All posts by Rune Moelbak

I am Rune Moelbak, Ph.D.: A clinical psychologist in Houston, Texas. I write articles on therapy, psychology, and cultural-philosophical critique, and publish my ideas in national and international journals. I am the owner of Better Therapy: A therapy practice for people who are looking for a more in-depth therapy experience.
treatment of depression Houston

What Is Your Depression Telling You?

In my many years of experience as a psychologist and a psychotherapist, I have seen exceptionally few clients for whom depression was simply a disorder of the brain.

In the vast majority of cases, once a person begins to examine their feelings and their life more closely, they discover that their depression has a meaning and a message.

Depression, in other words, is not just a medical illness, but is what happens when a person is stuck in some aspect of their life without knowing exactly why.

Depression Hides its Own Cause:

Depression often conceals its own reason for being there. It is not unusual for a person to be depressed without being able to pinpoint some definite event that explains why they are depressed.

This absence of a cause often makes it feel like depression has no meaning and is simply the sign of a brain in disarray.

Perhaps this is why the vast majority of people end up treating their depression with anti-depressants, encouraged, no doubt, by commercials on TV.

However, if you go down this route you will largely miss the point of your depression, and will not  grow in the way your depression is challenging you to grow.

Your Depression has a Message:

why am I depressed?The reason why you are depressed is often not apparent. This itself is one of the hallmarks of depression. Depression tells us: you are stuck in some way, unable to deal with some emotion, haunted by the aftereffects of some experience, or dragged down by the reoccurrence of some pattern of behavior.

If you simply knew which emotion, experience, or behavior made you stuck, then perhaps you would not need to become depressed. Then you would have a pathway out: you would know what to do, or what to change.

The fact that you are depressed, however, tells you: it is not that easy.

Perhaps you have a need to be more assertive in life in order to not be walked all over, but this in turn triggers a fear that other people will reject you or that you will be abandoned by others.

Or perhaps, you have a vague hunch that you are not happy in your marriage, but this realization would have such disastrous consequences for life as you know it, and so instead you suppress it with the consequence that you are now depressed.

In both of these examples, depression simply communicates that you have hit some stumbling block to the authentic acceptance and expression of yourself.

It tells you: you need help to find a different path out of your current dilemma, and that your current solution isn’t working.

How to Get Unstuck from Your Depression:

What we discover when we take the challenge posed to us by our depression, is that we are almost always depressed for good reasons, even if it does not look like it from where we stand.

The trick of getting out of your depression is to get help to expand your awareness of what it is that is keeping you stuck. Once the full picture of what is keeping you depressed is brought to light, you will no longer feel stuck, and therefore no longer be depressed.

This was the case for both the person who could not be assertive, and the woman who could not allow herself to embrace her discontent with her marriage…

The Man Who Could not Be Assertive:

depressed manIf the person who is unable to be assertive begins to examine some of the fears that keep him stuck in unfulfilling relationships, he may begin to gain access to more of his frustrations with other people, which he now no longer needs to block from his awareness.

As he allows himself to more fully embrace his anger, he may realize that he is tired of always trying to please people, and may begin to express more dissatisfaction when people let him down. As his anger becomes accessible again, he may also be able to feel entitled to his sadness that people have not really been there for him, and to challenge his negative view of himself as someone who is not deserving of respect. As he gets to the root of where his negative belief of himself comes from, and begins to access more compassion for himself, he may be able to shift his view of himself and feel more entitled to have his needs met.

His depression, which was simply telling him that he was stuck in the dimness of a narrow awareness, would now give way to insight and new possibilities of being himself. As he would then no longer be stuck, he also would no longer be depressed. His depression would have served its purpose, and he would have heeded its message.

The Woman Who Was Unhappy in Her Marriage:

depressed womanIf the person who is unhappy with her marriage begins to more fully allow herself to feel her discontent, and if she examines what the fears are about that hold her back from accepting her discontent, the dilemma in which she is stuck may begin to shift. She may be able to more fully discover what she needs in order to be happy in her marriage and may begin to realize that she has some options to more actively fulfill these needs that do not involve getting a divorce. The fear of realizing that she and her husband may in reality be incompatible, may then lessen, and may cease to serve as a barrier to more fully embracing her needs and wants.

As the unconscious dilemma in which she was stuck begins to become known, and she begins to become more fully aware of the reason for her fears and her unhappiness, she is then able to unlock the message of her depression and use it to become unstuck.

What is Your Depression Telling You?

In the majority of the cases of depression I have seen in my many years as a psychotherapist, there was a message to be unlocked in the person’s depression. Once the person began to fully access and examine the full extent of their feelings and experiences, they were able to see what their depression was telling them, and were able to feel unstuck again.

The reasons for one’s depression, cannot be found by looking at the bottom of a pill bottle, but must be discovered through a process of self-examination that is best facilitated by the process of psychotherapy. Only then will you address the real issue which your depression is telling you to look at, and only then will you be able to set your life on a different path.

For more on the causes of depression, watch the following video:

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist who specializes in helping people unlock the message of their depression. Please visit my website for more information about the treatment of depression. 

Part of a black and silver mask on a white background

The Truth about Pathological Lying

The line between telling the truth and telling a lie has always been the central theme of psychotherapy.

The real self (an acceptance of one’s real feelings and motivations) and the reality principle (a sober assessment of the world as it really is) has always been considered the hallmark of health or good adjustment. 

Various forms of lying, on the other hand, have been the hallmark of what we consider to be pathology or maladjustment.

When we tell a lie, we make reality conform to our ideas rather than adjust our ideas to fit reality. 

In neurosis, for example, the truth gets distorted (minimized or magnified) in the service of maintaining a certain level of psychological safety. We need reality to BE a certain way in order to feel okay with ourselves and comfortable in the world.

