In short order, letters written by psychoanalysts, analysands and fellow travelers responding to an Opinion piece published by The New York Times entitled, “Still in Therapy? Enough Already” (Jonathan Alpert, 4.21.12) will be added to this blog. The letters address the publication of an article that, beneath an image of Freud’s couch, lambasted, if not lampooned, long term therapeutic work–aka psychoanalytically-informed treatment. While the letters speak for themselves, a few short words of introduction might help to orient the reader. Ask yourself how often, in America, do we encounter the words of a psychoanalyst outside of the consulting room, uttered in a public, non-psychoanalytic, surround? I suspect for most of us, unless we were born into an analytic family and parented by analysts, or are analysts ourselves and socialize with other analysts, the answer is seldom. The analyst is in, yet the analyst is also always an enigma, and that perhaps is as it should be. And yet, here we read the words of analysts about their way of working, describing it, elucidating the reasoning behind the approach they take, showing the reader their modus operandi, and expressing their feelings about their life’s work being attacked. We also, in these letters, hear from those in analysis about why they chose to go the analytic route–either as patients or as professionals–and what it meant and means to them to do so. In the end, these letters raise consciousness and and we publish them here with exactly that aim in mind. They also build community in a certain way. We hope that educators will build lesson plans around them, and that people interested in psychoanalysis will feel enlivened and invigorated by the sentiments expressed herein.
In the coming weeks, more letters will be added to this collection so if there is a letter you are looking for, by a specific person, stay tuned as we will be updating frequently. They are currently in no particular order but will be eventually grouped according to the date they were written. As you will see if you read these letters through, some writers build on the ideas of others who have written before them. The process by which these letters were written is akin to the snowball effect in research–sort of like he told two friends, and they told two friends. In the beginning, a letter was sent inspiring others to write the NYT on this issue, and this letter made the rounds. Every letter writer was asked to also submit what they had written to The Time to Treat the Times Working Group (T2ttT), an ad hoc bunch who sought to keep the ball rolling for a time. Every letter that was submitted to the T2ttT group was then sent out to provide inspiration and perhaps courage to the ever growing list that was amassing. You will find Classical, Relational, Lacanian, Interpersonal, Jungian, Feminist, and Modern voices included in the cacophony that follows. Meanwhile, the letters please…..
Dear Mr. Brisbane,
This letter is in response to Jonathan Alpert’s New York Times article, “Is Therapy Forever? Enough Already.”
It doesn’t require psychiatric training to diagnose Jonathan Alpert. He is a self-promoting, irresponsible (at best) and destructive snake-oil salesman, who has been accused of possible professional misconduct (in Forbes magazine, 4/23/12). This “Manhattan’s most media friendly psychotherapist” has clearly spent so much time cultivating and appearing in all the media, and advertising in all the public listings for therapists (114 listings in Psychology Today’s therapy directory), that it is no wonder that he has no use for long term psychotherapy and can only devote a few sessions to any patient.
Clearly designed to sell his current book, “Be Fearless: Change Your Life in 28 Days”, this provocative article, evidently has succeeded in arousing much attention (albeit negative) in the therapeutic community. I know many therapists have responded to Alpert’s article with thoughtful defenses of long-term therapy and citing evidences of its value. Personally, I don’t think Alpert deserves to be treated as a serious commentator on psychotherapy (in spite of his very frequent such comments on TV). I recognize his expertise at only one thing: getting publicity for himself.
He cites the statistic that “42 per cent of people in psychotherapy use 3 to 10 visits for treatment, while only 1 in 9 have more than 20 sessions,” and goes on to question the therapeutic value of the 1 in 9. The fact that many people leave therapy after as few as 3 sessions indicates only that they have quit – not that they have been “cured” or helped. I remember years ago attending a large meeting sponsored by a managed care company at which similar statistics were quoted, and spokesmen for the company endorsed a goal of reducing the average number of sessions for psychotherapy even further. Alpert approvingly references a study that found that more patients improved after only one session than they did after 12 sessions. I also recall some years ago seeing a cartoon illustrating one-session psychotherapy: it showed a patient sitting in a chair with a therapist standing over him and slapping him hard with the back of his hand, while shouting “Cut it out!” Alpert must surely applaud such an aggressive, energetic, and motivating communication of such good advice, which utilizes the same principles as his own approach.
The idea that he does more for his clients in a few sessions than long-term therapy can do can only be reconciled if he deals with just one class of people (for which a new DSM diagnostic category will be required): people who suffer psychological difficulties (anxiety, depression, and relationship difficulties) only because they need a good kick in the pants and lack the good advice that Alpert provides in a few sessions. Alpert’s generalization of this kind of “treatment” as preferable for most people in long-term therapy, shows either his gross insensitivity and ignorance of the human condition, and/or his careless, manipulative efforts to promote an appealingly quick illusory alternative to the difficult task of genuine psychotherapy.
Lastly, if the New York Times can recognize that by publishing such a biased glib attack on long term psychotherapy and its practitioners it has participated in an injury to the profession of psychotherapy and to all potential psychotherapy clients, I hope it will make efforts in the future to repair that injury.
Retired Professor of Psychology,
Queens College of CUNY
254 East 68 Street
New York, NY 10065
212 628 7920
I am writing concerning the article that Jonathan Albert wrote “In Therapy Forever?? Enough Already.” I do not agree with this at all, it is not based on any study or facts and to be putting this is the NY Times is just stupid. I personally expect more than this from the NT Times. I recently lost my husband and I went to a six weeks bereavement group, after the six weeks we all voted to have another six weeks, after
those six weeks we voted to have workshops on topics such as “How to
handle the holidays” how to deal with birthdays, favorite restaurants, family gathering, this went another six weeks. Everyone wanted
to join in the next bereavement group but we were not allowed to because whoever set this up thought six
sessions was enough, it was not. I am now continuing on a one to one basis. Having this type of attention is rewarding, talking about what you want to discuss is rewarding, having an intelligent un-biased person to communicate with is rewarding, doing something for
myself, having something to look forward to each week. I can’t name all of the benefits from seeing someone for more than
six weeks. I hope you consider what you are printing in the future. Is this information based on anything???? or do people just write whatever they want with no accountability??
Annette Rawlings – retired
1516 S Lakeside Drive #105
Lake Worth, FL 33460
Dear Mr. Brisbane.
I was surprised and troubled to read Jonathan Alpert’s glib article about the task of mental health professionals and their patients in the New York Times–”In Therapy, Enough Already.” While it is true that the majority of people who come into private practices are not schizophrenic they are nevertheless very often extremely disabled in some aspect of their life: we see so many young people with eating disorders that if left untreated are life threatening, so many trauma survivors with extreme, debilitating anxiety, or depression that will not lift and renders life colorless yet excruciatingly painful. So many women and men whose lives are disrupted profoundly because of the abandonment of parents through incestuous contact or emotional or physical abuse, who may turn to drugs or alcohol in order to maintain a feeling of being connected with another loving human being. Who exactly walks into Mr. Alpert’s office? How did his job get so easy? Try telling an incest survivor to get over it and move on. These are people whose lives have been so disrupted at the core of human connection that the world becomes a mine field for them. The slow buildup of a relationship that is respectful of boundaries yet can contact important parts of the self is no easy matter and certainly not possible with a few bromides and a pat on the back.
And while we are speaking of schizophrenia, let me suggest that a more important article might have been about the living conditions of people who are mentally ill and must depend on out-patient programs for their survival. As part of my psychoanalytic training I spent a year at an outpatient facility talking to “consumers”, many of whom knew that such a word was a joke. Without a choice you are hardly a consumer. The insensitivity to which these indigent, mentally ill people are treated is something to take note of. Underpaid and untrained counselors who are ill equipped to handle the kinds of issues such “consumers” bring to them and psychiatrists, often overwhelmed by the onslaught of difficult patients who defensively assume noncompliance when told of side effects that are often torturous–such conditions hardly make for an environment that we, as a society, can be proud of. Without money of their own or family members to advocate for them, these people are at the bottom of the health care system. If you choose to write about the mental health crises in America today, I would expect an article that deals with the real issues of suffering people, not with some panacea devised by a quick fix advocate. Of course there are cases where people are not helped and kept in treatment to fill the coffers of the therapist. But blithe references to some sort of magic bullet will not help anyone. Mr. Alpert’s article is certainly congruent with how the insurance companies view mental health. But I do not believe our health care system is there for its “consumers”. Leaving decisions about health care in the hands of the insurance companies is like mandating that the banks decide where customers spend their money. It expresses a total lack of interest in the patient and an equal disrespect for the health care provider.
