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Humans of MHT: An Interview with Maria Elena Marquez

Humans of MHT: An Interview with Maria Elena Marquez

Lauren Ziel: Hi Maria Elena! I am really excited to talk with you today about humanness. I think this is the second to last interview we’re doing with all of our clinicians. And the first question we lead off with in this series is: What does humanness mean to you?

Maria Elena Marquez: Great question. What does humanness mean to me...it's where I feel most grounded, the most connected…to myself. And in this case it means with food and those around me. So, for me humanness is a sense of calmness in myself.

L: You mention food and your connection with food as this space of feeling grounded, feeling connected…it's so interesting because that’s such a primal thing. It's in Maslow’s Hierarchy of Needs – it’s the baseline, you know. And on one hand it's survival but it can also be a way to connect socially and a lot of the activities we have are based around food. I am wondering for you how food is the mechanism to which you find your humanness. So, why is it FOOD for you?

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ME: Food for me is a place in which I can be in my five senses. I can look at this dish, I can smell it, I can see the smile of the person bringing it to me; and just talking about the ingredients, it takes me to a place; it either takes me to my childhood or to a place in my adulthood maybe where I am going to a new restaurant and trying a new dish and we’re both discovering this new dish together. So, it’s a sense of being connected to my past or just in this present moment and both of us are just enjoying this, and talking about it; talking about the ingredients and if anything feels familiar or totally not familiar to you. So, that’s the connection part for me  - the connection with the other person that’s sitting with me or a group of friends and we’re really just connecting and enjoying this present moment with this food and it's doing something, and just connecting to your emotions and your warmth in your body or the coolness when you're eating something like sushi… so that’s a little bit about my process with food.

L: I can see you light up when you talk about it. Like even as you describe it you are completely going into the memory of.  I mean, it radiates off of you! I was also thinking as you were talking it also sounds like a mindful meditation practice - using all of your five senses, being in the moment, if there is someone with you connecting with them in that moment. It just sounds like a really real-world practical way you can be mindful and present. I hadn’t thought about it in the context of food but there a little ‘light bulb’ moment.

So food being an extension of a place of grounding for you, I can totally see how that applies perhaps on a personal level, how does it show up for you in your work as a therapist?

ME: As my work as a therapist, I feel it really helps me be in the moment. When I am with clients I try to calm myself down in the process of looking at all these processes the client is going through. So it reminds me to calm down and go piece by piece, ingredient by ingredient with a client. And also I use it outside of therapy for me - it's my self-care - in actually making an intention to go out with someone or maybe by myself and try new food just to get me in the state of acknowledging what’s in front of me instead of always being in my head and trying to process client work. It’s really a place for me to calm myself down and just enjoy my surroundings, the person serving me, this dish. I feel it helps me to be more grounded and just more mindful of what’s in front of me, whether it’s a client or maybe an amazing dish. 

L: This is a little off the sheet perhaps but I’m really curious what’s a recent meal you had that just blew your mind because it reminded you of something or that it was completely new and exciting? I should have eaten before this…

ME: Well, a dish that took me back, or a restaurant that took me back to my roots, which is Salvadorian and Columbian, was actually a Mexican restaurant here in Highland Park. I was with a colleague and we had plantains and black beans, a nice queso fresco; we had some fresh avocado. And just the way it was plated was so beautiful. To me it was very simple, it was very humble because that’s the type of food I would have in El Salvador so it took me back. It was really nice.

I was eating with this coworker and I was able to go back with her and tell her a little bit about myself and a little bit about my culture. Though I was in a Mexican restaurant, all these ingredients and all the spices and how it was plated was so home-based that it was just a great way to start my day.

[It’s] a place in which I can be in my five senses. I can look at this dish, I can smell it, I can see the smile of the person bringing it to me...it’s a sense of being connected to my past or just in this present moment.
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L: I mean, I was thinking about kind of an analogy - you're in a Mexican restaurant but then there are all these familiar flavors - its almost as if…I mean, sometimes I find myself in front of a client and I don’t share their cultural background, or I don’t have parallel experiences to them, but there is always this sort of ingredient or this flavor of “I see you. I understand”. Anyways, that was a little off the cuff but… its really lovely to hear how food is this one connecting thing; how you bring your culture in your work with clients, how it helps you stay grounded, how it keeps you full so that you are able to be that for the clients that you have. Its just really awesome. I would have never thought ‘food’ but I totally see it now.

