Some of you easterners probably saw this on Saturday afternoon or Sunday morning already, but if you’ve got a spare 20 minutes and you’re so inclined, take a look at Daphne Merkin’s essay in the New York Times Sunday Magazine called “My Life in Therapy.” She writes really thoughtfully about her experience of therapy, and wonders what (after 40 years) it’s done for her. Part of the problem, she notes, is that psychoanalysis and its offshoots tends to be an end in itself without fixed goals or an endpoint, unlike a consultation with an allopath or a dentist to fix a specific problem. You have a toothache, or a bodily pain? The doctor will diagnose it and make you feel better. The psychoanalyst’s approach isn’t always diagnostic, and even when a problem is identified, what a patient should do about it isn’t always clear. Merkin writes about going to yet another therapist. Would this one help her? And how would she even know if his approach was helping?
And then there was my feeling that I better not get in too deep. I was wary by this point of the alacrity with which I attached to shrinks, each and every one of them, as if I suspended my usual vigilant powers of critical judgment in their presence merely because they wore the badge of their profession. The truth of the matter was that in more than 40 years of therapy (the only person I knew who may have been at it longer than me was Woody Allen, who once offered me his own analyst), I never developed a set of criteria by which to assess the skill of a given therapist, the way you would assess a dentist or a plumber.Other than a presentable degree of intelligence and an office that didn’t set off aesthetic alarms — I tended to prefer genteelly shabby interiors to overly well-appointed ones, although I was wary of therapists who exhibited a Collyer Brothers-like inability to throw anything away — I wasn’t sure what made for a good one. I never felt entitled to look at them as members of a service profession, which is what, underneath all the crisscrossing of need and wishfulness, they essentially were. The sense of urgency that generally took me into a new shrink’s office was more conducive to seeing myself as the one being evaluated rather than the evaluator. Was I a good-enough patient? Would this latest psychiatrist (I saw mostly M.D.’s) like me and want to take me on? Or would he/she write me off as impossibly disturbed under my cloak of normalcy?
I knew I wasn’t the most promising candidate — I was, in fact, a prime example of what is referred to within the profession as a “difficult” patient, what with my clamorous ways, disregard for boundaries and serial treatments — but perhaps this time, after so many disappointments, I would get lucky. Somewhere out there, sitting in a smaller or larger office on Central Park West or the Upper East Side, tucked behind a waiting area furnished with a suitably arty poster or two, a couple of chairs and old copies of The New Yorker and National Geographic Traveler, was a practitioner who would not only understand my lifelong sorrow and anger in an empathic (but not unduly soppy) fashion but also be able to relieve me of them. Just as some people believe in the idea of soul mates, I held fast to the conviction that my perfect therapeutic match was out there. If only I looked hard enough I would find this person, and then the demons that haunted me— my love/hate relationship with my difficult mother (who has been dead now for four years), my self-torturing and intransigently avoidant attitude toward my work, my abiding sense of aloneness and seeming inability to sustain a romantic relationship and, above all, my lapses into severe depression — would become, with my therapist’s help, easier to manage.
Merkin doesn’t address gender issues in her article, but throughout I couldn’t help but see her problem as a gendered one. Why should she feel like her therapist was someone she needed to please, someone from whom she couldn’t demand results, however modestly or vaguely defined? Continue Reading »