Yes, and no. It’s true that tiny infants are so in need of emotional and physical attachment that they would die if they didn’t receive it. (Studies of orphanages and other attachment-deprived environments for children have proven that.) But we don’t need a study to prove that, right? We know that babies and little kids need attachment. What’s harder to realize is that humans of all ages need it. And without it, they’ll die.

That’s why couples fight, and why they get so upset with each other. You sense that your lover, your beloved attachment source, is slipping out of your grasp, and so you protest that. Even if you’re the “distancer” in your relationship—the one who seems not to need others, the aloof one—even you have serious attachment needs. So serious that if you don’t have healthy attachment in some form, you really will get sick and die.

Lately I’ve been referring to the film “Cast Away” when clients ask about adult attachment needs. I hope you’ve seen it. I don’t want to ruin it, so—spoiler alert. (Though this bit of content won’t give away the ending, and the ending is fairly predictable anyhow.) The movie is about a FedEx employee who survives the crash of his cargo plane and fights to survive alone on an uninhabited island. Since the cargo plane broke apart when it plunged into the ocean, Chuck (Tom Hanks) finds FedEx packages washing up on the beach over the course of his time on the island. One of the packages contains a Wilson volleyball.* (Yeah, the product placement is pretty over the top, but it’s still a great film.)

As months stretch into years, Chuck finds himself talking to the volleyball, and paints a face on it, naming his new friend “Wilson.” Wilson provides a rudimentary form of attachment for Chuck, because it is intolerable (and life-threatening) for a human to be utterly alone. Chuck anthropomorphizes Wilson because he must do so to survive. And at one point later in the film, when Wilson floats away from Chuck’s raft and can’t be recovered, Chuck is racked with sobs, cracked in half by crippling grief at the loss of his friend. “I’m sorry, Wilson,” Chuck moans. “I’m sorry.”

…All this about a volleyball? No, it wasn’t a volleyball at that point. It was every bit as real a friend to Chuck as any of the human friends he left behind when he crash landed on that island. Psychologically, Wilson was a being for Chuck, not just a thing. Chuck was a full-grown man, not a little kid. He was resourceful, clever, determined, and, as he changed and hardened on the island, increasingly wise. By the time he dared to make an escape to the open sea, Chuck was almost fearsome in his physical and emotional strength. But his attachment needs still pulsed through him. And so he grieved the loss of his dear friend.

I believe that if something else hadn’t happened to save Chuck, he would have died, but not from starvation or dehydration or sunstroke. He would have died of heartbreak.

That’s why you fight with your partner. That’s why, when something goes wrong in your relationship, you can feel panicked, or feel deeply hurt. You have attachment needs. You need others. Can you talk about this and discern how to meet these needs in a healthier relationship?

*Correction: the original post incorrectly identified Wilson as a soccer ball. Sorry, obviously I’m not a sports fan!

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Meanwhile, I’ll be catching up on some admin work, writing a blog post or two, and making up new apocalyptic names for the storm and its effects on a city that’s not used to digging out from under snow and ice, let alone driving through it. (Ice-chaton is a twist of “eschaton,” a term for the end of the world. And no, you don’t need to know this, or care!)

Oh, and I’m taking these lovely creatures out for regular snow romps. Be safe!

Stella and Hoku ala enjoy the winter wonderland.

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But what I liked best was his courage. Here’s an excerpt of what his brother had to say about it. I harp on courage with my clients. The old song “Love is all you need” has been a bane of this therapist’s existence: love is not all you need. It’s courage that you need. Courage to confront your partner about the truth that needs to be told. Courage to confront yourself about your failings, blind spots, weaknesses. Courage to pursue the best possible relationship: one that is filled with honesty, vigorous argument, ecstatic union, and thousands of days of ordinary kinship and friendship. Love also requires courage in no small part because the price of love is grief, and that price is often staggeringly high.

Chances are good that if there’s something wrong in your relationship—it’s falling flat, or it’s driving you crazy, or it seems to be slipping away from you, right before your eyes—you will probably find your way to a new, rewarding relationship when you begin to think, talk, and act courageously.

I highly doubt that Hitch would have been very interested in my line of work. But he has contributed something to it, nonetheless. I remember him for this, and raise a glass of Jim Beam to his memory. (Just one! I would never have been able to keep up with him.)

