Thriving in a Sick Society

Philosopher Jiddu Krishnamurti once said, “It is no measure of health to be well adjusted to a profoundly sick society.” So if you don’t feel well adjusted, take heart! It probably means you’re exactly as you should be, and that you have a lot to offer this crazy world. It’s a beautiful place to be, yes. But it’s also a terrible place, and it’s getting worse. If you’re at all sensitive or have just one artistic bone in your body, this world won’t just break your heart, but shatter it. Over and over again.

Some people respond to a sick society through activism. They will tell you that your lack of action is part of the problem. But everyone responds differently to insanity, and their response largely depends on two things.

First, how much energy do they have? Most people are exhausted. Despite technology’s promises to save us time, it’s actually made us busier, more scattered, and less comfortable with slowing down in a way that would allow us to recuperate from all the busy-ness. Not to mention our largely sedentary lifestyles and unhealthy diets that keep us feeling lethargic if not downright depressed.

Second, what do they believe about their ability to effect real, lasting change? Most people simply don’t believe that they can make a meaningful difference in the world. This isn’t a belief you can talk — or more importantly, guilt — them out of. It’s the result of years of conditioning that probably started in their family of origin, and to shame them for it isn’t fair. In fact, those people need extra compassion. It’s painful to feel ineffective, to feel like no one cares. And in many cases it’s not just a feeling. When it comes to the ones who actually can effect change (i.e., those in charge), nobody does care. Clean air? Free healthcare? A relatively comfortable existence for your children and grandchildren? Go suck an egg!

Add to this the fact that we’re constantly bombarded with messages about how we can be better, stronger, faster, just so we might keep our heads above water in this nutso world, and it’s no wonder people aren’t raring to effect social change. They’re too wrapped up in trying to change themselves. Mainstream advertising is an obvious example, but a quick scan of recent titles on also tells me that my approach to life isn’t optimal: “30 Excuses Stopping You From Living Your Best Life (and 30 Solutions to Overcome Them)”; “6 Important Questions That Will Improve the Quality of Your Life”; “6 Ways to Live Boldly and Passionately, As If Your Life Depends On It”; and “7 Things That Happy People Do Differently.”

Visit the site tomorrow and you’ll probably see a whole new slew of similar how-to articles, many of them with a numbered list of things that you “should do,” written by people who stake their credibility on the number of followers they have and the amount of money they’ve earned.

I’ve been compelled to read such articles time and time again (click bait!), and I rarely ever feel better for it. Most of the time it’s a comparison trap. And as Jean-Paul Sartre said, “Comparison is death.” The second we expect ourselves to be like anyone else but ourselves, a part of us dies. Pay attention and you’ll feel it. In those moments we lose touch with everything we have to offer that no one else can, because no one else is like us. We are all snowflakes, damnit.

So whenever you feel insecure, demoralized, depressed, irritable, or some version of “there’s something wrong with me,” remember that you’re basically living in a coo-coo clock (to quote Homer Simpson), and that everything sweet and wise inside of you is probably, on some level, responding to that insanity. In trying to survive — let alone thrive — in a sick society, you’re attempting something that’s incredibly difficult. Hats off to you for hanging in there.

Men’s Relational Needs and the Specter of Neediness

Even with all the strides we’ve made in gender equality and emotional intelligence, it seems many men still equate having relational needs with being needy. I’ve seen it in my work with clients and in my conversations with male friends. The truth is, men’s relational needs reflect the desire to feel seen and understood that is hardwired in all of us. But I recently witnessed how the mere existence of such needs can turn a man against himself.

I’d been listening to my friend Gram (a pseudonym) explain the latest conflict between him and his girlfriend. When he finished, I made a simple suggestion. I wasn’t really meaning to give him advice. The logical next step merely seemed so obvious to me that it came spilling out: “Just tell her what you need.” But Gram’s resistance to this idea was downright visceral. He groaned from somewhere deep in his chest and pulled on his hair with both hands. Blood rushed to his face as he yelled (not at me, but to me): “If I do that, she’ll think I’m needy!!!” But all he wanted to do was say he’d changed his mind about something.

the baby in the bathwater

To quote comedian Louis Black, “there is a big fuck difference” between having basic relational needs and being needy. In Gram’s situation, what he needed from his girlfriend was by no means excessive. But in an effort to appear totally needless, he’d communicated with her from a defensive place. She had responded in kind. For Gram, this response created even more emotional distance, and therefore more needs. So he protected himself further by becoming all the more defensive and shut-off.

