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After receiving my Masters degree in Social Work in 1987, I went to work as a psychotherapist at an outpatient psychiatric clinic for adolescents and young adults. The Youth Counseling League was located in a brownstone on 19th Street around the corner from 3rd Avenue in the Gramercy Park section of Manhattan. The model of psychotherapy there was explicitly psychodynamic. The psychodynamic approach is an offshoot of psychoanalysis and psychoanalytic psychotherapy.
As a generalization, this approach is longer-term and therapists at YCL had the luxury (unusual even by the late 1980s) of working with clients on a sliding scale without constraints on the number of sessions allowed or the length of therapy. Some clients had been in treatment there for multiple years. The agency provided an intensive formal training program in psychodynamic theory and practice. The attention to supervision and training was incredible, and it proved to be an ideal environment for me to learn the ropes of psychotherapy.
Every therapist was required to have a monthly case consultation with the Medical Director, an eminent psychiatrist, Dr. Eugene Glynn, MD. Dr. Glynn was a brilliant psychodynamic deconstructionist with a quiet but intimidating demeanor. His consultations routinely evoked dread in therapists who had worked there for five to more than twenty years. Prior to my initial meeting with Dr. Glynn, a number of them told me grisly anecdotes about having their work ripped apart, experiences akin to verbal evisceration. I braced myself—if this was the experience of people infinitely more experienced & skilled than me, what could I expect? When it came to my psychotherapy knowledge and skills I was still learning how to differentiate my ass from third base.
While his feedback and critiques could be pointed, Dr. Glynn was much kinder and gentler with me. To my surprise, he complimented my apparent ability to engage oppositional adolescents, in the process teaching me that just getting such clients to continue to come to therapy was a big deal. Sometimes what we anticipate is considerably worse than the reality that unfolds. As Mark Twain put it, “I have been through some terrible things in my life, some of which actually happened.”
Dr. Glynn was also the long-time partner of renowned children’s author and illustrator Maurice Sendak, who’s Where the Wild Things Are, happened to be my favorite book in early childhood. My guess is that he had some influence on Mr. Sendak’s insightful depictions of the powerful ambivalence & deep intrapsychic conflicts intrinsic to childhood. During my tenure at the Youth Counseling League, I heard Dr. Glynn make many statements that elevated my knowledge and understanding. Often, these were highly complex psychodynamically-oriented formulations, requiring me to strain my cognitive capacity to unpack their meaning.
Yet, the statement that resonated most deeply for me over time was among his most simple, at least on the surface: “You pays your money and you takes your choices.” When Dr. Glynn first shared this with me, I was surprised because it seemed so elemental. My reaction resembled that of my initial exposure to certain twelve-step sayings that at first glance seemed superficial and trite. However, on further consideration, aphorisms like “One day at a time,” “This too shall pass,” and “Keep it simple,” are succinct statements of principle imbued with great depth and wisdom. Similarly, as Dr. Glynn was communicating to me via the parallel process of clinical consultation, we can make whatever choices we want/need to—as long as we are willing to accept the consequences of those choices. This equation represents the intersection of awareness and accountability. It is applicable to virtually every area of life, but it is especially relevant to recovery from both addiction and chronic pain.

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