ME: Yeah! And that’s why we should make a date and have a group dinner, and we can really enjoy and dive in and be mindful and just engage with a different place within ourselves.

L: Love it. I love it. Well it was lovely to interview you here and I am definitely going to go have food now . But thank you Maria Elena. I appreciate it.

ME: You're welcome. Thank you.


Maria Elena Marquez, MA, is a bilingual Spanish-English Associate Marriage and Family Therapist, IMF #103470, working under the supervision of Michelle Harwell, PsyD, LMFT.  As an art therapist, Maria is passionate about helping clients unravel complex cultural beliefs and family pressures through the use of expressive art.


Lauren Ziel, MSW is a Registered Associate Clinical Social Worker, ASW #76483, working under the supervision of Gabrielle Taylor, PhD. Through the use of movement and mindfulness, Lauren develops specialized treatment for anxiety, depression, eating disorders, challenges in life-stage transitions, relational difficulties, and identity/intrapersonal development.

A Place to Dwell: An Interview with Annie Choi, Owner of Found Coffee

A Place to Dwell: An Interview with Annie Choi, Owner of Found Coffee

Annie Choi, Founder and Owner of Found Coffee in Eagle Rock, Los Angeles. 

Annie Choi, Founder and Owner of Found Coffee in Eagle Rock, Los Angeles. 

Lauren: I’m with Annie Choi from Found Coffee here at Michelle Harwell Therapy....Well, Annie it’s so good to meet you.

Annie: So lovely to meet you, too

Lauren: So we’re talking a lot about the idea of home here at MHT and we’re wanting to know how you came to find a home at Found. So, to get started, maybe you can just tell me a little bit about what drew you to pursue 3rd Wave Coffee and eventually establishing Found?

Annie: Actually that’s a really great question because I was in the process of switching careers - I was working in entertainment and I was working post-production. And so for me, something that’s really important is storytelling. And so I thought “OK I’m going to tell stories in TV.” And when I was working in post-production, I was actually behind a screen for 12 hours a day with headphones, so it ended up being very isolating and lonely. And I’ve always wanted to open a coffee shop - going to coffee shops and coffee shop-hopping has been a hobby for me.  So, when I entered coffee, the first two weeks of being in coffee I felt like my lifelong friends.

I think it’s because just being in the service industry, too, people are welcoming and they know about customer service. And so for Found I wanted definitely to create a space where people were comfortable.  And I think also the church for a really long time has been a place where people have been able to find community.  And I think LA has changed and I go to church, but I feel like as I was working in coffee, I found a lot of regulars found community in the coffee shop. And so I wanted to create that kind of vibe and that kind of atmosphere at my own coffee shop.  And I think Eagle Rock is the perfect place for it because everyone here is so supportive of small businesses and I have SO many regulars. And I think the regulars are the heartbeat of my coffee shop, they allow me to pay my guys, they come every day, we know their kids, we know their dogs, so I think in that sense for Found I wanted home for a lot of people. And a cup of coffee is very comforting.  And I think that too creates a sense of home and a sense of familiarity. And so I was really excited to do that and it’s kind of evolved to be that for a lot of people, especially in this kind of community.

Lauren: Beautiful - how you’ve been able to transfer that desire for community into your passion for coffee. Can you tell me about the first cup of coffee you really enjoyed?  Where was it? Who was with you?

Annie: So, I didn’t actually start drinking real coffee for a while, until I was in college. I can’t tell you when I had my first cup of coffee but I can tell you my best cup of coffee.  When I was switching careers, during my gap year, I went to Costa Rica on my own and went to a coffee plantation and I had the best cup of coffee in my life. The beans were grown there. And I like to put sugar and milk in my coffee sometimes, and the sugar was grown there, they had a sugar plantation, it was crystalized there, too, the milk was milked from the cows on the farm...So it was just this natural, everything organic, wonderful cup of coffee that I had gotten from the source. And I realized how much work went into it and so that’s definitely - it was just - it was so incredible. 

Lauren: Yeah and I feel like that ties into community, too.  It’s not just an isolated cup of coffee.  There are people who harvested the beans, there’s folks who milked the cows...