In psychosis, on the other hand, our lies become fully-fledged fantasies without any basis in external facts.

Pathological Lying:

Although we all need some modicum of fantasy and untruth in order to make our lives and our view of ourselves more tolerable, for a certain group of people, lying becomes the central mechanism by which they interact with others.

We can call these people pathological or compulsive liars, although in many cases, pathological lying is really more of a symptom than a definition of who I am. 

The compulsivity of pathological liars means that these are not people who choose to lie. Lying here becomes automatic. It is a mechanism for maintaining psychological safety and reducing interpersonal anxiety.

Pathological Lying as Reaction to Trauma:

In my own work with compulsive liars I have generally found that the lying is a reaction to trauma.

One person, for example, was in a physically abusive relationship where he learned that he needed to say or do things more out of a concern for maintaining the other person’s happiness, than out of a need to express his true thoughts and feelings. The truth became associated with danger and became hijacked by the more primordial need for safety. Who I am, in this scenario, becomes who I need to be in order to be liked or accepted by others. Being myself becomes a dangerous proposition, a luxury which I cannot afford. Instead my truth becomes a self-presentation I can adapt to what I think others want from me.

Another person was helped to discover that at the root of her lies was a profound fear of being abandoned if she were to be herself. Vivid examples stood out about not having been picked up after soccer practice, and otherwise being forgotten about or neglected by caregivers in many situations. Now, she had come to think of herself as mostly a burden and as someone who could only count on others to be there for her as long as she provided a benefit to them. Most of this woman’s life thus became a frantic effort to be who others needed her to be so she would not be rejected and plunged into a deep dark hole of feeling worthless and dispensable.

Truth is Only Possible When We Feel Safe:

In both of these examples, the compulsion to lie was driven by a compulsion to stay safe, and a perceived risk involved in being and expressing one’s more genuine self.

Both examples reveal to us that telling the truth is always only possible on the basis of a fundamental sense of safety in one’s relationships with others. The ability to be real with oneself and with others requires validation that one is good enough as is, and certainty that others will be able to tolerate and care for one’s unembellished unadulterated self.

In this sense, pathological lying is really just like any other neurotic defense mechanism. It serves to ward off shame, lack of self worth, and a fear of abandonment and rejection.  

image of psychodynamic therapist, Dr. Rune MoelbakAbout Me: I am Rune Moelbak, Ph.D., a psychologist who helps people get in touch with their personal truths. If you have been hurt or shaken up by the lies of someone you love, or find it difficult to relate to others without lying to them, psychotherapy can help.


Why Is It So Difficult to Change?

When people come to therapy it is usually because they have identified some behavior, some feeling, or some aspect of their life which they find problematic and want to change.

Yet psychotherapists have long known that clients usually resist the very changes which they consciously claim they want.

For example, I know I should not procrastinate in school or at work, but even though I can list all the rational reasons why procrastination works against me, I still cannot simply make a rational decision not to procrastinate anymore.

Resistance to Change:

In therapy this force within me that is working against myself is referred to as my resistance.

My resistance confronts me with the fact that I am not always the master of my own house. It tells me that all the logic, reason, and will-power in the world often isn’t enough to bring about change. It reveals to me the presence of motivations within me that do not fall under the purview of my rational self.

These motivations that work against me oftentimes do their work outside my conscious awareness. They are not parts of my personality, which I identify with. It is this that makes them my most formidable adversary, for how can I win a battle against forces that are mostly invisible to me?

The Benefits We Derive from Symptoms:

The part within a person that resists change is considered by psychodynamic therapists to be motivated by secondary gain. It derives comfort from the very symptom the rational part of me wants to get rid of.

When looked at from the perspective of the rational mind this of course does not make any sense. Why would I for example not want to stop procrastinating? What possible benefit could I get from sabotaging myself?

The secret to understanding this conundrum is to begin to unlock the unconscious logic that makes procrastinating a successful bulwark against greater fears or threats to a person’s psychological safety.

Could it be that I am afraid to succeed because I at some level don’t believe I am worthy of success? Could it be that I am afraid that if I truly try and ultimately fail, I will get affirmation of this fact? Or could it be that a part of me resents the fact that I have taken on a career or a field of study which I thought would make my parents proud, a fact that I cannot openly acknowledge to myself, or which would require me to live with the guilt of openly disappointing my parents?

From the perspective of the unconscious, these would all be excellent reasons to procrastinate. My resistance to change is here the last bulwark against an unconscious and unacknowledged conflict, which must be kept out of my awareness to spare me much psychological turmoil and anxiety.

Keeping Unconscious Conflicts at Bay:

Oftentimes when we seem to not be able to wrest ourselves free of a depression, or change a self-destructive habit that keeps us stuck, it is because of the presence of an underlying unconscious conflict, which motivates us to resist a change to the current status quo.

Although being depressed, for example, is pretty miserable, it is often unconsciously preferable to being assertive and risking other people’s rejections or wrath, or confronting the realization that I need to change career or get a divorce. Depression sometimes keeps me from drawing the unpleasant conclusion of a realization that would cause too great of an upset to myself or to others.

It is often safer to stick with the devil we know.

And so it is that approaches to change that only address the conscious rational side of a person are almost always destined to fail. Although willpower and logical reasoning can get us far in life, they cannot win the battle over our secret fears and unacknowledged conflicts. To truly change oneself is thus ironically to first truly accept oneself: to honor our resistance and let our resistance reveal its logic to us, which means to become more aware of who we truly are and what is truly motivating us not to change.

