Tag: psychotherapy

The Barren Midwife: On Socratic Method and Psychotherapeutic Art

Posted on by Gary Borjesson

by Gary Borjesson

I’ve rarely regretted holding my tongue during a session. I’ve rarely regretted drawing out what’s on a patient’s mind instead of offering some (apparently) juicy insight or interpretation of my own. Holding myself back is sometimes a matter of willpower, but mostly a matter of art. The root of this art is the Socratic method.

In broad terms, the Socratic method can be used to teach law and other technical subjects, but these aren’t psycho-therapeutic in the way that Socrates was, that Plato’s dialogues are, or that a psychotherapist is. Law professors are not examining a student’s unconscious feelings, thoughts, or beliefs. Rather, the student has taken in a teaching, and their grasp is tested by Socratic-style questioning. But Socrates and Plato themselves are concerned with making what’s latent in the mind conscious, as are psychoanalysts and other depth therapists.

Socrates distinguishes the deeper, more therapeutic potential of his method by calling himself a midwife. This ‘maieutic’ metaphor has become synonymous with his method, as the accompanying definition shows. I want to unpack the meaning of Socratic midwifery and how this is reflected in psychotherapeutic art. The parallels are naturally of interest to me, having spent the first half of my career as a philosophy professor before leaving academia to become a psychotherapist. But more than that, the wisdom folded into the metaphor of midwifery sheds light on how to pursue an aim shared by philosophy and psychotherapy: getting to know oneself. Read more »

Friday, October 17, 2025

Friendship Begins at Home

Posted on by Gary Borjesson

by Gary Borjesson

To love someone else is easy, but to love what you are, the thing that is yourself, is just as if you were embracing a glowing red-hot iron: it burns into you and that is very painful. Therefore, to love somebody else in the first place is always an escape which we all hope for, and we all enjoy it when we are capable of it. But in the long run, it comes back on us. You cannot stay away from yourself forever, you have to return, have to come to that experiment—whether you can love yourself, and that will be the test. —Carl Jung, lecturing on Nietzsche

L’amitie, Pablo Picasso, 1908. Permission of the State Hermitage Museum, US.

1. Friendship Born of Self

It is commonly, and truly, said that you can only love someone as well as you love yourself. For many of us, myself included, this is a hard teaching. As Jung says in the epigraph, we hope that we can love others without figuring out how to love ourselves, but eventually “it comes back on us.” The love I’m talking about is friendship. (It should come as no surprise that philosophers and psychologists haven’t looked to familial or romantic relationships as exemplars of enlightened love!) I want to explore how this curious relation between befriending ourselves and befriending others works. Along the way I show how we can use our discoveries to become better at both.

The notion that loving others depends on loving ourselves is not new. Aristotle discusses how the kind of friend we are to ourselves will be reflected in the kind of friendships we have with others. Where there is “internal conflict,” where, as he puts it, “souls are divided against themselves,” they will not be able to love themselves, or others. I think of people I’ve known who end up in therapy because a friend or partner made it clear that the relationship would be over if they didn’t address their depression or anxiety or addiction—examples of how internal discord causes troubles for others.

2. It’s Mutual, Actually

But friendships don’t just reflect who we are. Who we are, and how we show up in relationships, depends also on how we have been treated by others. If you grew up with a hypercritical rejecting mother, your attachment pattern and personality will reflect this. In other words, our way of being with others is informed by the way others have been with us; in particular, by how attentive and attuned (friendly) early caregivers were. Read more »

Sunday, August 24, 2025

The Meaning of Boundaries, Real and Imagined

Posted on by Gary Borjesson

by Gary Borjesson

Everything that irritates us about others can lead us to an understanding of ourselves. – Carl Jung

Note: I always disguise identities of patients in my writing.

An image of boundary problems
Robert Delaunay’s painting, “political drama.” Used by permission of National Gallery

As a psychotherapist, it’s poignant to recognize in my patients’ struggles aspects of my own. An example is the tendency to imagine we are “holding boundaries” when in fact we are retreating from them. This common delusion has far-reaching consequences.

