Therapy is a psychological effort to heal psychological wounds. But it also includes a “coaching piece” which supports your efforts to solve objective problems in the outside world. For example, getting and keeping a good enough job, partner, or circle of friends can require plenty of collaborative work, bringing the situation into sharper focus and finding the most strategic spots where a little pressure can turn things around.

But what about those giant historical forces that contribute to depression and/or anxiety, but that can’t be addressed by personal coaching? They shouldn’t be “therapized away” either, because they’re mostly objective and external, not subjective and internal. It isn’t neurotic at all to be concerned about climate change, or the loss of the natural world, or the rapid erosion of public institutions that used to guarantee a basic standard of political stability. In fact, being concerned about these huge trends is an important part of living together in the real world, and a therapeutic culture of atomized individualism can prevent the public from getting together to improve things.

Yet this, too, is a delicate balance to be struck and maintained, because we don’t pay our therapists to sway us into their favorite world-saving projects. Politicized utopian therapy tends to help nobody at all. In it, the patient is manipulated and under-prioritized; the therapist becomes a self-important priest of virtue; and the public they pretend to rescue is never actually served in any detectable way. The proper balance, it seems to me, remains focused on the patient’s individual well-being, and includes bigger issues only insofar as the patient is already struggling with them. I don’t cause people to start worrying about global warming, but I do not flippantly suggest that patients who are losing sleep over rising sea levels should just forget about it.

I’m a member of the Climate Psychology Alliance, and I’m aware of the extremely serious state of the world’s natural systems on which our safety depends. I’ve been interviewed on Guy McPherson’s Nature Bats Last radio show several times, and the recent book I Want A Better Catastrophe by Andrew Boyd contains an interview he did with me in Los Angeles. So I get it. 

I’m a bit more hopeful about the human prospect than I was when those were recorded, some years back. But our industrial system of living arrangements hasn’t changed, and humanity still seems locked into the cornucopian dream of infinite economic growth on a finite planet. The world needs collective psychoanalysis, but there’s no way to deliver that. A decade ago, Naomi Klein wrote a book about the climate crisis, saying we had just about missed our chance to address it democratically, so that only a top-down, autocratic solution would have much chance of reversing our reckless course. Now it seems we’re getting the autocracy, but without much progress on climate change—indeed the opposite, at least for the moment. 

And yet, here and there amid the mayhem, courageous people achieve real improvements every day, with a local reforestation program here, a soil restoration project there; another solar power plant replaces another coal plant; a threatened species like the peregrine falcon is nursed back to sustainable population levels in the wild. Though Yes! Magazine ceased publication in June of this year, you can still get a regular dose of positive reporting, environmental and otherwise, at https://www.goodnewsnetwork.org/.

None of this is enough, of course, and the big climate problem is a trillion tons of excess carbon already in the atmosphere. “Net zero” is politically frozen, and even if it were enacted tomorrow, it would only prevent new carbon from adding to the existing load. Yet all is not lost, and that margin of brighter possibility—however slim—means two things: 

One, we have to try. As Rabbi Tarfon says in The Ethics of the Fathers: “It is not your duty to finish the work, but neither are you at liberty to neglect it” (Pirkei Avot, 2: 16).

Two, we cannot let the giant issues of our day prevent us from fulfilling our birthright: our lifetime’s chance at the earnest effort to achieve wisdom and well-being. I use those terms instead of the Declaration’s famous “pursuit of happiness” because the latter is often too light a word, given what many of us deal with, and what we face as a society and as a species. If happiness is to be our aim, let it be a deeper version that includes the bittersweet struggle to achieve it. As I often mention, Aristotle says happiness “is not amusement; it is good activity,” and goodness often involves the sober and courageous confrontation of what’s necessary. 

All is not lost. Two organizations, and probably more, are focused on restoring the climate, not just slowing its destruction. One is www.climatefoundation.org, based on a fine book by Peter Fiekowski called Climate Restoration. The other is Project Drawdown, which includes a range of already-existing efforts to pull carbon out of the air, and into commercial products and processes that benefit the public and the natural world. These need more attention than they now receive, but that’s changing every day. 

I’m a therapist and a writer, not a climate scientist or an industrial engineer. I don’t know the future. But I am entirely convinced that your best bet, and mine, is to live lives of hope and effort, reaching for agency and awareness rather than helplessness and dissociation. When I work with patients who aren’t troubled by the giant themes of our collective historical moment, I let those sleeping dragons snore in peace. But when patients suffer from excessive preoccupation with problems of greater-than-human scale, I invite them to toggle back and forth between brave confrontation and merciful rest. If your top priority is to push back against the Big Troubles of our historical moment, remember that you can contribute a lot less when you’re exhausted and despondent than when you’re healthy and strong.