Perhaps we should become a little more like Soeren Kierkegaard who instead of declaring warfare on his symptoms, acknowledged with a degree of self-compassion: “My depression is the most faithful mistress I have known — no wonder, then, that I return the love”.

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist and psychodynamic therapist in Houston, TX. To read more about my approach to therapy, please visit my website:


depressed man

Shame: The Hidden Root of Most Psychological Problems

You won’t find “disorders of shame” as a category in the DSM-5 (the official American catalogue over mental health diagnoses), and yet shame is probably the biggest single cause of most of our psychological problems.

Shame is often the secret engine that get us started on a path of disordered eating, makes us feel bad about our bodies, causes us to be depressed or have social anxiety, makes us engage in pathological lying, leads us to feel lonely and empty in our relationships with others, and makes us escape into addictions of all kinds.

Shame: A Personal Story

When I was first starting out in this business and had to learn to market my private psychology practice, I had a very shameful experience.

I had been invited to a radio show to talk about my views of therapy. Thinking that this would be an excellent opportunity to plug my practice, I spoke at length about how listeners could contact me, and sought to market my website and my blog. After the show was over, the radio host did not realize that he was still on air as he turned to his assistant and bad-mouthed me for being so self-promoting. My initial reaction was one of embarrassment. The radio host had seen me and judged me in a way that was not flattering, and had pronounced it to the world. He had attributed qualities to me that I both recognized as somewhat true and felt were undesirable and incongruent with how I would want to be. In spite of this, the experience was probably most shameful for the radio host who had been caught off guard in a role that put his professionalism into question. He too must have felt ashamed that these private thoughts had now been broadcast to the world and to his radio show guest.

The example illustrates well what shame is really about. It is about being seen by others in a way we do not want to be seen and in a way that make others pass negative judgment on us.

The initial reaction that comes with shame is the urge to hide or run away. We feel as if we would rather cease to exist for a period of time as evidenced by the expression: to “die of shame”. And yet, if all goes well, we learn through these experiences to adjust our behaviors to become more acceptable to others: to be less self-promoting, or be more careful about what we say and when we say it. In short, we learn from our mistakes, and forgive ourselves and forgive others for their faux-passes.

Shame, in this way, is not altogether bad. In fact, without out it, we would not be able to adjust or regulate our behaviors to the socially acceptable norms, and would not be able to coexist with others.

The Benefits of Shame:

Shame makes us inhibit ourselves to preserve and protect social bonds. It is what makes people not just prattle on endlessly about themselves at a party, and it is what makes us “get a hint” when someone politely brushes us off. In this way it makes us able to function in our society without getting shunned or bothering others too much. Some people who have too little shame, may in fact find it very difficult to get along with others and may feel shunned and rejected in their lives, without quite knowing why.

Pathological Shame:

Shame only becomes disordered when it over-functions or over-regulates our behavior. Instead of becoming a learning experience about the particular norms of a situation, it may instead become a permanent mark on our personality or a permanent rejection of some aspect of who we are. Instead of just becoming the occasion of embarrassment, it may turn into a more permanent sense of ourselves as bad, wrong, repugnant, or unlovable.

The wish to hide now gets attached to an aspect of the self, which we can no longer allow others to see because it would be mortifying for that to happen. We may become ashamed of our body, our sexual desire, our need for others, our desire for independence, or any number of other things. When the shame is really deep, we can’t even access these attributes of ourselves without confusing them with our judgment of them. I may for example refer to any consideration for myself and what I need as a sign of “selfishness”, I may think of sex as inherently “bad” or “dirty”, or I may think of a healthy ability to rely on others as “being needy” or “weak”.

The more powerful my experience of shame, the more I have a need to hide those aspects from others, and even from myself. A part of who I am or how I feel must now be disowned, silenced, or hidden at all cost, and I essentially become estranged from a part of myself.

The problem with this desire to push aspects of myself away is that my shame continues to exercise influence even when it is disowned or goes unacknowledged.

Unhealthy Ways of Dealing with Shame:  

Whenever who we want to be begins to diverge from who we inherently are, the result is almost always some form of psychopathology.

Many people with histories of shame develop an obsession with becoming someone other than who they are. Their entire life may now become a flight from self and a desire to merge with an ideal image of themselves. They want to be free from blemishes and embarrassing traits, but can only hope to achieve this by cutting off a part of who they are.

Unfortunately, the solution they are seeking and the problem they are trying to escape, are two sides of the same coin. The more I pursue my aspiration to become other than myself, the more I increase my judgment on who I really am. Shame and the pursuit of overcoming shame are thus often one and the same.

The problem is of course that I cannot run away from my past, nor can I heal the wounds of shame by simple trying to run away from myself. Shame will always follow me as my shadow, unless I attend to it and address its root cause.

No amount of money in the future can ever heal the wounds of childhood of someone who grew up poor and was teased and ostracized by his classmates, and no amount of self-sacrifice can ever heal the shame of someone who adopted the belief that their lack of love for their parents was what led to their parents divorce.

If we want to overcome our shame, the cure does not lie in ridding ourselves of our shameful attributes, but rather in learning to accept who we really are.

The Cure for Shame:

The antidote to shame is love and self-compassion. However, since shame is such an interpersonal experience and is tied to how we view ourselves in relation to others, simply reciting self-affirmations or telling ourselves we love ourselves, will not produce any real results.

Since shame was created through an emotional experience originating in a social encounter, or was internalized from messages we received from others about what is acceptable and what is unacceptable, the cure for shame must be “a corrective emotional experience”. Love for oneself has to come from the experience of being lovable or acceptable to others. One has to be able to open up to others, to show oneself as one is, and to experience that others can still love and accept one in one’s most vulnerable and exposed state.