Annie: The family who owned the farm...yeah they put a lot of hard work into it.

Lauren: In this day and age, and especially in Los Angeles, 3rd wave coffee shops have become a place for people to meet, artisan coffee is a common topic of conversation, it’s even a listed interest in many instagram bios…what is about coffee specifically that you feel draws people together in Los Angeles?

Annie: Well, I think 3rd wave coffee just started to explode in the last 5 years. Thankfully, there have been coffee shops for ages and ages, but I think specialty coffee, because there is such craft and care that goes into the product -   a lot of specialty coffee shops are independent, mom and pop shops - because of that I feel that a lot of people in LA, especially, know what is a good product.  They also want good product and quality.  In 3rd wave coffee there’s just so much effort that goes behind it.  I don’t know if anyone has explained to you what 3rd wave coffee is, but this is what I tell my guys whenever I interview them.  First wave is instant coffee, mass commodity delivered to your home, immediately available.  Second wave is the fast-food culture of coffee.  3rd wave is where you’re actually caring about the origin of the bean, everything is hand crafted by the cup. And so there’s a lot more care that goes behind it. And I think because of this artisanal food movement, there’s so much love that goes behind it, there’s a lot of passion.  People are drawn to that.  Because they know it’s been made with love. 

Also, I think with Found, especially, - I was instilled with this knowledge when I was working in my first coffee job - my old boss told me, “You can’t teach personality.” And I think customer service is a big part of my shop in the sense that all my staff, they’re very kind people.  They’re very warm.  Thankfully I have control over who I can staff.  I think people are drawn to that too.  With other shops, I hear this a lot, “I hate it when in 3rd wave coffee shops, the baristas are so snobby.” Whereas for me I don’t like to say that we’re “coffee snobs,” we’re “coffee enthusiasts.” With my guys I stress to them that they be friendly.  In the interview process I see if they have a good heart.  With the bigger chains, it’s harder to handpick people that are good-hearted because they have so much volume and they just need people to work.  Whereas for me, I’m definitely smaller and I get to choose. And I’ve told my guys too it’s really important for them to develop relationships with the regulars.  To know their first names, you always get their name. 

Lauren: It’s not just the product they’re getting, but there’s a human behind the coffee and what the human is showing is love behind the coffee. There’s passion.

Annie: It’s the connection.

Lauren: Beautiful. Well, when I was hearing you talk, I was thinking it sounds like coffee is sort of a means to an end - coffee is the means, and the the end being community, human connection or - home.

Annie: I like the way you put that, it’s actually right on the ball.

Lauren: We’ve been reading a psychoanalyst called Robert Stolorow, here at MHT and in his works, he writes about the importance of finding a relational home.  He shares about, and I’m liberally paraphrasing here, how mismatched or shattered pieces of our story need to discover a home within relationship - with friends, families, coworkers, communities.  How do you feel Found coffee represents a kind of home for mismatched pieces in that way?

Annie: Hm. Well, maybe not mismatched pieces, but the vast array and types of people that you meet in a coffee shop are so different. I think being a coffee shop owner, I get to meet these people, and their stories all add to mine. I love hearing people’s stories and where they’re from and I think behind it all is that everyone struggles, everyone struggles well, everyone has joys, too.  And so I tell this to my staff, “if you have a rude customer, give them the benefit of the doubt in the beginning.  You don’t know their story, you don’t know if they’re having a bad day.” 

The type of people, the network of people I meet, they are the mismatched pieces, and the connection between them all is that they are human.  I am so thankful because I get to meet so many different types of people. Something I like to do, on a personal note, is to connect people to each other. So, for instance, we had a guy who was a recruiter at an entertainment studio and I know that my friend has been wanting to animate forever and so I connected the two.  And I asked, “Can I do an intro?” And they both were like, “Yeah!” 

And then also on the other hand, too, I think coffee shops are a really special place where people who are on the shyer side, I get to bring them out.  We have a little bar area and it’s three seats, it’s very close to the barista making the drinks. When I first opened, a girl, I could tell was into coffee, but she didn’t want to talk.  And as she came every other day for weeks I got to know her, I slowly got her to talk, and then I realized she wanted to intern at Found.  So I interviewed her and she is one of my best now.  I told her on the first day, “You need to learn how to need to talk! It’s ok to talk.”  And she said, “I know, I know. I’m a little shy.“ And I said, “That’s ok. We’ll find a way for your passion to come through, too.”