Long term psychotherapy, has recently been shown in studies to be more effective than CBT or medication for many disorders. Psychoanalysis tends to be a therapy that takes a long time. It should be the therapy of choice for those wishing to work with a therapist trained rigorously in how to listen to patients and how to understand the often hidden reasons for difficulty in achieving one’s goals in all aspects of life. Psychoanalysis is the only mental health field that requires the practitioner be in psychoanalytic therapy as part of his or her training. Some people come into our offices and are helped very quickly. Most often it takes some time to unravel the complex strands of experience that are not apparent until looked for. Such experiences, not in the forefront of the mind, might help a person, nevertheless, through life but some, on the other hand, get terribly in the way. Neuroscience is now validating much of psychoanalytic theory and opening up new areas of study for psychoanalysts. Psychoanalysts, as a rule, are profoundly dedicated to their work and desire to help their patients. Many of us accept very low fees where insurance is non existent or treatment is denied. I, myself, have been working with a schizophrenic woman for over ten years who pays me what she can afford–many of those years it was 50 cents per session. Our training is long, expensive and arduous. Mr. Alpert’s lack of respect for patients and therapists seems ill informed and prejudicial.
Josie Oppenheim, L.P., N.C.PsyA.
Research Faculty/Center for Modern Psychoanalytic Studies
16 West 10th Street
New York, NY 10011
354 West 12th Street
New York, NY 10014
Dear Mr. Brisbane, 2012-05-19
As a Community College English professor currently in psychoanalytic training, I gave Jonathan Alpert’s article, “In Therapy Forever? Enough Already” (April 21, 2012) to my remedial English students to see what they could come up with in terms of critical argumentation. The remedial English course at CUNY teaches Basic English skills as well as argumentative and rhetorical skills preparing students to re-take the CUNY entrance examination. Usually I can rely on the NY Times opinion pieces to inform students about basic issues relevant to their lives and they enjoy discussing and debating the articles in class. The following are a list of argumentative points taken from students’ homework assignments in response to Jonathan Albert’s article. Their signatures are their own.
“In Jonathan Alpert’s article, “In Therapy Forever? Enough Already” (NY Times April 21 2012) he quotes a therapist who said, ‘See you next week’ to the patient when a patient asked for advice. The author is using the example supposedly to show that therapists don’t care about their patients. He wanted the reader of his article to be appalled or disgusted with therapists; the author thinks therapists should give advice. Well I bet that Albert hasn’t taken College English. In English class we have to come up with our own ideas; we can’t rely on the teacher to tell us what to do. When we have thoughts about an issue or about an article we read in class, our professor never tells us what to write. Most of the battle is figuring out how to do it yourself. I learned that therapy is supposed to be the same.” Student from Ukraine, first in her family to attend college.
“Alpert claims that “ineffective therapy is disturbingly common. He does not define what effective therapy is. His idea of ineffective might not actually be ineffective. Let’s say for example that I deal drugs. I get caught and do some jail time. I have to see a counselor who has me talk about my childhood and how I hate my dad who beat up my mom. Say I don’t stop dealing drugs. Was that because my therapy was not effective or because I simply make too much money and don’t have the education or the connections to do something else to make a better living? Let’s say that I do stop dealing drugs, how do you know that was because of the therapy I had in jail? Maybe I found a cool girlfriend and I just don’t want to piss her off. I think this is an example of the fallacy of false cause.” Native from the “hood.”
“It seems Mr. Alpert thinks problems should always be solved. If you come from where I come from in the South Bronx, and you think problems can be one day just solved, well, then you are REALLY CRAZY!” Mother of two from the Bronx.
“Mr. Alpert claims that he has patients who achieved life goals within weeks. I lost 120 pounds on Weight Watchers two years ago. I have gained most of it back. It is easy to say that people have achieved their goals when you don’t treat them long term. Long term is always a long problem.” Teenager trying to get over Fast Food Addiction.
“I wanted to focus my argumentative note on the title of Mr. Alpert’s book cited at the bottom of his article, “Be Fearless: Change Your Life in 28 days.” I have two points. First his command “Be Fearless!” This sounded like the Nike ad “Just Do It.” Albert assumes that fear is what gets in our way. How does he know? What if being poor is what gets in your way? What if you have to take care of a handicapped mother? Secondly, I wondered why he uses 28 days as the time period for change. For this assignment I googled “28 days” and found a lot of symbolism, primarily of the woman’s menstrual cycle and of the lunar month. I figured Osiris’ reign and the Chinese Zodiac were less important. I wondered why he would use 28 as opposed to two weeks or one month or 90 days as in P90X?” Brooklyn Thinker.
I hope you find my students’ critique as compelling as I do.
Manya Steinkoler PhD
Psychoanalyst in Training
Associate Professor of English
New York Times
April 29, 2012
Dear Mr. Brisbane:
As a psychoanalyst, cultural critic, and teacher of psychoanalysts, I would like you to consider that your paper’s biased criticism against psychoanalysis is grossly irresponsible. Even worse, its approval of the short-term therapies and their accompaniments amounts to an uncritical celebration of a form of psychotherapy which has come into being largely in response to the needs and values of the powerful pharmaceutical and insurance industries. While often citing science as validation for its claims, these therapies fail to recognize or give recognition to the following: it is not psychoanalysis which is inadequate in its ability to scientifically demonstrate its value, but rather it is science that is inadequate in its inability to access that which psychoanalysis treats and studies. The claim that the short-term therapies have made psychoanalysis obsolete are nothing more than propaganda and, perhaps at times, ignorance.
Psychoanalysis continues to be invested in by many individuals who value something beyond the “fast-food”, quick-fix, immediate gratification culture that is dominant today. The practitioners of psychoanalysis, and the analysands who seek them out, are interested in something more substantive than the vacuous benefits of the dominant ideology’s intervention industry. We seek to find the highest nobility in ourselves of which humankind is capable. We are not content with mere relief of “presenting problems” and a mindless adjustment to a society which continues to rush headlong toward its own destruction. Rather, psychoanalysts and analysands seek to confront what it is within all of us, that produces presenting problems and symptoms in patients, whose disavowal or ignoring, on a collective scale, is ever more rapidly destructive to humankind and to the planet.
Psychoanalysis is content with nothing less than that. And psychoanalysis has discovered and treats something crucial, and to which science, psychotropic medications, and short-term therapies have no access.
These are just a few kernels of thought for you to consider in your paper’s decision to malign psychoanalysis. You are maligning the very thing that addresses what is indispensible to any meaningful life and indispensible to justice, critical thought, and the future of us all.
Joseph Scalia III, M.Ed., Psya.D. Dissertator;
103 1/2 South Main Street,
Livingston, Montana 59057
Psychoanalysis & Culture; Boston Graduate School of Psychoanalysis
Director, Northern Rockies Psychoanalytic Institute; Bozeman, Montana
To the editor,
This letter is in response to the article that appeared in the NYT written by Jonathan Alpert on April 21, 2012 in the Opinion/Sunday Review Section, entitled “In Therapy Forever? Enough Already”
In Donizetti’s opera “L’elisir d’amore” a self-proclaimed doctor, Dulcamara, enters the village with his entourage selling his product that cures virtually everything. When he is asked to produce the elixir of love he comes up with a bottle of wine and the price is set based on how much Nemorino, the desperate young man in love, had in his pocket. “Doctor” Dulcamara of course knows that what he sells is really a promise and nothing more–maybe even the people who buy his product know that as well–but the sale pitch is so compelling, and the price so attractive, that it becomes irresistible. He sells a placebo full of promise and by the time disappointment might set in he is in the next village.
It is unclear whether Dr. Alpert, like Dr. Dulcamara, is aware of the nature of the product that he is selling but he is definitely aware of his marketing methods. Using highly selective ‘evidence’ from selective sources and by caricaturing everyone else in the profession, he aims to elevate himself as the only holder of the psychological truth. The one who holds the secret of the human condition and its cure. A cure he can deliver not in ten years, five or even one but in 28 days! He caricatures all other therapies and therapists, and also caricatures the very people who decide to seek treatment.