If this perspective appeals to you, consider booking an appointment with me today at 917-873-0292, or use the contact form on this website.

What’s “hoarding”? Well, the DSM-V includes hoarding in its section on obsessive compulsive disorders. There’s OCD, which is a pattern of behavior and inner experience, and there’s OCPD (Obsessive-Compulsive Personality Disorder), which includes that pattern, but also extends to deep-seated and pervasive concerns with order, regularity, and tight control. You exert unnecessary and excessive control over variables you can actually affect, like neatness or punctuality, but your opportunities to do so are often subject to other variables beyond your reach, like the weather, traffic, or other people’s actions. This brings plenty of episodes of frustration, when highly charged efforts at maintaining order get interfered with by unpleasant surprises from outside. The irony is that someone suffering from OCD or OCPD is exercising what can look like a heightened personal mastery over their immediate environment, but it’s actually a type of helplessness: they cannot control their relentless need for control.  

OCD tends to start in childhood, but like most personality disorders, OCPD usually (not always) shows up a bit later, in adolescence or early adulthood. Hoarders typically don’t have OCPD. They don’t care much about order; their environments tend to be chaotic, and they often hold onto broken or incomplete items without repairing or maintaining what they insist might someday come in handy. Their problem is classified next to OCD because it’s a maladaptive behavior pattern they can’t regulate, with a thinking style that’s distorted to legitimize it. Of course, this fits addiction, too (so does disordered eating), and compulsivity is part of addiction—especially behavioral addictions that aren’t drug use, like shopping, sex, or gambling. Psychological diagnosis and “nosology” (the part of our science that divides human troubles into discreet categories) are not entirely scientific, and plenty of books (here’s a favorite) rightly criticize the Diagnostic and Statistical Manual of Mental Disorders for the limitations of its ever-changing categories (a more nuanced and humane approach has produced the Psychodynamic Diagnostic Manual, or PDM, by Vittorio Lingiardi and Nancy McWilliams). We do need some way of talking about what ails people; imprecision is inevitable; and imprecise terms are far better than none.  

Like many ailments, hoarding occurs on a spectrum of severity. It can be a light nuisance, a serious problem that impinges on one’s life-possibilities, or a severe mental affliction with potentially dire implications for physical health. Like some other conditions, it’s a distorted version of some natural and necessary mental functions. In the deeply ancient world, long before civilization, people generally kept almost nothing, or only what they could carry. When the Paleolithic (“Old Stone Age”) became the Neolithic (“New Stone Age”), the first settlements were established where people lived for an entire season, or even year-round, storing food and artifacts. Evolutionary psychology of this sort can easily jump to mistaken conclusions, but it seems likely that somewhere along the line it became adaptive to try and hang onto stuff that might be useful later on. A temperament that disposed people to a more retentive attitude became partly heritable—despite the fact that it could also cause trouble, like plenty of other genetic traits. Even if OCD were entirely DNA-based, which it isn’t, activating it would still require a releasement mechanism in the form of a lived experience. Such mechanisms are usually traumas of one kind or another, having to do with some kind of scarcity: food insecurity, inadequate love and affection, episodes of being robbed or cheated—all these can make someone err “on the safe side” by keeping too much stuff.  

Obsessions are a cognitive thing, with affective (i.e., emotional) dimensions, manifest as intrusive repetitive thoughts, preoccupation with certain themes or figures, or recurring words that take up too much mental space for no good reason. Compulsions are behavioral; often they’re involuntary rituals, involving repetitive counting, arranging objects in spatial patterns, or “checking” again and again that one really did lock the door or turn off the stove, far beyond the point where you’ve already secured that important information. There’s usually some misery in it, along with efforts to conceal the problem. Hoarders rarely have people over to visit, because shame is usually involved—unless the person is oblivious to other people’s judgments, or to their own disorder, two features of more severe presentations. If you suspect you may be hoarding, it’s likely a good thing that you’ve got the perspicacity to be concerned.  