Lauren: There are people who have their own unique stories as customers. They feel care in the product, or they feel the care in customer service, they’re understood, there’s a patience there.  We’re all human.

When I think about coffee itself, it draws to mind aspects similar to community - it is warm, comforting; it perks you up when you’re having trouble getting through your day; it is rich and flavorful - even to the last drop.  What do you consider on a daily basis (from coffee composition to design of your space to interactions with people) that helps Found Coffee consistently feel like home for your customers?

Annie: When people ask me why I call Found Coffee "Found," I have two main reasons, and then a third one.  First one is that a lot of things in my shop are Found.  They are vintage, upcycled.  They have been loved, and they will be loved again.  Secondly, I want community to be found, it’sa very big thing for me.  In the beginning I had one communal table, now I have two.  I’m really eager for people to meet each other and not to be a Laptop City.  I love introducing regulars to each other, because then they know the person in their own neighborhood. It’s really great! The third reason why I called Found Coffee “Found” was because I really found who I was in the last 5-6 years, and one of those parts is I found myself in coffee.  And I think with all these elements, the communal tables especially, that’s a big part in just providing a space and a place where people are able to find each other in community.  It allows for people who haven’t seen each other in a long time to meet.  And I think also with the design of the shop, it’s not 30 single tables.  I also like to keep it very bright.  You see some coffee shops, they’re darker, they’re a little more somber.  For me, even the espresso machine is yellow!  I think the reason is, you know a lot of Subway restaurants are painted yellow, the walls yellow because it invites people.  For me, I took that into consideration for the machine, the main workhorse of my shop, so people feel welcomed, feel invited.  And then yeah, it’s just a place where I hope people feel comforted in that everything is close, you don’t feel like you’re stepping on each others’ toes, but also, you have people are nearby. 

Lauren: There’s so much there.  There’s a sense of closeness with the people you are with, there’s also space to be who you are, and there’s also space to connect. There’s intentional space to connect, where you turn to your right and there’s a person that you can connect with.

Annie: Also a big thing for me is displaying local artists on my walls, allowing creativity from the community to be displayed.  They’re all local artists I’m really proud to say that.  For instance right now is a family.  The father took black and white photos, their 3 year-old girl drew on them and the mother is a weaver and she wove those pieces.  Even in the artwork, I hope to convey family. You know?

Lauren: That’s a huge part of home, it feels like family. There’s elements of that.

Annie: And I think also, our regulars see the same baristas every day.  And so, that is actually intentional, too.  So they don’t feel, for instance, out of place.  I’ve been very fortunate my current staff has been with me for a while.  They’ve actually maintained regular relationships with the locals so that’s really exciting to me, they ask how they are, I think some have friended each other on Facebook.

Lauren: There’s so much thought that went into designing this. You get an amazing product and a sense of connection in a city you so often get lost in. 

Annie: I think something God has gifted me in as an entrepreneur is I am able to create spaces that gather people.  And so I love, I used to hate when my worlds collided, but now I’m just like OK fine you guys have gotta meet each other, so I love that Found is a place where people can just come together.  Something else, is I used to be an event coordinator, and so because of that experience, too, I know what draws people in.  I don’t want my space to feel so cluttered where people feel uncomfortable but where it feels airy, it feels light.  It’s not too over-designed.  Keep it simple so people can do their thing.

Lauren: They can be themselves.  I’m even thinking about the brightly lit space at Found, you can actually see one another, you can actually be curious about the people around you.

Annie: Right, something that I really value is transparency, the reason why my bar is open is you get to see how your coffee is being made from the bar so if people have questions, I’m not gonna look down on you. I don’t know everything, but if you want to learn about coffee and how it’s made and what temperatures it’s at, etc, etc, we’re totally open to tell you, and also to talk about it with you.  So I think people see that, too.  They see that, “Oh, they’re not going to look down on me because I don’t know a lot about coffee.” So specialty coffee -  because it’s a bit more particular, a bit more crafted - it can seem daunting to people.  But I tell my guys, “Be open to it.  Talk to people - they want to learn.” You can tell when people are really eager to talk to baristas and we just engage them in conversation.  So it’s just about being transparent about what you do know and what you don’t know. 

