aTypical Joe: a gay New Yorker living in the rural South

Tuesday, October 24, 2006

Talk Therapy

When I was 38 I had been in therapy for twenty years. I up and quit. The therapist, seeing me in her penthouse apartment, was visibly shaken. From then on I took to saying, “self-awareness is the most over-rated aspect of personal change.”

From a NYTimes interview of Dr. Owen Renik, an analyst questioning the self-perpetuating side of therapy:

Q. You place great emphasis in the book on symptom relief as the central measure of the effectiveness of therapy. Shouldn’t that be obvious?

A. Not necessarily. There is a tendency among psychoanalysts to pursue self-awareness as a goal in itself, rather than a means to an end. Originally, the idea was that the self-understanding that arose as a result of psychoanalysis was unique and impressive and valid because it afforded relief from symptoms that were otherwise impossible to treat.

If you don’t require that self-awareness be validated by symptom relief, there are two destructive consequences. The first is scientific. You have no independent variable to track; you set up a circular situation in which it’s the analyst’s theory that determines what is found in analysis. Many critics of psychoanalysis have recognized this.

But an equally important consequence is that you relieve the analyst of any accountability. The process can go on forever, and there are all kinds of temptations to extend it, including the therapist’s vanity, his inability to admit failure, his narcissism - and nobody likes lost income. The therapy then becomes an esoteric practice of proselytizing, rather than a discipline, and the proof of that is everywhere in the world, where fewer and fewer people go to analysis at all. If the therapy worked, people would be going.

Therapy is the norm in New York; leaving was a bold contrarian move. Here there’s just as much need (if not more!) but in this culture it is stigmatized, frowned upon and to seek it out is seen as a personal failing. Is there irony then in the fact that being here has driven me back to the therapist’s couch?