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? She reflects on the years and years of dredging up childhood memories for one new therapist after another, and wonders what the point is if she doesn’t achieve any sense of resolution and the process doesn’t make her happier. (She has struggled with depression.) Finally, an encounter with a therapist who offers a clear diagnosis of what he sees as her problems gives her the courage to leave therapy:
Dr. F. and I made a fourth appointment for him to give me his impressions as well as his suggestions on what I should do next. Knowing his reputation for being confrontational with his patients, I braced myself for the worst. Even so, I wasn’t prepared for his ruthlessly pragmatic line of thinking, which had less to do with any inner torment I alluded to and more to do with the face I presented to the world, as if I were applying for a position as a flight attendant or a sales rep. He wondered, for instance, whether I thought of losing weight. Dumbstruck, I momentarily lost my footing, and then I answered that I had. He nodded and then coldly observed, “But you lack the motivation.” No, I said, I didn’t lack the motivation forever, I just lacked it for right now. Dr. F. looked entirely unconvinced and went on to ask me if I didn’t long to be part of a couple, to have someone to visit art galleries with. I said I did but that it hadn’t worked out thus far. “You are alone,” he repeated, as if I were in a state of denial. “I know,” I answered. “Many women are alone.” He then noted that I hadn’t written as much as I might have, that I procrastinated and was often late on coming through with assignments. His tone was smug and self-congratulatory, as if he had adduced these aspects of my character on his own when in reality he was simply throwing back at me the bits of incriminating information that I had willingly offered up. I found myself growing ever more defensive, ready to rise up and fight for the rights of unsvelte, unattached and underachieving women everywhere. Who was he to cast me in his patriarchal, bourgeois mold? Sure, I could lose some weight, but how had this come to be the main diagnostic issue? And I wasn’t completely alone: I had a daughter, I had friends, I had had my share of passion, ex-boyfriends and an ex-husband, there were more things in heaven and earth than were dreamed of in Dr. F.’s philosophy.
What was that–a time warp back to the Golden Age of New York Psychoanalysis, ca. 1960? Merkin could have picked that advice up from a waiting room copy of Redbook or Mademoiselle, for cripessakes. All women are warned from the cradle against the two sins against the world we must never commit: fatness and aloneness. Everything must be sacrificed in order to achieve thinness and coupledom! Oh, and telling a writer that she procrastinates? That’s like observing that she breathes. Gimme a break. What a charlatan.
I maintain that feminism is the best therapy of all, and the only kind most women will ever need. (Oh, and maybe a blog, too. That might help.) Seems like it’s worth a try, compared to 40 years of therapists’ bills!