Now I am mad. I finished an article last week that I was reading to review for this blog, and set it down because I wanted to re-read parts of it before deciding about how to write it. After procrastinating for days, I am up against a self imposed deadline (end of the weekend) and I can’t find the friggin’ article anywhere. I never throw anything away inadvertently, and this is so unlike me. It probably got mixed up with a batch of other newspapers and wound up in last Thursday’s recycling, Greenie that I am.

But we know what THEY would say. Lost the article on purpose. Expressing some inner conflict about the review, or the article, or the blog itself, and IF you could come to terms with those feelings, you wouldn’t need to lose the article in the first place. Aha! Go figure that the article was on psychoanalysis! My Life in Therapy–What 40 Years of Talking to Analysts has Taught Me –— was a funny, enjoyable, yet painful summary of Daphne Merkin’s run-in with psychoanalysis. At first, I couldn’t decide if the article was some sort of comedic rant on the subject, as– she just wasn’t serious, was she? Her experience couldn’t have gone that way could it? One begins to realize that she recounts things that really one could only know if they had been in analysis themselves. So she had been there, but……

Through comedy and humor, Ms. Merkin writes about alot of different situations during her decades of psychoanalysis.Not all were funny, though. Although from the patient’s perspective, this well written article interestingly serves as the counterpoint, or bookend to the last article I reviewed, the psychiatrist who could only give meds. Here it is the psychiatrist who could only analyze–the polar opposite. Being a New Yorker myself, I suppose I can say, “Only in New York,” as the association to as lengthy an analysis in our popular culture leads to Woody Allen, who likewise in interminable analysis, in this article actually offers her a referral to his analyst.

My Life in Therapy recounts what is both good and bad about psychoanalysis. The psychiatrist as analyst takes a neutral stance and through tthe results of their training uses techniques so as not to inject themselves into the treatment. In this way, the motivations, wishes, decisions can wholly be understood as belonging to the patient. It can allow for a much more intensive understanding of one’s internal self. However, Ms. Merkin sometimes finds herself on the short end of that “neutral” stick–an analyst is closing his practice due to terminal illness, and instead of simply informing her of that when she applies to be a new patient,  he tells her that he cannot invest his time into her care. She is left wondering all kinds of things about her acceptablility as a patient, rather than the fact that the decision had nothing to do with her at all.

In the end, Ms. Merkin decides after 40 years, that maybe she doesn’t need to talk all of her issues over with an analyst, that it is not worth the time or the money or the emotional investment, and that she could do reasonably well on her own. It could be said that her analysis had a reasonable outcome on that basis–she was able to reach a psychological independence, finally. My beef is that the analytic stance would not allow the question to be asked, “After all this time, why are you still here, and what has happened that you can’t do this on your own?” My agenda perhaps, not hers, it would be argued – if she wants to come, let her come. But I think to allow her to come and take her money after all that time, without asking that question, is almost like taking advantage of her conditionand repeating something from her past.

When I did my psychiatric training, we learned both psychodynamic principles and medication treatment and how to blend them together. But the king of the hill back then was the psychoanalyst, who commanded the highest regard due to the mystique of psychotherapy and the often-inabilty back then to treat psychiatric problems ably with medications.  I decided not to trek up that hill, but to dwell amongst the “regular” psychiatrists. Regular enough to learn to try to distinguish what was pscyhologically based, what was biochemically based, and to be able to talk about whatever was necessary without having to tell the patient that I couldn’t help them because my appointment structure for medications only wouldn’t allow it.

I had to go around my house and look for the article one last time. Of course, now that this review is finished, I did find it under a mass of papers I was sorting on my dining room table. I guess you could say that I didn’t need it any more.