Welcome! If you would like to join the conversation here on After Psychotherapy, respond to what I or other site visitors have said or share your own experience, feel free to submit comments on any of the posts. I read and approve everything unless it’s hostile, irrelevant to the post or overly rambling.

As site traffic has increased, however, I find it increasingly difficult to respond to all the comments. Many of the older posts still have active threads and as the number of site visits increases, I spend more and more time reading and responding to these comments. I find I can no longer answer direct appeals for advice in detail, but you may find that other site visitors will share the benefit of their own experience if you submit a comment. A strong community of thoughtful readers is here to support you.

By Joseph Burgo

Joe is the author and the owner of, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.


  1. Hello Joseph,
    Although I have never left a comment(until today) or ask for professional advice, I just purchased a copy of your book and look forward to reading it. Your website has been extremely helpful with its clear and concise writing for my psychotherapy practice.
    You tackle difficult areas with sensitivity and thoughtfulness. Keep up the great work!

    Toby Gould

    1. Thanks, Toby. I’m grateful for your support, and glad to hear that a fellow colleague finds the site useful.

  2. I am currently reading Why Do You Do That? I love the abundance examples to which I can so easily relate! Good job, Dr. Burgo!!

  3. Not a request for advice, OK? Just a few thoughts: Initially, I was a bit…”hmmm” thoughtful about your study requesting a self-select sample to participate in what would eventually be a for profit publication AND for them to pay for their consult with you through Skype. It gave me some ethical-from-a-professional POV cause to pause about this as well as the limits of technology-yes, we DO loose a lot even on Skype…
    I see where you’re going now and I’m much more comfortable in every way with your most recent endeavor. (Aye, as if it really matters, eh?!)
    And I’m pleased for you and if anyone can make this “work” I do believe it’s you. Thanks for giving ME “cause to pause.” We all have blind spots no matter how self-aware we think we are, and you opened one-no, another of mine. Thanks for this.
    Best wishes, I’m excited WITH you and FOR you!

    1. Thanks, Nona. You’ll be pleased to hear that I decided to eliminate the Skype portion of the project, mostly because I don’t see how I could fit all those sessions into my schedule.

  4. Hi Dr. Burgo,

    I was cruising the net looking for info on what drives people to be vindictive as I have somewhat recently had a relationship go awry, ended it, only to have my partner turn on me with vengeance. I can’t make sense of it or the pain that has followed. I feel like a deer in the headlights, still. Somewhat emotionally numb and frozen. And I found your post about VN. Wow. Everything that you wrote was how he reacted . And that post led me to “shame and blame”. I am intrigued. I feel that you have hit the nail on the head. You present the material in an easy-t0-read and logical manner. I have just purchased your book on Amazon and I am looking forward to the read. I hope to learn more about myself and how to shake the current mode in which this behavior has me. Certainly there is more to this story and I hope maybe someday we could discuss it. I shared you on Facebook.

    Thank you for your insights.

    1. You are very welcome. And thank you for showing your support in both ways. It really helps.

  5. Thank you so much. I have only just discovered your website and it is very reassuring to read your comments on neediness. I didn’t feel loved as a small child and was sexually abused as a teenager. I have realised that I have had relationships with unhealthy levels of neediness and I have found it difficult to commit at a more intimate level in close relationships. I have always found relationship break ups unbearable and carried the deep ache with me which has stayed with me in my marriage of 20 years. I have had therapy for over 2 years and have become very dependent on my therapist. This neediness is agony at times and my defense mechanisms work very hard to try and hide this neediness and have sent me into quite desperate measures at times. My therapist has taken this very slowly and I am deeply grateful for his presence and patience, but at times the physical ache from this neediness is excruciating and I feel so desperate that I’ll do anything to get rid of it. It doesn’t matter how much I rationalise and understand this neediness, it still hits me hard and sometimes when I least expect it and the more I fight it the harder it hits. I now realise the importance of being open and honest with my therapist and taking this slowly to unravel the complexity that lies beneath my neediness.

    1. Yes, that’s what you have to do. If you can talk about this neediness, experience it in your treatment with someone you trust, over time it becomes much more bearable, no longer excruciating.

  6. Although I’m waiting (once more) for my *next* paycheck before buying it, I’m getting your book both to deepen my understanding of your ideas and to insure you can afford to be available to us all.

    I recently had a powerful interaction with my massage therapists, who are dear, long-time friends and next-door neighbors. I asked to make an appointment and my normally even-keeled friend got sharp and brittle, pointing out that I’d blown off my last appointment which cost them lost opportunities, and that they were fully booked now and I’d have to wait. I was shocked and hurt, feeling ambushed, as I had no memory of my fault and thought our relationship was peachy.

    I spent a couple days stewing in my own shame before checking in with her; I learned that while I’d been paying attention to other things my struggling start-up neighbors had seen their practice explode and professionalize, and now they simply couldn’t work on “local time” any more. Because they are among the very few people I’m close to, I was able to work though my shame with her at feeling cavalier, obtuse and frankly, less hard-working.

    1. Thanks for your support, and I liked your account of working through your shame. I’ll bet that, once you accepted it and moved on, it wasn’t so hard to bear. Sometimes we fear that accepting shame will be much worse than it really is. It’s actually liberating.

  7. A Freudian slip, perhaps? The book is called called ‘Why Do I Do That?’… not ‘Why Do You Do That?’ (chuckling!!)

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