakes are high then candor feels caring. When the conversation turns to my friend’s new haircut, candor feels narcissistic. I am willing to soften my opinion in order to spare another’s feelings so, I guess that makes me an advocate of the little white lie. Some might argue that I am narcissistic for thinking my opinion holds that much weight. Others may argue that anything but radical candor does not allow for growth or authentic relationship. I think it is a balance – a relational dance that we all engage in. If we are attuned then we may discover our rhythm is different from our partners, friends and co-workers.

“...it is a balance – a relational dance that we all engage in. If we are attuned then we may discover our rhythm is different from our partners, friends and co-workers.”

Consider candor versus the little white lie and children’s sports teams. For preschool age children, most team activities are not competitive. No one keeps score and “everyone’s a winner.” This team philosophy carries on until the early school age years where children begin to compare themselves to their peers. The preschool bubble bursts as, children figure out they may not be, for example, the fastest. As children age, coaches and parents provide more feedback about the game. The most developmentally appropriate coaches will speak to where the team worked hard and where they could have worked harder. Children need to experience a sense of mastery before being able to process where they might improve.

As a mother, I carefully choose my words. This does not mean that my children do not hear my truth. I simply aim to deliver my truth in a manner they can developmentally digest. Words hold power. What I say as a mother can propel my children forward or cripple their sense of self. In order to be an agent of change, candor needs to be delivered with preparation and caring. Telling a child “the truth” will only help them grow if they are prepared to receive it. I am also careful to consider their truth might be different from my own. Helping my children connect to their own voice is often more powerful then looping and repeating my own truth.

So, when do we utilize a white lie and when do we speak with candor? Words become weapons when fueled by distressing emotions. Candor, even radical candor has a time and place but it is important to remember that, delivery, relationship and self-regulation all matter. If those are not in play then maybe a little white lie is developmentally appropriate.

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-Laura MacRae-Serpa, MFTI, CCLS has special interests in supporting children and families navigating adoption and the challenges of chronic illness.

Clinical Candor: An Interview with Dr. Karen Maroda

M: I'm at the tail end of my analytic training and I’ve become fascinated by how my mind has shifted in the process of training. How in love I am with this process, this way of thinking but how inaccessible it feels to the masses. I don't think it has to be. My idea with my newsletter and blogs, similar to analysis, is how can we think more complexly about simple ideas and think more simply about complex ideas. Karen, I think you excel at this. You have a great ability to speak about ideas in a really clear and approachable way. Before we jump into the idea of candor, can you give us an idea of how you got interested in psychoanalysis.

K: My mother, who we did not have a college education, was naturally psychologically minded. She would observe our emotions and if it wasn't clear to her what I was feeling or why, she would inquire. She would say, “Well, Karen you seem a little down or you're not as lively coming home after school. Did something happen?” She always knew of course. She was very intuitive. She was just asking, “did I want to talk about it?” So, in a sense, my mother was psychoanalyzing me from the time I was young and inducting me into the whole notion that you don't just accept what someone says at face value, that you should trust your feelings. I think that my mother introduced me to the whole notion of trusting my emotional intuition and that asking someone about what they were feeling was an expression of love.

K: It’s been life pursuit, a way of being. I was speaking in Indianapolis a few months ago and I was pleased to hear a candidate talk about psychoanalysis not simply as a profession, it’s a calling. It’s a life.

Dr. Karen Maroda

M: Yes! I had this experience when I was developing as a young clinician where I would get around analysts and I couldn't always keep up with the terminology used but their minds were so alive to me. They had this spontaneous quality. It reminds me how you shared the origins of the word candor is candid which evokes a sense of freedom and spontaneity. There was a flexibility and freedom to explore, play and reflect that was more than the sum of its parts. And I could just feel the difference between their mind and my own. It's a way of thinking and being that that evolves overtime...

In your paper on counter-transference, you talk about how clinicians, by our nature we are often empaths. We feel, we care, we listen but we are not very good at being direct or honest both clinically and in our lives.  How do prepare your client for the role of honesty in therapy?

K: Well, most people don't really understand what an analytically-oriented treatment looks like. I tell them the three basic rules are: they have to show up, they have to be as open as they reasonably can be given that no one is completely open, and they have to pay. (laughs)

M: (laughs) Good basics.

K: Then I usually explain about transference. That any of their feelings toward me are not out of bounds. Anything that comes up and particularly anything that's repetitive that they're feeling either positively or negatively toward me is important for them to express.