It’s a lot easier to deal with hoarding when it’s got other meanings to it besides the traumatic, maladaptive ones. If you’re a collector—of art, musical instruments, rare handmade tools, antiquities, autographs—you may manage to sublimate the underlying anxiety into a life-enhancing fascination with some aspect of culture that speaks to you. A “philatelist” collects stamps, a “numismatist,” coins. Book collectors may be captive to their enormous holdings, and being only human, they don’t have the necessary centuries to read every book they own—but come on, it’s the cumulative wisdom of the world on those shelves, not, say, a hundred pairs of shoes (ok, I’m a bit of a bibliomaniac myself). Then again, hearing a balanced, articulate shoe collector hold forth about his or her favorite specimens might be interesting enough to earn a guest’s instant respect. There’s something cool about a passion that builds expertise and a refined capacity to appreciate the larger meaning, history, and design of what appeals to you, however esoteric it might be. But there are limits. 

When there’s no unifying theme to the possessions, when they’re not in good shape, when their owner can’t find anything, and the space is cluttered to the point that the room is hard to cross without knocking things over, when dust is a major issue, when acquiring and retaining things has crowded-out self care, sociality, and financial prudence—and above all, when there is no joy in having all this stuff, well, that’s obsessive-compulsive hoarding disorder.  

Aristotle recommended “the golden mean,” the sweet spot between the extremes: “nothing in excess.” It may seem odd that people who endure opposite insults like “neat freak” and “slob” will find their problems listed on the same pages, but remember the horseshoe metaphor? The extremes have more in common with each other, than with the center. Dante put the Spendthrifts and the Misers in the same circle of the Inferno, where they taunted each other forever, shouting “Why hoard?” and “Why squander?” That’s also the soundtrack of the hoarding experience whenever it’s time to try and escape it: the first question is your exasperation at all the junk you’re living with, but as soon as you pick up any single item of it and try to throw it away, the second question kicks in.  

Let’s linger on that a moment. You’ve just picked up one of your hoarded objects… an extra audio speaker, a bundle of obsolete cords, a chipped tureen, the wrong-sized pair of old new shoes you never got around to listing on eBay. You’re holding it in your hands. The pleasure of keeping it is only a very brief moment of relief at not having to part with it. But the pleasure of removing it lasts, because you keep noticing the cleared space you freed-up by releasing it. Suppose you hang onto a belt sander for eight years because you might have a carpentry project one day. Then you get fed up, or you’re given an ultimatum by a lover or a landlord, and finally manage to fetch $40 for it on Craigslist. A week later, your favorite aunt Facetimes you out of the blue, about the wooden stairs at her place—how they keep giving her splinters, and they need “a coat of varnish or something.” Waves of self-reproach come flooding in from your inner tyrant: How could I let myself give up that sanding machine, after keeping it for eight years! Now I need it! I knew this would happen. The people who urged me to get rid of it were wrong! Now I’ll have to spend a hundred dollars to buy another one! 

Persuasive as that mighty voice may seem, it doesn’t know the whole truth. And the part it does know, isn’t helping you. Sure, you could buy a new sander, but you’ve just learned that the need for this tool arises about once per decade. And for under $40 per day, you could rent one and be rid of it when the job is finished. Look around the living room, the garage, the storage unit. Of all the objects you see, what percentage of them have suddenly come in handy the way the belt sander just did? Wrapping paper will get reactivated on holidays, and candles are a good hedge for a possible blackout. But the extra speakers, the orphaned USB cables, the chipped tureen? Almost no foreseeable scenario will turn their lost importance back on again, and what you see when you look at them is stagnation, anxiety, and reluctance to govern your own affairs without excessive fear of being caught without a tureen, just in case a soccer team drops by with five gallons of soup in a bucket. Giving up that belt sander was a victory. It turned out you could’ve saved some money by keeping it, after all. But there would have been value in getting rid of it years ago, to enjoy the freedom of choice, and the decluttered living space, its absence would afford you.  There are hidden costs to hanging onto things you don’t need now, even if there’s a chance (and there’s always a chance) you might need them in the future.

Suppose you do throw out some usable item, and some years go by. Then the phone call comes, announcing a sudden occasion to make use of what you sold, or gave away, or threw out so long ago. Suppose there’s no option to rent a new one, and no cheap replacement waiting for you on some website or a thrift shop. If you want to do the project, you’ve got to spend $50 that you could’ve kept if you’d only continued hoarding the thing. Well, consider the $50 a small fee you pay for those years of being unencumbered by the thing.  

We know some of the neural correlates of Hoarding Disorder, and there are medications that can be useful components of treatment. While there’s currently no 100% effective psychopharma for it, HD often occurs with depression, so any successful treatment for that mood issue can alleviate HD, sometimes significantly.  

