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March 10, 2015 By Susan O'Grady 9 Comments

Psychotherapy, Love, and Healing

 

Psychotherapy takes place by holding the space for healing to occur.Nothing is more natural than the urge to be held and comforted by someone who understands our suffering. Whatever the painful situation (a relationship breakup, medical scare, financial disaster, the death of a loved one) we want to turn toward someone who will hold us and let us cry in loving arms.

Sometimes we need to seek that understanding from someone other than a lover, parent, or friend. These figures may be too close to your issues or otherwise unsuitable for receiving confidences and providing nurturance. Psychotherapy provides a safe, confidential, neutral relationship to explore what hurts.

Therapist and client sit together in a quiet space being present to whatever feelings come 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.

Good therapists with proper boundaries will not gossip about you, laugh at you, seduce you, or allow themselves to be seduced by you. At the same time, psychotherapy at its best gives room for love to be present. In fact, love is an important aspect of all good psychotherapy. In a letter to fellow psychoanalyst Carl Jung, Freud wrote that “Psychoanalysis is, in essence, a cure through love” (1906). In the client–therapist relationship, love, and gratitude are healthy human emotions just as they are in the world outside of the therapist’s office, although the client expresses his or her feelings while the therapist experiences them privately.

Many forms of love may be possible: that of a parent toward a child, of siblings, or adults with erotic feelings, or narcissistic self-love. Discussing such feelings is sometimes difficult—in part because love is fraught with vulnerability, in part because we have all been injured in our loving feelings. In therapy, it is helpful to both respect and be curious about this range of feelings for what it reveals. Much can be learned about how one loves, about how one contends with the fears and anxieties over love, about how one chooses a person to love, and about what it is that one loves (beauty, truth, kindness.)

Ultimately, the therapeutic process will lead to reclaiming the self that became lost, whether through years of living inauthentically, practicing unhealthy behavior or through emotions such as depression and fear that hold us back from living fully. Another way of putting it is that therapy is about putting life back together again based on a clearer understanding of ourselves.

Reconstructing identity is, as Plato wrote, a kind of remembering of what we’ve forgotten about ourselves; through therapeutic dialogue and listening to our intuition, we remember that self. Sometimes, for example, we lie about what our lives are because we need to create something to give us the comfort of that longed-for love.

When we live life that’s not in accordance with who we are, we are doomed to fall hard, cracking the veneer of the perfect life. If, like Humpty-Dumpty, we fall tumbling from perches too lofty (narcissistic) or too unstable (based on fantasy) all the king’s horses and all the king’s men will not be able to put us back together again.

A successful outcome of therapy is to find comfort in your aloneness because we are never truly alone if we know ourselves. The self, or soul, is with us all along, walking beside us. Throughout life, we are given glimpses of this companion self.

As Juan Ramon Jimenez wrote in his poem “I Am Not I”:

 

I am not I.

                  I am this one

walking beside me whom I do not see,

whom at times I manage to visit,

and whom at other times I forget;

who remains calm and silent while I talk,

and forgives, gently, when I hate,

who walks where I am not,

who will remain standing when I die.

 (Juan Ramón Jiménez, “‘I Am Not I’” from Lorca and Jiménez: Selected Poems. Translation copyright © 1973 by Robert Bly.)

Perhaps the therapist models this companion self for the client until the client can better become his/her own companion. The best psychotherapy creatively facilitates developing the disposition for happiness by encouraging self-transformation and self-integration. Ultimately, the therapeutic relationship ends and the client moves on in life with a strengthened sense of self that can better tolerate being alone with both good and painful feelings.

Filed Under: Depression & Anxiety, Dr. Susan O'Grady's Blog, Psychotherapy, Uncategorized, Well-being & Growth

February 24, 2015 By Susan O'Grady 7 Comments

Standing Behind the Waterfall: Learning to Change Distorted Thinking with Mindfulness

Giving yourself a ledge to stand on as you watch your thoughts will help get perspective.
Getting a Different Perspective

Thoughts are not facts. When we’re upset, our thoughts seem valid—yet it’s exactly when our emotions get stirred up that our thinking can easily become distorted. Conclusions based on distorted thinking can’t be trusted.

When my friend Sharon returned from a business trip, she was feeling disturbed and uncomfortable. As she described her experience, she clarified why: She had been working remotely in Africa and knew few of the other participants in her company’s conference. She wanted to be included, but wasn’t part of the main team; she felt uncharacteristically shy and felt that her participation wasn’t up to her typical style. Sharon was aware of the tremendous talent that surrounded her and wished she’d had more opportunity to interact with her co-workers.