M: This idea of having candor, of being direct, the fear is, in speaking up, you might shut the client down. How do you negotiate this: keeping lines of communication open given that generally the analyst is in a position of some kind of power?

K: The idea is there’s candor and then there’s candor.  You know what I mean?  You don't just blurt out anything that you may be thinking which is like, “Boy, was that a stupid thing to do.”

M: Right, right.

K: So I take a moment to gather my thoughts and think about how it fits in the context of the person. I seek to complete the analytic task to gain perspective on their behavior historically and currently. But you know if somebody did something really stupid then I am more likely to say, “Well, it seems to me that this behavior had a pretty bad outcome for you. You know, probably not one of your finest moments.” (laughs)

M: (laughs)

K:  I use humor a lot. It cuts the tension. I'm agreeing that they screwed up without saying you're screwed.

M: I'm thinking about this on two levels: what are you trying to create within your client through the use of candor; what are you hoping that they bring into their lives through this process? The other part I'd love to hear more about is, the fact that our patients don't just want empathy, or I should say, sympathy, they also crave sincerity. There's relief when we can speak directly to all parts of the self, even negative ones.

“Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you’re talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it.”

K: Absolutely. I think people want feedback. Particularly, as I wrote in “The Power of Countertransference” if they are seeking it, then I don’t understand why you would not be responsive to a direct request for feedback. I think where we get into the delicate issue is when you're not sure, or when the patient is provoking possible feedback but not asking for it directly. Then you have to explore it and make a decision which may or may not include asking them if they want feedback. I think it's a no brainer when the patient is literally saying I want to know what you are really thinking or feeling about me?

M: Yeah, yeah.

K: For example: most of my clients become much more successful as a result of their treatment and they want to know am I going to resent them? Especially if their parents were very competitive with them. If they are too successful will I try to destroy them, take it away?

M: So what do you think benefits your clients in being able to ask you those questions in terms of their growth and development?

K: I think it gives them a tremendous confidence in their own intuition because I think one of the greatest contributions of neuroscience and the whole notion of unconscious to unconscious communication, is that clients already know what we are feeling. We already know what they’re feeling. I think the art is to determine, ultimately, what's most beneficial to actually discuss to get to the bottom of what’s going on. What's important to the work and what isn't. Will some of our ideas, notions shut down the patient experience, I think inevitably yes! That's the nature of relationships, whether it's analyst and patient or mother and child or spouse. There are ways you just cannot relate to someone else or you can't promote it.

M: A client having to contend with the real you rather than just feeling it.

K:  You know, I successfully treated someone with severe borderline personality disorder. That was where I first experimented with expressing rage. She thought everything was somebody else's fault. She would talk about her husband and blame the poor guy for everything. He was responsible for every feeling she ever had. She wanted me to endorse that. That he wasn’t sufficiently empathic but he was!  He martyred himself for her, whatever it took. She really needed somebody to stand up to her.

M: You made a comment about our culture not leaving room for negative emotions. I see this an an epidemic in parenting. We've got the hover parent generation where parents can't give feedback to their children or they have to sandwich it with so much goodness. To me, it's about emotional clarity, right? Sometimes it's not about positive or negative. It's about being clear with emotions and our intentions.

K: Yes. Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you're talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it. Neuroscience shows us that negative emotions are rarely outside of our conscious awareness. (They are felt and known even if not explicitly acknowledged). So we need to talk about it….

M:. You alluded to something earlier that I’ve been processing for a while, personally. I have a tendency at to be effusive with my language, you spoke to how we can say something positively in a way that is not too overstimulating.  Candor is about being clear in feedback. I have an awareness  of my tendency to slant towards hope and it has impact. Not always negative but I have to watch it. The truth is I have these little awareness all the time in session and I think ‘bookmark’ I need to go back to that. But how often do we, have the internal candor to take a deeper look?

K: Bookmark is a great word. That’s the beauty of the whole analytic approach. You bookmark it and you're curious about it. You don’t just blurt it out to the patient. You bookmark it and think about it. You wait to see, is this more about me or more about the patient. Because transference is repetitive, it will always come up again, and you don't have to figure it out in the moment.

M: So, what I hear is with candor, there's a certain amount of measure. Working towards an internal space that is curious. Curiosity to pay attention to the tiniest movements inside, an internal honesty that translates to a clinical (relational) honesty. 

So with enactments, there can be a dishonesty there. I mean, of course, we fall into things but I think you're putting more onus on the clinician to pay attention. 

