Off the couch

After 40 years -- and more than $100,000 in bills -- I finally gave up on the talking cure.


Meredith Maran
February 18, 2004 3:03AM (UTC)

"I'm sorry. We have to stop now," Miranda says.

"What do you mean, 'we'?" I say, leaning back into her comfy white couch. "I don't have plans."

Miranda gazes at me knowingly, a small smile tugging at her lips.

"Why don't we continue this over martinis?" I press on. "I'll buy."

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Miranda's smile disappears. Like a bee poised to sting, her eyes dart to the clock beside me and -- zzt! point made -- back to me. I'm buying, all right. I sigh, pull out my checkbook, and scribble Miranda's name across a check for about the 300th time. The brittle rip as I tear it from my checkbook silences, for just an instant, the ruthless ticking of the clock. Still, I can almost hear Miranda's tsk-tsk of disapproval. If she's told me once, she's told me 300 times: I only hurt myself when I use humor to mask my feelings.

I gather up wads of soggy Kleenex, my bike helmet, my purse. "See you next week," Miranda says. Despite Miranda's admonitions I always try to leave on an up note. "Don't get up," I say, looking down at her in her leather chair. "I'll let myself out."

Eventually I did exactly that. God knows, neither Miranda nor any of the approximately 25 other therapists I had seen between the ages of 6 and 46 -- and to whom I had paid more than $100,000 -- was about to open the door for me. And now, with seven years of therapy sobriety under my belt, I can say with pride: Hello, my name is Meredith, and I'm a recovered psychoholic.

Breaking free wasn't easy. I needed support for my recovery effort. I turned to the poor woman's self-help tool: Google. I typed in "critics of psychotherapy" and got instant validation. Turns out my feelings about therapy were historical, not hysterical. As long as there's been psychotherapy, there have been psychotherapy renegades -- some who advocate a political analysis of personal pain, some who see therapy as a dangerous, damaging rip-off.

Back in the day, Freud's colleague Alfred Adler broke from "the master," arguing that mental problems could be caused by environmental factors, not just sexual "hysteria." Karen Horney (1870-1937) and, later, Erich Fromm (1900-1980) renounced their psychoanalytic training, focusing on society's effects on people's neuroses. The mad genius R.D. Laing (1927-1989) served his patients a combo platter of psychoanalysis, mysticism, existentialism and left-wing politics designed to free them from "social conformity." "True sanity," Laing (himself a depressed alcoholic) wrote, "entails in one way or another the dissolution of the normal ego, that false self competently adjusted to our alienated social reality."

Anti-therapy therapists dot today's landscape today as well. Dr. Thomas Szasz -- professor emeritus of psychiatry at the State University of New York, and the author of the 1961 classic "The Myth of Mental Illness" -- holds psychiatric abuse accountable for everything from Winona Ryder's drug problem to pedophilia in the church. "In the long history of priests sexually abusing children," Szasz wrote in a 2001 Washington Times essay called "The Psychiatrist as Accomplice," "the identity ... of the other accomplices -- the psychiatrists and psychiatric institutions that 'diagnose' and 'treat' priests who, in fact, are criminals -- has been overlooked. Why? Because they are an integral part of our love affair with medicalizing life and replacing responsibility with 'therapy.'"

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Dr. Tana Dineen, a Canadian psychologist and the author of "Manufacturing Victims: What the Psychology Industry Is Doing to People," describes her book as an "apology for almost 30 years (as a practicing psychotherapist) of biting my lip about the role psychologists are playing in society." I e-mailed Dineen to ask how she sees that role. "Most psychotherapists are well meaning but naive," she wrote back. "They harbor the illusion that (1) they are fighting injustice when, in fact, they generally operate in a manner which fits the politically acceptable motif of the moment and (2) they are helping people to heal or feel better when they may be debilitating them or turning them into satisfied customers. While psychotherapy can mean virtually anything, it is portrayed as something that will make not only the individual but also society better, healthier, more peaceful, more fulfilled, and more utopian.

"Psychotherapy is chameleon in nature," Dineen added. "There has been for over a century now a continuous shift in fads, theories, and therapies. Whoever sells the psychological cures of the day claims that the old ones were bad and that the ones they sell -- usually described as the newest, the best, and the most scientifically proven on the market today -- will surely work. So, the old warning 'buyer beware' should be extended to consumers considering any form of psychotherapy."

Perhaps the best-known living critic of counter-therapeutic therapy is Dr. Jeffrey Moussaieff Masson, the ex-psychoanalyst, media lightning rod, and author of "Against Therapy" and many other books. Fired from the Sigmund Freud Archives in 1980 after publicly asserting that Freud had "capitulated to reactionary forces in society that wanted sexual abuse kept hidden," Masson has since switched his focus from patient rights to animal rights. I asked him whether he sees therapy as a Band-Aid for social ills. "Band-Aids are OK as long as they're not mistaken for a cure," he answered. "But what if the Band-Aid increases the problem? The trouble with psychotherapy is that there's no way of knowing in advance who your therapist is. Why should a degree be any guarantee of intelligence and compassion? How can we discover those who genuinely can help and recognize those who can't? And who gets to decide? People are unhappy and have every right to seek help. But not everyone who's a therapist should be seeing people who need help."