Dr. Alpert, like everyone else, is entitled to his opinion of course but where does the responsibility of what gets printed in the NYT come into the picture? This, like other articles of its kind, appear more as an author’s promotion of his or her book rather than a presentation of something that can further understanding in a certain field. This article fails to produce anything of substance where other authors more often than not present something of value. Is the distance between tabloid sensationalism and what appears in NYT disappearing? Are we, the thousands of its readers who are being insulted and assaulted, obligated to buy it?
Most of us know that a love affair of six or eight weeks is free of the difficulties that come from a long term relationship but such love affairs are devoid of the gains and maturity one can achieve from working through painful problems and conflicts. It is an analogy potentially fraught with problems but one worth considering when thinking of therapy.
Becoming free of problems in six sessions or becoming fearless in 28 days sure sounds compelling but at least in Wagner’s mythical character Siegfried being fearless did not serve him very well. Thank you for your consideration.
Fellow, Center for Modern Psychoanalytic Studies
To the editor,
In my professional experience, short term therapy results in short-term relief. For some people this is enough. For others whose emotional distress persists, additional therapy is necessary. This may result in analysis of many years duration as layers of concealed painful memories emerge. Jonathan Alpert may not find it comfortable to deal with the intimacy that develops in an analytic transference relationship. After over 30 years of experience I cannot imagine that 28 sessions of therapy can result in anything more than a temporary, superficial relief.
Dr. Lynne Laub
Faculty/Co-Director of Admissions, CMPS
15 West 12th Street
New York, NY
People spend longer with their interior decorators than you suggest they might spend for their mental health. Ridiculous.
Rev. Robert Jones
Dear Mr. Brisbane,
This letter is in response to the article that appeared in NYT written by Jonathan Alpert on April 21, 2012 in the Opinion/Sunday Review Section, entitled “In Therapy Forever? Enough Already”.
When we moved in to our Brownstone in Brooklyn, 19 years ago, we were well aware of how lucky we were that my husband was a carpenter with extensive talent. The previous owners attempted to apply quick fixes to every problem so we discovered drop ceilings and layers of flooring atop a structure that badly needed repair and straightening. Room by room my husband took apart years of inadequate carpentry bandaids, unravelled layers of unnecessary clutter and performed needed structural repair. Our finished product was not only aesthetically pleasing on the outside, but also structurally safe and sound beneath the surface.
As he proceeded to unpeel the layers of our home, I undertook a psychoanalytic training and analysis, unpeeling my own layers of maladaptive behavior and learning how to help my patients do the same. I have seen and experienced myself that as the mind unfolds in a good analysis, better adaptive behaviors begin to replace the old, and the new structure of the psyche is better equipped to handle the trials and tribulations that life inevitably brings. Structurally safe and sound beneath the surface.
Would you prefer to live inside the 28 day renovation, or the one that required time, effort and thought?
Teresa Solomita, LCSW, NCPsyA
Psychoanalyst in private practice NYC and Brooklyn
Assistant Clinical Director SBPC Mapleton Clinic
May 17, 2012
Dear Mr. Brisbane,
I wanted to add my voice to those of my colleagues who, in their outrage and concern, have written letters objecting to the OpEd piece by Jonathon Alpert regarding psychotherapy. But I find that the content of that article to be so puerile that I am reluctant to give it the attention it has aroused.
On the other hand, I feel deeply disappointed in the New York Times for allowing itself to be used in such a superficial and obviously self-serving endeavor without recognizing the recklessness and weightlessness of the piece. I would expect that even on the OpEd page there would be reasonable scrutiny and intelligent analysis of contributions.
The jury is no longer out. There is substantiated research data as well as over one hundred years of anecdotal experience to verify the effectiveness and importance of intensive psychotherapy – not advice, not coaching, not hectoring. There are many modalities and there is brief as well as long term therapy but what Mr. Albert is calling therapy is no different than Mel Brooks’ 2000 year old man who, when asked about his experience as a colleague of Freud’s, described curing a woman who had a compulsion to cut paper by yelling “Don’t Cut Paper!” A delightful joke but that’s about it.
Lee Crespi, LCSW
Teacher and Supervisor
Dear Mr. Brisbane,
Your position that long-term therapy is the only desired form of therapy – and that those who practice long term therapy (psychoanalysts) is an insult to the patients more than it is to the analysts. Patients may elect to stay in long-term therapy not because they are being swindled by ill-informed or money-hungry therapists, but rather because they have a deep interest in understanding themselves on an on-going basis. Whenever they reach this understanding – whether it be 2 months or 2 years or 20 years, the patient may choose to stay in therapy – even until there is a death – of either the patient or the analyst – whoever comes first – because the relationship has become a meaningful one; because there is an on-going dialogue which is fulfilling and enriches the patient’s life; because flexing the muscles of the psyche is not so different from flexing the muscles of the body – it keeps one in shape. (Do you go the gym for a few weeks, see your muscles develop – then do you stop going because after all the muscles are there to be seen? No – you keep going to keep them vigorous and vital – and so too with therapy and the mind.) For many reasons a patient may elect to stay in long-term therapy – reasons that the patient makes as an independent thoughtful person, having committed to accomplishing a specific (or even a non-specific) goal, and understanding that therapy is one route toward accomplishing that goal.
JANE G. GOLDBERG, Ph.D.
- Licensed Psychologist and Certified Psychoanalyst
- Owner of La Casa Day Spa
- Founder of Brainercize
- Blogger for HuffingtonPost.com
- Blogger for AOL Healthy Living
Dear Mr. Brisbane,
In his recent opinion, published by the New York Times, “In Therapy Forever? Enough Already,” Jonathan Alpert presents good general and basic ideas about how a properly conducted therapeutic treatment should aim at. As an example, an initial assessment takes place. What the patient wants from the treatment is determined; treatment goals are identified; the treatment plan is created, and the work begins. This is what any ethically- practicing clinician does, so it is not so different from what Alpert suggests. Towards this end is where Mr. Alpert’s opinion ends. Everything else said by him, thereafter, is regrettably a disservice to his professional colleagues, the whole spectrum of therapeutic practice, and to the public he wants to enlighten.
The type of treatment approach described by Alpert has a place in the vast continuum of available treatments, all of which ascribe to the same baseline function and best-practice model mentioned by Alpert. But, here is where I think Alpert is myopic is his views. He fails to describe the many different approaches available to the public, with their divergent theoretical perspectives and associated practice styles for creating change for concerns and challenges that are as diverse as the public it serves. Alpert’s paranoid-like and righteous opinion reveals a narrow and megalomaniacal style of his own: his way or no way! For him, all other treatment approaches, at least in his opinion, are in the service of the therapists self-interest, of deceiving, and of taking complete advantage of the public. This revealing presentation is disturbing and dangerous because it simply creates unfounded anxieties, fears, suspiciousness, inhibitions, moral panic, and mass hysteria amongst all involved. Therapy is supposed to expand the mind not shrink it, Mr. Alpert! Alpert’s treatment approach may be fine for some people, but absolutely not for everyone. Alpert fails to explain this important distinction and presents the illusion or delusion that treatment is a one size fits-all-too-well endeavor. Ouch! This fit is much too tight for those who may want a fitting and not something mass-produced and off the racks.
Other treatment approaches, such as the analytic ones, the behavioral, gestalt, cognitive and systemic, espousing both short and long-term treatment aims, hold the same treatment principles that Alpert wants you to believe are uniquely his own. The difference being is that these treatment approaches emphasize different aspects of the person, such as the role of the unconscious, of behaviors, of a unified whole, of cognition, and of interfacing systems, affecting the overall life and motivation of each person. To suggest that if change does not happen fast enough means that the treatment is not working and that the public is being exploited by a treatment is a gross misleading perception, and ironically enough it accomplishes what Mr. Alpert accuses other treatment approaches of doing to patients…wasting their time and now ours!
Individuals are unique and require all types of levels of care at a given time and sometimes for varied reasons. The treatment, which is right for you, is ultimately determined within the confidential patient-therapist therapeutic relationship by you, based on your desires for brief or more open-ended therapies. Mr. Alpert, here is a progressive communication for you, let us all keep the interest of the patient in the forefront of the work that we all do and avoid a pseudo interest in patient care, when underlining motives seem more in keeping with what sounds like self-promotion and a witch hunt, than anything else!