Attention to boundaries is often forced on us by difficult situations or people. Perhaps we’re being criticized; someone’s intruding on our physical space, or dominating a conversation; maybe we’re worrying about how to set boundaries with our partner or child, or whether we should tell the server the food is bad. I envy people whose instinctive response is to confront the situation. But I admire those rare souls who manage to do so generously, in the spirit of resolving the issue collaboratively. This shows self-respect and goodwill; it also shows courage to be able to remain present when circumstances are threatening. It is, in all, a very good mindset for holding boundaries and building good alliances—not to mention for warding off trespassers and enemies.

Most of us, however, tend to react to boundary issues in a variety of less-ideal ways. There’s open hostility, of course; but the reaction I want to explore involves a more or less deliberate avoidance of the person, the problem, and the boundary—all in the name of holding boundaries.

This behavior can take a variety of forms, from the slow ‘avoidant discard’ to ghosting, canceling, or cutting someone off. While retreating thus, we may tell ourselves or friends or a therapist about the righteousness of our action, so that it can even seem like we’re confronting the situation. But often we’re doing the opposite: skirting that fraught, intimate space of contact and potential conflict. Instead of telling the server we’re unhappy, we never go back to the restaurant. Instead of offering feedback to the colleague or friend whose behavior is troubling us, we nurse our resentment and stop engaging with them.

So, why imagine we’re holding boundaries when we’re not? Read more »

Friday, August 15, 2025

Blending Psychotherapy and Spirituality

Posted on by Marie Snyder

by Marie Snyder

In my last post of meditation, I suggested that there’s not a lot of harm that comes from meditation and mindfulness training, so maybe it doesn’t need the kind of scientific scrutiny that we might expect from a clinical drug trial. However, in Toward a Psychology of Awakening (2000), Buddhist psychotherapist John Welwood documents three traps: spiritual bypass, narcissism, and desensitising, that arise in part because we’ve leant too far to either psychology or spirituality instead of using both. He also discusses them in brief in a paper, “Principles of inner work: Psychological and spiritual” (1984). 

Both psychotherapy and spirituality are about “developing a new kind of loving relationship with one’s experience,” and both help us break free from our conditioned reactions. But spirituality doesn’t address our early mishaps that affect our perceptions, and psychotherapy doesn’t address the need to transcend our personal feelings. 

When he first trained as a therapist, Welwood was concerned that psychotherapy has a narrow view of human nature, but then realized how much it can help once we no longer demand answers from it. It can help free people from negative childhood conditioning, particularly from dismissive or engulfing parenting, by working with our needs, scripts (now narratives), fears, self-respect, etc. A lot of us don’t learn how to exist in the world well. Welwood claims that part of the problem is the “breakdown of extended families and tight-knit communities” so that children just get influenced by parents or just one parent instead of many people providing a variety of ideas that can help a child figure out where they fit in the group. As far as I understand this point, with only one or two major influences, children might accept lessons without question, then have to “spend a good part of their lives freeing themselves” from this singular impact in order to find their own sense of self. It’s somewhat unintuitive, but a larger group influence helps a child find their individual self by differentiating from others more clearly at a younger age. But whether we find it at 5 or 50, it’s necessary to have this “stable self-structure” before trying to go further.  Read more »

Tuesday, April 22, 2025

Yalom on Approaching Meaning

Posted on by Marie Snyder

by Marie Snyder

About 45 years ago, psychiatrist Irvin Yalom estimated that a good 30-50% of all cases of depression might actually be a crisis of meaninglessness, an existential sickness, and these cases require a different method of treatment. We experience this lack of purpose as boredom, apathy, or emptiness. We are “not told by instinct what one must do, or any longer by tradition what one should do. Nor does one know what one wants to do,” so we feel lost and directionless. Instead of addressing meaninglessness as the problem, though, we’ve been merely addressing the symptoms of it: addictions, compulsions, obsessions, malaise. In today’s context, it might suggest that even social media issues could be problems with a lack of meaning. 