K: Absolutely, and I think that if you look at the literature most of the enactments are not positive, they’re negative. But if you have transcript of sessions you would see there are just as many positive enactments as negative going on, but we don't yet care about those. Because those generally are not disturbing the universe of the relationship. (laughs)  I will notice with a patient that I really like or admire we do this little mutual admiration thing, you know? It is a sense a form of acting out. A little flirtation, something.

M: This is where the awareness comes in. How much of that is unconscious to the analyst?. There's a part of you that's just feeling good and maybe another part has the passing thought..I wonder if this is something?

“Be thoughtful, of course, but be courageous. If you have any anxiety when you’re practicing, that’s good...Take risks. If you’re never afraid and you’re just offering soothing, comforting things you’re probably not giving the person everything that person really needs.”

K: Right, it depends. If it’s happening too often (repeating) then it's like OK, well, wait a minute.  The enactments that we talk about in literature are mostly negative ones. I have yet to talk to a therapist where they were not aware of some negative feelings before the enactment. An enactment comes typically after an impasse that’s lasted a minimum of days if not a weeks or months. The impasse is broken by an enactment or treatment is destroyed by the enactment. I think that since I started using self disclosure regularly I have almost no enactments. I currently have one patient I have regular enactments with on a regular basis because she cannot accept negative emotions mine or hers. She simply won't allow for an emotionally honest exchange. You cannot eliminate enactments with everyone.

I think if you are sitting harboring negative feelings and thinking about them, no treatment is taking place. That’s why my new line I'm going to be using a lot in my next book is, “what is the analyst’s fiduciary responsibility to the patient? (laughs) What is clinically beneficial and to what extent are we stealing their money? When we sit white knuckled and think ‘this guy is a pain in the ass.”

M: Well, it’s another aspect of coasting in the counter-transference right?

K: Yes, like what you were saying about parents being overly effusive or overly positive. Therapists do this too. They try to be super positive or uplifting and affirming. Of course we want to do that to a point but that's not really what most people come to treatment for. Most people who have a lot of positive attributes and good relation skills get reinforcement in the world. They come to us to help them work through the obstacles and the negative behaviors that they can't work out anywhere else and the pain.

K: Right. I was thinking about submitting a presentation to Division 39, “Did Winnicott kill psychoanalysis?”

M: (laughs) Oh no!

K: Of course I’m tongue and cheek but we are so enamored with good enough mother which is about always being positive,  always being the cheerleader. I think most therapists are so masochistic and they allow patients in small and large ways to be abusive towards them...

M: Yeah I thought that that is what is revolutionary about your paper. In the first paragraph you talk about why as therapists we're drawn to this profession to help but simultaneously you are calling out our own masochism.  The way we feed off our ability to hold pain in the service of someone, to contain, soften…

K: To be saint like.  We're so overly invested in ourselves being the perfect mother to all of our patients. As if  the perfect mother is somebody who would just lie down, puts up with everything. It’s not.

M: Well, thank you for jumping in with me to explore the concept of candor and your clinical practice. Your mind is so alive. It’s been a pleasure.

K: You know, I end my most of my lectures with this:  Be thoughtful, of course, but be courageous. If you have any anxiety when you're practicing, that’s good.

M: Ah! I love that.

K: Take risks. If you're never afraid and you're just offering soothing, comforting things you're probably not giving the person everything that person really needs.

Karen Maroda, PhD is a clinical psychologist in private practice in Milwaukee, Wisconsin and a board certified in psychoanalyst by the American Board of Professional Psychology. In 2012, she was elected Fellow status by the American Psychological Association for her contributions to psychology on a national level. She is also a Fellow of the American Academy of Psychoanalysis. She has been in private practice for over 30 years and lectures nationally and internationally. She is the author of three books, several book chapters, and numerous journal articles and book reviews. She is passionate about the change process and has made it her life’s work to innovate psychodynamic techniques, making the process more interactive and collaborative. 

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Michelle Harwell, MS, LMFT is an expert trainer, respected speaker, and licensed therapist in trauma and attachment. She is noted for her specialization in areas of development, attachment, trauma, and neuroscience, and her ability to communicate complex topics with clarity and humor. Michelle is currently completing her PhD in Psychoanalysis from The Institute of Contemporary Psychoanalysis. She received her BA in English Literature from University of Oklahoma, MA in Theology from Fuller Theological Seminary, and MS in Marriage and Family Therapy from the Fuller Graduate School of Psychology.