Talking about Talk Therapy

Recently, a cover story in the New York Times Magazine, “My Life in Therapy,” by Daphne Merkin (August 8, 2010) generated an onslaught of responses in print and the blogosphere that, I believe, anyone passionate about psychoanalysis should be aware of and concerned about. http://www.nytimes.com/2010/08/08/magazine/08Psychoanalysis-t.html?pagewanted=all

In the article, Merkin details her 40-year history in psychoanalysis with various psychiatrists. The piece reads like a tell-all revenge fantasy against her former analysts. Her portrayal of the analysts is cartoonish in its presentation. Several analysts are silent and withholding. Others are bungling, authoritarian, and arrogant. Merkin’s sarcastic tone throughout clues the reader that she believes the doctor is crazier than the patient.

Her article is an indictment against these individuals in specific and against psychoanalysis in general. She believes neither served her well, yet she returned again and again to “classical” analysis for treatment of her depression.

As I was reading the piece I had a building sense of dread that the author was painting an inaccurate portrait of psychoanalysis that would proliferate rather than dispel old stereotypes. Beyond a chronological detailing of how each therapist, in turn, failed her, she weaves in rudimentary explanations of drive theory and ego psychology.

She has little curiosity about developments in psychoanalytic theory and practice over the last several decades. Nor does she explore other therapy modalities. This created quite an outpouring, as you can imagine, from blog and letter writers from the CBT community.

Many of the letters to the editor and blog entries confirmed my dread. Responses ranged from assertions that psychoanalysis is dead and discredited to judgments that psychoanalytic patients, indeed anyone who seeks therapy, are whiny navel-gazers.

However, there were also postings from current and former patients who responded that psychoanalysis had saved and enriched their lives or had put a stop to self-defeating patterns. Many analysts wrote in to invite Merkin, The New York Times, and its readers to learn more about the process and efficacy of contemporary psychoanalysis.

Psychoanalysis is a powerfully effective therapy. And, we need to get the word out. Recently a peer-reviewed journal article asserted that “talk therapy” works and keeps on working after sessions stop. Check out:

http://www.scientificamerican.com/article.cfm?id=talk-therapy-off-couch-into-lab

Researcher, Jonathan Shedler, has published articles that can be downloaded from his website. I recommend:

https://portfolio.du.edu/pc/port?portfolio=jshedler

The Efficacy of Psychodynamic Psychotherapy (American Psychologist, 2010)

That was Then, This is Now: An Introduction to Contemporary Psychodynamic Therapy

Analysts are wonderful listeners and profound change agents in the privacy of the consulting room. Now they must be excellent talkers and changers in the larger world as well. We need to present an accurate picture of what psychoanalysis is and how it helps people. Merkin will soon be enlarging her article into a book. We have our work cut out for us.

Sally Rudoy, LCSW