The last sentences of his lengthy tome, Existential Psychotherapy, sum up his solution: “The question of meaning in life is, as the Buddha taught, not edifying. One must immerse oneself in the river of life and let the question drift away.” How he lands here is an intriguing path through a slew of philosophers and psychiatrists. Even without symptoms of a problem, attention to meaning is necessary as it gives birth to values, which become principles to live by as we place behaviours into our own hierarchy of acceptability. 

“One creates oneself by a series of ongoing decisions. But one cannot make each and every decision de novo throughout one’s life; certain superordinate decisions must be made that provide an organizing principle for subsequent decisions.” 

Yalom doesn’t suggest coming up with a list of values that can become meaningful to us, but that we immerse ourselves in life to become more aware of which values we already have.  Read more »

Path and Pathology: Some Philosophic Aspects of Psychotherapy

Posted on by Gary Borjesson

by Gary Borjesson

I came to psychotherapy from philosophy, first starting therapy in my forties while on sabbatical from St. John’s College. I was struck by its transformative power—so struck that I ultimately resigned my tenure and returned to graduate school to train as a therapist. But I’ve hardly left philosophy behind. Freud reminds me of Nietzsche. Socrates’ fingerprints are all over the motives and methods of psychoanalysis. Donald Winnicott and Erik Erikson bring to mind Hegel, and the list goes on.

Philosophy and psychotherapy (and the humanist tradition in general) see our lives as developmental journeys. In the spirit of Socrates, they view self-exploration and self-awareness as essential to self-actualization. This may seem obvious, but it’s easy to lose sight of. Which makes it remarkable that many academics don’t believe being a “philosopher” need include examining themselves. Yet, how could it not? After all, philosophy means the love of wisdom, and who would say of a true philosopher what Regan said of her father, King Lear, that “he hath ever but slenderly known himself.”

It’s equally remarkable that the Socratic spirit is often absent in therapists, in their own lives and in their work with clients. A variety of forces (not least insurance companies) lead many therapists and clients to focus on techniques and tools for reducing symptoms; this draws attention away from the person as a whole. There is nothing wrong with focusing on symptom-relief, as the advertised “evidence-based” “solution-focused” therapies like CBT do. After all, people vary in what they want and need from therapy, so we should welcome experimentation and a variety of approaches.

That said, if therapy is to encourage deeper self-exploration, it needs to go beyond symptoms to the whole person suffering them. Read more »

Monday, January 29, 2024

Yalom’s Gift

Posted on by Marie Snyder

by Marie Snyder

I recently binge-watched all of Group, a show inspired by the Irvin Yalom novel, The Schopenhauer Cure. So I revisited Yalom’s non-fiction to see how closely the series aligns to his actual practices.

The Gift of Therapy is a fascinating read from 2017 in which Yalom dives openly into his existential psychotherapy practice, explaining the four givens that affect how we think, feel and act that need to be explored at depth: death, isolation, meaning of life, and freedom (xvii). In the introduction, he jumps right into death denial revealed through a belief in personal specialness (xiii). Our current culture of selfies is likely rife with this! An existential perspective is best for clients who despair from “a confrontation with harsh facts of the human condition” (xvi). We didn’t see much of this type of discussion in the show. In fact, the therapist didn’t talk much at all beyond reminding the group to be honest and forthcoming. Read more »

Monday, November 6, 2023

Goleman’s Emotional Intelligence

Posted on by Marie Snyder

by Marie Snyder

Daniel Goleman’s Emotional Intelligence: Why It Can Matter More than IQ, was originally published in 1995 but more recently updated in a 25th anniversary edition in 2020. Well, he added a new introduction, but no study or concept in the book was updated despite huge changes in our lives since then and tons of new studies with updated technology. It’s kind of refreshing to read a book about the problem with kids today without a single mention of phones, but it feels a little sloppy. Goleman is a science journalist without a clinical practice in psychotherapy as far as I can tell. While his book is about how to be smart according to the front cover, it’s also being used in psychotherapy. It’s a fast, engaging read, but I have some concerns about the content and application.