To the person on the receiving end, such defensiveness typically translates into assholery, or dickheadedness. In reality, though, it’s coming from a place of fear and isolation. It’s the little boy who has learned he mustn’t cry or ask for help. In some cases, he mustn’t even change his mind. This state of affairs saddens and confuses him — and it pisses him off. Inevitably, from time to time, he will direct this anger at his partner. Damn her for making him have to voice his needs! And damn himself for having them in the first place! The real kicker here is that most of this mental activity happens on an unconscious level. And activity on that level is most likely to control behavior.

At one point in my conversation with Gram he talked to himself from that conflicted place inside: “Quit being such a fucking baby.” It was like witnessing child abuse. Then he did what so many people, regardless of gender, do to ostensibly soothe themselves. With a tremble in his voice and a humorless smile he said that his problems were nothing. So many other people had it so much worse.

comparison is death

Granted, noble intentions were guiding Gram’s sentiment. But in most cases, that sentiment only functions to invalidate. It turns us against our emotional experience even more. There’s no denying that other people suffer from sickness, hunger, and any number of awful circumstances. But for whatever cosmic reason, that particular brand of suffering is not what we’re facing today. And if Gram were to wake up starving and sick tomorrow, I’m sure his relationship struggles wouldn’t seem so bad. Conversely, if the hungry were given food, and the sick given health, soon enough they would probably find suffering elsewhere on the hierarchy of needs.

Chastising ourselves for having difficult emotions only prolongs our difficulty. You might even say it’s more self-indulgent than simply acknowledging we’re hurting, and turning with curiosity and compassion towards that hurt. The sooner we can do that, the sooner we will feel better and be able to turn our attention outward again. If we’re constantly putting energy towards warding off our relational needs, then we simply won’t have much energy left for our relationships.

Needs are necessary

It would be too cruel a joke, even for life, if we were supposed to be completely independent. Consider the huge role that dependence plays in that most formative of relationships: the one we have with our primary caregiver in our earliest years. Yes, as adults we are far more equipped to take care of ourselves than we were as children. But the need for relational security and connection — the need to feel truly seen and understood — is hardwired into the deepest circuits of our brains.

So to men who might be equating needs with neediness, and who fear that expressing your emotional needs will ultimately destroy your relationship: take heart. Your partner might surprise you. And to all the women out there: keep in mind that we, too, are affected by the messages our society perpetuates about men and how “strong” they’re constantly supposed to be. Even if just a small part of us buys into those messages, we miss out on a deeper emotional connection with the men in our lives. We might wonder if a part of us actually fears being needed. And whatever our gender, we should all stop and wonder if our partners feel safe enough to be vulnerable with us.

Present Moment Processes

In every blog post thus far, I have focused a lot on the past by discussing first memories, life stories, and genograms. Indeed, exploring past experiences and seeing how they affect the present is an important aspect of psychotherapy. Such explorations can also be more comfortable for certain individuals who are new to therapy or a particular therapist. Talking about the past can be more intellectual, and therefore less vulnerable feeling, than exploring the embodied, unpredictable present with a virtual stranger. But I cannot emphasize enough the extent to which mindful contact with the present moment facilitates true healing. For many people, the therapy session provides this kind of contact for the first time, and is a practice ground for mindfulness.

Resisting the Here-and-Now

One widely accepted definition of mindfulness is Jon Kabat-Zinn’s. He describes it as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” So I invite you to ask yourself this question: To what extent do I really pay attention to how I am feeling in the present moment?