If you believe you may have a milder degree of trouble with hoarding, it may help to watch some of the documentaries and reality TV shows that have been made about cases much worse than what you’re contending with. That can make unpleasant viewing, but it can jolt you into firmer resolve to make some changes.  

An excellent psychodynamic treatment approach for OCD in general is George Weinberg’s book, Invisible Masters.  

Some cultural resources that may help anybody who needs them include Swedish “death cleaning,” which builds on the truism that “you can’t take it with you,” and Japanese housekeeping, which emphasizes an elegant minimalism.  

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Licensed in NY, NJ, TX, and CA. www.drjameyhecht.com

We often want to help people with their regrets, by telling them: “If you could have done any better, you would have. The reason you didn’t, is that you were constrained by your trauma background, your history.”

They reply that this is a slippery slope; that if they allow themselves the solace of explaining their bad choices by invoking their past history, they might recklessly let themselves off the hook for all kinds of error—laziness, impulsivity, greed—in the present and the future.

But it is not a slippery slope, so long as we locate the determinism in the past, where it belongs, and the freedom in the present, where we need it. Both the past and the present are constrained by the effects of the remote past I call my childhood. But the past of my young adulthood is already fixed, whereas the present is still relatively fluid, with room for choice and decision.

What is the precise extent of today’s freedom? How far can I hope to excel my previous performances? How free am I this morning, to do better than before? The only way to find out is to do the best I can now do, and learn about the flaws in today’s efforts only in hindsight, later on. Only tomorrow’s perspective will reveal the hidden limits of today’s freedom. I can best reach those limits—I can make optimal use of today’s undefined opportunities—by living as if I were entirely free of the constraints my origins impose on me. I am now 55. For my twenties, therefore, this process is now complete, so I’m now free to conclude that at 25 I indeed did the very best I could do—even though some of my choices that year were relatively disastrous. Had I been more free, I would have done better.

This is not a moral framework; the goal is to understand, not to excuse. Understanding will give me the breathing room to choose how to handle the moral dimension of my past conduct, prioritizing compassion over punishment, wisdom over bitterness, edification over regret.

Every child experiences some particular mixture of three things: getting the good stuff (love), not getting the good stuff (neglect), and getting the bad stuff (misuse, or worse: abuse). The particular mixture supplied by a particular childhood has consequences—exerts constraints on our freedom of thought and action—for the whole lifetime. But those constraints can loosen and fade with experience, especially with enough good experience. At no point am I ever in a position to assess exactly how much my early years are still shaping my current actions and perceptions right now.

So: today, I will do the best I can, as if I were no longer limited by the consequences of my origins. Tomorrow will show me why I got as far today as I did, achieving no more and no less than my level of maturation could permit. The psychotherapy that helps me understand the tragedies of my young adulthood also equips me to improve my future, not only because it helps me learn from experience, but because it explains why I suffered from the particular ignorance that I did.

Today’s ignorance will be tomorrow’s knowledge. As I contemplate the ways I fell short in the past, the more compassion I can muster for my youthful self, the less regret I must endure today. From present contemplation of my past mistakes, I must learn both prudence in dealing with the outside world, and mercy in dealing with myself.

Of course my history limits my choices. But exactly how much? I don’t know, and that’s a good thing. Our ignorance of the precise nature and extent of our constraints is part of our freedom. And just as a temperate optimism can enhance my odds of success in the world outside, my inner life will likely go better if I let myself assume I have achieved more growth and healing than I can readily prove. “With every mistake,” wrote the Beatles, “we must surely be learning.” In the absence of an impossible certainty, we are better off trusting in the human spirit’s innate powers of development.

One way to have that experience, to grasp for that faith, is to “see” your elderly future self kindly smiling down on you from the future. You might as well… look.

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

People cheat when they feel cheated. They lie when they feel lied to, and they steal when they feel robbed. Some of that springs from a need for cosmic balance, where I pay-forward whatever I suffered that should not have been my fate. But some of it is a communication, where my behavior is meant to inscribe on the walls of the universe: this thing I do to others, is what was done to me.

Compulsive shoplifting, for example, can be a kind of broadcast to the world, silently announcing that I have been deprived of my due. Typically, the stolen good was not a material object but a form of experience, some crucial, human relational need that I now despair of ever meeting. Why the despair? Because of too many failed attempts to get hold of that primal good, and because the critical period has passed, in which the needful thing could have found its mark, by meaning just what I needed it to mean: that I am a good-enough person, in a good-enough world. If I can believe this belief, then a good-enough life-of-my-own can feel both permissible (fate will allow it) and feasible (I can manage it). If I doubt my own goodness and/or the goodness of people in general, it will be much harder for me to build an ongoing good experience of being myself. So, whence comes this necessary faith in the human good?