And not everyone who needs help can get it from a therapist. Seven years after leaving Miranda, my mortgage payment costs exactly what I used to spend on therapy each month, and I'm not about to take out a second. I wonder, now, how I afforded all that therapy, and why, and what I could have done with all that money, and whether a nicer house, or a master's degree, or a self-funded 25-city book tour, or a bundle in the bank would have helped me more than Miranda and her predecessors did. But the notion of therapy as a highway to emotional health was ingrained in me from an early age. And, like my mother's urgings to drink four glasses of milk a day, wait an hour after meals before swimming, and hold my brother's hand whenever we crossed the street, the idea was -- and sometimes still is -- hard to shake.

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I know I need to take responsibility for my own behavior, but the truth is, it's all my parents' fault. In the late 1950s, soon after psychotherapy (and I) burst upon the American scene, my worried parents turned to what was fast becoming the middle-class family's nuclear balm. I'd taken one look at my new baby brother and told my mother to take him back, I'd been expelled from nursery school for biting, I'd ripped my copy of "Little Women" in half when the babysitter tried to take it from me. And so I was delivered to the Manhattan office of a child psychiatrist, in whose presence I underwent my first psychological testing, grimly struggling to squeeze bright yellow round wooden pegs into bright blue square holes. Years later, as I became an out-of-their-control teenager, my parents sentenced me to weekly sessions with a pipe-smoking Freudian. I endured Dr. Nussbaum's grunts, nods and secondhand cherry-flavored smoke only because his Central Park West lobby was such a great make-out spot for my boyfriend and me.

Released from my parents' jurisdiction at last, I swore I'd never cross another therapeutic threshold. But then in the 1980s, stumbling through the maturational minefields of marriage, motherhood and mortgages, I weakened. I fell. It started with the $5-an-hour Catholic nun cum social worker who introduced me to the cheap thrills of mother blaming. I quickly moved on to harder stuff: the sex therapist who blamed my father for my blossoming lust for women; then the series of Berkeley body workers who helped me "recover" nonexistent memories of sexual abuse.

Before I knew what had Rolfed me, I'd sunk into the abyss of therapy addiction. By the early 1990s (back when employers were still paying for health insurance, and health insurance for therapy) I'd started taking jobs to support my habit. Each week I attended and paid for one session with Miranda. (Or two, or three, but only when I was really upset). One session with a couples counselor. (Or two, but only when my girlfriend and I were really upset with each other.) And one session with the family therapist whose job it was to mediate between my sullen juvenile delinquent son Jesse; his indignant, "Why do I have to be here? I didn't do anything wrong!" brother Peter; and the motley crew of parents and stepparents -- each bearing nuggets of blame and insight mined from the mother lode of our own individual therapies -- who had spawned or married into the whole catastrophe.

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I knew I had a problem with therapy. I tried to cut back. I fired the adolescent psychiatrist who'd put Jesse on Ritalin, then told us to test him for epilepsy when he forgot to take his pills. I axed the couples counselor who'd provoked far more conflict than she'd ever resolved -- I insisted we spend the money on a Key West vacation instead. (The vacation didn't save the relationship either, but at least I had conch fritters and a tan to show for it.)

Now I was down to the hardest nut to crack, the tightest bond to break. Quitting individual therapy took years. I took steps forward, suffered relapses, fell back. I'm not sure I would have had the ego strength to stop if not for some life-changing events. First: I got out of the bad relationship, promised myself I'd never be part of another couple that required therapy to prop it up, and -- miracle of miracles! -- got into a good one. My son grew out of his adolescent maelstrom -- saved not by the succession of counselors, psychologists and psychiatrists who seemed to have done him and our family more harm than good, but by Jesus, whose hourly rate is far more reasonable and whose guidance Jesse found far more empowering.

Then I hit my personal therapy bottom. It happened to me where it happens to many junkies: in jail. I was in Los Angeles, writing a story for Mademoiselle magazine about what makes men rape. I'd been interviewing a convicted rapist who was about to be released from prison; now I was interviewing his court-appointed psychiatrist. Why, I asked him, was this obviously un-rehabilitated predator being set free? What made the psychiatrist think the rapist -- who'd been bragging to me about how attractive his victims found him -- wouldn't rape again? The psychiatrist told me confidently, as if he were actually making sense, "Because he's in therapy."

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Where had I heard that argument before? Ah, yes. I'd used it to persuade myself -- and a few friends -- to stay in much too hard relationships with much too incompatible people. I'd used it to persuade basketball coaches and principals not to expel my son. I'd used it to convince my parents that I was working on my relationships with them when I was, in truth, doing no such thing. Could therapy be society's crutch, not just my own -- a non-status-quo-threatening "treatment" for social, cultural and political, as well as personal, ills?