The book outlines the need for emotional intelligence (EI) to be overtly taught to children, explains the psychoneurology of EI, argues for the primacy of emotional intelligence for success, adds in the need for emotional supports, and ends with a call for parents to be better educated as well. The principle underlying Goleman’s text is that there are four specific domains, adapted from Salovey & Mayer, that emerge from the activity of our brain circuits that have more of an impact on our general well being than does our intelligence: self-awareness, self-management (formerly motivation and self-regulation), empathy, and skilled relationships. Goleman explains that people will be better off emotionally, relationally, and vocationally if they develop their emotional intelligence to identify and understand their feelings as they happen, manage them effectively, understand other people’s feelings, and relate to others more positively. With a calm mind, people can make better decisions, which positively affects all other aspects of their life. Goldman has used these domains to help to develop educational programs to teach children Social-Emotional Learning (SEL) in the schools through the CASEL organization. I feel like it goes without saying  that being able to manage our emotional experiences helps in other aspects in our lives, so I’m all in at this point. Read more »

Monday, August 14, 2023

Menakem’s Somatic Therapy Approach to Anti-Racism Work

Posted on by Marie Snyder

by Marie Snyder

Resmaa Menakem’s My Grandmother’s Hands came highly recommended. The title refers to the effect that being enslaved had on his grandmother, and Menakem traces the violence of racism through the specific perspectives of people on either end of racial conflicts. Beyond just explaining how racism affects all of us in variable ways, he provides specific exercises for overcoming our past. The book contains some excellent and unique ideas about healing from trauma and responding to pain within the context of ongoing racial oppression, but it takes some liberties with explanations of neuroscience and might be better approached as philosophy.  

I’ve previously written about healing advice from Gabor Maté focusing on trauma as the cause of all our ills, Viktor Frankl finding a purpose for himself in order to cope in a concentration camp and advocating for the courage to have an authentic experience of the self and world, Mark Solms reworking Freud to better understand the process of tracing emotional experiences to the past, and the use of Buddhism to stop seeking something outside ourselves in order to find slivers of peace between our thoughts.  All of them, more or less, aim to get to something akin to this point: 

“Once we can find the spaces between the cacophony of thought, in that tiny gap between trigger and reaction, we can reclaim our agency to decide how to act. When we focus on the nothingness instead of following our personal thoughts and feelings, then we’re no longer dragged along by the drama in our lives.” 

Menakem’s book is no different in that respect. This quest has been repeated for thousands of years in various ways and shows up over and over because there’s something to it. It works.  Read more »

Monday, July 17, 2023

Maté: Part Depth Psychology but Part Questionable Quick Fix

Posted on by Marie Snyder

by Marie Snyder

He received the Order of Canada, profoundly helped many people with addiction on the streets of Vancouver, and is much loved and admired, but some of Dr. Gabor Maté’s claims feel like they don’t hold water. And some claims might actually be dangerous if blindly accepted.

I’ve encountered Maté in a few courses I’m taking, and have been strongly encouraged to watch his newest film and read his book several times now; I opted for the former. One follower was excited to tell me, with great confidence, that ALS (Lou Gehrig’s Disease) is caused by a specific trauma and that everyone is carrying unresolved trauma which, if resolved, can heal physical ailments like cancer.

I’m dubious. I have some reservations that I’ve kept to myself until seeing  so many in academia wholeheartedly promoting some poorly substantiated claims.

While Maté has some excellent techniques in the work he does, the way he presents and explains the material provokes me to look up research studies to try to corroborate many of his ideas. 

I gobbled up his books twenty years ago, and there are some useful analogies and treatments in there, but even then there were parts that gave me pause.  Read more »