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Here’s why. If you have medical insurance, it’s possible that your insurer has listed me on their website as a provider, whether I’m “preferred” with them or not, and it’s also possible that they have told you they cover couples counseling. But this is technically incorrect. And to do it, I’d have to breach my own ethical code. Here’s the explanation:

The insurance industry is built to serve individuals, not couples, which means if we bill your insurance, I have to diagnose one of you with a mental disorder and bill the session as an individual session (with the individual’s spouse/partner present), implying that the session is intended to treat that one individual’s mental disorder. This is why insurance companies don’t really cover couples counseling: they cover individual counseling with the (presumably non-disordered) spouse/partner in the therapy room. And in my book, that’s not couples counseling.

If I were to bill the session properly and ethically, I would diagnose neither of you with a full-blown disorder, but would code it V61.10, which is “partner relational problem.” And there are two reasons why that won’t work. First, I’m still billing your insurance for one of you, not both of you, and that’s inconsistent with my view of you as my client. You are both my client—my singular client. Your dyad is my client unit. And I believe that these little details do matter. They have an effect on how we see ourselves and each other, try as we might to avoid it. And the second problem is that no insurance company I know of pays claims with V61.10 as the diagnosis. It’s a V-code, and my guess is that the V stands for Very Unlikely We’re Going To Take Your Problem Seriously.

“But,” you say, “I do have a mental disorder! I’m depressed, and my relationship problem contributes to my depression. So I’m fine with you diagnosing me and billing it as an individual with his partner in the room.” I understand that, I really do. I even share your belief that working on couple issues can alleviate depression and other disorders like anxiety, PTSD, and many more. Maybe it seems like an absurd distinction, but to serve you ethically I still have to hold the line on my belief that what we do in couples counseling treats both of you as a unit, and to do that effectively, I can’t have the paperwork telling me, you, and your partner that your depression is the central problem. It truly might not be. Let’s say your partner also has a disorder in the category that includes depression—bipolar, say, or alcohol dependence. Why should I put your name on the chart and not his? Maybe his alcoholism is a bigger issue than your depression…but your depression is also a really big deal. It becomes an ethically shady game of drawing false distinctions. I know many therapists (my past self included) who have blurred this line and said, “Oh, it’s not a big deal, I know the truth,” but I’ve been doing this work long enough to know that blurring a line like that is dangerous.

Two more points and I’m done, I promise! I want to add that my holding the line on this can be a source of comfort for anyone who is afraid to begin couples counseling because they (understandably) fear that the therapist is going to side with their partner. I am doing everything I can in and out of my sessions with you to prevent that from happening. In the sessions themselves, when I am naturally drawn to your partner over you, I go on alert and wonder how I’m being “drawn in,” and what you’re all about, and how I can be as well connected with you as I am with your partner. And outside of sessions, I pay attention to things like this insurance issue to be sure the structure of our therapy—even the tedious paperwork—is not getting in our way.

And finally, I have learned through long experience that out-of-pocket therapy is generally more effective and powerful, both for couples and individuals—and perhaps more so for couples. You’re investing time and hard-earned money on your relationship. That motivates you, and it makes it a true investment on your part. It can be expensive (though perhaps not as much as you fear…many couples require surprisingly few sessions). But you really do get what you pay for.

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Dear Mr. President,
Great to talk with you today. Thanks for the invitation to what promises to be a great state dinner. See you there.
Take care,
–Stephen

If I’m doing a long back-and-forth email string, at some point I’ll ditch the “take care” and just respond more casually:

Barack,
No, I’m right-handed, so it doesn’t matter where they seat me. But next to you or Michelle would of course be great. Tell Malia I love the shoes!
–S

But these days I’ve been ditching “take care” entirely, replacing it with (drum roll) “Only good things.” I got it from our favorite dog trainer, a skilled professional who uses completely non-violent methods in her training programs. I’ve assumed all these years that she uses that signature line because it fits best with her general philosophy of life. It certainly fits with her work training dogs: no punishment, no nastiness, only treats for good behaviors and an understanding that dogs learn best when the training is positive and thoroughly non-violent.

But I had another reason for switching my signature line. I recently attended a workshop on conflict resolution, and the workshop leader mentioned that telling people to “take care” is actually problematic. Taking care of oneself seems like a perfectly good thing, right? Except sometimes the healthier choice is to take a calculated risk, or make yourself intentionally vulnerable. I know from years of working with people on relationships that self-protection is never enough to ensure a healthy union. If I’m 100% safe, I’m probably only 0-50% intimate with my spouse or partner. Relationships are about both risk and safety.

So I suppose I could sign emails, “Take care—and take risks!” But that’s clunky, and corny. And as a therapist I don’t need any help being clunky and corny. So I decided our dog trainer has it right: I wish you only good things. I don’t wish you badness, malice, or suffering. You may suffer if you take the healthy risks I wish you would take, but that’s different: that is the suffering of growth, so in a backwards way it too is a good thing.