Jose A. Hevia, LCSW-R, LP
223 Bloomfield Street, Suite 117
Hoboken, NJ 07030
Dear Mr. Brisbane,
Since reading the recent Times piece promoting quick, pep-talk therapy over long-term, psychodynamic models, I’ve been reviewing my caseload. Could I cure the major depression of a suicidal young mother with some tough-love encouragement? Might there be a short cut to train the victim of childhood sexual abuse to stop repeating self-destructive relationships? Is there something I could say in half a dozen conversations that would melt away the defenses of a 40 year old woman so brittle she can’t let anyone get close?
I’ve been wondering if the guy who writes about changing people’s lives in ten quick sessions has known the experience of working intensely over five or ten years with someone who has revealed her deepest held anxieties, and in that process discovered the ability to create intimacy outside the consulting room. Has he known the hard-won victory of seeing a once house-bound, video-game-addicted youth find the courage to make a career and a family?
If it is that author’s misfortune that he has not, the more important question is why is The New York Times in its opinion pages advertising quick-fix quacks, rather than reporting on the real work of healing mental pathology? Most psychodynamic clinicians are in for the long haul. People come to us because of intractable pain. Advice they get from girlfriends, parents, and self-help authors has not helped.
Psychoanalysis, since 2005 a licensed profession in New York State, has changed from the days of authoritative interpretations and five times a week sessions. We collaborate with our patients on a journey that strives towards understanding hidden destructive forces and gaining mastery over behavior. Thousands of hours of training (part conservatory, part academia) allow us to use both character and intellect to help each patient develop a more flexible psyche. Why is the training so extensive? How come the cure takes so long? Now these would be valuable questions for The New York Times to explore.
31 Washington Square West, suite 6B
New York, NY 10011
31 Washington Square West, st.6B
New York, New York 10011
26 Cheever Place
Brooklyn, NY 11231
Dear Mr. Brisbane:
I would like to take issue with the New York Times for running a recent Op-Ed piece by Jonathon Alpert entitled, “In Therapy Forever? Enough Already.” It is alarming to me that the New York Times, the newspaper of record, has run such a reckless piece of opinion. Practitioners like Jonathon Alpert are not unique and there is nothing particularly new or original about his quick-fix ideas. His ideas reflect particularly Capitalist notions about time, money, expediency and human relationships and as such are a reproduction of dominating cultural norms. His views are also in line with the interests of insurance companies who have a monetary incentive to limit mental health coverage to vulnerable individuals by vilifying longer-term treatment approaches in favor of short-term approaches. In Alpert’s form of therapy, there is a “doer” and a “done-to” which typifies the mindset of a coach, not a psychotherapist. “Alperts” are a dime a dozen but they DO perform a function for the public. People who have the means are free to go to a golf pro to improve their swing. The public should be freely able to choose these types of services. However the public also has a right to informed consent when seeking psychotherapy for serious mental health issues.
In his Op-Ed, Jonathon Alpert did not seem to want to educate the public as to what he does best and how he does it. Rather he devalued, minimized and disrespected what many of us know and practice about process-oriented psychodynamic psychotherapy in order to promote his own self-interest (a book which promises quick fixes to life problems.) As such he was allowed to run amuck like a playground bully in the pages of The New York Times. To suggest that his approach essentially makes depth-oriented therapies such as psychoanalysis obsolete is irresponsible on the part of the New York Times.
By featuring perspectives from the likes of Alpert (without a balanced analysis of other therapeutic approaches), the New York Times does a huge disservice to those of us who practice with integrity and with an appreciation of our patient’s complicated trauma, history, culture, life problems – and of relational and unconscious processes which take time to unfold.
Anne L. Wennerstrand
Faculty/The Women’s Therapy Centre Institute, NYC
215 Katonah Avenue
Katonah, New York 10536
Dear Mr. Brisbane,
Regarding Jonathan Alpert’s “In Therapy Forever? Enough Already” opinion piece from 4/21:
I’ve been a patient in psychoanalysis for several years. In that time, I’ve felt better and worse, hopeful and in despair, happy and sad, angry and tranquil. Mr Alpert’s vision of therapy seems to be one where the desired outcome is known before the start, the end of the journey is clear before embarking, what is to be discovered is obvious before the exploration begins.
Many of my original “goals” — most importantly, to get rid of the “bad” feelings I didn’t want — have radically changed. I now place much more value on learning to be able to tolerate and understand all my feelings, rather than get away from them.
These changing goals and perceptions would no doubt upset any survey that asked me if I was getting from my therapy what I set out to get. As I go through the rich experience of psychoanalysis, I no longer want what I thought I wanted, what I told myself I wanted. I see those early desires as naive and self-deceiving. If Mr. Alpert was able to “improve” me and discard me in the first 28 days of my coming in to therapy, I fear I’d be much worse off today than I am now!
Dear Mr. Brisbane,
Reading the NYT article by Jonathan Alpert’s, “In Therapy? Enough Already” was a disturbing experience. The oversimplification of the human experience, the workings of the human psyche and of our emotional lives grated like nails on a blackboard. If it were possible to fix ourselves and our patients in 28 days we would also be able to put an end to war, bigotry and various forms of violence. What a wonderful fantasy, albeit an elusive goal – the quick fixes tap into this fantasy while negating the existence of a far more complex, dark component to human motivation that lays in our unconscious. The hostility expressed towards the in-depth, psychoanalytic psychotherapeutic process is indeed an expression of a massive, cultural disavowal of this complexity. The process of depth psychotherapy takes into account the complex, multi-layered struggle against our self destructive tendencies that prevent us from living the kind of lives we would like to live. This is an ongoing struggle not to be resolved in 28 days or 28 years. To quote Jonathan Lear on the subject (from “The Shrink Is In” ): “A battle may be fought over Freud, but the war is over our culture’s image of the human soul. Are we to see humans as having depth–as complex psychological organisms who generate layers of meaning which lie beneath the surface of their own understanding? Or are we to take ourselves as transparent to ourselves?”
Michal Tziyon, LCSW
Dear Mr. Brisbane,
As I am sure you are increasingly becoming aware, the opinion piece authored by Jonathon Alpert, “Still in Therapy? Enough Already,” has caused quite an uproar amongst psychotherapists, in particular those with psychoanalytic training. A loose campaign has been started, called “Time to Treat the Times”, made up of analysts, psychotherapists, analysands, fellow travelers, and training institutes, whose aim is to address a perceived anti-Freudian, anti-unconscious, and anti-psychoanalytic bias at your paper. We hope to raise consciousness in your editorial room with our efforts, and that our words might serve to open a dialogue between the paper of record and adherents of the talking cure. I am sure anyone who has written to you would welcome your reaction. Perhaps more though than wanting a private back-and-forth, there is an interest in seeing you perhaps use your column, representing the voice of the public as it were, to engage with what has been brought to your attention these past few weeks.
I believe my colleagues have been spelling out very clearly the problems with the denigration of what we feel is our life’s work (you may also call it a profession) by The Times, so I will not reiterate points made more powerfully and well by others. I want to draw attention to a different issue; perhaps it is an issue of semiotics. As this opinion piece struck my eye, the first thing I saw was Freud’s couch positioned atop the words, “enough already.” My reaction to this visual, chosen by your paper, was akin to having my face suddenly slapped. I moved slowly towards the article and as I read I thought to myself, wouldn’t a drawing of a stop-watch have served a similar but less malicious purpose? Why the attack on Freud, the couch, and psychoanalysis?
I went to my consulting room that Monday and felt a bit demeaned, looking at my own couch with my chair positioned behind it. The day before, my paper, The New York Times, had not only published something so preservative of a conservative status-quo in which everything needs a quick fix or forget it, but had actually lampooned my vocation. I waited that day for patient’s to attack their treaments–the negative transference is what we call this–with the help of the NYT. Curiously, patients who mentioned it were critical of the Times, finding such visual derogation a “cheap shot.” I could not have agreed more.
It is my hope that the sentiments expressed in the letters you are receiving and will continue to receive these next weeks might give you cause to pause, to use your column space to address our concerns, and to offer an op-ed piece to those of us who believe that time is what is needed for psychic change to occur.
