Diary of a Cognitive Therapist
When I was in a clinical program learning to do the old-fashioned kind of psychotherapy, it was all about interiors – inside the treatment room, inside the patient’s mind, inside the therapy relationship. Those things are still the most important, but context is everything.
Outside the therapy room, it’s not just that we have new, better models for understanding human troubles, and empirical evidence for treatments that improve lives. It’s also that the modern world, and the ways we interact with it, have changed radically from when talk therapy was being developed.
I’m talking about changes in the definition of family and identity, the rise of social media, the polarization of the nation, the pandemic, the changing nature of work and the workplace, the legalization of weed… Huge changes that affect our emotional lives and interactions. All the while, I’ve been doing the same core work - helping people not panic on airplanes, give a Zoom talk without stage fright, manage relationships with their partner or in-laws, and generally figure out how to calm down in the midst of an overactive anxiety brain center. But an understanding of context, how our brain centers are being bombarded today - that’s also key to a good, modern psychotherapy experience.
And since I invited you to my diary, I’ll share that, as a curious and engaged person, I think it’s enriched my work to meet amazing people in NYC and helping them on their very modern journeys. What could be better for a talk-therapist-turned-sophisticated CBT practitioner?
From my perch in Soho, at the corner of trendy & cool, I’ve had a front-row seat to all the industries and all the changes that have shaped our modern life, and some of its troubles. When I got here, the neighborhood was anchored by the gourmet shop Dean & DeLuca, and Soho was still synonymous with art galleries. Now D&D is gone (along with my over-priced chocolate run in the afternoon), and Nolita, which was a sleepy few blocks to the east, is full of model shoots on Crosby St., long lines for sneaker drops, and it’s hard to grab your single-origin coffee without overhearing a founder pitch a startup to a potential investor. (Ironically, two weeks ago I heard one for an AI therapist that would supposedly be just as helpful as me!) So it’s tech, fashion, hedge funds, branding. We went from cubicles to open plan offices to stand-up meetings to WFH. It was SixSigma, now it’s Series B.
The core of the work is still the same - to help people and teach them what I can about what ails them and how to repair it. But applying it in the context of all the changes around us - that has deepened my work, and my gratitude that I get to do it.