Psychotherapy and the Power of Being “Good Enough”

When the Past Knocks

In the past few weeks, a couple of people from my earlier life reached out—an old friend and a former colleague—each message arriving within days of the other. It made me pause. This time of year often brings a natural turning inward. We take stock of our lives, wonder how we’ve changed, and remember who stood beside us during difficult periods. Sometimes the relationship was brief or imperfect, but meaningful all the same.

As I sit with this, I’m aware of how grateful I am for the life I have today. It isn’t perfect; no life is. But it is good enough. And lately, that phrase has felt especially true to me.

The Power of “Good Enough”

In my work, especially with patients who lean toward perfectionism, I often remind them that perfection isn’t the goal—nor is it even possible. What matters is being good enough: good enough parents, good enough partners, good enough employees, good enough friends.

This idea comes from British pediatrician and psychoanalyst Donald Winnicott, who introduced the concept of the “good enough mother.” He observed that when mothers respond consistently—but not instantly or flawlessly—they actually help children develop resilience. Those slight, tolerable delays teach a child that frustration can be survived. They learn that imperfection does not equal abandonment, and that they can manage difficulty without falling apart.

Letting Ourselves Be Human

I think that principle applies long after childhood. We can allow ourselves to live lives that are real instead of polished, grounded instead of perfect. We can show up with presence rather than performance. We can let our connections be meaningful even when they’re not seamless.

And maybe, in the end, that is more than enough.

 

 

 

The Hidden Life Within: What Cells Can Teach Us About Therapy

When we look at a diagram or image of a cell, it seems simple on the surface — a neat circle with some faint shapes inside. But scientists know there’s much more hidden within. Inside every cell are organelles: the nucleus, mitochondria, and many other structures, each performing essential work to keep us alive.

Therapy is a lot like this. On the outside, a person’s life may look orderly, stable, or even “perfect.” But inside, there may be a world of thoughts, feelings, and experiences that others cannot see.

The Depth Beneath the Surface

Just as the nucleus holds our genetic code, each of us carries inner material that defines us — our history, relationships, fears, and hopes. The mitochondria power the cell, much like our emotions and motivations fuel our daily actions. These inner elements are not always visible, yet they affect everything we do.

In therapy, the work often involves moving beyond what’s visible on the surface. Symptoms like anxiety, depression, or relationship conflict may appear in everyday life, but the roots of those symptoms lie deep inside — just like organelles hidden within the cell.

What It Means to “Go Deep”

Sometimes when I encourage a patient to “look inside,” they are unsure what that means. In practice, it involves slowing down, paying attention to the inner world, and being willing to notice feelings or memories that may not be obvious at first.

It can be uncomfortable — just as examining a cell under a microscope requires magnification and patience, exploring the self requires courage and openness. Yet, this process often brings clarity and healing.

Therapy as an Inner Exploration

When we examine the hidden structures of a cell, we gain a deeper understanding of life itself. Similarly, when we examine the hidden structures of our inner world, we begin to understand ourselves. Therapy offers a safe, structured way to explore these depths, so we can bring what is hidden into the light and use that awareness for growth.

Final Thoughts

A cell is more than its surface appearance — and so are we. Just as science reveals the complex world inside a single cell, therapy helps us uncover and understand the complex world within ourselves. Through this process, healing and transformation become possible.

Psychotherapy Can Help Open the Door to Life Decisions

When people think about therapy, they often picture it as a place to go in a crisis. But therapy is not just about surviving hard times—it’s also about making space to reflect on the major life changes we consider, the ones that shape who we are and who we want to become.

Therapy Beyond Crisis

Therapy is a place where we can process the questions and uncertainties that come with life’s turning points. These moments aren’t always dramatic or visible to others, but they carry enormous weight inside of us.