This corrective experience is in large part what therapy is about. Therapy helps create the safety and trust to reveal ever more of who one truly is from underneath the layers of social pretense. Sometimes this means getting in touch with facets of one’s experience, which are even foreign to oneself, since one has spent most of one’s energy repressing them in order to fit in and become what one thinks others want one to be.

Ironically, the greatest change in oneself and how one feels about oneself, doesn’t come from changing who one is, but rather from truly becoming who one is. Too many people are embroiled in battles of self-improvement that are nothing but concealed manifestations of an underlying shame. The distance between who one truly is and who one feels a need to be in order to fit in, be normal, or be acceptable, is often the culprit of many of the psychological problems that people report with in therapy, and is often what needs to be dealt with if a person is going to experience lasting peace and happiness in their life.

> Also Read: Social Anxiety and Shame

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist in Houston, Texas who helps people get to the root of their psychological problems, so they can experience real change and not just temporary gains. Click to visit my website.


anger management

What Do I Do with My Anger?

Anger is an uncomfortable emotion for most people. We often wonder what to do with it when we feel it, or want desperately to get rid of it because we associate it with being out-of-control, find it to be destructive, or are afraid it. 

The Benefits of Anger:

Anger has gotten a bad reputation, but like any emotion can be quite useful and adaptive at times.

Just imagine the life of someone who cannot feel angry. Such a person will likely feel compelled to make their life all about other people’s needs. He or she will have a hard time saying “no” to other people, because to do so requires the ability to feel inside of oneself where one’s boundaries are, and to assess what is fair and just, and therefore what one will do and not do.

Anger is that initial alert that things are out of balance or that a boundary has been crossed. It calls upon us to be assertive: To say what we want or need even when it goes against what somebody else might want or need.

A person who is out of touch with themselves and therefore does not experience this “alarm” could therefore easily become stuck in a series of one-sided relationships. They might become a perpetual care-taker, but have nobody there to take care of them. Or they may attract a series of people who do not know how to set limits on their own desires, or might purposely take advantage of the self-sacrificing nature of the unassertive person.

Ultimately without access to what we could call righteous anger, we would not be able to build or sustain healthy relationships based on give and take, and would find ourselves becoming like a chameleon who adapts and changes to each situation, because we wouldn’t really know how we are different from others. Many people who are uncomfortable with anger therefore end up living rather passive lives and have a hard time defining who they are outside of the use or value they have for others.

Read: In another article I have described how this lack of access to righteous anger is one of the key issues involved in Borderline Personality Disorder

Isn’t Anger Destructive?

The problem is that people confuse the feeling of anger with the expression of anger, and may have images in their mind of anger as an explosive and destructive emotion that is quite dangerous and out of control. They may be thinking of the anger that led to domestic violence at home, or the anger that got them fired from a job because they told their boss off. If they were the recipient of this kind of anger, they may be reminded of fear, or if they were the one’s who lost control of their temper, they may be reminded of the sense of shame or remorse they felt after “letting someone have it”.

Ironically, these kinds of violent or exaggerated expressions of anger, are often the result of not paying sufficient attention to anger in the first place.

Don’t Ignore Your Anger:

Anger is one word, but covers a whole spectrum of angry emotions on a continuum from annoyance and irritability on the one end to murderous rage on the other.

Oftentimes, a person will have signs of irritability or annoyance long before they simply become irate. But if they are ashamed of past outbursts or afraid of the experience of anger in themselves or others, they will try their best to ignore these early signs.

This means that they will not have the opportunity to assess what their anger is really about, and will not have the opportunity to address whatever feels boundary violating with an appropriate assertive response. The anger therefore has nowhere to go and may become bottled up until it erupts in a moment of out-of-control behavior.

Why Am I Angry?

At other times, a person may experience intense anger very quickly, and may bypass the feeling of frustration, annoyance, and irritation altogether. In these cases, it often pays to step back to examine what the anger is really about…

If a person is able to be curious about why they feel so angry all of a sudden, they will often discover that their anger is a response to a more vulnerable emotion, and that that this more vulnerable emotion was triggered, causing anger to arise as a natural defense.

Anger mobilizes a person to defend themselves or demarcate a territory. But what is that thing that needs defending? Or what is that territory that is threatened?

Is it my self-esteem that has plummeted, making me feel like I want to hurt this person who doesn’t seem to respect or value me? Or is the territory that is threatened my sense of having a place in my relationship, having a voice, having a role to play, mattering?

Anger often offers us valuable insights into ways in which we feel wounded, rejected, unappreciated, afraid of losing someone, or unable to be ourselves.

It is an alert system that calls for rapid action to restore an equilibrium, or right a wrong. But like any alert system, we have to first examine what set it off, before we can know what action steps to take.

Anger as Path to Self-Understanding:

If we can allow ourselves to feel our anger, we will be able to examine why we feel angry, and will be able to have more control over when and how to express it.

Then we can realize, for example, that the anger we feel at our friend for calling out a flaw in us, is really about embarrassment or shame, of finding it humiliating to agree, of not being able to maintain a positive view of self while taking a critical view of an aspect of ourselves, of having our feelings hurt, or not quite knowing if we are still valuable, likable, and acceptable to our friend or to others at large. In fact, it may protect us from feeling sad or down, or shameful or worthless.

If we can decipher the full message of our experience of anger, then we are free to respond in a more accurate and balanced manner to the perceived threat or violation of our boundaries. We will not have to erupt in rage, but can better express what is really going on within us.

Sometimes this may mean deciding against expressing our anger because we know the anger is really more about us than the perceived threat. At other times this may mean expressing our anger at what we have assessed to be a legitimate concern. And at yet other times, it may mean expressing the actual feelings underneath the anger, and letting people in on the vulnerabilities or sore spots that the anger is simply there to protect ourselves from.