Lauren: If someone is curious you’re responsive to them.  Well it’s been such a pleasure hearing more about your story.  Is there anything else you’d like to add about Found Coffee?

Annie: Yes, something that is really important to me is I don’t want Found to be a place where people feel awkward and excluded.  I am actually quite sensitive to that.  I want to be inclusive.  That’s a big part of community.  And I think community is not defined as a people who are all uniform, and the same.  I think coffee is really lovely because most people love coffee, and we have something to offer most everyone, even with tea, we have tea too.  I feel like it’s a simple meeting ground where people can engage and have a similar interest with people that are different from them.  Community is basically broken people or people who have different stories coming together.  That’s my community at Found and I am super thankful.  

Annie Choi is the founder and owner of Found Coffee in Eagle Rock, Los Angeles. She is also the co-founder of FrankieLucy Bakeshop, a collaborative coffee and pastry shop that will soon open in Silver Lake, Los Angeles.


Lauren Masopust, MS, MFT Intern has extensive experience working with young adults, adolescents, and couples, and specializes in areas of trauma, identity development, and multicultural issues.

Clinical Candor: An Interview with Dr. Karen Maroda

Clinical Candor: An Interview with Dr. Karen Maroda

M: I'm at the tail end of my analytic training and I’ve become fascinated by how my mind has shifted in the process of training. How in love I am with this process, this way of thinking but how inaccessible it feels to the masses. I don't think it has to be. My idea with my newsletter and blogs, similar to analysis, is how can we think more complexly about simple ideas and think more simply about complex ideas. Karen, I think you excel at this. You have a great ability to speak about ideas in a really clear and approachable way. Before we jump into the idea of candor, can you give us an idea of how you got interested in psychoanalysis.

K: My mother, who we did not have a college education, was naturally psychologically minded. She would observe our emotions and if it wasn't clear to her what I was feeling or why, she would inquire. She would say, “Well, Karen you seem a little down or you're not as lively coming home after school. Did something happen?” She always knew of course. She was very intuitive. She was just asking, “did I want to talk about it?” So, in a sense, my mother was psychoanalyzing me from the time I was young and inducting me into the whole notion that you don't just accept what someone says at face value, that you should trust your feelings. I think that my mother introduced me to the whole notion of trusting my emotional intuition and that asking someone about what they were feeling was an expression of love.

K: It’s been life pursuit, a way of being. I was speaking in Indianapolis a few months ago and I was pleased to hear a candidate talk about psychoanalysis not simply as a profession, it’s a calling. It’s a life.

Dr. Karen Maroda

Dr. Karen Maroda

M: Yes! I had this experience when I was developing as a young clinician where I would get around analysts and I couldn't always keep up with the terminology used but their minds were so alive to me. They had this spontaneous quality. It reminds me how you shared the origins of the word candor is candid which evokes a sense of freedom and spontaneity. There was a flexibility and freedom to explore, play and reflect that was more than the sum of its parts. And I could just feel the difference between their mind and my own. It's a way of thinking and being that that evolves overtime...

In your paper on counter-transference, you talk about how clinicians, by our nature we are often empaths. We feel, we care, we listen but we are not very good at being direct or honest both clinically and in our lives.  How do prepare your client for the role of honesty in therapy?

K: Well, most people don't really understand what an analytically-oriented treatment looks like. I tell them the three basic rules are: they have to show up, they have to be as open as they reasonably can be given that no one is completely open, and they have to pay. (laughs)

M: (laughs) Good basics.

K: Then I usually explain about transference. That any of their feelings toward me are not out of bounds. Anything that comes up and particularly anything that's repetitive that they're feeling either positively or negatively toward me is important for them to express.

M: This idea of having candor, of being direct, the fear is, in speaking up, you might shut the client down. How do you negotiate this: keeping lines of communication open given that generally the analyst is in a position of some kind of power?

K: The idea is there’s candor and then there’s candor.  You know what I mean?  You don't just blurt out anything that you may be thinking which is like, “Boy, was that a stupid thing to do.”

M: Right, right.

