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Ego weaknesses don't respond to such exhortation as "be open to your vulnerabilities."

There are basic developmentally derived ego (psychological) abilities which govern control of thinking and feelings and the sense of self (sense of who one is) and the ability to modulate mood which crucially determine one's ability to function. Knowledge of these can make one's personal difficulties logical and meaningful though certainly not eliminate them for which replacement of these deficient ego capacities with more mature ones is needed.

How can this knowledge be most effectively introduced to people without causing them to feel "crazy"?

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    Jan 17 2012: Dr Goldstein. I would love to read the book but am a little swamped at the moment. So this is what I know.
    A lot of people have happy fulfilled lives with deficient psychological capabilities. (indeed the capacity for true happiness may be linked to deficiencies in certain capabilities). I understand that you deal with people with extreme deficiencies and resultant pathologies. I understand you assist the people who present with pathological symptomology to find meaning and replace the severely deficient capabilities with more mature ones (actually I think you probably just assist them to mature the ones they have anyway- but different discussion). By doing so you assist them to a more meaningful life.

    Please correct my understanding at this point if I am incorrect.

    Most of us running around with subclinical deficiencies of psychological capabilities can benefit from reflective introspective exercises. I think that is what the video was getting at (still have not been able to get completely through it). I did not get from the video the intended audience was people exhibiting pathological behavior.

    That being said, your second question about introducing the knowledge and people feeling crazy. I think that feeling crazy is a necessary cue for people to get help. If they did not feel crazy they would not seek out your services. The challenge here is to destigmatize crazy. (And in my case, enjoy it:)
  • Jan 17 2012: My comment yesterday seems not to have made it onto the website. As you state, medication can modulate but they cannot heal the ego difficulties I described for which replacement of their deficiencies is required through psychotherapy. Understanding the source of one's limitations scientifically can give one hope, rather than presume that they are unchangeable. The mind is conservative and the unconscious is powerful but all people possess a natural innate striving toward increased mental health, more effective functioning, and greater joy in life.
  • Jan 16 2012: Your questions are very good ones. There is no explanation or research described in the video, which is well spoken and at times amusing but little more than one can read in many woman's magazines, several of which I get in my office. But I don't mean to knock it for it is enjoyable. The basic psychological capacities which I described govern the ability to function in school, the work setting, and the broad field of life. These capacities are possessed in a range from severely inadequate to adequate to of great strength. Those possessing significant weakness In one or more of these abilities (control of thinking and behavior, sense of self, mood modulation,capacity to distinguish reality from fantasy) will have a gravely impaired ability to function, and to achieve happiness (however one defines it). Thus there is a logic to mental health symptoms. The benefits of psychotropic or psychological medication are greatly exaggerated and the research underlying them are generally gravely deficient with few long-term studies (more than several months) or double-blind studies. Moreover, these medications often have significant side effects, which is not however to say that they are not at times helpful. But to replace deficient psychological capacities, psychotherapy is needed--there is no medication for this nor can there be. I hope that I have answered your questions, which are broad and I've addressed in several books, chapters of which are on my website (, or in the online book stores at, barnes&, or in the iBook store.
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    Jan 16 2012: Dr. Goldstein. I am intrigued by your posting. I valiantly tried to view the video but it crashed half way through. I will attempt again later when bandwidth in my area is less in demand. I do need a bit of clarification though. You state the ego governs control of thinking, feelings, sense of self, and mood. I also know that all of that can be modulated with medications and drugs.
    So please clarify for me how this knowledge can make personal difficulties logical and meaningful. Also I need to understand what you meant about replacing deficient ego capacities with more mature ones and how do I go about doing that.
    And I love feeling crazy. Excuses a lot of behavior;)
    Again, I do apologize if some of this is explained in the video.