An op-ed caught my eye in the New York Times yesterday. The headline: In Therapy Forever? Enough Already.
As someone who has been in psychotherapy more or less since I was 17 years old (except for a period of one year, another period of two years, and another period of several months), and as someone who recently switched therapists after 11 years, and as someone who is fascinated by psychotherapy in general, I knew I had to read it.
Well, I read it, and it bugged me on and off all day. I read it two or three times yesterday and again this morning.
I read it the first time with shame. I asked myself: have I been in therapy too long? Are my problems more solvable than I think they are? Maybe I don’t really need therapy in order to fix them?
But if that were the case, wouldn’t I have fixed them already?
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The guy who wrote the piece, Jonathan Alpert, is apparently a psychotherapist who has a book coming out this week: Be Fearless: Change Your Life in 28 Days. It’s common practice for newspapers to publish op-eds by authors who have books coming out; op-eds are often marketing tools. But to me, this piece just smacked of blatant marketing. I went to the author’s website, and right there on the front page it says: dubbed “Manhattan’s most media-friendly psychotherapist.” Those are also the first words on his “About” page. Being “dubbed Manhattan’s most media-friendly psychotherapist” is a good thing? If I were looking for a new therapist, that would be a complete turnoff. It makes Mr. Alpert sound like someone who’s more interested in getting publicity and making a name for himself than in helping other people. I would want a therapist who thinks his primary job is to help his clients, not to become famous.
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In addition to his coming off as kind of a dick, I take issue with some of what he says in his op-ed. For example, if a woman comes to him because she’s in an unhappy relationship:
…I ask what might be missing from her relationship and sketch out possible ways to fill in relationship gaps or, perhaps, to end it in a healthy way. Rather than dwell on the past and hash out stories from childhood, I encourage patients to find the courage to confront an adversary, take risks and embrace change. My aim is to give patients the skills needed to confront their fear of change, rather than to nod my head and ask how they feel.
OK, but psychotherapy is not just about solving problems. Some of us have lifelong psychological issues that pervade our lives, that derive from troubled childhoods, where we learned patterns that have kept us stuck, and we can’t be “cured” by antidepressants (because we’re not actually depressed) or by solving one specific problem and then quitting therapy.
He also writes:
In my experience, most people seek therapeutic help for discrete, treatable issues: they are stuck in unfulfilling jobs or relationships, they can’t reach their goals, are fearful of change and depressed as a result. It doesn’t take years of therapy to get to the bottom of those kinds of problems. For some of my patients, it doesn’t even take a whole session.
Fine. But sometimes an unfulfilling job or relationship or whatever is not the real problem: it’s just a symptom of the problem. If you just fix the relationship situation or the job situation, you might just be treating the symptom, not the underlying disorder, and the disorder will just re-manifest itself in another problem.
It seems like a very American, surfacey way of dealing with things. It brings to my mind Annette Bening’s character in American Beauty, this hard-working, high-achieving, outwardly perfect-seeming woman who just thinks positively and tries to ignore or bury anything that’s troubling under the surface. Don’t explore anything: just achieve and move on to the next life goal! Again, so very American.
But what the hell do I know. After all, Alpert is right in one sense: if your therapy isn’t working, it is time to move on. Things weren’t working anymore with my old therapist, so after months of trying and waiting, I moved on — to someone who’s more interactive, more willing to give me fresh insights.
Still, this whole idea about “achieving life goals” — it seems so American. And so late 20th century/early 21st century. People didn’t used to talk about “life goals.” I mean, life goals are a good thing, I guess. But the concept comes from our having moved on from a religion-based world. If you don’t believe in God or an afterlife — which I don’t — then you have to provide your own meaning in life, and that comes from setting goals for yourself. I think it’s a more truthful way to live, but god, it was a lot less complicated when you just felt stuck in your station in life and worked the fields until you died, right?
It’s really annoying to have to come up with “life goals” when you have no idea what those goals should be. What are my goals? I’ve been struggling with that question ever since high school, and I’m no closer to finding them than I ever was.
Have you seen any career counselors about this? A few months ago I went to this talk by a young guy who dreamed of working for an ad agency, but for some reason he didn’t end up getting a job at one. But on the side he would do little projects for fun and one of them was putting these blank thought bubble stickers all over ads in the city and seeing the kinds of things that people would write on them. Eventually his project caught the attention of an ad agency who ended up hiring him and now he loves his job. So his whole talk ended up being about how personal projects can lead to you doing something that you love, for work, even when you don’t think what you’re doing will get you a job.
