media misunderstanding

November 18th, 2017

The media is doing their best to keep up with the sexual abuse/sexual offending allegations that are rampant in recent times, but there is one thing they haven’t quite gotten yet. Sexual addiction isn’t sexual offending. The allegations usually involve one person “the perpetrator” violating the sexual boundaries of the victim. And yes–the victim is being victimized because they are being intruded upon sexually in ways that they did not ask for. Although a sex addict can participate in sexually-offending behaviors, and a sex offender can have sexually-compulsive tendencies, they are not to be confused.

When it was reported that Harvey Weinstein had a long history of sexual offenses, apparently, this was common knowledge in the industry. But, unfortunately, it was reported that he was going to treatment for sex addiction which may be part of the story but only a small part of it. Only the evaluating clinician can tease out the issues with the client, but it’s important for the media to report these offenses accurately and not throw them automatically into the sex addiction category.

Yes–it’s confusing even for mental health professionals, but it’s an opportunity to understand these differences and treat the wounded individual accordingly.


September 25th, 2017

Socrates said, “All I know is I know nothing.” I love this statement of humility because it’s so true. As much as we know, we really don’t know. As a seasoned therapist, sometimes I forget this simple truth. I believe that many of the answers are inside of my clients–not somewhere on the outside. And many of these so-called answers are only partial. We need others in our life to get reality checks. We need humility to remind ourselves that it’s ok not to have all the answers.

Last weekend I was a member of a training group with a very talented group therapist from Austin named Katie Griffin. I’ve actually known Katie for many years but not until she came to Los Angeles to facilitate our group therapy conference did I really see her in action. In the training group I became very aware of my own primitive needs for deeper understanding and to be seen for who I truly am. It was a challenging weekend in many respects but also quite satisfying in spite of my so-called needs only getting partially fulfilled. Because we will be meeting every 4 months, I’ll have other opportunities to process these relationships, and it left me longing for more.

As I sat in the group for nine hours over the course of the weekend, it was a terrific reminder of the group experience my group members have each week with one another. Uncomfortable at times and warm and fuzzy at times. But always a chance to learn about oneself and help others learn about themselves. Humility above all.

asking for help

September 8th, 2017

As a recovering perfectionist, I used to think that mistakes were lethal. When I was in 2nd grade, I had an egg carton project that I didn’t understand. Instead of trying to understand the instructions better from my teacher, I suffered in silence. You see, I was too perfect to ask for instructions, directions or anything that might leave me feeling foolish. So I stewed and I stewed and I stewed some more until the pressure cooker broke open into uncontrollable crying.

Why do I remember this seemingly innocent and imperfect moment? Because it was traumatic to me–something I wanted to control but couldn’t because i was a seven year old who wasn’t supposed to know everything about life and certainly not about egg carton projects. If I recall correctly, my grandmother came to my aid and helped me understand that this was a relatively simple problem leaving me with the task to go back to my teacher for further clarification.

So what does this have to do with recovery? Well, perfectionism leads to shame and shame leads to withdrawal and withdrawal leads to acting out. Acting out in some form or another to escape and numb out the feelings of shame and profound loneliness. When I was 7, I didn’t know how to ask for help–I had the idea that I was supposed to be self-sufficient. Nowadays, I still carry the distorted belief that I am supposed to pull up my bootstraps and solve all of my problems on my own, but the ongoing challenge is to practice humility and depend on the dependable people around me.

I’ve been fortunate enough to have emotionally-reliable people in my life, and these are the folks to lean on. Not the myth that it’s all up to me and certainly not trying to find someone unavailable to rescue me. But to know who “my people” really are and to cultivate and cherish those solid relationships around me.

The Joy of Sexual Recovery (Part I)

August 27th, 2017

THE JOY OF SEXual Recovery (re-issued from 2010)

Long-term sexual recovery is quite different than early recovery. At the beginning stages recovery focuses on stopping self-destructive, out-of-control behaviors while long-term recovery welcomes new, life-affirming experiences. Early recovery requires the acknowledgment and recognition of a dangerous problem while long-term recovery can be a time of expansion and resourcefulness. Early recovery sifts through the wreckage of the past while long-term recovery makes room for the exploration of the limitless possibilities for the future.

Although it’s crucial to learn how to stay away from depleting and sometimes self-destructive behaviors of the past, there seems to be a lack of information, support and research for those who have been sexually sober for many years. This two-part article takes a look at this growing population through the lens of coaching, Somatic Experiencing and 12step wisdom—a journey of those who have crossed the threshold beyond early recovery and entered into this uncharted territory.