Taking a Different Vantage Point Gives Perspective When Thoughts Are Overwhelming

Sharon observed her feelings and thoughts with great skill, teasing out the mixture of sometimes conflicting emotions she felt, but importantly, she wasn’t condemning herself or anyone else. If her thought had been “I’m so inept, I can’t compare to these other people,” she might have gotten carried away with ruminations about her inadequacies. By asking herself “What is this I am feeling, in this moment?” Sharon gave herself a vantage point—feeling anxious is not the same as being worthless.

Teachers of meditation often use the image of the sky to illustrate how thoughts, like clouds, come in and out of our mind. The sky is always there, even when dark clouds momentarily obscure the sky. In another moment, the sky might be a brilliant blue with white downy clouds moving slowly or swiftly across its surface. We use these images to show that clouds come and go changeably, just like our thoughts, but mind and sky always remain. Sitting in meditation, we witness the changes of thought and feeling but don’t partake in them, just as the sky is unchanged by the clouds.

One of the exercises used in mindfulness-based cognitive therapy is that of standing behind a waterfall. Standing behind the rushing water and watching it without getting swept away by the torrent gives us a ledge to stand on, just as meditation gives us the perspective to look at our thoughts. We don’t have to believe everything we think, and we don’t have to be deluged by ruminations arising from anxiety or depression.

Try this short meditation:   

Filed Under: Blog, Depression & Anxiety, Dr. Susan O'Grady's Blog, Health Psychology, Mindfulness & Meditation, Psychotherapy, Stress, Well-being & Growth Tagged With: Anxiety, Depression, Meditation, Mindfulnees-Based Cognitive Therapy, Mindfulness

February 17, 2015 By Susan O'Grady Leave a Comment

Building and Keeping a Strong Relationship After Having Kids

Couples counseling to help cope with disappointments with partner. Marital conflict is bad for kids. While every marriage has conflict, especially after the first baby, persistent difficulties in the marital relationship expose children to increased chance of depression, poor communication skills, and conduct disorder later in life.

Cindy and Max came to see me after their daughter Sophie started pre-school and teachers called them in to discuss her inability to speak in class or to play with other kids. Cindy and Max thought she was just shy, but Sophie was diagnosed with a form of social anxiety. I learned that the couple, not wanting Sophie to suffer the anxiety of being left with a babysitter, had never gone out on a date after her birth. They were never alone together and had even stopped entertaining friends. At home, Cindy and Max spent no couple time, except perhaps when bickering about who was going to do certain chores. Most meals were eaten in front of the TV; when the family did all sit down at a table together, Sophie would be the focus of their attention.

Cindy and Max responded to these tensions by stonewalling. Conflict lingered without any closure. Sophie observed all this, of course, and her separation anxiety increased until she became mute in front of anyone but her parents. It was only the diagnosis of anxiety that spurred her parents to look at their unhappiness and how it was affecting their daughter.

The Best Way to Take Care of Your Kids is to Take Care of  Your Marriage

The most important thing you can do is to stay good friends with your partner. Handle conflicts with gentleness and positivity; repair arguments when they become nasty. These seemingly simple things can create a climate that fosters intimacy, romance, and emotional engagement because these things grow out of a couple’s friendship and their ability to manage conflict.

Couples of today expect a lot from marriage; in previous generations when roles were more clear-cut, expectations were lower. People become partners because they value time together, but a new baby shifts the balance. Couple time recedes and baby time takes the lion’s share. For women, marital satisfaction goes way down, from 62% of childless married women reporting being very happy to only 38% of new mothers reporting feeling happy.

Please note: While many women get the “baby blues,” a relatively brief emotional letdown after childbirth, some 8 to 19% of women reported having frequent postpartum depressive (PPD) symptoms in a CDC survey. These symptoms include having scary or negative thoughts about the baby, worrying about hurting the baby, and feeling ashamed about not being a good mother. PPD is a serious problem that can not only affect the sufferer but also impair infant-mother attachment and the marriage. If a woman has this more severe depression, it is important she discuss her symptoms with her physician, who will refer her to a psychologist for counseling and a psychiatrist for medication evaluation.

Protecting Your Sex Life is One Way to Stay Connected When Children Take So Much

Having kids puts a damper on a couple’s sex life in several ways. Nursing shifts the hormonal balance by suppressing estrogen, increasing prolactin, and lowering testosterone levels. This combination results in vaginal dryness, which can cause pain during intercourse and lower libido. Breastfeeding is literally draining, and it’s additionally tiring to have sole responsibility to feed or even pump, especially on a newborn’s two-hour feeding cycles. Nursing does increase oxytocin, the feel-good hormone. With the baby meeting the mother’s needs for happiness, warmth, and intimacy, fathers can feel left out. However, fathers can experience rising oxytocin levels when cuddling their babies—they don’t have to feel left out http://www.livescience.com/10784-dads-hormone-boost-caring-baby.html. Many women, whether they nurse or not, feel “touched out” by the end of a day full of clingy young children.