More often than not, most of us instantly react to an emotion, usually in order to get rid of it, or sometimes (if it’s “good”) to ensure it won’t go away. Rarely do we take the time to see it and feel it for what it is. We blame others for “making us” have a certain emotion, and we lash out at them in aggressive or passive-aggressive ways, without ever turning towards our pain to see what it needs from us. We subconsciously believe, “I shouldn’t be feeling this way,” thereby judging our emotional experience and essentially invalidating it. Some people go through their entire lives like this. And the scariest part is that they don’t even realize they’re doing it.

Ways to Practice Presence

Various therapeutic modalities facilitate in-session present moment processing. My three favorites are Contemplative Psychotherapy, Acceptance and Commitment Therapy (ACT), and the Hakomi Method. All of these approaches involve facing our defenses or resistances head-on and experiencing firsthand how conditioned we are to avoid the tenderness and expansiveness of the present moment.

Contemplative Psychotherapy

Contemplative Psychotherapy is grounded in Buddhist philosophy and also incorporates psychodynamic and humanist counseling theories. For all of 2016 I trained intensively in this modality, and the most important skill I learned was how to sit with clients in their pain, without trying to guide them out of it and into the next moment. Again and again, I was amazed by how subtly I could steer the conversation away from suffering and toward problem-solving or rationalizing. Sometimes I would latch on to a certain piece of content in a client’s narrative, when really what needed attention was their process. I was not meaning to do this, but in watching session footage week after week, I became more conscious of my tendency to guide clients away from painful material.

Into the Fire

Most of us do this sort of thing with ourselves and our loved ones all the time. When someone cries we usually say, “Don’t cry. Everything will be okay.” Or we ask how we can make them feel better. But usually what feels most nourishing in times of distress is to have someone simply acknowledge our pain. They might say something like, “I see that you are suffering, and I am here. Tell me where it hurts. Tell me what it feels like.” With this type of inquiry, we feel seen and understood. It validates our experience and begins a process of true healing.

I still receive biweekly supervision in the contemplative approach to counseling and have become more adept (with a lot of room to grow!) at guiding clients “into the fire” of their own pain. Together we explore its nuances and uncover its sacred messages. We track when the urge to turn away from it takes over, and we bring the focus back to the experience at hand. Too often we are told to “move on,” “get over it,” “let it go.” But if we can just stay with our experience and let it be, our understanding of it will deepen and it will become less frightening. Less fear means more clarity and a deeper trust in our own brilliant sanity.

Acceptance and Commitment Therapy

ACT (pronounced “act”) is a hardcore behavioral therapy whose ultimate goal is greater psychological flexibility. It focuses on strengthening six different domains: values, committed action, self-as-context, cognitive defusion, acceptance, and contact with the present moment. The last of these domains is obviously most relevant to the current discussion.

Sunset Mind

One rule of thumb for many ACT therapists is “When in doubt, first get centered!” Becoming more in tune with their present moment experience ensures that they will not be acting from an unconscious, problem-solving mode of mind with clients. Rather, they will be utilizing what ACT refers to as a “sunset” mode of mind. When you look at a sunset (or gaze at a painting or listen to a nice piece of music, etc.), you are not trying to fix it. You are simply noticing and appreciating.

Therapists can foster the sunset mode of mind in-session with clients by inviting them to focus attention on their breath and other bodily sensations. Notice what areas are tight or relaxed, hot or cold, tired or energized. Addressing each of the senses can also encourage real presence: “Tell me what you’re hearing right now. What do you smell? How does the pillow feel against your arm?” From this centered and embodied place, we can approach problem-solving in a more mindful way, suspending judgment of our experience. Or we might realize that problem-solving won’t even help in this particular situation. Sometimes all we can really do is acknowledge that life has wounded us, and go about tending to that wound.

Slowing Down

Another ACT technique involves slowing down the pace of the session. Sometimes clients come in with a long list of worries and a palpable sense of urgency to address them all at once. The sooner we can eliminate those worries, the sooner they can feel better. But life will always give us things to worry about. So rushing through the worries at hand just means we’re rushing towards the ones awaiting us. At some point it all becomes the same experience: worry.