First step in managing our anger is therefore never to suppress it, but to feel it. Sometimes this means working through the fears and shame that makes us uncomfortable accepting this most natural emotion into our repertoire of feelings. At other times, it means undoing cultural messages that make us feel weak or pathetic if we admit to vulnerabilities and mistakes, and make us unable to express what is really causing our anger because it would be too shameful or humiliating to do so.

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist in Houston Texas, who can help you discover the underlying causes of your anger, so you will gain more control of your emotions and feel more effective in your dealings with others. Visit my website to read more about my approach to psychotherapy.

depressed woman

A 1001 Depressions: Which One is Yours?

When we generally think of depression, we think of it as the same phenomenon. People sometimes call it clinical depression, and professionals often call it major depressive disorder. However, depression is not really ONE thing, and there are as many variations of being depressed as there are people who are depressed.

Why is that? Because, in the majority of cases, depression is the individualized expression of a life struggle. It is simply like a fever that tells us there is something we need to look at or something about the way we live our life we need to resolve.

Sure, we cannot exclude the possibility that depression is once in a while the symptom of a brain in disarray, but this type of more biologically based depression is only a small subset of a much more diverse landscape of causes.

There are indeed a 1001 different depressions…

A 1001 Varieties of Depression:

Insecure Attachment:

One of the more common forms of depression is rooted in what we now have come to know as insecure attachments in childhood. Growing up with uncertainty about the availability and dependability of key people in one’s life robs a person of a secure core of knowing they will always exist and will always matter to others around them. As a result, this kind of person is perpetually fighting a sense of frightening loneliness, which they are always trying to distract themselves from. The frightening loneliness is the same kind of fear a child has who gets lost in the grocery store and isn’t sure if she will ever find her parents again. It rears its head when important relationships are severed or when the person feels abandoned. At such times this person may become severely depressed and lose any kind of hope for the future. They get lost in their sense of not mattering to anyone and find it hard to carry on  when they feel their life has lost its meaning.

Loss of Self:

Revolutionary Road is an excellent illustration of how a person can get caught in an empty life and get lost to oneself in the process

Another kind of depression happens as a result of the emptiness that follows from a loss of clearly defined self. People with this kind of depression have become so accustomed to adapt to their circumstances, that they have lost touch with what they really need or want. For far too long, their agenda has been to keep others happy or avoid upsetting anyone, and now they feel empty and hollow because they have completely lost touch with their needs, wants, and passions. Their life starts to feel like it is just a performance. Many people lose themselves this way in their marriages or at work, where it feels like they are just filling a role, and not really living their life. You can find a good illustration of this kind of depression in the movie: Revolutionary Road.

Avoidant lifestyle:

Then there is the avoidant kind of depression, brought about by living a fear-drive life. This kind of person cuts off too many areas of their life to avoid failure or anxiety. Maybe they avoid risking altogether, and therefore also do not get the rewards of those who conquer their fears and face their challenges. This leads to a dull life robbed of excitement and thrills that come with being fully alive. This kind of person may shy away from the risk of rejection and therefore never experience romantic intimacy with another person. Or, they may avoid truly pursuing their career dreams because they are afraid of failing. The end result is an impoverished life and chronic sense of dysthymia.

Shame about Self:

Then of course we have the people who are too ashamed of themselves to fully let themselves be known and seen by another person. These people have mistaken unkind acts by others as a sign that they deserved mistreatment and are blemished, broken, damaged, or bad. Histories of sexual or physical abuse can often lead this kind of damaged view of oneself and the price of this view is depression. Such people end up not really relating to others fully. They may be afraid that others will reject them if they truly know them, or may ward off love from others, which they discredit or believe to be disingenuous. They cannot be nurtured by love because they cannot love themselves, and the result, of course, is a chronic sense of dissatisfaction with life and with oneself.

Internal Conflict:

Karen Horney’s book “Our Inner Conflicts” is an excellent resource for people wanting to know more about potential conflicts that can lead to depression

Another common variety of depression is the one caused by an internal conflict that leads a person to become stuck in an unresolvable dilemma. A person may for example feel guilty or fearful of choosing a career not condoned by their parents, but may also feel lack of motivation and lack of passion if they pursue the path laid out for them. Oftentimes these conflicts that lead to action paralysis or a sense being damned if I do and damned if I don’t, are entirely unconscious. A person may simply show up to their therapist and complain of feeling depressed without knowing why. Depression can in other words take the place of fully dealing with an uncomfortable dilemma that may involve making others unhappy, or may threaten a person’s established sense of self.

996 Other Depressions:

Add to this catalogue, hundreds of other varieties of depression and you will get the point that depression is not ONE illness, nor is it reducible to a simple catchall diagnosis that must be dealt with the exact same way. In fact, for different people, different life events can trigger a depression. If your life is built around security needs, the ending of a relationship may be the trigger. If you gain your self-esteem from being the life of the party, losing favor with certain friends may be the trigger. If your life is about achievement, getting fired might do the trick. It is therefore important to not get lost in the diagnosis, but to see what the diagnosis reveals about the person beneath the diagnosis.

Heeding the Message of Depression:

Depression is not simply a problem to be treated with anti-depressants. It is a starting point for self-examination. It tells us we are “stuck” in some area of life, cut-off from our true feelings and needs, or unable move on from traumatic experiences of our past. It tells us we must get our life back, and reclaim it from whatever forces are keeping us back.

In the short term we may be able to medicate the problem away, but rest assured, the depression will return until its message has been received. No one in the history of mankind has ever been able to run away from themselves.