Tracy D. Morgan, LCSW, M.Phil., CGP
Host, New Books in Psychoanalysis (www.newbooksinpsychoanalysis.com)
Member/Time to Treat the Times Working Group
99 University Place, Suite 205
NY, NY 10003
Dear Mr. Brisbane:
Since many of my colleagues have already spoken eloquently about Mr. Alpert’s unabashed effort at self-promotion while also denigrating long-term, perhaps analytically-oriented treatment, I would like to focus on a crucial issue in therapy to which he appears not to attend. That is the centrality of the therapeutic relationship in addressing any of the suffering that people bring to therapy. Nothing can change without the establishment of trust and respect—which can take time to evolve—between one person and another. Further, the attitude of superiority and arrogance he demonstrates would set up the worst kind of interaction in treatment in which the client is seen and treated as being in a one-down position. There are many people for whom this feels normal and who do have the expectation that being told what to do by a so-called expert will be a cure-all for whatever ails them. This, in itself, is exploitative on the part of a therapist like Mr. Alpert.
Valerie R. Frankfeldt, LCSW, PhD
60 East 12th St., #2F
New York, NY 10003
Dear Mr. Brisbane,
In reference to Jonathan’s Alpert’s article “enough already” about talk therapy that exceeds 20 sessions, I would like to say that I don’t know of anyone who stays in therapy if it isn’t helping. Are we patients really that dumb?
Yes, I have stayed in therapy when it is not working. And yes, I have told my therapist it is not working. And that is what has helped me most of all.
Sara Sheftel, PhD, LP
NYS Lic. No. 000172
225 West 86th Street Apt. 1104
New York, N.Y. 10024
May 11, 2012
Mr. Arthur Brisbane
NY Times Public Editor
Dear Mr. Brisbane,
By now you have received numerous letters regarding the piece by Jonathan Alpert recently published in the Times. I will not take issue with Alpert’s views other than to say that any therapist who promotes himself by denigrating and attacking other psychotherapies and psychotherapists should a priori be found suspect. You could not have offered your readers a better example of a destructive clinician so totally devoid of what he should have displayed in his article: a therapeutic personality.
But more important is the negative role the Times has chosen to play by publishing a tendentious article that does such a deep disservice to the mental health field and to the public at large. The Times could provide a truly critically needed public service by informing and educating the public about the wide range of psychotherapeutic modalities available today. What better place than your Science section to do so, for example? Most people do not know the difference between a clinical psychologist, a clinical social worker, a psychiatrist, a psychopharmacologist, a medical psychoanalyst and a lay psychoanalyst, group therapist, mental health counselor, and the training that each of these professions requires in order to certify their practitioners. In addition, within these specialties, there exist a wide range of schools and methodologies, as well as subspecialties such as family, child, adolescent and couples therapists, music and art therapists, occupational therapists—and there may be more…
I would urge you to consider your position as a leader in the field of responsible journalism by undertaking an educational campaign such as the one I refer to above.
Sara Sheftel, PhD, LP
Director of Continuing Education,
Center for Modern Psychoanalytic Studies
New York City
Dear Mr. Brisbane,
I’m a person who has been in analytic treatment for about a decade and have found it very helpful and rewarding. While I don’t think this form of treatment is the right “fit” for everyone, I don’t understand why the TIimes felt the need to allow Mr. Alpert to denigrate this therapeutic intervention that has been so useful to me and thousands of others?! Mr. Alpert seems more interested in promoting his own interest than he does in promoting effective treatments for patients in need of support and understanding for their problems. There are many credible and thoughtful practitioners who could have provided a more nuanced appraisal of the field. I’m sorry that the Times chose to give a platform to Mr. Alpert. As a daily reader of the Times (the actually hard copy newspaper), I expected more from “the paper of record.”
Dear Mr. Brisbane,
Jonathan Alpert’s “enough already” article was right on target — you aren’t getting much good advice if you are in therapy for over 22 sessions. And advice is great, no question.
But let’s not forget that we have an unconscious that makes us repeat patterns unwittingly. A therapist treating over time has a chance to see those patterns play out in the therapy and talk about them, which doesn’t usually happen in real life, since unconscious patterns usually just invite havoc, irrationality and suffering — even for people who aren’t certifiably “crazy.”
“Transference” is something that is still called upon widely as an effective means of effecting change, and it comes with disappointment, frustration, heartbreak and rage. You don’t see a whole lot of that in six sessions or less.
Dear Mr. Brisbane,
Regarding Jonathan Alpert’s “In Therapy Forever? Enough Already” published 4/21:
As someone who’s been in therapy forever, I’ve been trying to come to grips with what it is about Mr. Alpert’s piece that is so seductive to me. Two selling points stood out:
1) that he is able to rapidly asses how a patient feels without any pesky questions and 2) he actually seems to believe that he can get to the bottom of a patient’s core issues in under a session without consulting them in depth (“If she knew, she wouldn’t ask me for my thoughts”).
It’s very reassuring to know that there are experts out there, like Mr. Alpert, whose manifest comprehension of the mind comes to them effortlessly. It gives me hope that maybe one day, I too will have the conspicuous power of knowing exactly how someone else feels and what they ought to do about it.
But my psychoanalyst doesn’t think that I’m really all that into Mr. Alpert.
30 Seaman Ave.
New York, NY 10034
Dear Mr Brisbane,
As someone who has been on both sides of the couch, I think the thing that is most harmful about Mr. Alpert’s “get it together in 20 sessions” piece is that it sends a message of shame to many of us who have had the courage to recognize we need some help to make changes that allow us to have a more enriched relationship with ourselves and others and to heal from injuries that often only our analyst will learn the true depths of, when we may need and want the help for a much longer period that may last any number of years. The myth of individualism is that we pull ourselves up by our own bootstraps, this, as most who aren’t deluding themselves know, is a fallacy, nobody goes or does it alone. Why is needing someone for more than 5 months bad or harmful to growth and development? We live in a time where there is little space for daily reflection on how we are living, making decisions and connecting with others. We also live in a culture where self loathing is epidemic, which incidentally, often has great negative impact on a societal level.
Some may decide they need a therapist possibly for a very long haul, a life time of habits does not miraculously go away in 6 months. If confrontation and self help worked for most then they would not come in for help. For those that have a crisis and come in for help, feel better and want to leave, they often do. But there are dark treacherous places that some of us need to explore that would be too scary to navigate alone, and why should someone? For what reason? For whose good? This is not because we are crazy or weak or duped but because we decide that there is something that happens which is powerful, life saving and awaking that occurs together. This can’t be qualified by a managed care plan goals and objectives. Speaking of which, I wonder sometimes if the NY Times gets money for promoting the managed care agenda. I have had these companies decide that they know better than I that therapy is no longer required after 20, even when the patient’s plan allows for more. It does not matter that I, who have been working very closely with the patient, which includes me getting supervision, think this is a terrible idea and detrimental to his/her mental health. If you wonder why many of us in private practice don’t take insurance, that is reason number one, they get in the way of the progress and sustained healing. They demean and devalue our worth and work as does so often the New York Times by giving prominence to letters such as Mr. Alpert’s.
Jacqueline Ambrosini, LCSW
23A W. 10th Street
New York, NY 10011
To Arthur Brisbane-
I am writing in response to Jonathan Alpert’s recent article “In
Therapy Forever? Enough Already.”
It is short-sighted and frankly disturbing that the NYTimes continues
to publish articles such as these, discounting the benefits of
long-term, insight-oriented psychotherapy and psychoanalysis. I am
disappointed that the NYTimes has taken such a stance regarding mental
health treatment. Promoting pop psychology in this way is not helpful
to the public, your readers, or society at large. There is no
quick-fix to mental health issues, despite the desire to have one.
Long-lasting change requires effort, time and work.
My hope is that those of you at the NYTimes who continue to publish
articles such as these will come to your senses and realize that it is
harmful to promote such fads. Hopefully, the outpouring of letters you
receive in response to this article will help you to recognize the
detrimental effect articles such as these have, especially when coming
from an authority such as the NYTimes.
Vanessa Sinclair, Psy.D.
Licensed Clinical Psychologist
Phone: (917) 297-8794
24 East 12th Street, Suite 704
New York, New York 10003
20 West 86th Street, Suite 1AA
New York, New York 1002
Dear Mr. Brisbane,
I’d like to applaud the New York Times for its recent op-ed by Jonathan Alpert, In Therapy Forever? Enough Already. If only you could hear my sigh of relief upon reading this piece! The New York Times, to my mind, is responsible for portraying the immediate dominating trends of the day, whether they are ethical or not. It does not need to pay homage to some obsolete therapeutic program like psychotherapy or psychoanalysis and their antiquated notions of cure and holistic change akin to something like a 17th century idea of the human soul. Don’t they realize we are post-soul!