After all, these days therapy is the simple answer to far too many complicated questions. Your marriage sucks? Don't ask why half of American marriages end in divorce -- go to therapy. Your teenager's flunking out, blasting hate rock through his headphones, doing drugs? Don't ask why we're spending more money on juvenile halls than schools, or (perish the thought) become an activist and do something about it -- send him, yourself, the whole family to therapy. No need to punish thieving CEOs, unrepentant rapists, racist cops; no need to wonder how we might change our priorities so America starts producing more healthy citizens and fewer creeps and crooks -- not when we can send 'em all to therapy. Why bother protesting the inequities and injustices that are causing marriages, families -- the whole damn social contract -- to unravel, when we've got therapy to make us feel better about that unraveling?

Once I'd started to see therapy as part of the problem, not part of the solution, I could no longer delude myself that even a little therapy was OK. I broke the news to Miranda, refused her request for a few "termination sessions," and -- lump in throat, checkbook in hand -- I ended our relationship, cold turkey. As most junkies do, I quickly substituted one fixation for another, obsessing endlessly about what had caused me, a deeply neurotic but somewhat rational (not to mention exceedingly frugal) person, to have spent the price of a house (a Midwestern house, but a house nonetheless) in the past 17 years on an intangible, self-perpetuating indulgence whose benefits I could scarcely discern or measure, that didn't come with a 30-day warrantee, let alone a money-back guarantee, that had somehow insinuated itself like a tapeworm into every twist and curl of my being.

True, there had been times -- precious times, magical times -- when "the work" with Miranda felt not only soothing but transformative; when her "mirroring" helped me to see myself, other people, life less painfully, less self-disparagingly. Miranda was there for me (at $75 a pop) through one breast lump, one out-of-my-control teenager, one awful breakup, several career shifts, and too many small to medium-size crises to count. But the best thing about my relationship with Miranda -- knowing I could count on her for a fix of one-way attention whenever I needed it -- was also the worst. The more addicted I'd become to opening up in the safe womb of Miranda's office, the less reason I'd had to open up to friends and other unpaid support staff outside it. For the better part of a decade I'd spent less time grocery shopping, seeing friends, making love, working out, or even watching television than I'd spent in therapy. How had I let that happen? No more, I vowed. I will never be shrunk again.

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I found it a lonely calling, being an anti-therapy crusader. My friends -- those who could afford it, despite the shrinking economy and decimated insurance plans -- were still seeing their shrinks and/or couples counselors. "It's just a phase," I knew my friends and family were thinking. "She'll be back. God knows she needs it." In my weaker moments, I myself wondered how long I could hold out.

I won't lie: there are times when I still want to take a shrink. More than once I've caught myself lifting the phone to my lips, Miranda's phone number running through my mind. It doesn't surprise me that the siren call of succor for hire still tempts me. I quit smoking 25 years ago and I still crave cigarettes; I still suppress longings for terrible ex-lovers, Kit-Kat bars, Zoloft and more than my ration of two "Law and Order" reruns a night. But I'm always glad I resist. The rerun episodes always turn out the same way they turned out the first time. I suspect another go-round with Miranda would, too. I'd sink into that cozy couch, buy myself a few more 50-minute shots, go back to depending on Miranda instead of building real relationships with real people, and hate -- or at least, seriously doubt -- myself in the morning. So I've been working on finding other ways of healing (and learning to live with) my suffering instead.

What might these wholer-than-thou healing methods be? Nothing special, really. When the angst kicks in, I recite my own serenity prayer: God (or whoever's active-listening), grant me the serenity to accept the neuroses I cannot change, the courage to change the neuroses I can, and the wisdom to know the difference. Then, I "say more about that" to a friend. Get "mirrored" at my favorite discount boutique. Drift through a bookstore. Hike a sweaty hill. Write a story for Salon. Daydream about Miranda reading my story in Salon, confronting her fear of intimacy, overcoming her countertransference issues, and asking me out for drinks. (Return to serenity prayer.)

Don't get me wrong: I still think therapy has its place. It can be part of the solution -- lifesaving, even -- for people with mental illness, people in true life crises, people who are court-ordered or girlfriend-ordered into self-examination. I'm no better a person for being out of therapy than I was for being in it. Quitting didn't make me any kinder, saner, more productive or happier -- life circumstances did that. But quitting did stem the flow of my indisposable income, time and self-sufficiency.

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The choice, as I see it, is not between doing therapy and getting better versus not doing therapy and staying screwed up. The choice for me -- and I keep making it, one day at a time -- is whether to be screwed up and broke and dependent on someone I pay to care about me, or screwed up and less broke and more self-sufficient. People who choose to stay in therapy have harder decisions to make: who to see, how to know if it's working, when to move on.

There's lots more to say. I'd love to continue. But I'm sorry. Our time is up.


Meredith Maran

Meredith Maran, a frequent Salon contributor, is the LA-based author of 14 books including "The New Old Me" and "Why We Write." A book critic and book editor, she’s on Twitter and Instagram at @meredithmaran

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