About me: I am Rune Moelbak, Ph.D., a psychologist in Houston Texas, specializing in the psychodynamic treatment of depression. To learn more about my approach to depression, please visit my website, where you can access additional resources.

unpleasant emotions

Why Should I Feel My Unpleasant Emotions?

One of the most frequent objections I hear as a therapist, is the objection by clients who don’t see what the point is of re-experiencing unpleasant memories and emotions from the past.

How is feeling sad going to help me?” they ask.

Or: “How is getting angry at people in my life who mistreated me really going to serve me?”

Here is my answer to their concerns…

The Desire to Be Rid of Negative Emotions:

Anger, sadness, loneliness, emptiness, despair, grief; these are all emotions that many people don’t know what to do with, and would most of all like to dump in a dumpster or bury deep underground.

And so they typically do…

They try to quarantine pockets of unpleasant experiences from the rest of their life, and spend much of their time trying to actively repress, ignore, rationalize, or minimize how they really feel.

Why Emotions Should Not Be Pushed Away

Of course emotions don’t go anywhere just because we don’t want to feel them. The more we fight them, the more havoc they generally wreck on our lives:

  • You don’t want to be overcome by grief at the passing of your beloved mother, so you push your grief away. Now the grief instead becomes a depression and the loss, which can never be mourned, a perpetual companion rather than a passageway to a better place.
  • You don’t want to feel angry at your parents for the mistreatment you felt as a child, so you tell yourself it really wasn’t that bad. Now instead your unexpressed anger interferes with your ability to have a REAL relationship with your parents, or gets pushed down so far that when it finally erupts, it erupts as rage.
  • You don’t want to get in touch with the loneliness and emptiness that haunts your marriage, so you try to distract yourself by going on expensive trips, redecorating your house,  or having another child. Now instead the emptiness becomes a perpetual hollowness, and the lack of satisfaction in your marriage the cause  of a manic frenzy of activity that never quite fills the underlying void.

The Price We Pay for Ignoring Our Emotions:

As a general rule the more we fight our emotions, the bigger and “badder” they become. If we don’t allow ourselves to feel them and to hear what they have to tell us, they will keep haunting us until we finally get their message. Fighting them is a losing battle and we always pay a price for denying their reality.

As long as we are not at peace with ourselves, but must deny aspects of our emotional reality in order to feel good, a sense of genuine happiness, calmness, and self-acceptance can never take root.

By getting rid of the “bad”, we also ironically get rid of the “good”.

Why? Because we divert our energy from a path of genuinely accepting ourselves, and replace it with a perpetual fight to deny the realness of our own experiences, which means denying the reality of who we are. Happiness constructed on such as a deceitful basis is not real happiness, but a flight from ourselves that can only lead to perpetual unrest.

The Benefits of Our Negative Emotions:

Contrary to what many people think, all emotions are adaptive and purposeful when experienced accurately and expressed appropriately.

Anger, which to many people can feel scary and unsafe to express, is a signal to us that our boundaries have been violated or that we feel mistreated in some way. If we allow ourselves to experience our anger, examine what boundaries might have been crossed, assess the accuracy of our evaluation of the situation, and express our concerns in a calm and constructive manner, our anger will have served its purpose. Our needs can now become known to others, disagreements can be resolved, relationships can be repaired, and we can command respect even when relationships need to be severed.

Sadness also serves a purpose. It tells us what matters to us, or alerts us to what we are missing. If we can allow ourselves to feel it, we will become wiser about our needs and longings, or the things we missed when growing up. Sadness can lead to self-examination, and can lead to greater acceptance of that which we cannot change. It can also lead to greater clarity about what we really value in life and how we should move ahead. When expressed to others in an appropriate way it can bring others closer to us, invite comfort and caring, and make us feel that we are less alone.

Emotions are Really Movements not States:

The myth about unpleasant emotions is that they are rather static experiences that simply take us over, dominate us, and keep us stuck. However, emotion is really more accurately described as a process or a movement. It is derived from the Latin verb “movere” which means “to move”.

Emotions help move us or motivate us, they give us direction, help us to clarify our thoughts and priorities, and serve as vehicles for making changes to our life. Only when we do not allow ourselves to move with them, do they become static road blocks: obstacles rather than passageways.

So to those clients who wonder, “why should I feel my unpleasant emotions?”, my answer is, “to let them move you to a different place”.

By moving into them, you move through them, and by moving through them, they move you to a different place.

By not fighting your negative emotions, you will be transported to the other side, where they no longer bother you, because they have now served their purpose and set you free.

Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D. a psychologist in Houston, TX who believes good therapy involves a transformation through your emotions. To read more about the process of therapy, visit my website.

picture of plants sprouting

Growing Strong in Your Weak Places

“The world breaks everyone and afterward many are strong at the broken places” (Ernest Hemingway)

Ernest Hemingway spoke of a universal psychological truth, when in A Farewell to Arms, he suggested that you grow stronger in your broken places, much like a wound that heals itself by growing a protective scab.

Those who suffer through difficult experiences and invalidating environments have to find within themselves a strength that others don’t necessarily have to. They grow stronger in their weak places.

Strengths through Suffering:

If my family was abusive, my psychological survival would demand of me that I stretch myself beyond the normal requirements for human development.

I might have to develop special abilities to numb my feelings, get into my head, or depend on myself, in order to survive such an upbringing. As a result, these facets of my human capacities will become more developed in me than they will in others, and might give me special advantages, in spite of their drawbacks.

If I become skilled at numbing, suppressing, or silencing my feelings, I might be particularly skilled at working in professions that are too emotionally intense for others. I might handle the job of a paramedic, that would make others queasy, with an even keel, or I might keep calm in a crisis situation when others lose their ability to think or to act.

