There are many benefits to psychoanalysis or psychotherapy (I’ve enumerated them in the FAQs) although the road to resolution will be different for everyone, every time. Here are examples of the kind of work I do. Please note these are fictional vignettes; they are not real. All work is strictly confidential.

Meet “Bill,” a 48-year old financial services executive, struggling to keep his second marriage alive. His wife is growing tired of his inability to be present, physically or emotionally, with either her or their 6-year old son. He fears, she’s done and he will again lose his family...

Early Days:

Bill spoke of an excruciatingly lonely childhood where this only child was frequently alone whilst his kindly, albeit intellectual parents would be engaged in conversation elsewhere. They were always near him but rarely with him. Bill was, to them, cute and smart but, really, a distraction.

He made his own fun when friends were unavailable which, as he looked back on it was far too often, with LEGOs, books, and TV if allowed. He grew weary of others and eventually discovered that his longing was heavily repressed to minimize the shame upon his parents and himself. Better to be seen as a happy, precocious boy while keeping the negative emotions locked deeply away.

The Issues: Yesterday & Today:

He maniacally focused upon schoolwork and sports, graduating magna cum laude and winning a full scholarship to an ivy-league university. There he made friends across every peer group, which made him feel popular yet he found himself unable to form strong ties. Each friendship was marked by a hesitancy on his part and a tendency to pull away at the slightest slight. He left with many acquaintances but few real friends and no true romances. In his adult life, little has changed although he has been able to find a spouse (twice now). In the corporate world, Bill laments a lack of passion for his work and how his professional relationships don’t exist beyond the transactions. Despite a lofty title, a gifted team and an enviable P&L, he has few friends and there’s discord, yet again, on the home front.

The Work & Working-Through:

Over time, he covered each decade of his life, uncovering a veritable volcano of affect.  He came to realize how he’d internalized his parent’s distance, thinking there was something wrong with him, that he’d done something to cause this relational rupture. His work ethic was driven not by ambition alone but by an abject fear of failure; only perfection would keep him safe and attract at least a little parental attention (who were moved only by his perfect GPA).

Bill fantasized about being far closer to others but felt he couldn’t muster the strength nor could he bear yet more loss. Instead he’d present a self that was fun enough, funny enough but always a bit distant. His charm worked until the shallow magnetism wore off. He’d then have to aim it elsewhere.

I interpreted a false-self. That is, he looked so good on paper and made solid first impressions, but it wasn’t real; there was little to no depth or substance to his persona and so his impact upon others couldn’t endure. All of this was never said to him before. His defenses were unconscious so he didn’t know what he was doing nor truly appreciate the impact it had on others. All he knew was that “something was missing” – him!

He’s worked hard to understand how he presents himself, socially and emotionally, when, and even why. This working-through has allowed him to revisit the relationships whose embers still glowed – with those in his immediate family. Since then, he’s sharing increasingly more of himself with his wife and is now able to be much more comfortably playful with his son. These days, things are looking far brighter for them all.

Meet “Kathryn,” the 37-year old former chief-of-staff to the CEO at private equity fund. She’s invaluable to everyone, sacrificing everything to do it all and stay in everyone’s good graces. Over the past year, she’s become unhappy and wants to change things, but isn’t sure how…

Early Days:

Kathryn was her father’s favorite. This successful, well-respected banker died in his mid-50’s when she was 13. His passing affected her profoundly. She tried, as always, to be a good member of the family, but after the father’s passing, she was resoundingly rejected not only by her widowed mother but also by her two female siblings. Nothing she tried would change their minds.

At school, she’s be all smiles as she believed the “family name had to be preserved” but privately, I came to learn she felt (and still feels) completely alone: lost and without guidance, attention or affection – which she had in ample supply when her father was still alive.

The Issues - Yesterday & Today:

Instead of sharing even a tiny part of her misery with friends, she’d pretended everything was fine. Because of her many gifts (which likely garnered her father’s affection) she was able fool everyone. She had straight-A’s; she was a nationally-ranked athlete; she was super popular; she modeled, earning enough to pay her own way through college – something she insisted upon.

In college and throughout her career, Kathryn kept a few friendships alive, but no one really knew her. She dated but end things when future-related conversations crept up – when things became “too hot.” She turned to online dating but limited herself to casual relationships. At work, she could not work for women but rose quickly whenever working for men. She wondered about all this and, now, approaching 40, she’s worried her life lacks meaning.