Some of you may think all of this is silly. It’s an email signature line, what’s the big deal? Well…it’s not necessarily a huge deal. But it is one of those everyday things that can gradually have a significant influence over you, day by day. Now that I sign emails “only good things,” I’m reminding myself daily that a well-lived life isn’t only about safety, and there are good things to be had when we do something brave, or move outside of our comfort zone…when we stop just “taking care.”

Only good things,

Stephen

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I’m not whining. (Okay, I’m whining a little.) I say all this (more importantly) because I’ve noticed something while spending so much more time with our puppy dogs, Stella and Hoku ala. Whenever they can—that is, whenever I can provide a place for them to do it—they just, you know, lie around.

Of course they do, you’re saying. They’re dogs. Big deal. But it is a big deal. It’s one of those obvious things in front of our noses that we too often ignore: the fact that all the other mammals on this planet, after finding food, satisfying today’s procreative needs, and securing shelter, just…lie around. They don’t have to do anything. Only the benighted humans have created a world in which they have to do things, do more things, do so many things that their sense of self-worth is caught up in all the things they do, or can’t do.

Why don’t we all do something unusual today: after we’ve taken care of the basics, why don’t we all just lie around? I’m going to give it a try.

Hoku ala enjoying the simple experience of being an earthling with nothing to do.

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Nah. Don’t bother.

Here’s why: life is not about balance. Don’t believe any counselor who tells you otherwise. You think you’re focusing “too much” on career and not enough on your relationships? Says who? Maybe your career is your lovely baby, the beautiful thing you’re giving birth to in the the world. Your clients or customers or care recipients don’t think your career-focused life is out of balance. And that’s probably not only because they know your so-called “workaholicism” brings benefits to them. It’s also because they know that what you do is valuable. It’s a force for good in the world. Does that make you a bad girlfriend? Maybe. But maybe that’s okay. (And yeah, maybe you should be honest with your partner about that.)

Or maybe you’re going through a time in your life when you’re doing, well, everything. Kids, jobs, grad school, pets, family visits, volunteer work, friends…everything except rest and relaxation. This is unhealthy? Says who? Maybe this is a time of immense growth and development and change in your life. Maybe you’re young enough and energetic enough to do all of these things, and do all of them rightthissecondnow. Sounds good to me. You’ll have time for yoga and meditative silence in a year or two.

Having said all that, you may decide that your life is out of balance, but in a way you don’t want it to be. You want it to be out of balance in another way. That’s fine. But it can be very freeing to let go of the idea of “perfect” balance. And I’ll close with a little nugget on the word “perfect.” A friend of mine who studied Latin told me that the English “perfect” comes from the Latin per fecare, which does not mean to “do something flawlessly.” It means to do something thoroughly.

In your out-of-balance, crazytown life, are you doing what you love, and doing it thoroughly? If so, good on ya.

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You can take the MBTI assessment online by yourself and come in for a 1.5-hour session with me to interpret it, or you could come in as a couple for a 2-hour session. (For couples, both of you would take the online assessment separately.) I’m also available to work with larger groups such as your work team. The online assessment will generate a detailed report personalized for you, based on your answers to 144 short questions about your personality preferences.

MBTI focuses on two basic human activities: the way we take in information (and the kind of information we tend to trust), and the way we make decisions. The first activity—taking in information—is about whether 1) you prefer to pay attention to the many here-and-now details and facts that you get from your five senses, or 2) whether you like to see broad patterns and tend to trust your ideas and hunches.

The second activity—the way we make decisions—is about whether 1) you prefer to make decisions using logic and a critical, principled method; or 2) you prefer to make decisions by listening to your values and your concerns about the impact of the decision on the people involved.

MBTI also helps you decide whether you put most of your energy out into the external world (extraversion) or whether you prefer to direct most of your energy inward, cultivating a rich inner life (introversion). Finally, MBTI helps you decide whether your attitude toward the external world is marked by a desire to be organized with lots of closure and certainty or a desire to be open-ended with lots of room for discussion and uncertainty.

All of this is intended to be useful in practical ways. You can use MBTI to understand how you behave in conflict, how you communicate with others, how you manage change, how your preferences affect your marriage/partnership, and more.

Again, you can take the assessment by yourself and come in for a 1.5-hour session with me to interpret it, or you could come in as a couple for a 2-hour session. I’m also available to work with larger groups such as your work team. Think about it, and stay tuned for more information about this useful tool.

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