While it’s not possible to change your hormonal balance, looking at what you can change will go a long way. Understanding that loss of desire is normal and that it will return is reassuring. It can also be reassuring to know that couples can maintain good sex lives without gymnastics. As Dr. Helen Fisher says, “If you want to start a very active sex life with your partner, don’t wait for your sex drive to get you to the bedroom. Just get to the bedroom.” Quickie sex releases all the feel-good chemicals of long gourmet sex. I tell my clients that meat & potato sex is fine (or gluten free.) Not every meal is gourmet.  Even if you aren’t in the mood, the closeness you feel will increase warmth and affection when not in the bedroom.

There are many other ways to protect your relationship after having children. In future posts, I will discuss other important ways to take care of your children by caring for your marriage.

Filed Under: Couples & Marriage & Family, Depression & Anxiety, Dr. Susan O'Grady's Blog, Psychotherapy, Relationships, Sex and Intimacy, Well-being & Growth Tagged With: Couples, Family, Gottman Couples Counseling, Intimacy, Parenting, Post-partum depression, Separation anxiety in children

January 27, 2015 By Susan O'Grady 9 Comments

The Church of the Backyard: Finding Comfort in Nature

For many years I have met with a group of women one Friday morning a month. Around our kitchen tables, we light a candle, have a moment of quiet, and then sip tea together as we read from a variety of spiritual works. In recent years, we often turn to poetry. Most of our meetings have a theme, yet an unexpected ritual has arisen: we open the kitchen doors and go out into our host’s garden. Like watching our children grow, we notice the seasonal changes in each other’s gardens and how they’ve evolved from year to year.

Nancy died about six years ago. She was sick for a long time and unable to get to the church she had regularly attended, but she found her temple in the “church of the backyard.” During our kitchen-table meetings, we often remarked on the garden’s healing influence.

Emily Dickinson, a poet who rarely left her home or garden, wrote:

 Some keep the Sabbath going to Church –

I keep it, staying at Home –

With a Bobolink for a Chorister –

And an Orchard, for a Dome –

 Some keep the Sabbath in Surplice –

I, just wear my Wings –

And instead of tolling the Bell, for Church,

Our little Sexton – sings.

 God preaches, a noted Clergyman –

And the sermon is never long,

So instead of getting to Heaven, at last –

I’m going, all along.

Research has shown that time in nature is one of the eight therapeutic lifestyle changes (TLCs) that enhance well-being. Watching critters, gazing at plants, and listening to birdsong or the low hum of insects brings us back to earth. And back to our Self.

Temples are places of quiet, of worship, and transcendence. Sacred spaces are found in all cultures and faiths around the world, and go back to before recorded history. The essence of a temple is stillness, as in Mary Oliver’s poem “Today”:

Today I’m flying low and I’m

not saying a word

I’m letting all the voodoos of ambition sleep.

 The world goes on as it must,

the bees in the garden rumbling a little,

the fish leaping, the gnats getting eaten.

And so forth.

 But I’m taking the day off.

Quiet as a feather.

I hardly move though really I’m traveling

a terrific distance.

 Stillness. One of the doors

into the temple.

 The temple is a doorway which, upon entering, we put away the “voodoos of ambition” and ego so that we can access the inner voice. Being in nature—whether a park bench, camping, or in our backyard—promotes reflection and quiet. The world goes on as we sit observing and listening. We are replenished before we return to our daily routine.

In mindfulness-based cognitive therapy, we do a five-minute “seeing” or “hearing” exercise to become aware of how easily the mind wanders from observing into judgment. You hear a cough, or loud, thunderous walking from the office above, or snoring from another participant, and critical thoughts immediately arise: “How annoying! Am I going to get sick? Who’s snoring? Why can’t I pay attention? Focus!” Through practicing awareness, we can see how easily our slippery mind moves away from paying attention to the sounds as sounds, or from what we’re viewing as only patterns, shapes, color, and movement, to categorization and criticism.

As I wrote this post, I picked up the new book The Art of Stillness: Adventure in Going Nowhere by Pico Iyer. As in all things synchronistic, one line randomly caught my eye and spoke to me, Dorothy’s in The Wizard of Oz: “If I ever go looking for my heart’s desire again, I won’t look any further than my own backyard. Because if it isn’t there, I never really lost it to begin with.”

If you would like to listen to a short guided meditation using the imagery of a temple, click on the link below. Temple meditations have been used in many healing traditions.