Today, the trends that dominate are the most efficient in line with contemporary capitalism: pharmaceuticals, SELF-help, manualized therapies (where we know exactly what we are getting in advance and what we are paying for), and, my personal favorite, neuroscience. I don’t want to know what I think in some long tedious process of open-ended conversation. I want to be told what to think. And if that doesn’t work I want medication. I like pictures of the brain. I can see the neurons light up in direct response to what the doctor does. What you see is what you get. Why anyone would want to stick to this fiction of the unconscious that some megalomaniac cocaine addict named Freud invented in 1905 is beyond me. Out with the old, in with new, as I always like to say.
In line with this article and Alpert’s book “Be Fearless: Change Your Life in 28 Days” I did a search of Amazon best sellers and want to also suggest other lines for your Opinion Editorial section:
§ Real Happiness: A 28 Day Program
§ Prayfit: Your Guide to a Healthy Body and Stronger Fitness in 28 Days
§ 28 Days A Daily Horoscope of Your Hormones!: What Your Cycle Reveals About Your Love Life, Moods, and Potential
§ Feed Your Face: Younger, Smoother Skin and a Beautiful Body in 28 Delicious Days
§ Why Not You?: Twenty-eight Days to Authentic Confidence
§ Thin Thighs in Thirty Days
§ Thirty Days to a More Powerful You
§ How to Heal a Broken Heart in Thirty Days: Saying Goodbye and Getting On With Your Life
§ The Ninety Day Novel: Unlock the Story Within
As a final aside that you might find humorous: my husband Simon Critchley is the moderator of an opinionator series known as The Stone. They have recently had several pieces advocating for the virtues of psychoanalysis. The psychoanalyst Adam Phillips spoke about the idealization of children being a sickness in the adult who refuses to be an adult and dreams of his dependant life as a child as some Valhalla (which he says it never is, being a child is very difficult). Psychoanalysis, he claimed, can give you back some of the truth of your childhood and allow you to create an image of adult life that is more appealing beyond this nostalgia. Andy Martin made a video that spoke about Freud’s work Civilization and its Discontents from 1930 that delineated the program of the pleasure principle. Everyone, he said, has a unique history of pleasure and pain, and everyone must find out for them selves in what fashion they can be saved. Barbarism is the belief that a strategy from the outside can control an individual’s pleasure categorically and en masse. And Benjamin Wong spoke of the radical conversation that is psychoanalysis, one that looks pointless on the outside but is about the steps necessary to introduce new lines of communication between affect and reason.
What hogwash! At least you have cordoned this nonsense off in a philosophy section. I shall feel a sense of vindication over my husband and thank you merrily.
Jamieson Webster PhD
Dear Mr. Brisbane,
Is it really possible that the New York Times would so quickly discredit a longterm therapeutic process than would involve meandering through feelings and thoughts, where discoveries are made and new territories stumbled upon, in favor of short -term directed change that, since it involves only small regions of the brain, engages so little of the psyche?
EXPERIENCES change us where cognition cannot even hope to influence the most minimal transformation. These experiences, the deeper the feelings towards the therapist trained to navigate dark emotional terrains, are the gleaming treasure longterm analysis yields.
Dear Mr. Brisbane,
I am writing to you as a psychoanalyst and a member of a group of psychotherapists who are proponents of talk therapy.
Often, in Times articles, psychotherapy and psychoanalysis are explicitly or implicitly maligned as unscientific, ineffective, or supplanted by advances in neuroscience and genetics. Additionally, when psychoanalysis is attacked what is usually criticized is Freudian theory. There have been many theoretical advances in psychoanalysis in the last hundred years, post Freud. They are rarely mentioned. This is akin to criticizing the current medical establishment for relying on leeches!
It would be interesting to see a series of articles about the difficulties of conducting long term research on the efficacy of psychotherapy. Two people meeting to talk on a regular sustained basis with the stated goal of one helping the other may not be amenable to scientific research, while still being extremely useful and profound. This point is rarely, if ever discussed in articles like Jonathan Alpert’s, championing briefer therapy. Ultimately, this is a question of whether the values of scientific research, economics and efficiency should always be paramount, particularly in a complex human endeavor such as psychotherapy/psychoanalysis.
I hope that you will take my thoughts and those of the other therapists writing to you, under serious consideration.
Christopher Bandini, L.C.S.W.
113 University Place, 10th Floor
New York, NY 10003
Dear Mr. Brisbane,
I write in response to Jonathan Alpert’s article in The New York Times. Let me first say that I am a psychoanalyst/psychotherapist. In order to be a certified psychoanalyst one must initially be a licensed masters degree in clinical social work, a licensed doctoral level clinical psychologist or a licensed physician with a psychiatric residency. At this point one then enters an acredited psychoanalytic institute, takes four years worth of course work in clinical psychoanalysis and psychotherapy, commits to a minimum of five years of one-to-one clinical supervision with a senior practitioner, and undergoes a personal analysis with a senior therapist/analyst for a minimum of four years, at least three times weekly. There is no other sub specialty in psychotherapy that requires any where close to this degree of intense education and personal scrutiny.
Because psychoanalysis aims for what we call shifts in core personality, the process takes much longer than those therapies that aim for symptom relief only. When psychoanalytic therapy is successful, one sees symptom relief in the context of change in character structure. For better or for worse, this ambitious project, by definition takes much longer than weeks or months. It takes many years to become the people we are, and we simply cannot change basic aspects of who we are in less than a few years of psychoanalytic therapy. Therapy does not take a long time because it is failing, the very aims of the process require some time.
Most psychotherapists do not undergo a fraction of the training that we analysts are committed to engage. There is great economic competition for patients among psychoanalysts, and between psychoanalysts and those therapists with far less training. Most lay people have no appreciation of the difference in level of training between psychoanalysts and other types of psychotherapists. I would be very interested to examine Mr. Alpert’s credentials as a therapist. What is his degree and how much post degree training has he undertaken?
I am disappointed that the venerable New York Times chose to publish what is essentially a personal advertisement for Mr. Alpert. Without disclosing his credentials and giving him the prime space that he received, The Times essentially endorsed Mr. Alpert’s claims that he is a better therapist, getting faster and more profound results, than the rest of us, including both other non psychoanalysts and trained psychoanalysts. I could not help but wonder who at The Times is either a close friend or a family member. Either way, publishing what amounts to a personal advertisement as a responsible scientific article reflects in my mind, journalistic irresponsibility.
Irwin Hirsch PhD
Dear Mr. Brisbane,
I want to add my voice to those who have so eloquently and passionately written before me in response to the Times’ printing of Jonathan Alpert’s opinion piece on April 21. I wondered, as I read it, when the Times had become the agent of the insurance companies who seek to limit treatment to as few sessions as possible. While it’s important to acknowledge the value of short term therapies in certain circumstances, Mr. Alpert’s approach more closely resembles that of a coach than a psychotherapist. Mr. Alpert is licensed by the state of New York as a Mental Health Counselor. As such, the scope of his training was more in line with “counseling” than “psychotherapy.” What he offers is advice, not therapy. Some people need and want advice. But this is not the stuff of psychotherapy, as I understand it.
Training in psychodynamic psychotherapy, and particularly psychoanalytic psychotherapy, requires many years of rigorous academic and clinical learning and supervised practice, as well as (often) lifelong self-reflection and growth through personal therapy or analysis. With the benefit of this training, a psychotherapist is equipped to work with people with a wide range of emotional problems that keep them from attaining what they want in life. Helping people grow and change is a far cry from telling them what to do. An investment advisor tells you what to do. A psychotherapist helps you gain the strengths to decide for yourself. It requires a trusting relationship between patient and therapist that will endure the difficult feelings that inevitably arise for growth to occur. This takes time — far more than the several sessions recommended by Mr. Alpert.
It seems to me that the New York Times, as the paper of record, has a responsibility not to print self-serving opinions by members of a small niche of the mental health profession, berating the work of the rest of us. This kind of negativity has no place in a newspaper of your stature.