The Need to Rise Above our Vulnerabilities

The world is filled with people, who due to their trials and tribulations in life, have developed unique facets of themselves that have propelled them into successful endeavors: Comedians who learned that laughter was the best medicine to cheer up their depressed mothers, business men who vowed to never lack money in order to overcome the suffering endured by their parents, and world travelers who came to embrace freedom and independence to deal with the anxieties of getting too close to others.

Alfred Adler, one of the early psychoanalysts, developed the idea that human beings have an inherent need to rise above their weaknesses and excel at something.

Oftentimes our particular hardships become the driving force that propels us to succeed, or that supplies us with a mission for our life and a reason to get out of bed in the morning.

The Desire to Be Super-Human

A colleague of mine recently finished his dissertation on what he calls the “Superwoman Schema”. This is a mindset originally found in a subset of African-American women. These women develop a belief that they must be strong at all times, never show their vulnerable emotions, never allow themselves to depend on others to have their needs met, and always set their own needs aside to take care of others.

This Superwoman schema, helps such women develop the thick skin that allows them to keep afloat in tough environments, and not let their personal feelings get in the way of what they need to do.

Although disavowing one’s own needs and setting one’s feelings aside comes at a price, it is undoubtedly also what has propelled some women like these to achieve great success.

If you have watched the Real Housewives of Atlanta, you will know what I mean. These ladies do not easily let their vulnerabilities show. Having a thick skin has helped many of them rise above tough upbringings, feelings of abandonment and histories of abuse.

Attending to the Underlying Wound:

Of course, the strengths that are born out of weaknesses, also tend to have their downsides. The more one tends to pursue life goals out of an underlying wound, the more these goals tend to take on a compulsive quality: I MUST be strong at all times, I can NEVER allow myself to depend on others, I NEED to ALWAYS be smarter than the next person, I can NEVER make enough money. These dictates soon become tyrannical and perpetuate a judgment of oneself as never quite good enough.

Being human for such people is a dangerous reminder of the past they are trying to leave behind. They therefore spend their lives aspiring to rid themselves of their human frailties. Of course such endeavors are ultimately futile since one can never become what one is not.

Instead of dealing with their pain, and grieving the nurturing they didn’t receive, such people instead disavow their feelings, hoping that they can out-run them. With each accomplishment, however, they only alienate themselves further from who they truly are, and remove themselves one step more from the self-acceptance they ultimately long for.

As long as we cannot accept all of our human experience, including the full gamut of human emotions, from assertive anger, to the pain of disappointment, from the sadness of loss, to our need for closeness, we will always fall short of realizing our most precious project: to become who we are, not more than who we are.

Dr. Rune Moelbak


About Me: I am Rune Moelbak, Ph.D., clinical psychologist in Houston, Texas. I help people attend to their emotional wounds so they don’t have to spend their entire life running away from their pasts.

change in therapy

At the Edge of Your Experience: How Therapy Creates Change

What happens in good therapy is hard to explain to someone who has not yet experienced it.

Why is that? Because the person who enters the therapy room often isn’t the person therapy will reveal her to be. Her very goals and definitions of who she is belongs to her pre-therapy self.

If she is like most people she is used to the idea that life consists of a series of problems to be solved. She views herself as a kind of processing machine that takes in information or challenges, uses logic and planning to tackle these challenges, and produces an output or performance. Her score card is life. She asks herself: Am I married? Do I have a good job? Can I deal with stress at work? Am I happy in my relationship? And if the answer is no, she extrapolates, it must be because she isn’t doing things right, isn’t using the right logic, doesn’t have the right attitude.

She feels like a machine that is broken; a person who cannot deal as effectively with life’s problems as the the next person. She feels deficient, lacking skills that others seem to have, and needing knowledge that will help her deal with life in ways that will make her feel effective and successful again. She needs to get fixed!

However, this is the person’s ego speaking: the ego who believes she is the queen of her own castle, who problem-solves, who plans, and who thinks she is in control.

Therapy, however, is not for the ego.

Encountering a Different Self:

Therapy does not focus on who you are and what you want. Instead it seeks to give you an experience of who you do not know that you are and what you did not know that you wanted.

Instead of focusing on providing knowledge about well-defined problems, therapy seeks to take you to the unclear edge of what you do not yet know. Here at the edge, your own experience can teach you something new. Here you can access feelings you had not previously been aware of, or rediscover fragments of your experience which you had previously forgotten.

Here at the edge of your own experience, you encounter a different you; a “you” that is larger and more complex than your well-defined ego, or image of self. And as you bridge this abyss between who you have been thinking about yourself as, and what you are becoming, change happens to you: Therapy becomes therapeutic.

Will You Trust Me?

It is hard to explain this process of metamorphosis to someone who thinks the solution to their problems lies in techniques, knowledge, or wisdom that they can receive and implement in some rational and planful manner. Because what I am saying, this part of the self cannot understand.

And so you must trust me enough to dare to leave your preconceived notions to the side. You must take me up on my invitation to speak freely, to speak what you do not want to say, to speak about that for which you have no words, that which is farfetched, childish, has no form, makes no sense, or is slightly beyond reach. And here at the edge, is where new experiences take shape; where the self is in the making.

The Role of the Therapist:

Your therapist is there to help you stretch beyond your own capacity, push you towards insights that is slightly beyond reach, notice where the body betrays a consciously held view, where the voice stammers, where emotion hides, or where novelty lurks.

Therapy is not the doing of the therapist, nor the doing of the client. It is the happening of the unseen, the unsaid, and the unfelt from a place “between” the two; the arising of something that neither could have produced on their own.

Therapy is also not the linear execution of a solution to a predefined problem. Change in therapy is not something you implement, it is something that happens to you. And it happens to you always from a place that was initially outside your awareness.