Temple Meditation

 

Filed Under: Blog, Depression & Anxiety, Dr. Susan O'Grady's Blog, Health Psychology, Mindfulness & Meditation, Uncategorized, Well-being & Growth

December 21, 2014 By Susan O'Grady 1 Comment

Every Ornament Tells a Story: Coping with Holiday Stress

ornament

Two weeks into December, and I had no holiday spirit. I had no desire to decorate or to do what I have done for the last 25 years. I am not a bah-humbug person! I love the holiday season: the tree with its hodge-podge of ornaments hiding in the branches illuminated by colored lights; magic memories from my childhood; reading “The Night Before Christmas”; and the magic come newly alive in my own daughters.

That magic was never just about presents. It lay in the expectation, the surprise, and the stories, like the ones I created about each small ornament, tucked into the branches. The glass moose was grazing on the evergreens, the pink elf was watching over the skiing Santa, and the rat king was just inches away from the prince. Every ornament has a history that began from its entrance into our household, and I remember most every one.

But this year was different. I dreaded getting out the boxes or ornaments and mantle decor. I dreaded the holiday parties. I was not inspired by any of it. And while it may have been unusual for me, I know that the holidays are fraught for many. For example, our feelings might not match up with the ones we’re supposed to have. When our emotions aren’t congruent with our expectations and the mood we perceive around us, they feel inauthentic and out of synch. Instead of being the one time of year when everyone comes together in love and support, the holidays can throw a spotlight on a year’s worth of things left unsaid, hurtful words that should never have been said, and all the ways last year’s New Year hopes didn’t pan out. And of course, there is the nearly ubiquitous overconsumption (food, alcohol, shopping) which can create conflicts, guilt, debt, or other problems.

Expectations, Overconsumption, and Depression

In my psychotherapy practice, I often see people who don’t just dislike but hate the holidays. For some, the season reminds them of childhood Christmases when mom and dad would argue, or maybe dad fell off the roof putting on the lights because he was drunk. For others, their kids have left the nest, and all the seasonal rituals feel empty without them. And some parents make the horrendous mistake of using the holiday to announce to their kids that they’re getting divorced, leaving terrible associations for my clients. Although Christmas music and decorations dominate the month of December, holiday stress bleeds into our culture so that people who don’t celebrate Christmas are affected. Families who celebrate other holidays, or none, can feel mixed emotions around this time of year.

I work with people who are experiencing loss of various kinds during the season: loss of an elderly parent; a marital separation; a job loss. The analogy I sometimes use is that this period of their lives may be like a tree weathering a bad year. Growth rings aren’t always even; drought, disease, or just a northern exposure can affect the ring’s thickness and shape, and so the tree trunk’s straightness. In time, their lives would be like that tree, incorporating the unique patterns formed in the process of living.

Nothing is ever perfectly straight. If it was, Christmas trees would be like the artificial ones in shops decorated with perfectly matched bows and garlands. There are no broken ornaments, but also none made by a child’s hands, or passed down from grandma, or chosen together by a young couple. Finding the joy in the season doesn’t require perfection. The imperfect family, the broken ornament, or the crooked tree all offer opportunities for reflection and stories told around the fire.

This poem by Rabindranath Tagore expresses some of the complexities of the season. In living alongside the joy and sorrow it becomes easier to find meaning in a season that remembers so many stories.

 He it is, the innermost one, who awakens my being with his deep hidden touches.

He it is who puts his enchantment upon these eyes and joyfully plays on the chords of my heart in varied cadence of pleasure and pain.

He it is who weaves the web of this maya in evanescent hues of gold and silver, blue and green, and lets peep out through the folds his feet, at whose touch I forget myself.

Days come and ages pass, and it is ever he who moves my heart in many a name, in many a guise, in many a rapture of joy and of sorrow.

      Gitanjali, with an introduction by W.B. Yeats, Scribner Poetry, 1997.

Gradually, almost imperceptibly, I came out of my funk and realized that I felt like my usual self again. Recognizing that emotions can be mixed during this time of year, allows for acceptance of feeling that doesn’t fit the season’s glitter and glam. As Tagore wrote; days come and ages pass, and enchantment joyfully plays on our hearts in the varied cadence of pleasure and pain.

If you are having difficulties coping with holiday stress, this article from APA has some good suggestions.
—Susan J. O’Grady, Ph.D.

Filed Under: Depression & Anxiety, Dr. Susan O'Grady's Blog, Psychotherapy, Stress, Well-being & Growth Tagged With: Depression, Holiday stress

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Dr. Susan J. O’Grady is a Certified Gottman Couples Therapist

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