According to Heinz Kohut, what children need are parents who can supply two crucial developmental resources: first, a mother (figure) who mirrors our childhood grandiosity and affirms it for us, and second, a father (figure) whom we can idealize and look up to, identifying with him in an aspirational way. Kohut saw these two needs as ordered, both chronologically and in their relative importance. He also saw childhood and youth as eras that often afford us second chances to get what we need, or, if things go poorly, a new round of trauma (from deprivation or other emotional injury). A step-parent, say, can step in and make things much better, or much worse.

In the 1970’s, psychologist Urie Brofenbrenner made an observation which has often been quoted, and deserves even more notice today: “In order to develop normally, a child requires progressively more complex joint activity with one or more adults who have an irrational emotional relationship with the child. Somebody’s got to be crazy about that kid.” This Somebody need not be the original parent (biological or adoptive) or a step-parent; it can be, say, a relative, a guidance counselor, or a teacher — often an art teacher, perhaps because art is nearer to the emotions than most other subject areas taught in schools. But the changes in institutional culture of the past two decades have made it more risky and difficult for teachers to show special interest in troubled students who may need it. Among the religious, clergy can be well placed to show this kind of individualized interest, but they, too, have become understandably risk-averse as the stakes of being misunderstood have sharply risen. Librarians sometimes took on this kind of role in children’s lives, with often wonderful results, but smartphones and the internet have so fully replaced books that librarians are fading from view.

If a community is in sufficiently rough shape, an idealistic nonprofit might come along and offer a program that pairs at-risk youth with ethically ambitious adults who help them along in caring ways. But those programs don’t always appear, and not all childhood neglect or abuse happens in poorer cities and towns that are in obvious trouble. Much of American literature is about the family traumas of the middle class, and even the wealthy are often very desperate people — in part because they already have the money that everyone else assumes is the solution to every problem, yet their pain continues. “Spoiled,” remember, does not just mean “pampered.” It means a kid has been given everything except what’s most important: wholesome loving care. It is, after all, a metaphor about rancid milk — because material abundance paired with emotional scarcity can spoil a person’s capacity to believe that real love (which psychoanalytic language symbolizes as the breast milk of a loving Mother) exists anywhere.

Some kids who are deprived of one or more of Kohut’s two essential relational supplies (a mirroring mother figure and an idealizable father figure) become hyper-competent, fiercely independent adolescents. Later in life, they can have trouble coupling-up, because romance involves giving what they never received, and because the offer of love feels strange and dangerous to them. By contrast, some other deprived kids remain dependent for decades, relentlessly hoping the caregivers they need will come along, or indeed, that their own feelings and behaviors will eventually transform the attachment figures they do have into the wise and generous ones they still crave. Then there are those who combine elements of each, presenting as adults with impressive professional success while remaining lonely and emotionally entangled with their withholding parents. These people are ahead of their peers in the outside world, but behind them on the inside.

Much trouble can be avoided if several afflicted kids find each other in time to form a group, where they can do their best to raise one another. But this is hard, because independent kids are reluctant to depend on anyone, including peers; dependent kids may welcome fellowship, but their resentments can get displaced and wreck the very friendships they have loaded with meaning and value. An adolescent friend group, with its intense attachments, passions, and impulses, can work wonders or exacerbate personal trouble, depending which personality elements get validated within it, and how the larger world responds. Plenty of movies are about the various storylines that such a group can be found living through, though it’s rare that a clique of teenagers manages to learn, from a film, how to avoid the pitfalls in its path. Art might seem to promise lessons of useful prudence, but it mainly offers us a deeper understanding of those losses and mistakes we’ve already endured.

The benefits of therapy derive from insight on the one hand, and the therapeutic relationship on the other. Between the two, it’s usually the relationship that does the most good — but it’s a relationship built on a series of conversations whose main ingredients are the patient’s stories of the past and the recent past, expressions of feelings in the present, and interpretations that come from the therapist or from the patient (in other words, insight). Some of what gets illuminated and reframed is the experience of not-getting what we needed. It might seem like a waste of painful effort, to recount what you already know about old yearnings and losses. But it often turns out that the telling is itself a healing process, when someone is listening with consistently reliable respect and empathy. The teller and the listener can then reshape what the story means, shifting control of that meaning from the outside world of the past into the inner world of the present.