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Solving Problems. Creating Well Being.

Helping you engage in life, discover meaning, and reach your heartfelt goals.

Dr. David O’Grady

After 25 years in practice, my work still enlivens me, and I am deeply committed to my patients. First and foremost, I am a humanist–I see life as a process of growth and development. I believe strongly in the resilience of the human spirit and our capacity to create a true sense of well-being. I am board certified in clinical neuropsychology, the specialty that focuses on brain-mind relationships. I am fascinated by the brain and what we are learning about the complexity and wonder of the human experience. Learn more …

Individual Therapy

We work to help people create a sense of well-being that remains steady despite the frustrating and unexpected challenges of life. Often, negative habits of thought and automatic reaction interfere with achieving happiness. ...

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Date night is good for you and the kids.

Therapy for Children, Families, and Teens

Counseling can help kids feel better about themselves, teach them skills to get along better with others, help them develop mature self-control, and improve ability to solve problems. Counseling can also help parents learn to ...

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Neuropsychological Assessment

Unlike CT or MRI scans, which show what the structure of the brain looks like, neuropsycho-logical testing evaluates problems in brain functioning, examining how well the brain is working when it performs certain functions ...

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Dr. Susan O’Grady

Psychotherapy provides a safe, confidential, neutral relationship to explore what hurts. We sit together in a quiet space being present to whatever feelings comes up. The noise of the outside world is put on hold for an hour: no ringing phones, text messages, TV, or other distractions. This environment invites opening up the parts of ourselves we keep shut down, secret, or tied up in knots. Tears are likely, but so is laughter and joy. Therapy is not only about pain but also learning to live well with the inevitable difficulties that life holds, and finding the laughter that lives alongside pain. Learn more …

Couples Counseling

When a couple comes to couple’s therapy for the first time, emotions are often intense. I approach the first session with an attitude of “no blame.” Using a combination of questionnaires that assess your relationship ...

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Mindfulness-based Interventions

Mindfulness-based therapies are effective because they alter emotional responding by modifying thoughts and feelings that affect negative self-beliefs. By regular practice of the techniques in these structured sessions, you ...

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Responding to first responders and PTSD

Special Assessments

We offer professional assessments for a variety of special situations. In each case, we conduct our assessments using the most up-to-date testing methods. We apply expert knowledge based on thorough familiarity with the ...

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Video from Dr. Susan

What to Do After a Fight and How to Repair

One of the most important skills you can learn to better manage conflict is how to make a repair AFTER you’ve had a fight, big or little. I’ll tell you right now, just saying you’re sorry is not going to cut it. In fact, even if you do get off the hook by simply apologizing, you won’t learn anything about how to improve things in the future. In my work with couples, we’ll take several sessions to build a kind of template, the “Aftermath of a Fight” exercise. Developed by Dr. John Gottman, the technique gives a way to talk over emotions and background issues after a recent argument in a more compassionate and productive way. By recent, I mean some time after the fight, when you’re no longer flooded with feelings.

Making Up After A Fight

Although at first you may feel awkward, you’ll find that the exercise becomes more automatic with practice.  You won’t have to go down the same rabbit hole with every disagreement. You’ll be able to understand each other better, and not just repair the current situation but also help prevent future arguments.

The guiding idea of the Aftermath of a Fight exercise is that there is no absolute reality in any relationship conflict, but rather two subjective realities or points of view. Both are right. By using the six key components of a post-fight debriefing, you’ll have a  help you to process without getting back into the fight.

“There is no absolute reality in a disagreement, but rather there are two subjective realities and points of view”

Aftermath of a Fight or Disagreement Debrief

Let’s look at each of the 6 key components for making effective repairs after a fight:

  1. What were your feelings during the argument?
  2. What was your subjective sense or reality about the argument?
  3. Can you find something you can understand about your partner’s position?
  4. Are you flooding as you talk about it during the debrief?
  5. Admit your role. What was your contribution to the fight?
  6. How can you each make it better in the future?

Step 1 is to describe what you were feeling during the argument. It’s important to follow the rules of active listening by using “I” statements — that is, describe simply how you feel without blaming your partner. So, you’d say “I felt worried,” not “You worried me,” or “I felt lonely,” not “You made me feel lonely.” Saying “I felt like you made me feel…” is cheating!

Also, keep Step 1 brief. Avoid the temptation to explain at length, justify yourself, total up points, or add a laundry list of grievances. When that happens, I gently stop the partner and remind them to just say, “I felt” — fill in the blank. PERIOD. Long explanations just make the other partner defensive and get more flooded all over again. Yes, it’s very hard to own your own stuff, and much easier to project onto your partner. But I’ll tell you, that won’t get you anywhere but two steps backward.