K: So I take a moment to gather my thoughts and think about how it fits in the context of the person. I seek to complete the analytic task to gain perspective on their behavior historically and currently. But you know if somebody did something really stupid then I am more likely to say, “Well, it seems to me that this behavior had a pretty bad outcome for you. You know, probably not one of your finest moments.” (laughs)

M: (laughs)

K:  I use humor a lot. It cuts the tension. I'm agreeing that they screwed up without saying you're screwed.

M: I'm thinking about this on two levels: what are you trying to create within your client through the use of candor; what are you hoping that they bring into their lives through this process? The other part I'd love to hear more about is, the fact that our patients don't just want empathy, or I should say, sympathy, they also crave sincerity. There's relief when we can speak directly to all parts of the self, even negative ones.

Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you’re talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it.

K: Absolutely. I think people want feedback. Particularly, as I wrote in “The Power of Countertransference” if they are seeking it, then I don’t understand why you would not be responsive to a direct request for feedback. I think where we get into the delicate issue is when you're not sure, or when the patient is provoking possible feedback but not asking for it directly. Then you have to explore it and make a decision which may or may not include asking them if they want feedback. I think it's a no brainer when the patient is literally saying I want to know what you are really thinking or feeling about me?

M: Yeah, yeah.

K: For example: most of my clients become much more successful as a result of their treatment and they want to know am I going to resent them? Especially if their parents were very competitive with them. If they are too successful will I try to destroy them, take it away?

M: So what do you think benefits your clients in being able to ask you those questions in terms of their growth and development?

K: I think it gives them a tremendous confidence in their own intuition because I think one of the greatest contributions of neuroscience and the whole notion of unconscious to unconscious communication, is that clients already know what we are feeling. We already know what they’re feeling. I think the art is to determine, ultimately, what's most beneficial to actually discuss to get to the bottom of what’s going on. What's important to the work and what isn't. Will some of our ideas, notions shut down the patient experience, I think inevitably yes! That's the nature of relationships, whether it's analyst and patient or mother and child or spouse. There are ways you just cannot relate to someone else or you can't promote it.

M: A client having to contend with the real you rather than just feeling it.

K:  You know, I successfully treated someone with severe borderline personality disorder. That was where I first experimented with expressing rage. She thought everything was somebody else's fault. She would talk about her husband and blame the poor guy for everything. He was responsible for every feeling she ever had. She wanted me to endorse that. That he wasn’t sufficiently empathic but he was!  He martyred himself for her, whatever it took. She really needed somebody to stand up to her.

M: You made a comment about our culture not leaving room for negative emotions. I see this an an epidemic in parenting. We've got the hover parent generation where parents can't give feedback to their children or they have to sandwich it with so much goodness. To me, it's about emotional clarity, right? Sometimes it's not about positive or negative. It's about being clear with emotions and our intentions.

K: Yes. Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you're talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it. Neuroscience shows us that negative emotions are rarely outside of our conscious awareness. (They are felt and known even if not explicitly acknowledged). So we need to talk about it….

M:. You alluded to something earlier that I’ve been processing for a while, personally. I have a tendency at to be effusive with my language, you spoke to how we can say something positively in a way that is not too overstimulating.  Candor is about being clear in feedback. I have an awareness  of my tendency to slant towards hope and it has impact. Not always negative but I have to watch it. The truth is I have these little awareness all the time in session and I think ‘bookmark’ I need to go back to that. But how often do we, have the internal candor to take a deeper look?

K: Bookmark is a great word. That’s the beauty of the whole analytic approach. You bookmark it and you're curious about it. You don’t just blurt it out to the patient. You bookmark it and think about it. You wait to see, is this more about me or more about the patient. Because transference is repetitive, it will always come up again, and you don't have to figure it out in the moment.

M: So, what I hear is with candor, there's a certain amount of measure. Working towards an internal space that is curious. Curiosity to pay attention to the tiniest movements inside, an internal honesty that translates to a clinical (relational) honesty. 

So with enactments, there can be a dishonesty there. I mean, of course, we fall into things but I think you're putting more onus on the clinician to pay attention. 

K: Absolutely, and I think that if you look at the literature most of the enactments are not positive, they’re negative. But if you have transcript of sessions you would see there are just as many positive enactments as negative going on, but we don't yet care about those. Because those generally are not disturbing the universe of the relationship. (laughs)  I will notice with a patient that I really like or admire we do this little mutual admiration thing, you know? It is a sense a form of acting out. A little flirtation, something.