ACT therapists can help clients see their worry for what it is (not what it says it is — a problem that must be eradicated) by picking one item from the worry list and saying it very slowly, in a very gentle tone: “I… won’t… be… able… to… meet… my… deadline.” They will do this a few times, tracking with each repetition what is going on somatically for the client, and inviting them to breathe into those sensations and simply notice any tensions that arise.   

The Hakomi Method

“Hakomi” is a Hopi Indian word meaning, “How do you stand in relation to these many realms?” Like ACT and Contemplative Psychotherapy, this method uses a lot of somatic (body-based) interventions to facilitate a deeper connection to the present moment. Its founder, Ron Kurtz, developed some ingenious ways to help clients stay with their difficult experiences and tap into the body’s innate wisdom. Two of my favorite Hakomi techniques are verbal probes and “taking over.”

Nourishing Words

Verbal probes are a great way to experience profound, conscious contact with our own defense mechanisms. Such mechanisms typically operate on an unconscious level, where they are more likely to control us. In my counseling practice, I see a lot of defenses arise in the realm of self-compassion. People resist the concept of offering themselves compassion because they believe it is selfish. Other people have it way worse and they should therefore suck it up and be grateful, damnit. They equate self-compassion to self-pity and wallowing.

If I sense that these beliefs are active in a client, I will invite them to get centered. Plant both feet on the floor and tune into your breath. I will ask them to simply notice what happens in their minds and bodies when I say something like: “Your pain is real and deserves loving attention.” Most people are surprised by the reactions they observe themselves having to such a statement! They become aware of a physical aversion to it. Voices in their head immediately start yelling in protest. People realize that on some level they’ve actually been resisting what they need in order to heal themselves. This awareness alone is often enough to shift things dramatically and catalyze the healing process. 

Supporting the Defense 

“Taking over” is a technique I sometimes use in conjunction with verbal probes. It works when a discreet somatic response arises to something I’ve just said. A common example is when clients report their shoulders tightening. In this case, “taking over” would involve my physically squeezing their shoulders up for them as I repeat the same verbal probe that initiated the tight sensation. Or clients can exaggerate that tightness themselves by bringing their shoulders up to their ears. They can give themselves a similar experience by using their arms to represent the wall that they feel coming up in response to a certain probe. With the defense thusly supported physically, their psyches are freed up to receive information in a less defended way. They can then take in the nourishment of my words. And they can contact the vulnerable part of themselves that believes it needs protection. 

Accepting What Is

In The Power of Now, Eckhart Tolle says that we have three options for dealing with a given situation. We can accept it, attempt to change it, or attempt to get out of it altogether. Any other response is just resistance, and resisting what is, according to Tolle, is simply insane. This makes sense if you really think about it.

At various points in our lives we will all be faced with situations we’d like to escape or change but cannot. In those moments we have one option: acceptance. This does not equate to settling, giving up, or being happy with a given scenario. It just means we’ve stopped resisting. On some level, however subtle or energetic, we’ve relaxed into it. Instead of clinging to the rocks while the waves crash down upon us, we’ve loosened our grip and learned to ride the waves. We can say without judgment and without taking it personally, “This is how it feels to be alive right now.”

The interventions used in Contemplative Psychotherapy, ACT, and the Hakomi Method are just a few among many that can assist us in cultivating mindfulness and acceptance. Both skills are necessary for contacting the present moment in a nonjudgmental way. Of course, one can cultivate presence at home via meditation, yoga (these YWA videos are my favorite), and bringing bare attention to activities like cooking and washing dishes. With practice we see that in refusing to accept what’s happening right now, beneath all the defenses and distractions, we’re resisting life itself.


Hayes, S.C., Stroshal, K.D., Wilson, K.G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York, NY: Guilford Press.

Tolle, E. (1999). The power of now: A guide to spiritual enlightenment. Novato, CA: Namaste Publishing and New World Library.