What is Good Therapy?

Therapy is therefore about welcoming in experiences that lead to a revision of previously held understandings or that help you discover something about yourself from a place that was not previously accessible.

Therapy is about growth, revision, becoming. It is about gaining contact with an aliveness and self-evidence in your own experiential depths that will change how you feel about yourself and who you can become.

We don’t know the answers, nor the outcome, before you enter therapy. Therapy itself is the pursuit of these answers. It is through therapy that the mysteries of your existence, of your choices, and of your hang-ups shall be unraveled. Not from a place of universal knowledge, but from an experience of your own personal truth.

Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychodynamic therapist in Houston, Texas. To read more about my approach to therapy, visit my website:



Finding Your Way Out of Obsessive-Compulsive Disorder (OCD)

Are obsessions and compulsions the result of your brain going haywire, or could they have a meaning and a function, which can be addressed through psychological therapies?

Although there is some evidence that severe forms of obsessions and compulsions, such as excessive cleaning rituals or time-consuming fears about contaminating others, might best be treated with medication, we should not rule out alternatives to pharmacological therapies for less severe forms of OCD.

Behavior Therapies for OCD:

One such form of therapy which has been well-established as the psychological treatment of choice for OCD is Exposure and Response Prevention. Exposure and Response Prevention is a behavior therapy that focuses on exposing the person to the very thing they are anxious about and preventing them from engaging in rituals intended to ward off their anxiety.

If somebody, for example, has an excessive fear of being dirtied or contaminated, believing that they might contract a deadly disease from any contact with a soiled surface, they may be instructed to deliberately touch all door knobs in a public office space, and then tolerate the spike in their anxiety that ensues without engaging in any cleaning rituals to rid themselves of dirt and germs. Over time this exercise retrains the brain to not fear, and leads you to “habituate” to the anxiety, which slowly decreases without any need for rituals.

Behavior therapies can be an excellent alternative or adjunct to pharmacological treatments for OCD. They often reduce distress and increase your sense of control over your life, and they don’t come with all the side-effects of anti-depressants and anti-anxiety agents (which are often the drugs of choice in the treatment of OCD).

In the Houston area, you can contact the following providers, to learn more about this approach to treatment of OCD:

Going Beyond Behavior Therapies:

If you want to not simply experience relief, but to find out if deeper underlying issues may be causing your obsessions and compulsions, then psychodynamic therapy might be a good next step.

According to a psychodynamic viewpoint, obsessions and compulsions are defenses against underlying feelings or conflicts of which the person is unaware.

In this kind of therapy the content of a person’s obsessions is not simply treated as arbitrary or irrelevant, but is seen as a meaningful and significant clue that will help unlock the larger unconscious struggles in which the person is caught.

What Obsessions and Compulsions Mean:

If a person is having fears of their own aggressive impulses, such as fretting about the perceived likelihood that they will run somebody over when they are driving their car, this could indicate that anger is not a comfortable emotion for them.

The exaggerated fear that one has the potential to kill another person may here be an outward expression of the inward experience of guilt or shame one feels about one’s anger.

A person may develop guilt or shame about feeling and expressing anger for a variety of reasons.

Further analysis may reveal that:

  • The person feels intense anger at their deceased mother, who was never really there for them when growing up, but whom they feel they need to love and respect
  • The person may hate their boss, but may have learned that it is bad to challenge people in authority.
  • The person knows in their heart of hearts that they really want to divorce the person they are married to, but cannot bring themselves to admit this to themselves or to their spouse.

In each of these scenarios, the outward expression of anger or dissent in their rightful situations has been blocked.

The result is the manifestation of a symptom that displaces their conflict to another arena that is perceived to be psychologically “safer”.

The exaggerated fear that one might run a person over is here a displaced fear of the calamities what would happen if one were to be honest with oneself and admit to feelings of anger directed at actual people in ones life.

The obsessional nature of the fear of hurting a stranger is fueled by energy from the original dilemma which must be defended against at all cost. The obsession represents a fear of the danger of the truth erupting.

As a consequence, the obsession is likely to intensify at times when the actual conflict is threatening to erupt. The person may for example become particularly paralyzed after being told to handle job responsibilities that are not in their job description. This kind of experience threatens to bring anger at the boss to the surface, thus necessitating a greater degree of mental control to keep the truth from breaking forth into the person’s reality.

The trick here is that the person who experiences the OCD symptoms are not themselves able to discover the logic that keeps their obsessions and compulsions in place. Their truth is hidden from themselves precisely to avoid the shame and guilt they need to defend against. It is for this reason that seeing a psychodynamic therapist can be useful and sometimes necessary.

Benefit of Psychodynamic Therapy for OCD:

Psychodynamic therapy is about helping people figure out why they are experiencing the symptoms that are making it difficult for them to live a good life. It is about discovering the meaning in the seemingly meaningless. It is about gaining control, not just of your behaviors, but of your psychological life.

The benefit of this goes beyond simply resolving or dissolving a particular symptom.

When a person realizes that they have unresolved issues related to the expression of anger, they are able to not just stop the ruminations and rituals, but to address the guilt or shame that blocks them from having healthy access to their assertive emotions. They can then be helped to grieve the love they did not receive, or to feel better able to express their needs without feeling guilty or ashamed.

The  treatment of the symptoms of OCD, now gives way to the treatment of the person. Obsessions and compulsions are now no longer the focus of the therapy. Instead they are the starting point for understanding something deeper about a person’s life.

Dr. Rune Moelbak

About me: I am Rune Moelbak, Ph.D., a psychodynamic therapist in Houston, TX. I help people discover the causes of their symptoms. Visit my website for more information.