Some examples might include:

  • Deciding whether to stay in or leave a marriage
  • Considering weight loss surgery
  • Exploring gender-affirming care
  • Thinking about a career change or a move

Even when no clear crisis is present, these choices stir up complex emotions that deserve attention.  I have also witnessed that they can cause significant anxiety, depression and grief.  Rarely have I seen it cause psychosis, but that does happen too, particularly around major life-changing events.

Sometimes making a major decision feels like standing before a closed door. A blue door, in particular, can symbolize calm and hope, yet also the unknown. Therapy allows us to pause at that threshold, to explore our fears, and to imagine what stepping through might mean. Even when it feels scary, choosing to walk through the door—whether toward change or toward deeper self-understanding—can be the beginning of real growth.

The Power of Talking It Through

It’s not always the outcome that matters most—it’s the process of giving voice to our feelings. For example, if I feel uncertain about leaving my marriage, simply talking about my doubts in therapy can bring clarity. Even if I ultimately choose to stay, the act of exploring my emotions openly helps me understand myself better.

The talking part matters more than rushing to a decision. When we honor our feelings by bringing them into the light, we give ourselves the opportunity to make thoughtful, intentional choices about what we want in our lives.

Honoring Feelings Without Judgment

One mistake people sometimes make is believing that talking about a difficult possibility will automatically force an outcome. For instance, discussing gender-affirming care in therapy does not mean someone will be pressured into it—or pressured not to pursue it. Therapy should never be about rubber stamping treatment.   But to say that it’s not necessary to discuss it, ahead of time would be a disservice to our patients.  Instead, it should be a supportive space where feelings, identities, and questions are respected and explored without fear of judgment. By talking openly, people can make informed, authentic decisions about their lives—whether or not they choose to pursue medical steps.

Therapy as a Place of Possibility

Life is full of transitions. Therapy offers a safe environment where we don’t have to have all the answers right away. Instead, we can explore our questions, feel our feelings, and consider our options with compassion.

The point isn’t always to change—it’s to discover what truly matters to us. By talking it through, we make space for self-knowledge, healing, and growth.

The Seasonal Shift in Maine

As soon as the flowers begin to fade, we know that the seasons are changing. In Maine, autumn can be unpredictable—sometimes mild, sometimes severe—but one constant remains: the long stretch of darkness that begins in December. For many, this lack of natural light affects more than just the scenery. It can also impact mood, energy, and overall well-being.

Understanding Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is a type of depression that follows a seasonal pattern, most often appearing in late fall and winter. Symptoms may include:

     

      • Low mood or sadness

      • Loss of interest in activities once enjoyed

      • Fatigue or low energy

      • Difficulty concentrating

      • Changes in sleep or appetite

    While many people feel “winter blues,” SAD is more than that. It is a recognized medical condition linked to changes in light exposure and circadian rhythm.

    Why Light Matters

    Light is essential for both physical and emotional health. Natural sunlight helps regulate our body’s internal clock, supports vitamin D production, and influences serotonin—a brain chemical tied to mood. When Maine’s days become shorter and darker, the drop in light can disrupt these systems, leading to symptoms of SAD.

    Strategies for Coping with SAD

    Fortunately, there are effective strategies to manage SAD and reduce its impact:

    1. Light Therapy

    Specially designed light therapy boxes can mimic natural sunlight and help reset circadian rhythms. Many people find that using a light box daily improves energy and mood within weeks.

    2. Stay Active

    Even gentle physical activity, like walking outdoors during daylight hours, can boost mood and reduce stress. Movement helps release endorphins, which naturally lift energy.

    3. Maintain Structure

    Keeping regular sleep and wake times, eating balanced meals, and staying socially engaged can help buffer against seasonal mood changes.

    4. Seek Professional Support

    Psychiatric care, therapy, and sometimes medication can make a significant difference. Working with a trusted provider ensures that SAD is addressed in a way that fits your individual needs.

    Finding Support in Maine

    Maine winters are long and dark, but you don’t have to face them alone. As a board-certified psychiatrist, I provide telepsychiatry services across the state, helping patients recognize, treat, and cope with Seasonal Affective Disorder.

