We humans are very very good at pushing down feelings we don’t want to feel. Painful feelings.

I know a bunch of people who’ll tell you that therapy is the best thing that ever happened to them. Not the people you might see going on and on about their therapists at cocktail parties though. Other people.

Say you have a problem you’d characterize as addiction. Cigarettes. Vodka. Whatever. Or maybe your behaviors aren’t bothering you but your moods are. Hopelessness. Simmering rage. Feeling alone in a crowd. Feeling like you’ll never find someone because of the way you are. Maybe you come home from work and cry every night and you have no idea why. Maybe you can’t sleep. Or stop exercising. Or whatever. I’m going to try to explain to you briefly my understanding of all these things as some of the many different faces of depression and anxiety.

I say again. We humans are very very good at pushing down feelings we don’t want to feel. Painful feelings. Hazy memories of a father who couldn’t make eye contact with you, a mother who couldn’t let go. The way it feels to look in the mirror and hate the way you look. Wondering what boyfriend is really thinking about his ex. And much worse stuff than that, sure. Painful feelings in all their infinite variety.And we push them down in an infinite variety of ways. Behaviors like addiction and rage, the way we think, act, walk, talk, the way we hold our bodies clenched, the things we believe and over and above all of these, our moods. Depression. Anxiety. That’s what they all come down to with very few exceptions. Depression and anxiety.

We call the pushing down of feelings depression. And just like it’s impossible to spot-reduce, to lose weight from just your thighs, it’s impossible to push down only the feelings that hurt. So depression often looks like a flattening of the personality across the board.It doesn’t have to though. It can manifest in all kinds of ways.

And anxiety? Anxiety is depression’s obverse. You can’t have one without the other. Anxiety is the way it feels when we’re not sure (all of this is quite unconscious, remember) we can keep the pain pushed down. When we’re afraid the dam is going to burst. That right there, that’ll keep you up at night smoking cigarettes.

How do we treat depression and anxiety? We help people get better at feeling the things they’ve spent their lives trying not to feel. As the patient relaxes and learns to trust the therapist, buried feelings surface, symptoms abate, and it feels like a great weight is being lifted very gradually from his shoulders. Or hers. And that’s how I describe psychodynamic psychotherapy, (as distinguished from cognitive behavioral therapy. I think about seventy percent of therapists identify themselves as cognitive-behavioral, which in its strict interpretation deals with nothing that occurred before today. That’s not me.)

Does this sound too simple? I tell people my job description is helping people feel things that have been too painful for them to feel on their own. I don’t seem to need to make it any more complicated than that.

A little about myself: I did photography for advertising in New York. I was a California Nurse Midwife before I became a psychotherapist. I’m still licensed for old times’ sake I guess but I no longer practice. I was a mildly successful whistleblower versus an HMO. I’ve let my SAG and AFTRA memberships lapse (I was a detective on a soap once.) I’ve never written a self-help book but I have written a quasi-Little Golden Book about a thirty-week abortion that didn’t happen called Robbie the Rabbit Learns About Denial and Ambiguity Tolerance. I wrote it during my transition from OB-GYN to psychotherapy. If any of this is resonating with you give me a call. I’d like to hear from you.

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