As with John, the change David made is easily understood without any reference to the underlying neurological changes, and I don’t see how any application of current neuroscience could have improved the process or its outcome. Until neuroscience can tell us specifically what we should be doing differently in therapy, it’s about as relevant to our work as particle physics or the migration of butterflies.

Six weeks later, David said that he’d continued to feel comfortable interacting with young children. His sense was that the process had an across-the-board impact on his life, and his wife had noticed that he seemed calmer and more settled. He felt he could loosen up and have fun, whereas before the session, he’d been chronically serious and somber. About six months later, he reported that his wife was pregnant and they were both eagerly looking forward to the birth.

In a recorded interview two days later, David reported what had happened immediately following the session. “I was still processing, and I went off by myself to eat lunch at a restaurant. At the next table over, there was a family with a little baby. And I’m sitting there, and I’m looking over at it, and it dawned on me: I’m playing with this child! I’m playing the look-away game. And I got all excited.”

In the course of a single session, David learned how to take the image of his baby and see it straight in front of him, give it the same movement and other positive sensory qualities that the image of his professor had. Once he envisioned his baby this way—closer, life-size, and moving—his emotional response transformed spontaneously.

When Connirae next asked him to think of someone special he still felt connected to, but who was no longer alive or present in his life, he became more relaxed and animated as he said, “It’s an old college professor; he’s right in front of me—just, you know, life-size, in motion, outdoors, with cars and buildings in the background. I can talk to him and interact with him, and I feel a lot of warmth.” This image elicited a positive response of warmth and the felt presence of his professor, and proved to David that he could experience a person he’d lost as if he were physically present.

Resolving grief effectively requires reconnecting a client with the positive feelings of being with a lost loved one. To begin this process with David, Connirae elicited his experience of loss and grief by asking him what he saw when he thought of his child. He became tense as he responded, “I’ve got a picture of the grave, and a little closer to me is a transparent form of the way the baby would look now, if he’d lived. It’s located up and to my right, and it’s sort of like seeing the image through a tunnel. There’s black all around, and no sound.”

Most therapeutic approaches teach clients to get in touch with their feelings of grief and express them fully, which can result in uncontrollable, hysterical weeping. Although there’s a certain value in this kind of extended emotional outburst, it’s often deeply painful, and even if a client is willing to go through it, the process takes a long time. More importantly, fully expressing feelings of loss seldom resolves the loss.

“When I heard that,” David said, “I was absolutely terrified. I was fixing to lose my family, the whole kit and caboodle. I immediately clicked into my logic mode and pretty much just stayed there from then on.” He’d first learned the trick of suppressing emotions in the face of loss when he was 12 and his beloved grandfather died. “The day before he died, we didn’t know anything was wrong. He sat me down and said, ‘One of these days, I’m going to die and you’ll have to become the man of the family.’ When he died, my response was to separate completely from feeling anything.” Since then, David had experienced the deaths of about a dozen people close to him, including his child, and his response had always been the same: “Keep a good lid on it.”

David was still troubled by the death of his only child, who’d died a few minutes after birth. A year earlier, just before the birth, the doctor had told him, “You’re looking at a 99-percent chance of losing the baby, and a 50-percent chance of losing your wife.”

Working with grief provides an interesting contrast to working with PTSD. Although grief certainly can be disturbing and traumatic, the internal experience of it is structurally the opposite of PTSD. With PTSD, people reexperience a horrible memory as if it were happening again in the present. With grief, they experience a wonderful memory, but are separated and distanced from it. As a result, they experience feelings of emptiness when they remember the person they loved, instead of feelings of love and connection. With PTSD, the solution is to be more objective; with grief, it’s to be more subjective—by reliving the positive feelings of loving connection in the present moment.