    If you notice your mood dipping as the days grow shorter, remember: support is available, and relief is possible.  You can reach me through my contact page to set up a time to talk.  I look forward to speaking with you.

    When Food Is No Longer Your Friend: The Emotional Side of GLP-1 Medications

    By Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology

    GLP-1 medications have been a game changer for many—especially individuals with conditions like cardiac disease, where weight loss is not just helpful but medically urgent. Patients taking certain psychotropic medications  who have experienced significant weight gain have also benefited from these medications, offering a much-needed option for weight management that doesn’t require stopping effective psychiatric treatment. The ability to reduce appetite and promote steady weight loss can significantly improve cardiovascular outcomes and reduce long-term health risks. This makes these medications a potentially life-saving option for some patients, and their medical impact should not be underestimated.

    GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have been truly transformative for many people—helping with weight loss, blood sugar control, and overall metabolic health.

    As a psychiatrist, I’m not against these medications—in fact, I’m very much in favor of them for the right patients. But they’re not for everyone, and like any powerful tool, they come with layers that extend beyond the physical.

    This post explores some of the mental health implications I’ve seen in patients using GLP-1s—not to deter, but to add depth to the conversation. Because while appetite may go away, the emotional reasons we eat often don’t—and those deserve just as much attention.

    1. When Food Was a Friend—and Suddenly Isn’t

    Many of us develop a long-standing emotional relationship with food. It’s comfort, company, celebration, or stress relief. So when GLP-1 medications reduce appetite so drastically that meals feel like a chore, it can stir up feelings of loss, disorientation, or even grief.

    I’ve had patients describe it as “losing their best friend,” or “feeling like they don’t know themselves anymore.” This is a valid emotional response—and one that deserves support, not shame.

    For some, the grief can be profound. If a tough day used to end with a comforting meal or favorite snack, and that ritual suddenly disappears, it can feel as though a reliable coping mechanism is gone. That loss can feel overwhelming at times—not unmanageable, but difficult at best. Acknowledging this grief is the first step toward replacing it with healthier, more sustainable sources of comfort.

    2. Nutrition Still Matters—Even If You’re Not Hungry

    One of the most common issues I’ve seen is inadequate nutrition, especially protein. When appetite drops, it’s easy to eat very little—but without enough protein and hydration, people can feel weak, irritable, or even depressed.

    In fact, when nutrition suffers, depression can re-emerge, often presenting with psychomotor slowing, low energy, and even brain fogginess. These symptoms may not always be immediately linked to food intake, but they are critical to address.

    These medications are tools—not magic—and the body still needs fuel to function well. I often encourage patients to work with a registered dietitian or nutritionist, even if weight loss isn’t their only goal.

    3. Emotional Eating Doesn’t Magically Go Away

    Even when hunger signals disappear, emotional eating patterns remain. You might not feel hungry, but you may still feel lonely, bored, or anxious. That drive to soothe through food can come back suddenly, especially if the medication is paused or stopped.

    This is why therapy, self-awareness, and building alternative coping strategies are still crucial. GLP-1s can remove the cue (hunger), but they don’t erase the conditioning or emotional patterns. The groundwork still needs to be done.

    4. It’s a Personal Choice—Not a Shortcut

    I never tell someone whether GLP-1s are “right” or “wrong” for them. It’s a deeply personal decision—influenced by medical needs, emotional history, lifestyle, and goals.

    What I do encourage is informed use: knowing what you’re signing up for, not just physically but emotionally. Support from your medical provider, therapist, or support group can make the difference between feeling isolated versus empowered.

    Closing Thoughts:

    GLP-1 medications can be incredibly helpful, and I’ve seen many patients benefit greatly. But for long-term success—emotionally and physically—it’s important to do the inner work, too. Understanding why we overeat, how we soothe ourselves, and what role food plays in our lives is essential, whether or not we’re on medication.

    You deserve more than weight loss—you deserve peace with your body, your mind, and your relationship with food.