Weiss, H., Johanson, G., Monda, L. (eds.). (2015). Hakomi Mindfulness-Centered Somatic Psychotherapy: A comprehensive guide to theory and practice. New York, NY: Norton Publishing.


Honoring Your Context

The genogram is a kind of family tree that not only provides important names and dates, but also denotes patterns of relationship, mental health, and more. For certain personalities, it’s a very appealing way to begin the psychotherapy process. At minimum, a genogram represents three generations of one family. Some clients, though, can provide information that goes even farther back in time, which is ideal. More chronological depth means an opportunity to recognize more patterns.

When building a client’s genogram, I always start with when they were born. I represent them on the page with their name and a shape to designate their gender. Squares are for males, circles are for females, and a combination of one inside the other is for transgender individuals. I outline this shape again to denote that they are the index person around whom the genogram will grow. (Note in the hypothetical example above that Greg is this person.)

The next step is to add siblings, assuming there are any. If a sibling is older, they are placed to the left of the index person; if younger, to the right. This structure changes to accommodate multiple marriages. (See how Greg’s father remarried and had Greg’s younger half-sister with his second wife, Becky.)

In many cases, people need an entire session to start exploring the relational dynamics that existed and might still exist amongst them and their siblings. We typically take for granted that our parents have the most significant effect on our development. Genograms can help underscore the impact that siblings have, as well. 

Birth Order

In exploring sibling relationships, I like to provide clients with some psychoeducation on birth order. There are well-tested theories that make strong connections between personality and whether someone is a first-born, middle-born, or last-born child.

First-borns, for instance, tend to be perfectionists, leaders, over-achievers. They are conscientious and reliable, often utilize black-and-white thinking, and love to read. Unlike later-borns, these children only have adults to emulate and are therefore resemble “little adults” themselves. They’ve got some big shoes to fill.

Middle-born children take the opposite approach of their older sibling; they do their own thing. These individuals are often the ones who defuse conflict amongst other family members. They are very loyal and place a deep value on friendship, but at the same time they can be secretive. Middle-borns are typically not comfortable with being the center of attention because they never got a lot of practice in that role. 

Last-borns, on the other hand, love to have all eyes on them; they tend to be the funny, fun-loving sibling with good people skills. But in some cases, to some degree they’ve also endured bullying at the hands of their older siblings. Perhaps they received the message that they were stupid or inferior, or that their opinion didn’t matter enough. This can be a hard message to shake. 


Of course, not everyone fits the mold suggested by their birth order. But usually the reason behind a given discrepancy is relatively predictable. For example, gender can make a big difference. If a last-born individual presents more like a first-born, it might be that he is a first-born son with one older sister. One must also consider the physical and mental health of their family members. If a first-born daughter, for instance, has a major disability, her younger sister will probably display more first-born traits. Another exception occurs when more than five years separates the births of two children. If you were, say, seven when your younger sibling was born, that sibling will likely have some first-born characteristics. 

The birth order of one’s parents also plays a part. A middle-born mother is more likely to identify — and therefore favor — her own middle-born daughter than she is likely to identify with her first or last-born children. If both parents are first-borns, they will probably raise three children who all have a noteworthy amount of first-born traits, regardless of their actual birth order.

Talking about all of these nuances and how they apply to a client’s unique sibling constellation can often deepen understanding of and compassion for family members and help illuminate the hidden, pre-programmed motivations behind everyone’s behavior.

Relational Dynamics

Genograms use different kinds of lines to denote different kinds of relationships. For instance, if a client was very close with her older sister, I draw two solid lines connecting their respective shapes on the graphic. If she felt emotionally distant from her younger brother, I draw a dotted line to connect them. Jagged lines represent abusive dynamics between a pair of family members. Two lines with a bracketed gap in the middle denotes that a cut-off happened, or that communication completely stopped for a significant amount of time.

I am never surprised when a client reports a cut-off between two people in one generation of a family and later mentions another cut-off between two people in the previous generation. Such patterns are yet more proof that ways of dealing with pain and conflict tend to be passed down through the years. Mental illness (indicated by shading in one vertical half of a given person’s circle or square) and substance abuse issues (indicated by shading in the lower horizontal half) also tend to reoccur from one generation to the next.