In recent years there has been a paradigm shift in the healing professions from focusing on what’s going wrong toward what’s going right. Mental health professionals no longer limit their research and clinical work to psychopathology or deficits—positive psychologists led by Martin Seligman, PhD at the University of Pennsylvania now study What Makes Life Worth Living. Time magazine even coined this brand-new field of study The Science of Happiness.

I believe that it’s essential for those in long-term sexual recovery to take a closer look at what’s going right. Because the tone of the 12step rooms in sexual recovery (i.e. SAA, SLAA, SCA, SA, SRA) often follows the disease model of addiction, there becomes a focus on the so-called illness and what’s wrong. Sexual recovery fellowships have smaller participants than more-established groups like AA resulting in less old-timers in the rooms. As a result, sharing often focuses on the trials and tribulations of stopping behaviors rather than building more capacity for healthier patterns of sex and intimacy. Taking the lead from positive psychology, I’m curious what would happen if more shares focused on joy, gratitude, self-compassion and forgiveness.

Another fundamental difference exists between process addictions (i.e. sex, food and money) and chemical addictions because sex, food and money remain an ongoing part of one’s life. Long-term sexual recovery focuses on integrating sex and intimacy as a healthy element, and integration requires a self-exploration of what this means to the individual. The vision that I hold for myself, my clients and my sponsees focuses on living life to its fullest by creating greater capacity for all that life brings our way without a collapse back into old patterns of acting out.

Webster defines joy as the emotion evoked by well-being, success, or good fortune or by the prospect of possessing what one desires. This implies that someone knows what one desires, and here lies the initial challenge. The longer someone is in recovery, the clearer they usually become in knowing what they want and desire. Priorities have usually shifted away from the superficial and toward deeper pursuits of meaningful connection. I’d like to invite you to take a moment to reflect on the following: What brings you joy in your life today?

As part of the 12 steps, there are several types of inventories focusing on different parts of you—resentments, character defects, fears, etc. One exercise you may consider for yourself and/or your clients is to complete a joy inventory. Beginning with your earliest joyful memory, list as many experiences that you can remember. You might divide your life into a few separate time periods— childhood, adolescence, young adulthood or whatever works best for you. In addition to listing the specific experiences, you might add what made each experience especially joyful for you.

In his book Overcoming Addictions, Deepak Chopra posits that the absence of joy is the cause and the effect of addiction. A client recently illustrated this theory because he had a lot of difficulty identifying joy in his life before his addiction which took hold when he was 19. During his addiction it seemed like fun, but in retrospect it’s become clear that authentic joy was foreign to him.

In Part Two of this article we’ll explore what I call joy-builders—ways to invite more joy into your life and recovery.

the big sick

July 13th, 2017

I rarely post movie reviews, but this one was a stand-out for me like no other recent film I’ve seen. The Big Sick is an autobiographical piece that explores what happens when a lost love comes down with a mysterious illness and a culture clash begins. Because the lead character was raised in the USA but comes from an Indian family, he is “supposed to” marry an Indian woman. He is being fixed up by his mother with many, many prospects all of whom he rejects because his heart is already taken by a Caucasian woman who is very, very sick. In the hospital he gets to know her parents quite well–much better than he ever anticipated–and a mutual respect grows among them.

This is one of those films that brings tears and laughter-sometimes at the same time– and manages to strike up a balance of authentic family dynamics, racism, illness as well as the love that is pervasive throughout. Run, don’t walk to see this very clever, well-written, true-to-life story.

Intergenerational Trauma and Love

June 9th, 2017

Decoding the Tablecloth: Next Weekend–A Must-See!

Recently, I had the opportunity in New York to see this incredibly powerful play which integrates themes of immigration, abandonment, separation, family and love. Not only was it a beautifully-acted piece, but it portrayed a version of my own family’s immigration in the early 1900s. As a result, I see my grandparents and my family’s immigration through new eyes. I was deeply moved by Gabriela Kohen’s performance and hope you’ll join me in June as part of this worthwhile fundraiser.

Here are more specific details: Critically acclaimed New York actress, playwright, and drama therapist, Gabriela Kohen, will perform her autobiographical one-woman show Decoding the Tablecloth at Congregation Kol Ami in Hollywood at 7.30, Saturday, June 17. She will also perform on Sunday, June 18 in Venice at Beyond Baroque at 3 pm. There will be a wine and cheese reception after each performance.

In English, Yiddish, and Spanish, Ms. Kohen portrays over 20 characters from five generations. Her Jewish/Polish grandmother escapes from the holocaust to Argentina and the family later immigrates to Brooklyn. Intensely moving, and at times humorous, her narrative provides insight into the transmission of trauma, resilience and wisdom from one generation to the next.