    About Dr. Goodman: Dr. Madeline Goodman, is a board-certified psychiatrist offering compassionate, personalized Telepsychiatry to adults across Maine. She specializes in treating anxiety, depression, trauma, and emotional eating. Learn more at www.drmadelinegoodman.com

    Friendships: A Reason, a Season, or a Lifetime

    Why Some Friendships Don’t Last Forever

     There’s a phrase I’ve always found comfort in: *people come into our lives for a reason, a season, or a lifetime*. The older I get—and the more I work with people navigating change, grief, and personal growth—the more I see how true this is.

    Friendships don’t always last forever. Sometimes they drift, or end abruptly, or slowly fade away without closure. That can feel painful, confusing, or even like a failure. But when we look more closely, many of these connections served a purpose—some we can name, and some we may only recognize in hindsight.

    Friendships That Serve a Purpose: A Reason

    Some friendships arrive when we need support, encouragement, or guidance. Maybe it’s the friend who helped you through a breakup. The colleague who stood by you during a hard year. The neighbor who brought soup when your world was falling apart. These are connections that often burn bright but brief. Their role was to help us in a specific moment—and that’s okay.

    When Life Aligns: A Season of Connection

    Then there are friends who walk with us for a chapter of life. College roommates, coworkers at a job we’ve long since left, neighbors we once saw every day. These relationships are often rich and meaningful, shaped by shared routines or life stages.

    Some of the deepest friendships I’ve experienced were with other parents while raising children. In those years, our lives were so interwoven—playdates, school events, late-night texts about fevers or frustrations. We leaned on each other. We trusted each other. We often became each other’s chosen family.

    But children grow up. People move. Marriages change. And suddenly those connections can loosen, or even disappear. Not out of conflict—just out of the natural evolution of life. It can feel bittersweet. A little like leaving a job you once loved, or saying goodbye to a neighborhood where you knew every face.

    When a Friendship Circles Back Later in Life

    I remember one friendship from my internship in Michigan—someone I met during that intense and transitional time. She wasn’t in medical training with me, but she became a deeply important part of my life. We were there for each other in a way that only happens during vulnerable chapters. After several years, I moved to Washington, D.C., for a more competitive residency, and the relationship quietly faded. I hoped it would continue, but it didn’t—at least not then.

    Years later, she reached out again. The intensity we once shared wasn’t there, but the warmth was. It reminded me that even a “seasonal” friendship can carry echoes of a deeper bond. And sometimes, unexpectedly, a season can circle back into our lives. Maybe not in the same way—but still with meaning. Still with love.

    Lifelong Friends: The Ones Who Stay

    And then—if we’re lucky—we have the lifetime friends. The ones who know the whole messy, beautiful story. They evolve with us. Forgive. Celebrate. Show up. We don’t need a dozen of these to feel fulfilled; even one or two can be a gift beyond measure.

    Short Friendships Can Still Be Transformative

    It’s important to honor the connections that were brief but still meaningful. A friendship doesn’t have to last decades to be “real.” Sometimes, even a short-lived bond can be healing, joyful, or transformative.

    One walk. One conversation. One season of being truly seen.

    Instead of only mourning what ended, we can ask: *What did I learn from this person? How did they shape me? What will I carry forward because of them?*

    Letting Go of Friendship Without Guilt

    Friendship changes can be hard, especially when we feel left behind or unsure why it ended. But with time, we can hold the gratitude and the grief together. We can wish people well—even from afar—and release the idea that every connection must be lifelong to be valuable.

    Final Thoughts on the Changing Nature of Friendship

    You don’t have to hold on forever for something to matter. Some friendships were never meant to be permanent—they were meant to be powerful. And they were

    Therapy isn’t just for bad weather

    Therapy Isn’t Just for Bad Weather

    When spring arrives and the long Maine winters give way to sunshine and warmth, it’s tempting to step back from routines that feel “heavy” — like therapy. Life feels lighter, moods lift, and we find ourselves outdoors more. It’s understandable. But therapy isn’t just for stormy seasons.

