James Grotstein is a famous psychoanalyst/author who lives and works in L.A. He’s brilliant, funny, and can make dry psychoanalytic giants like Melanie Klein and Wilfred Bion sound hip and interesting. I saw him speak once in Los Angeles, where he was the “mop up squad” as he called it at a neuroscience and psychoanalysis conference. He stood at the podium, the epitome of elegant elder psychoanalytic statesman. Regal white hair swept back over his forehead, rumpled suit, and endearing, absent-minded-professor brilliance. His job was to integrate the multiple perspectives advanced by many clinicians and researchers throughout the weekend, and Jim did a credible job. He was especially entranced with Dan Stern’s book, The Present Moment in Psychotherapy and Everyday Life, and discussed how experienced therapists anchor themselves in right now. At one point Dr. Grostein became impassioned as he described Bion’s idea that mothers engage in emotional “dialysis” with their babies, helping them process and program emotional experience through intimate intersubjective relationships of understanding, holding, nursing, caring, vocalizing, and gazing. Then, with a sly twinkle in his eye, he pointed out how therapists perform similar intersubjective dialysis, helping clients process, understand, and integrate thoughts, memories, and emotions into more coherent life stories. “The therapist gives the patient visitation rights with himself,” he said to general laughter, but there was a poignant undertone. Most clinicians in the audience knew the feeling of helping another work through emotional toxins to reach the soulful purity of authentic self that we all yearn to identify with as “me.” I love, “emotional dialysis.” It totally applies to all relationships—even with ourselves. Check out the following two hypothetical conversations between Tim and Andrew, a couple discussing the upcoming wedding of Andrew’s niece, Wanda. First conversation: Andrew: “Wanda hates it when you drink too much and get rowdy at parties, so lighten up at the wedding.” Tim: “What do you mean, ‘rowdy?’ She and I have closed more than one club, dancing and drinking. You get so up-tight with your family!” Andrew: “You never listen! Don’t embarrass us again!” Tim: “Again? What do you mean, ‘again?’ How dare you call me ‘an embarrassment!” Andrew: “How dare I? Remember Cabo last year? You know, when they called the cops?” Second conversation: Andrew: “Wanda hates it when you drink too much and get rowdy at parties, so lighten up at the wedding.” Tim: “I thought she liked partying with me. God knows we’ve done it enough over the years.” Andrew: “You’re right, and we’ve had lots of fun! But this wedding is a big deal to her, and I think she wants us to dial it back at the reception.” Tim: “Did she say anything?” Andrew: “Not exactly, but she went on about how her fiancé’s family are ‘conservative.’” Tim: “I can see your point, but what if she wants us to—you know—liven up the party. The family can be so boring!” Andrew (laughing): “Well, let’s stay attuned to her during the night and try to make it great for her.” Tim: “I like that. Help me out if you think I’m pushing it too far.” Andrew: “No problem. Thanks for listening.” Which conversation do you prefer? I absolutely prefer the second. Tim and Andrew are dialysizing the initial distress by listening and bringing more acceptance and cooperation to bear with each exchange. They are taking the toxins out and leaving the love in—essentially engaging in emotional dialysis to purify their exchange. You can feel how the anger subsides and the understanding, love, and humor blossom. Apparently such exchanges might happen more frequently with gay partners. In a couple of studies, John Gottman found that gay couples were especially good at using humor and a sense of equal power and fairness to slow down conflict and speed up repair in difficult situations. All good therapists perform emotional dialysis. During a session I can feel the toxic and nutritious elements of peoples’ exchanges, and I deliberately help them strain out the toxins and focus on the nourishment. Often, after we make the transition to more accepting understanding, I’ll point out what just happened, and encourage the same at home. Many toxic processes are variants of “I hate myself,” or “I hate you!” If you can focus on emotional dialysis as soon as you notice such violent perspectives, good things happen. Try it next time you feel icky about yourself or someone you’re talking with. Accept the icky feeling while simultaneously attempting to soften the hostile parts and grow the “I want more warmth and shared understanding” parts. I suspect you’ll discover such emotional dialysis heals and purifies.