I wonder if there’s something like that where you’re dismissing it as a career because you like doing it for fun, like all the biographies and your interest in the Times and plays? That kind of happened to me when I was going to college. I didn’t think I could have a career out of art, which is something I did in high school, so I ended up choosing art history as my major in college to do something more “serious” but that was a big mistake (I’m bad at remembering names and that’s all art history is, plus there’s an even worse career path for people with art history majors…). I ended up switching majors back to doing art, but it got too expensive so I didn’t finish my degree. So now I regret not doing art from the beginning, which would have led me to learning about graphic design and industrial design and all the other fun things you can do for a career if you like to make art. I ended up getting there on my own doing things the self-taught way, but I would have been a lot further and learned more if I wasn’t so dismissive of doing what I actually like to be doing.
Plus people don’t realize that what is easy and fun for them isn’t so easy and fun for other people, and that the skills they have when they do something for fun could actually be useful in real careers. So maybe instead of thinking about what you want to be doing for work, think about what you like to do for fun?
Thanks Bart.
I like to read about history, and I like to write about other things. But I don’t really know how I can make a living doing either of those. I think there are a lot better writers than me out there. Sometimes I think I might like historical research, but it seems like maybe that could get boring quickly.
I wrote a piece for the New York Blade several summers ago, and it came out pretty inane and crappy and led to JoeMyGod and his friends deciding they didn’t like me.
I had several sessions with a career counselor a few years ago when I was between jobs, which led to my current job. Maybe it would be helpful to see another one… I don’t know.
This hit a little close to home. I did not read the article, but your post…the last week, I’ve said — both to myself and aloud, be it to my cat or to my friends — way too many times, “should I be back in therapy?” Saying it twice probably means the answer is yes. The amount I’ve said it is a definite yes.
My first battle with depression, I saw 4 or 5 therapists — none of them more than twice — and most of them just once. Hated them all. When I started law school, I was not in a good place — it is still unclear whether I was in a bad place because I was in law school or law school was a symptom of my bad place, or a little of both — but I was paired with a therapist through the school whom I really liked. I was with her for 18 months, but she was a 4th year Psy.D. student, so her fellowship ended and she moved on. I was in a good place, so I did, too.
But lately, I find myself in my old cycle. Not nearly as bad — I do not burst into random tears nightly, I do not hate myself as much as I did, but I still find myself thinking too much and getting inside my own head. I have a job interview tomorrow that I’m scared about, I just had a 3rd date yesterday (for the first time in 15 months…I’ve had almost 40 first dates through okcupid since joining in August 2009. I was off the market — be it dating someone or in too bad a place to date — for about 10 of those months, and to have this possibility of something with a girl whom I really like is scaring the hell out of me and giving me flashbacks to a girl who hurt me by suddenly pulling away after our 3rd date, which was one of the best dates of my life. Does rational me think there are similarities? no. But me-in-need of therapy cannot get out of my own mental way. I see the cycle I’m in, but I cannot break it alone.
I think the point I’m trying to make — even though this comment in itself kind of became a therapy session — is that I am a firm believer in the power of therapy, especially with the right therapist. For a therapist to come out and say, “Nobody really NEEDS therapy” is unconscionable. And maybe he’s right, maybe nobody needs therapy, but it’s a tool to help us get through the day. Nobody NEEDS indoor plumbing, electricity, or a pinky finger. But I have no desire to give up any of those.
I think the tool of therapy is one that should be encouraged, not shunned…especially by a so-called therapist.
And thus ends my rant on my own personal experience with therapy that is very loosely based on your post…
I’m glad you wrote that. It’s helpful to hear other people’s stories about their own issues sometimes. And I too am a firm believer in the power of therapy.
I remember reading another article once in which the therapists made a distinction between problems to be solved and tensions to be managed. She said sometimes people come to therapy thinking they have a problem to solve when in reality they have a tension they need to learn to manage. The end state is not that it goes away, but that they are more capable and comfortable managing it for however long )maybe their entire life) that it persists. This was a really useful distinction for me.
I’m not a huge believer in having big life goals, but I also know that without any specific milestones I feel dissatisfied … as if I’m not accomplishing anything. It’s an interesting balance to calibrate.