I made no effort to chart the progress of any particular patient but focused instead on my own feelings of having contributed something of value in whatever encounter I chose to record. In the course of this chronicle, therefore, many patients are introduced but make only a single appearance, while only a few reoccur. Rarely are any issues resolved or settled, but there are nonetheless often hints of movement, of growth, and of opening.

If I had gathered anything from studying mindfulness, it was this: don’t push away the unpleasant and don’t cling to the pleasant, but give impartial attention to everything there is to observe.

This is the ultimate Buddhist therapeutic maneuver. The trick is not to ignore the emotion but to leave it alone, allowing it to appear in its own way, appreciating it for what it seems to be without getting taken in by it.

But, as important as it is to understand the sources and details of one’s pain, understanding is rarely enough. My patients come to therapy wanting the burden of their accumulated experience lifted. Yes, they want to make sense of their lives, but that is not usually their fundamental or exclusive aim. First and foremost, they are trying to get over their accumulated trauma in order to feel less fearful, isolated, forlorn, helpless, alone, anxious, or depressed. They might not be able to say it so clearly, but they are reaching for things

beyond thought, trying to make contact with essential capacities that have been sacrificed in their efforts to adapt, adjust, comply, cope, or conform.

As a patient of mine once quipped when speaking of how writing her memoir had helped her

deal with a sudden and unimaginable tragedy that had upended her life, “Writing is a much better quality of agony than trying to forget.