Lucie D. Grosvenor, LCSW
Psychoanalytic Psychotherapy Study Center
80 Fifth Avenue
New York, NY 10011
Dear Mr. Brisbane,
I am writing in response to Jonathan Albert’s recent article “In
Therapy Forever? Enough Already.” I am not only writing as a response
to his article, but to your decision to print it as well.
As someone who has spent much time and energy devoted to the practice
of therapy, both personally and in a professional manner, I find it
appalling that the NY Times would choose to support such a
short-sighted attitude on the process of therapy. Mr. Alpert’s
grandiosity about his role as a therapist and the power he holds is
the very attitude many of us working in a slower manner are trying to
avoid. We do not feel we are the “experts” and our patients need to
learn from our high and mighty wisdom. We are there to guide them down
into the abyss of their complexes, history, struggles, pain, and
search for meaning. I cannot comprehend this coming close to being
accomplished in a mere 28 days.
As therapists, we are already facing constant scrutiny about length of
time and worth of our work in having to deal with insurance companies
calling the shots, which is why many of us have decided to take a risk
and not place ourselves, and more importantly our patients, in the
line of fire by being part of a panel. Therapy is very individualized
and cannot be boiled down to a couple of goals. By doing so strips
this process and the people involved in it of it’s capacity for
creativity, depth, and power to create any sustaining change. However,
in reading an article such as Mr. Alpert’s, we are given false hope
that we CAN change in such a short amount of time. If I could change
all that I know needs to be worked on within myself in only 28 days,
don’t you think I would? And i would do so for the people i work with?
I went into this work to help others find their own voice, not so that
i could shove my psychology down the throats of people who are
vulnerable when they walk in the door. And that takes time, sometimes
a long time.
I am ashamed that the NY Times would feed into such views over and
over. I hope the outpouring of letters that you receive as a result of
this article will help you to look at the effects your words have over
people. Words are extremely powerful, especially when coming from an
authority such as printed news.
Lisa Benger, LCSW, candidate for training at Philadelphia Association
of Jungian Analysts
Dear Mr. Brisbane,
Ever since the publication of Jonathan Alpert’s “In Therapy Forever? Enough Already” published 4/21, I have been considering the concerns and/or fears Mr. Alpert seems to harbor about the usefulness of long term treatment and psychoanalysis. Initially I felt injured by his attack on a mode of treatment which I have extensive experience in both personally, as an analysand, and professionally, as an analyst. Psychoanalysis has proven to be not only effective but preferred in helping people understand themselves. I find psychoanalysis to be mindful self exploration that offers long lasting healing.
Despite Mr. Alpert’s strong negative feelings I do find myself feeling rather sorry for him–sorry that he remains so misinformed with such a limited understanding of what fosters change and growth in people. Telling people what to do can certainly give a therapist or coach a sense of power, but it hinders the recipient’s personal growth. Some of the patients I work with present with an inability to know the parts of themselves which have been shut down possibly due to interpersonal traumas and disavowal of their subjectivity by people who have wanted to direct their lives for them. I am concerned that Mr. Alpert may be unconsciously repeating this with the people he “serves”. We analysts refer to this dynamic as identifying with the aggressor. I do not deny that in some instances a fairly intact individual, with sufficient ego strengths, may benefit greatly from a brief course in therapy. In fact I spent many years working in a unique EAP setting that allowed people to stay in treatment for as long as they found it useful which was often one to three years. For the executive that gets downsized and avails himself of the four session that an EAP counselor offers, a temporary setback like this may easily be resolved in short term treatment. Psychoanalysis is concerned with finding one’s true self; it is long term care.
It was quite disappointing to me that the New York Times presented Mr. Alpert’s opinion as factual. I am curious about Mr. Alpert’s lack of curiosity and disinterest in fostering a curiosity in the people he works with. Psychoanalysis requires a specific way of listening, sensitivity, curiosity and understanding and it happens in the context of a supportive relationship that develops between two people. Psychoanalysis does its job, it helps people understand why they think, feel and do what they do and change lifelong ways of coping that may be interfering in life, work and relationships. The New York Times needs to do its job and its homework more responsibly.
Andree-Maryse Duvalsaint, LCSW-R
PPSC Diversity Committee Chair
315 Fifth Ave. Suite 704
New York, NY 10016
Andree-Maryse Duvalsaint, LCSW
Dear Mr. Brisbane,
Jonathan Alpert is a psychotherapist who has been practicing for about ten years. His credentials have been called into question. He refers to himself as the most “media friendly psychologist.” Considering it took me at least ten years to feel I had training and capacity to help patients coming to me for help, it is notable that Mr. Alpert managed both to become such an expert in knowing what all sorts of people should do about their problems, often requiring no more than one session to effect his cure, and at the same time become the most media friendly psychologist in New York. More pedestrian professionals like myself generally find that the first session is devoted to actually asking the patient about his or her life. What a relief to know that I can go right ahead to the telling them what to do part.
To my mind the issue is not that Mr. Alpert practices short term therapy or questions the validity of some long term treatments. The question is rather how an author who is clearly motivated to have his name saturate the media, pitches an op-ed piece which quotes selectively from scientific research to support the points that he wants to make in order to sell his practice and his book. Is the article science, op-ed or simply the result of a media-friendly therapist of no note who through persistence is able to sell his self promotional piece? Having it run as an op-ed of course frees him or the Times from the need to question whether he has discussed all the relevant research findings into long and short term therapy – including those published in the New York Times! What is the responsibility of the Times in vetting such pieces and in running them with selected phrases in large italics in a manner that subliminally gives the reader the sense that these are not only opinions, but facts supported by the paper of record?
Evan Malater LCSW
Psychoanalyst in private practice
Dear Mr. Brisbane—
Of all months of the year, why did The Times fall for February, for a message from the Lover of the shortest of them all?
The Times should imagine March; consider even a June. It is the rest—29; 30; 31—which may constitute a real matter in this uncanny calendar of cure. I know you know, Mr. Brisbane, that even a February has been guaranteed a leap.
One must trust that people are not mere masses of innocent dupes: that they know how to number their days.
Member, National Psychological Association for Psychoanalysis
Faculty, School of Undergraduate Studies, The New School for Public Engagement
Dear Mr. Brisbane,
When I saw Jonathan Alpert’s article in the op-ed pages of the New York Times I started reading it with some interest. Being a psychotherapist who sees patients in long and short-term therapy I had a professional interest in the topic and was hoping to find a thoughtful presentation of the complex subject of length of treatment in psychotherapy. Instead, what I found was a piece of naked self-promotion. Mr. Alpert sets up some straw men, the passive, self-serving “bad” therapists who don’t help their clients and just keep them in therapy indefinitely in order to line their own pockets. In contrast, Mr. Alpert presents himself as this brilliant, forceful, rapid fire problem solver who doesn’t waste time helping the client reflect on his or her situation but immediately gets to the bottom of things. If Norman Mailer hadn’t already used it, “Advertisements for Myself “ would have seemed like a more appropriate title for Mr. Alpert’s piece.
Mr. Alpert is free to hold whatever opinions he likes about psychotherapy short and long and about the skills or lack thereof of other practitioners. The op-ed pages of the New York Times should have a higher standard. Didn’t anyone at the times read this piece and think, “Gee, this reads a lot like advertising copy.” The Times owes its readers more.
Steve Kirschner, L.C.S.W.
20 West 86 Street 1B
New York, NY 10024
Dear Mr. Brisbane,
I understand that you are gathering, or at least accepting, reactions to Jonathan Alpert’s opinion piece, In Therapy Forever? Enough Already, in the New York Times of April 21, 2012. Alpert is certainly entitled to his opinion, but I do not share it.
In his recent, book Subliminal – How Your Unconscious Mind Rules Your Behavior, Leonhard Mlodinow, Professor at the California Institute of Technology, describes the relative power of our subliminal mind, also called the unconscious psyche, and of our conscious mind, also known as ego consciousness. According to Mlodinow the unconscious psyche receives “about 11 million bits of information each second”, while the conscious mind is able to handle “somewhere between 16 and 50 bits per second” (page 33). That is a ratio of the capacity of the unconscious over the ability of our conscious mind of 11 million to a maximum of 50, or approximately 220,000 to 1. Mlodinow continues: “Though we don’t realize it, we [i.e. our unconscious minds] are making many decisions each second.” Most of these decisions are made without our conscious mind being aware of them, never mind being informed about them. Yet Alpert claims that in his practice change can be accomplished in the vast amount of processes of the unconscious – the 220,000 – by giving his “opinion, advice and structured action plans” to the conscious attention of the client – the 1.