The Work & Working-Through:

In our time together, Kathryn came to lament her father’s favor – feeling it served only to estrange her from her family and to mourn the fact that after he passed, there was nothing left for her, emotionally. The ample trust fund she dared not touch; she feared dipping into it would prove he was wrong to have chosen her above all others.

She became aware her sadness over his loss was less severe than her anger at him for what he created and what she as a young girl unwittingly played into. Whilst she intellectually understood her family’s hostility (“Who could blame them?”) she had heretofore rejected how incredibly hurt she was by their turning away from her – especially her mother. After all, it wasn’t her fault…

We spoke about how her ambivalence toward her family became projected upon others; she came to appreciate her reluctance to get involved with others beyond a surface level. Her need to escape from any relationship before it became “too hot” suggested an unconscious fear and a fantasy that they too would perish – and that it would be her fault.

She came to see her work was aimed at re-creating the family she never had yet always longed for, one where she’d finally be loved by all and understand her inability to trust female colleagues as they each magically reminded her of aspects of her lost mother and sisters. Her distrust kept her from forming deep, caring relationships; she feared that even if they didn’t perish, they’d ultimately reject her. Her devotion to senior, male executives proved an attempt to re-create the lost father.

Kathryn ultimately decided to leave the company after 13 years to “try out a new life” as COO at a healthcare startup run entirely women. She’s since been given a co-founder title due to her outsized contributions. She’s working to become more increasingly comfortable with other women and entering relationships that might turn into something more long-term and meaningful than she could ever have tolerated before.

Meet “Kenneth,” a 55-year old CEO of an advertising/communications agency. He’s risen quickly, at the expense of his personal life. Today, he’s wondering how to engage in his non-work-related affairs whilst keeping up at work, which is becoming harder every day…

Early Days:

Kenneth’s parents split up when he was eight. He and his siblings grew quite close, for they were the only bonds that felt real. They each struggled, however, befriending others – in part because they’d never be sure where they’d be on any weekend (as the father, who often travelled for work had joint custody).

His mother was devastated by the divorce and never fully recovered while his father remarried within a year. Both played nice in public but, behind closed doors, each used the children as pawns. The mother made them feel guilty whenever they’d leave her to see their father who, in turn, would consistently bad-mouth the mother, blaming her failure to understand how life works as instigating the divorce.

The Issues - Yesterday & Today:

In elementary school, Kenneth would become overwhelmed whenever he didn’t understand something immediately. Whether a new sport or a new mathematical formula, he’d dread the early days, feigning illness to practice “the unfamiliar” on his own (so as to return fully competent). He’d convince teachers to share lesson plans in advance so that he was always one step ahead.

This need to know grew, making middle/high school – full of secrets and uncertainty – a drag. He often recalled having to step out of class to “keep himself together” when it felt too much. In college and graduate school, the syllabi grounded him but socially, he still struggled, having few close friends. He flourished only in large, highly-structured companies where surprises were rare. In the last decade, digital transformation and the need to innovate has strained him enormously and he fears he’s lost his way professionally now, not just personally.

The Work & Working-Through:

Kenneth painted the picture of a perfect childhood. It was only after weeks of listening that I softly commented upon some inconsistencies (in his story) that was he able – after dismissing my initial musings - to speak of the “ugly parts” of his childhood which he said he practically forgot about.

He recalled a sense of panic in his youth, not knowing whose house he’d be staying at, but hid this concern from his siblings (who seemed not to care nearly as much). Equally, he couldn’t speak to his mother about this for it would only exacerbate her anger towards the father whose travel schedule was as unpredictable as his marital behavior.

Domestic dread was, he realized, projected onto other people and school work. He came to see how not knowing something meant, to him, that he was bad, no better than his wayward father and that, like him, he too would hurt anyone who loved him, so best to have that at all.

We spoke also of his need to control things and how much more difficult it was doing so - as his industry was changing at a rate he could no longer fathom. I noted that his sartorial perfection and the manner in which he spoke to people (including me, at first) was informed by both fantasies of seduction and fears of rejection and about how remaining unmarried might be his way not to hurt others, but it’s not the only way.

He was vaguely aware of some of this yet this was the first time he tried to really understand it.  He’s worked diligently to appreciate what he’s been doing and the impact it’s had on him. This working through has allowed him to revisit relationships – starting with those with his siblings. Since then, he’s begun to date with a more long-term ambition and work more closely with his leadership team to better steer his company into a future that is, for all of us, unknowable.