Triangles on the Genogram

Triangles are another element of relationship in a family that genograms can include. One tenet of family systems theory is that a dyad, or a pair of people, is unstable. So when any sort of conflict arises, the dyad will enlist a third person for “support.” The nature of this support varies greatly from family to family.

A common scenario involves the two parents arguing and one of the children stepping in to defend mom or dad. Or a child might develop some sort of issue, like an eating disorder, and become the focus of one parent. (I denote this focus on the genogram by drawing a solid line between the two family members, with an arrow pointing to the child in question.) Meanwhile the other parent feels neglected by his spouse and might then seek emotional support from another child. In this way, an additional triangle forms.

The Drama Triangle

Another typical arrangement is the Drama Triangle. This occurs when one person takes on the role of bully, the other of victim, and the third of hero. Sometimes these triangles can get especially messy. The hero, upon swooping in to save the day, is then cast as the bully, while the original victim becomes the hero and the original bully becomes the victim!

Where Drama Triangles are concerned, a good step toward healthy change is for the person in the original hero role to resist coming to the victim’s rescue in the first place. The victim will then have no choice but to step into his own efficacy. I denote such dynamics on a client’s genogram by shading in a triangular space that connects three family members. Sometimes these shapes overlap, with one family member playing a role in two or more different triangles.

“If it’s heavy, put it down.” -Clem Snide

One other aspect of family systems that genograms help illuminate is how maladaptive beliefs, or “burdens,” are handed down. The genetic foundation of mental illnesses like major depression, schizophrenia, and bipolar disorder has received much attention in the world of clinical research. However, there are subtler cognitive behaviors that we all inherit from parents, grandparents, great-grandparents, and so on. The creator of internal family systems therapy, Richard Schwartz, uses the term “burdens” to characterize these unhelpful thought patterns.

Body Image

Body image issues comprise a good example of such burdens. Children of mothers who consistently convey dissatisfaction with their bodies will often subconsciously assume that they should feel the same way about their own bodies. Deep down in their basic nature, they might actually like their bodies. But they’ve inherited the burden of a poor body image! The negative self-talk that colors their internal world isn’t actually their own but their mother’s, and perhaps their grandmother’s.


Do you find yourself feeling guilty on a regular basis? Think about your family context for a minute and see if you recognize any other relatives with a similar issue. Perhaps your grandmother was frequently guilt-ridden, causing her son (your father) to resist ever feeling guilty because even a little bit of such intense guilt was too much to bear. Later, upon having children of his own, he inadvertently projects his disowned guilt onto them, and the cycle continues.

Without a mindful awareness of how guilt is an inherited burden that spreads a false message, you could never take steps toward changing that painful pattern. Only when something moves into consciousness can we deal with it effectively. Genograms can help us see harmful patterns in stark relief, opening the floor for a conversation about setting our burdens down.   

“Taken out of context I must seem so strange.” -Ani Difranco

The various ways to use genograms in the therapy room are too numerous for the confines of this blog post. But the broadest and most important function they serve is to help clients literally see that they are part of a much bigger system than they might have realized. John Donne said, “No man is an island.” Applied to family systems, this statement suggests that everyone is connected to, affected by, and dependent on everyone else.

The nature of our parents’ upbringing has an undeniably huge impact on our own upbringing, which in turn affects how we raise our children. Even if every parental decision is a rebellion against how our parents did things, it is still the result of how our parents did things! Humans are contextual creatures. Therefore, to understand ourselves in a way that promotes healing, we must understand our unique context.


Galindo, I.; Boomer, E.; and Reagan, D. (2006). A family genogram workbook. Kearney, NE: Morris Publishing.

Leman, K. (2009). The birth order book. New York, NY: MJF Books.

McGoldrick, M.; Gerson, R.; and Petry, S. (2008). Genograms (3rd ed.). New York, NY: Norton Publishing.

Schwartz, Richard (1995). Internal family systems therapy. New York, NY: Guilford Press.