I can’t tell you how often I’ve been with couples and seen how, as they listen to their partner express their feelings in a clear and non-blaming way, they react with much deeper empathy and understanding. This alone makes a huge difference.  

In Step 2, each of you  expresses your subjective reality or point of view in a couple of sentences. Sometimes condensing and consolidating your experience during the fight is an art in itself, because so often we want to bring in everything else that has angered us over the last months, or years! Step 2 gives  practice in knowing yourself and using mindful attention to be concise.                                

Step 3 is about empathy: how well can you understand your partner’s point of view? It can be hard to put yourself in someone else’s shoes — even, or maybe especially, your partner. You want to be able to say“I can see how you feel” about such and such, or “It makes sense that you can feel that way.” 

In Step 4, you check in with yourself to determine if you’re getting flooded. Many times when couples debrief after  a fight, they just get angry all over again, defeating the purpose.  In therapy, I might ask at this point if anyone is flooded. If so, Iwe stop the exercise for a few minutes until they can bring their heart rate down and then they can reengage in the discussion. This may seem like a small or unnecessary thing; even experienced couples’ therapists can neglect it. But believe me, it’s crucial.  Again, for more information please see my video covering this topic.

Step 5 is admitting how you contributed to the fight.This is one of my favorite steps; from my work with couples I can say that this alone is eye-opening for both people. It’s also  something you can take with you into any other relationships with family and friends. 

Admit your role! It is essential that each of you takes some responsibility for what went wrong during your discussion and what made it go sideways. As with Step 1,  you’ll also use a simple, brief sentence. For instance, you might say something like “I’ve been very stressed,” or “irritable,” or “overly sensitive,” irritable,” or “I haven’t expressed much appreciation toward my partner lately.”  Or “I need to be alone,” or “I haven’t made time for good things between us.”

So often in life we get caught up in being busy,  or stuck in our resentments, and we don’t reach out to our partner. Then we’re surprised that they have no idea how we’ve been feeling! The common denominator of Step 5 statements is that they fill in the blanks and show the backdrop to what contributed to the fight.

Finally, in Step 6 you consider how you could do better next time. So, you ask yourself very directly, what is one thing my partner can do differently next time? And what is one thing I can do differently next time? Answering these questions takes some emotional intelligence, first to figure out how you can ask directly for what you need, and then  to accept what your partner says would help them.

This is very different from just saying “I’m sorry we got into an argument last night.” I won’t kid you that this is easy. Even though it’s easier in a therapist’s office, it still takes practice at home. I also want you to remind you that this repair never works if you get flooded again. That’ll just reignite the original fight, and if this pattern continues, you’ll only compound your difficulty managing conflict and build even more negative feelings about the marriage and your partner.

The example to follow goes something like this:  “I want to apologize for my role in our disagreement last night. I’ve been thinking it over and I realize I came on really strong because I was feeling worried about finances. I got worked up and didn’t really listen to what you wanted to say. I can see that you may have felt dismissed by me and I want you to know that I didn’t mean to be dismissive of your ideas for our vacation,” or garden — you fill in the blank. “I think I have been very preoccupied lately with my job stress and I haven’t been giving you much attention and making time for you.“ 

Overall, then, this is a process, but it’s  a powerful one. When I work with couples, I give them a written summary of the steps so they have it handy and can practice it together after a fight. You may need to do it together in a formal way with the six steps for a few times, or a few dozen, but it really will become imprinted and integrated into one clear and heartfelt repair.

Try it, and good luck!

Bittersweet and Everything In Between

Being able to hold opposing emotions is one of the hallmarks of good mental health. Something can be both bitter and sweet, and we tend to feel that we must pick sides. To our confusion, we often can’t stick with one or the other feelings — either getting pulled back and forth, or stuck in one or the other. Getting mired in the bitter side can lead to depression, but the sweet side has its own pitfall, such as denial about problems.

What does it take to hold the tension of the opposites? A willingness to acknowledge that we can be both happy and sad, weak and strong, and that we are in a continual state of change. If we can’t accept that  impermanence underlies life, we can be badly rattled when fortune’s wheel turns for the worse, or overly elated (and sure that things won’t change) when it turns for the better.  We must learn to live in between, alongside the difficult and the pleasant. When we taste only sweetness, then bitterness will not long follow — because nothing lasts forever.

We are living through a historic pandemic that’s made more acute by the daily (or hourly!)  news we get on the ever-present phone in our pockets. Adding to the constant angst is social media, frequently showing a rosy view of other people’s lives— the victory garden that is blooming like crazy, the family game night, Instagram-ready special recipes . All of these are examples of how we have made sweetness of a difficult situation, but they don’t tell the whole story. They can  also serve as stark reminders of all we had intended to do in the weeks of our confinement leading to feelings of loss that, that when combined with daily news of deaths, disease, and economic hardship, are very real reminders of the bitter side of life.