M: This is where the awareness comes in. How much of that is unconscious to the analyst?. There's a part of you that's just feeling good and maybe another part has the passing thought..I wonder if this is something?

Be thoughtful, of course, but be courageous. If you have any anxiety when you’re practicing, that’s good...Take risks. If you’re never afraid and you’re just offering soothing, comforting things you’re probably not giving the person everything that person really needs.

K: Right, it depends. If it’s happening too often (repeating) then it's like OK, well, wait a minute.  The enactments that we talk about in literature are mostly negative ones. I have yet to talk to a therapist where they were not aware of some negative feelings before the enactment. An enactment comes typically after an impasse that’s lasted a minimum of days if not a weeks or months. The impasse is broken by an enactment or treatment is destroyed by the enactment. I think that since I started using self disclosure regularly I have almost no enactments. I currently have one patient I have regular enactments with on a regular basis because she cannot accept negative emotions mine or hers. She simply won't allow for an emotionally honest exchange. You cannot eliminate enactments with everyone.

I think if you are sitting harboring negative feelings and thinking about them, no treatment is taking place. That’s why my new line I'm going to be using a lot in my next book is, “what is the analyst’s fiduciary responsibility to the patient? (laughs) What is clinically beneficial and to what extent are we stealing their money? When we sit white knuckled and think ‘this guy is a pain in the ass.”

M: Well, it’s another aspect of coasting in the counter-transference right?

K: Yes, like what you were saying about parents being overly effusive or overly positive. Therapists do this too. They try to be super positive or uplifting and affirming. Of course we want to do that to a point but that's not really what most people come to treatment for. Most people who have a lot of positive attributes and good relation skills get reinforcement in the world. They come to us to help them work through the obstacles and the negative behaviors that they can't work out anywhere else and the pain.

K: Right. I was thinking about submitting a presentation to Division 39, “Did Winnicott kill psychoanalysis?”

M: (laughs) Oh no!

K: Of course I’m tongue and cheek but we are so enamored with good enough mother which is about always being positive,  always being the cheerleader. I think most therapists are so masochistic and they allow patients in small and large ways to be abusive towards them...

M: Yeah I thought that that is what is revolutionary about your paper. In the first paragraph you talk about why as therapists we're drawn to this profession to help but simultaneously you are calling out our own masochism.  The way we feed off our ability to hold pain in the service of someone, to contain, soften…

K: To be saint like.  We're so overly invested in ourselves being the perfect mother to all of our patients. As if  the perfect mother is somebody who would just lie down, puts up with everything. It’s not.

M: Well, thank you for jumping in with me to explore the concept of candor and your clinical practice. Your mind is so alive. It’s been a pleasure.

K: You know, I end my most of my lectures with this:  Be thoughtful, of course, but be courageous. If you have any anxiety when you're practicing, that’s good.

M: Ah! I love that.

K: Take risks. If you're never afraid and you're just offering soothing, comforting things you're probably not giving the person everything that person really needs.

 

Karen Maroda, PhD is a clinical psychologist in private practice in Milwaukee, Wisconsin and a board certified in psychoanalyst by the American Board of Professional Psychology. In 2012, she was elected Fellow status by the American Psychological Association for her contributions to psychology on a national level. She is also a Fellow of the American Academy of Psychoanalysis. She has been in private practice for over 30 years and lectures nationally and internationally. She is the author of three books, several book chapters, and numerous journal articles and book reviews. She is passionate about the change process and has made it her life’s work to innovate psychodynamic techniques, making the process more interactive and collaborative. 


Michelle Harwell, MS, LMFT is an expert trainer, respected speaker, and licensed therapist in trauma and attachment. She is noted for her specialization in areas of development, attachment, trauma, and neuroscience, and her ability to communicate complex topics with clarity and humor. Michelle is currently completing her PhD in Psychoanalysis from The Institute of Contemporary Psychoanalysis. She received her BA in English Literature from University of Oklahoma, MA in Theology from Fuller Theological Seminary, and MS in Marriage and Family Therapy from the Fuller Graduate School of Psychology.