    In fact, some of the most meaningful work in therapy happens when we’re not in crisis.

    Why Summer Can Be an Ideal Time for Growth

    When we’re not in survival mode, we can reflect more deeply. We can ask:

    • Who am I becoming?
    • What habits do I want to reinforce?
    • How do I build on the progress I’ve made?

    Without the emotional urgency that comes with winter blues or life stressors, summer gives us space to explore.

    Skipping Sessions Can Disrupt Momentum

    Taking a break may feel harmless, but therapy often builds on itself. Each session adds to the last, and gaps in treatment can slow or even reverse progress. If you’ve worked hard to get where you are, summer might be the time to solidify that progress — not pause it.

    Therapy Isn’t Seasonal — It’s Foundational

    Think of therapy like tending a garden. You don’t just water it when it’s wilting — you care for it consistently to see it bloom. Our mental health is similar. Sunny days don’t always mean we’re done healing. Sometimes they offer the best light to see things clearly.

    Final Thought

    Enjoy the sunshine, take the beach days — but don’t lose sight of the steady work you’ve been doing in therapy. Emotional health isn’t a seasonal project. It’s a lifelong investment in yourself.

    How AI Is Changing Psychiatry – And What It Can’t Replace

    By Dr. Madeline Goodman, Psychiatrist & Psychotherapist

    In the past few years, artificial intelligence (AI) has moved from a buzzword to a powerful presence in healthcare—and psychiatry is no exception. From chatbots offering mental health support to algorithms screening for depression, AI tools are being hailed as the future. But as someone who practices both psychiatry and psychotherapy, I see both the potential and the limits of AI in mental health care.

    What AI Can Do in Psychiatry

    AI can be remarkably helpful in specific ways:

    • Screening and early detection: Algorithms can flag symptoms of anxiety, depression, or even psychosis by analyzing speech patterns, facial expressions, or written language.
    • Support tools: Chatbots and apps like Woebot offer basic cognitive behavioral techniques, which some people find helpful between therapy sessions.
    • Administrative support: AI can assist clinicians by summarizing notes, organizing data, and predicting medication responses—reducing our time spent on paperwork.
    • Access expansion: In underserved areas, AI-powered platforms can provide some mental health support where human clinicians are scarce.

    These are all meaningful contributions, especially in a system where access and time are limited. But psychiatry is more than pattern recognition.

    What AI Can’t Replace

    While AI might be efficient, it lacks emotional depth. Psychiatry is not just about diagnosing and prescribing—it’s about understanding the human story:

    • The therapeutic relationship: Healing often happens in the relationship itself—through being seen, heard, and understood by another person. This is something no algorithm can replicate.
    • Complex emotions and nuance: Human distress is rarely neat. A person may present with anxiety that is also grief, that is also trauma, that is also existential. Understanding that layering takes attunement, not coding.
    • Unconscious processes: As someone trained in psychodynamic therapy and dream work, I believe that unconscious patterns shape behavior in ways AI can’t access. Therapy often means sitting with uncertainty and ambiguity—territory machines aren’t built for.

    How I Use (and Don’t Use) Technology in My Practice

    I value useful tools. I offer telehealth, I keep up with emerging technologies, and I understand the appeal of convenience. But I’ve also seen what’s lost when care becomes too transactional.

    My practice offers something different: personalized, attentive, and deeply human care. Whether you’re navigating midlife transitions, relationship changes, or long-standing patterns, I create a space for exploration that goes beyond symptoms.

    The Future: Human + AI, Not Human vs. AI

    I’m not anti-AI—I think it has a role. But I believe the future of psychiatry is not about replacing clinicians. It’s about supporting them, so we can focus on what machines can’t do: build relationships, tolerate uncertainty, and sit with pain compassionately.

    If you’re looking for mental health care that combines depth, professionalism, and a human touch, you’re in the right place.