These painful feelings can include missing  our friends, seeing our child deprived of a real graduation ceremony, and worrying about front-line health care providers and essential workers who make other people’s lives easier.  They’re certainly not getting time in their garden or finding creative ways to make a meal.

Holding opposites in tension is  based on an awareness of both good and bad, which are both always present as forces in the world and within us. It takes a great sense of balance to live with this paradox, and it’s rare to remain  in the place of balance for very long. The reason is that our thoughts and emotions will tug at us continually pulling us all along the spectrum from bitter to sweet and back.

When I first started writing this blog, I called it “Creating Well-Being.” That title no longer fits my thinking about suffering and growth. It does not represent the complexity of how we live in a world full of trauma, inequality, and paradox.

In my thirty years as a psychologist I have been seeing clients grapple with the paradoxes in their lives and within themselves. One wants to be good and moral, yet has affairs that he knows would hurt his wife; he’s unable to stop himself, unable even to see that he’s hurting himself too by being pulled apart. Another stays silent about years of sexually abusing a younger friend when they were kids, meanwhile marrying and starting a family with the burden of shame and guilt weighing him down. And often we  externalize these negative and difficult feelings, because it feels safer to blame another person, a job, or our lot in life for all that we don’t want to look at in ourselves. Instead of growing, we’re stuck.

Psychotherapy is about finding the syntheses of opposites. A helpful technique is looking  for what’s left out of a clients’ narrative. Carrying secrets creates turmoil; the omitted truth wants to be heard, on levels that range from the faintest whisper in the back of the mind to a gnawing pain that keeps us tied up in knots.. ; When we ignore our full reality and drive awareness into the unconscious, we perpetuate default patterns that prevent us from becoming whole. It takes courage to open ourselves and allow a fuller view of consciousness to dawn. Expanding of one’s being means an enlargement, and enrichment of the personality and is no easy task —  arduous, but enlightening.  

The archetype of the shadow can be seen in many stories, such as Dr. Jekyll and Mr. Hyde, or in f Frankenstein, written by Mary Shelley in 1812. It struck a huge chord with the public as a profound example of the risks of disowning our dark side. In the story, Dr. Frankenstein is consumed by the needs of his ego to create life out of death. He works tirelessly, manically stitching together the parts of dead bodies to create his masterpiece. Avoiding all human contact for years, he is eventually successful in his ambitions. But on seeing  the creature he made, he recoils, calling it The Monster and abandoning it without a thought. He betrays his own creature, and it catches up to him, finding revenge in destroying the people Dr. Frankenstein loves most.

There is a bit of Dr. Frankenstein in all of us. We pursue our dreams and then when they do not satisfy us in the way we had expected, we abandon our creation — which has its revenge  in keeping us from full aliveness and wholeness. Or, because we’ve all been hurt, betrayed, or abandoned in some way, these unprocessed wounds can create a monster that’s embittered, enraged, and revenge-seeking, even taking the shape of self-harm. 

The poem “As I Walked Out One Evening” by W.H. Auden speaks of a healthy tension of opposites, which acknowledges the contradiction and beauty of human experience: 

‘O look, look in the mirror,

  O look in your distress:

Life remains a blessing

  Although you cannot bless.

‘O stand, stand at the window

  As the tears scald and start;

You shall love your crooked neighbour

  With your crooked heart.’

Personal growth through whole-hearted openness can  heal the split within ourselves, unifying opposites and defeating divisiveness. It is then that we can love our crooked neighbor with our own crooked heart.

The Latest From Dr. Susan O’Grady’s Blog …

Bittersweet and Everything In Between

Being able to hold opposing emotions is one of the hallmarks of good mental health. Something can be both bitter and sweet, and we tend to feel that we must pick sides. To our confusion, we often ...

Read More ...

Help Your Child Sleep Alone
The Goodnight Worry Program for Bedtime Fears

Some children are afraid to sleep alone. Despite reassuring words and checking under beds, your child can fall asleep only when you snuggle next to them at bedtime. Efforts to use reasoning to calm fears achieve nothing. Insisting on solo sleep may cause everyone’s patience to dissolve. Arguing and tears follow. In the middle of the night, more crying awakens you. Your child is now sleeping in your bed and cannot sleep alone.

Dr. David O’Grady developed the Goodnight Worry program in 2001, and over the years has refined this straightforward behavioral approach to solve this common problem.  Learn More …