Gabriela Kohen, MFA, received her acting degree from the American Conservatory Theater. She is a drama therapist at Sanctuary for Families and Restore NYC in New York City, a faculty member of the Therapeutic Arts Alliance of Manhattan, and an advanced candidate at the Center for Modern Psychoanalytic Studies.
Advance admission is $100. Student admission is $80. Admission is a tax-deductible donation to the Group Foundation for Advancing Mental Health. Advance payment must be made by contacting the Group Foundation at 1-877-668-2472. Proceeds will go to the Group Foundation for Advancing Mental Health and to the local Group Psychotherapy Association of Los Angeles to fund scholarships and provide group therapy services in emergency situations.

the bittersweetness of mother’s day

May 13th, 2017

Not all people look forward to Mother’s Day. In spite of the Hallmark hype of the holiday, everything doesn’t always come up roses. For example, I had a mom who did her best with four sons and a marriage that wasn’t always a loving one. My mom had a big heart but didn’t always know how to show it to others. I don’t believe she intended to be self-absorbed and walled-off, but unfortunately, this was her way of being in the world–not just with me, but with all people in her life.

As a kid, I always tried my best to do something special for Mother’s Day, and I believe, on some level, it was appreciated. But as I grew older, I felt more resentful and less inclined to go out of my way to find the right gift or the card that accurately expressed how I felt toward my complicated mom.

Six years ago my mom died of lung cancer after having been a lifetime smoker. In the final months when she was on hospice, we found a way to connect just a little bit more to one another. I believe it was a mutual desire to get a little closer before it was time for her to take her final breaths.

Nowadays I hold the memory of my mother with bittersweetness–the occasional, intimate moments that were few and far-between, but I remain grateful for them. And more than anything, I know that my mom will always be a part of me–I wouldn’t be who I am today if it wasn’t for her influence. The good, the bad and the ugly.

Tomorrow is really just another day of the year, but for those of you who have a complicated relationship with this particular day, keep in mind that it’s ok to have mixed feelings about it, and Monday is just around the corner.

intern search

April 14th, 2017

April is upon us and the rains in Southern California have finally come to an end-much needed storms but quite relentless this year. As spring unfolds around us, I wanted to let you know that I’m starting my search for an MFT intern or MSW associate in my practice. I’ve been training associates for many years, and I always feel so fortunate that I get to give back what was once given to me. And my associates truly keep me on my toes as I also get to learn from them.

In the early 90s, I was invited into a group practice called West Coast Counseling Center, and two very talented therapists took me under their wing and helped me take flight. I’m so grateful for their wisdom, patience and love.

Here is a brief description of the intern position available in my practice, and please spread the word if you come across anyone who might be a good fit:

Private Practice Internship: Part-time, post-graduate position available for MSW associate or MFT intern with fewer than 1500 hours. Addictions experience required. Group and somatic therapy experience preferred. Saturday hours required. Email CV to Andrew Susskind, LCSW

Thanks in advance for keeping me in mind, and please let me know if you have any questions.

neuroscience of traumatic memory

March 28th, 2017

The Neuroscience of Traumatic Memory
with Bessel van der Kolk, MD
and Ruth Buczynski, PhD

Sometimes people can remember what seem like the smallest, most insignificant details of their lives – their 8th grade locker combination, a story they heard at a party years ago, or all the lines from their favorite movie.

These memories – full of facts, words, and events – are explicit memories.
But there are different kinds of memories – ones that are evoked by sights, sounds, or even smells.
For example, the smell of coffee percolating atop a gas stove could bring back Sunday afternoons around the table with beloved grandparents, aunts, uncles, and cousins.
On the other hand, being surprised by the scent of a particular aftershave, for instance, could elicit feelings of fear, panic, or even terror.

A person who was traumatized as a child might re-experience the all-too-familiar sensations of quivering in fear or breaking out in a cold sweat.
And it may have very little to do with the verbal thought process of, “Oh, this reminds me of the incident of my father hitting me.”

Traumatic memory is formed and stored very differently than everyday memory.
So let’s take a closer look at what happens when a person experiences trauma.

How Traumatic Memory Is Different from Everyday Memory
Dr. Van der Kolk: If a person was abused as a child, the brain can become wired to believe, “I’m a person to whom terrible things happen, and I better be on the alert for who’s going to hurt me now.”
Those are conscious thoughts that become stored in a very elementary part of the brain.
But what happens to adults when they become traumatized by something terrible they’ve experienced?
Simply put, the brain becomes overwhelmed. That’s because the thalamus shuts down and the entire picture of what happened can’t be stored in their brain.

“Instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.”
So instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.
And certain sensations just become triggers of the past.
You see, the brain continually forms maps of the world – maps of what is safe and what is dangerous.
“The brain continually forms maps of the world – maps of what is safe and what is dangerous.”
That’s how the brain becomes wired. People carry an internal map of who they are in relationship to the world. That becomes their memory system, but it’s not a known memory system like that of verbal memories.

It’s an implicit memory system.
What that means is that a particular traumatic incident may not be remembered as a story of something that’s happened a long time ago. Instead, it gets triggered by sensations that people are experiencing in the present that can activate their emotional states.
It’s a much more elementary, organic level of a single sensation triggering the state of fear.
A person might keep thinking about the sensation and say, “Oh, this must be because it reminds me of the time that my father hit me.”
But that’s not the connection that the mind makes at that particular time.

How the Lack of Context Impacts Treatment
So what difference will it make in our work, knowing that a traumatic memory was encoded without context?
“It’s important to recognize that PTSD is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.”
It’s important to recognize that PTSD, or the experience of trauma is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.
When we’re working with people who have been traumatized, it’s crucial to help them learn how to field the present as it is and to tolerate whatever goes on. The past is only relevant in as far as it stirs up current sensations, feelings, emotions and thoughts.
The story about the past is just a story that people tell to explain how bad the trauma was, or why they have certain behaviors.
But the real issue is that trauma changes people. They feel different and experience certain sensations differently.

“ . . . the main focus of therapy needs to be helping people shift their internal experience.”
That’s why the main focus of therapy needs to be helping people shift their internal experience or, in other words, how the trauma is lodged inside them.

How Talking Can Distract a Client from Feeling
Now, in helping people learn to stay with their sensations, we need to resist the temptation to ask them to talk about their experience and what they’re aware of.
This is because talking can convey a defense against feeling.
Through the use of brain imagery, we’ve learned that when people are feeling something very deeply, one particular area of the brain lights up.
And we’ve seen other images taken when people are beginning to talk about their trauma and, when they do, another part of the brain lights up.

So talking can be a distraction from helping patients notice what is going on within themselves.
“ . . . some of the best therapy is largely non-verbal.”
And that’s why some of the best therapy is very largely non-verbal, where the main task of the therapist is to help people to feel what they feel – to notice what they notice, to see how things flow within themselves, and to reestablish their sense of time inside.
Why Restoring the Sense of Time Can Make Emotions More Bearable
“All too often, when people feel traumatized, their bodies can feel like they’re under threat.”
All too often, when people feel traumatized, their bodies can feel like they’re under threat even if it’s a beautiful day and they’re in no particular danger.
So our task becomes helping people to feel those feelings of threat, and to just notice how the feelings go away as time goes on.

The body never stays the same because the body is always in a state of flux.
It’s important to help a patient learn that, when a sensation comes up, it’s okay to have it because something else will come next.
This is one way we can help patients re-establish this sense of time which gets destroyed by the trauma.
“Once a patient knows that something will come to an end, their whole attitude changes.”
Sensations and emotions become intolerable for clients because they think, “This will never come to an end.”
But once a patient knows that something will come to an end, their whole attitude changes.

groups as a change agent

January 20th, 2017

Tomorrow I will be fortunate enough to be part of a faculty of four very seasoned and passionate group therapists as we will be teaching a 2-day course called Principles of Group Psychotherapy. The title of the weekend may be a bit dry but the deeper implications are not.

When I was in the graduate school of social work at UCLA in the late 80′s/early 90′s I was a member of a group of 75 students with a passion for making some kind of difference. At the time I don’t think many of us knew exactly what that difference might be, and I certainly didn’t know either, but something was instilled in us that spoke to the idea of being change agents–social workers who would bring about change in others whether that be intrapsychic, interpersonal or in larger groups and systems.

I’ve chosen to devote my career to helping others learn about themselves, and as a result, hopefully bringing that growth and wisdom to others one person at a time. Group therapy holds that same principle–learning about oneself and helping others learn about themselves–as a result, it may seem like a pebble being thrown into a still pond, but I believe it has a super meaningful ripple effect one person at a time (e.g.families, friends, colleagues and loved ones).

During the unfortunate series of events these last few months, I’ve been deliberating on what to do, how to do it, when to give my time and energy, and it feels like the time is here. Whether it be giving my all in my practice every single day or showing up at a rally or donating to my favorite activist organization or signing a petition, it all counts. As a group of sane, loving, respectful and sometimes angry people, we can make a difference. Bernie Sanders said that it’s not about going into despair, it’s time to fight for equality of all kinds. And the magnitude of our majority group will prevail in spite of the speed bumps ahead.

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