If it only were that easy! Alpert’s ignorance about the power of the unconscious appears to be as vast as his own unconscious. Let me demonstrate the power of the unconscious with a little story:
A host is giving an evening party. At the end of the evening he is tired but too polite to ask his guests to go home. Finally, one of the guests makes motions to get up and go home. The host notices this and, wanting to be polite, means to say: “Must you go home, can’t you stay here?” Instead, however, his unconscious feelings break through and he blurts out: “Must you stay here, can’t you go home?”
In this story there is a conscious attempt at a certain behavior, i.e. to be polite, but the true unconscious feeling, i.e. that the host is tired and wishes for his guests to go home, asserts itself and the host falls subject to what is known as a Freudian slip. The unconscious reflects the host’s true feeling and causes the host’s statement, “Can’t you go home, must you stay here?” overriding the host’s conscious attempt to be polite. I wonder what Alpert would advise this host and what “structured action plan” he would suggest.
There is more we can learn from this Freudian slip story. The unconscious true feeling is more powerful than the conscious desire to be polite. In spite of the directed and concerted effort of consciousness to go in one direction, i.e. to ignore the true feeling and pretend politeness, the unconscious feeling overpowers consciousness and makes the host say something quite unintended. It should be noted here that, in fact, the unconscious did the host a service. He was tired and it would have been better for his health if his guests had gone home and the host could have gone to bed. Since the host was unable to be honest about his feelings, the unconscious “took a hand”, so to speak, and made the host own up to his true feeling and his true need.
This story also nicely illustrates the problem with Alpert’s approach. He says he does not ask his patient who is “unhappy with her boyfriend for the past year, …’How do you feel about that?’ [because Alpert] already knows how she feels about that.” Really? As the story of the host demonstrates, we often do not know how we feel about something or we do not know how to integrate our feelings into our awareness and lives. This is particularly true when we, as so many in our society, have been taught in our childhoods, teenage years and beyond, not to pay any attention to our feelings, indeed not to have any feelings. But we do have feelings and if they are not consciously acknowledged and processed, they wander off into our unconscious where they become part of the patterns which govern our lives.
But our unconscious does not contain only these repressed feelings and other unwelcome and ignored personal experiences, it also contains the structuring patterns of our psychic and emotional life, especially those patterns which structure our basic and universal life experiences such as birth, initiation, marriage, mother- and fatherhood, separation, abandonment and death. These patterns have autonomous authority in our lives, and our ability to confront their potentially overpowering energy depends very much on the stage of our conscious development. The truth of this reality is probably well captured in this ancient aphorism attributed to St. Paul: “That which I want to do, I can not, and that which I should not do, I do.” Or, as one of my clients once exclaimed: “You mean to tell me that I am not master in my own [psychic] house?” Alpert seems to believe that we are very much masters in our own psychic house, and all we need to do to get emotionally well is to get “some advice and structured action plans”.
Unfortunately, however, the forces in the unconscious tend to act independently of our conscious mind because of their origin in the inherited structures and functioning of the human brain. Neuroscientists confirm much of what Freud and Jung intuited. They inform us that the nervous system of the unborn child, including its growing central nervous system and brain, develop a plethora of possible neuronal switching systems and synaptic connections. But only those switching options and synaptic possibilities which are activated again and again will lead to established and permanent pathways and connections. Which options and possibilities are activated, i.e. selected and stabilized, depends in large measure on the fetus’s interaction with its environment. The earliest selection and stabilization of switches and connections reflect the world of the fetus which for the first nine months consists of the womb, the mother or caregiver and all persons in relationship with her.
What do the mother, father, caregivers and all persons in relation to them bring to the fetus and later to the child? They bring and represent their accumulated knowledge, feelings, experiences, abilities and aptitudes, including also and especially their own unconscious processes which determine their thoughts, feelings and behavior, to the fetus and later to the child. These patterns are absorbed, unconsciously and without anybody’s conscious intervention or teaching, by the fetus and child, or more accurately, by the fetus’s and child’s nervous system and brain. In other words, the manifold stimulants, which result from the relationship between the mother and others and the fetus and the child, provide a steady stream of learning opportunities which the child experiences and integrates. If there are toxic elements in the fetus’s and child’s environment, such as drugs, alcohol, stress, anger, depression, etc., they have a direct and lasting impact on the child’s developing brain and nervous system. They are deeply embedded in the child’s and person’s unconscious psyche and not easily eradicated with conscious “action plans”.
Lest I draw too dark a picture, let me add that our unconscious is also the source of our creativity. I will give just two examples:
(1) The famous chemist August Kekulé, or just Kekulé (1829-1896), is reported to have discovered in two visions that carbon can link with itself to form long chains and that the structure of benzene is a ring. His first vision occurred in 1854 or 1855 after he had fallen into a reverie aboard a horse drawn bus in London. We probably have all experienced how regular rhythmic motion can put us into a reflective or trance state. Kekulé described his vision as follows: “Lo, the atoms were gamboling before my eyes. I saw how the larger ones formed a chain dragging the smaller ones after them but only at the ends of the chain.” The second vision occurred in the winter of 1861-62 while Kekulé was dozing in front of a fire in Ghent, Belgium, where he was then professor of chemistry. Again, we may also have experienced how the warmth and comfort of a fire can lull us into a dream like state. Kekulé described his second vision as follows: “I turned my chair to the fire [after having worked on the problem for some time] and dozed. Again the atoms were gamboling before my eyes. This time the smaller group kept modestly to the background. My mental eye, rendered more acute by repeated visions of this kind, could now distinguish larger structures, of manifold conformation; long rows, sometimes more closely fitted together, all twining and twisting in snakelike motion. But look! What was that? One of the snakes had seized hold of its own tail, and the form whirled mockingly before my eyes. As if by a flash of lightening I awoke …” These two visions, Kekulé said, led him to the benzene ring, i.e. the circular structure of the six carbon atoms connected to each other with each carbon atom attached to a hydrogen atom. This bit of history exemplifies the truth that discoveries made by the human mind are frequently not only the result of efforts made by our consciousness but come about because of emanations from the unconscious.
But do we really need this bit of history? Have we not all experienced struggling with a problem and then having a sudden insight, a flash of illumination, a vision or a dream which either solves the problem or at least brings us closer to a solution? These insights, illuminations and visions do not originate in our conscious mind, but in that part of our psyche which is not conscious, hence un-conscious. Painters, composers, writers, indeed all artists, and inventors and researchers will testify to the fact that their creations and inventions “come to them” from somewhere other than their conscious efforts.
(2) The second example for the creativity of the unconscious is from Sherwin Nuland’s most recent book, The Uncertain Art. Nuland, a well known surgeon and writer at Yale, describes his art of writing as follows: “And so, when asked how I write, I say that there is no real method but to have faith in the unconscious. … And I do trust my unconscious to find the way, and even to guide my writing towards the thematic cohesion”. And a little later: “And the unconscious does something else. … It unearths information that he [the writer] does not know he has. It brings back memories he would otherwise have no way of recalling” (page 85).
In addition to paying tribute to the creativity of his unconscious, Nuland gives us also a hint as to some of its other contents, namely our memories. Everything we have ever heard, seen, smelled, felt, and indeed experienced is stored in our memories which are in our unconscious. And our memories are not necessarily retrievable by a direct request from our conscious mind. Some of them are, many others are not. Many of them can irrupt into consciousness even and especially also when they have not been sought. We have all experienced, I am quite sure, memories suddenly flooding into our consciousness, sometimes triggered by a cue such as a smell or a sound, more often by something which we cannot identify. These suddenly irrupting memories are all part of the contents of the unconscious.
Obviously, I can hardly begin here in this short email to lay out a more complete understanding of the power of our unconscious psyche in our lives, both for good and for evil. It would seem to me that the New York Times would render a more valuable service to its readership by a thoughtful presentation of how our unconscious affects our lives, day by day, minute by minute, as represented in the ratio of 220,000 to 1, instead of letting Alpert proclaim his at best misguided opinions.
Thank you for attending to my ruminations.
Rainer Maria Kohler
Licensed Jungian Psychoanalyst
110 Richardson Drive
Needham, MA 02492-2854