Letters

[Read "Off the Couch," by Meredith Maran.]

As someone who got a master's degree in counseling but has so far chosen not to practice, I found Meredith Maran's article honest and insightful. And it brought to mind something a golf pro once said to me. I had just completed a series of lessons but didn't feel like I was getting the hang of it, so I asked if he would be teaching again. His response: "At some point, Christina, the best thing you can do is just get out there and play." And herein lies one of the ways to tell a good counselor from a less good one -- the good ones will tell you up front that their ultimate goal is to cut you loose, not keep you coming back. A good counselor wants his or her patients to get out there and play.

-- Christina Koomen Smith

Meredith Maran's "Off the Couch" vividly illustrates what I call the Great American Disaster, the belief that rather than face your problems (whether internal or external), you can just abrogate it to someone else in lieu of payment in cash. (Maybe as an immigrant it's easier for me to see the forest and the trees.) Here's my solution -- feeling down, dejected, useless and hopeless? Do what the rest of the world does; go out, make friends, live life, work less, drink wine, travel, talk to strangers, share yourself, be part of the world, do stuff with people. And pick up the phone and tell your therapist to get a life too.

-- Ken Kashani

Meredith Maran's piece is interesting, but I was most interested to see her write that she "knew (she) had a problem with therapy." Is it in the general therapy-going public's best interest to publish an article on psychotherapy written by someone who was possibly addicted to it? I firmly believe that therapy is not as terrible, autocratic, or disempowering as Ms. Maran thinks. Therapy can have good or bad effects, just like organized religion. Church can save you from a horrendous family or social situation or it can completely betray your trust, as recent scandals have shown. I wonder how much Ms. Maran understands psychotherapy at all, as she remains upset that her therapist won't have drinks with her even though that would obviously be a violation of professional ethics. Your therapist is not your friend.

-- Jean M. Chen

OK, OK, I confess: I'm a therapist. I'm writing because, unfortunately, I've heard far too many complaints like those voiced so eloquently by Meredith Maran, some from folks sitting on my very own couch.

The truth is, therapy is a complicated business. I'm an Adlerian, not a Freudian, and the coauthor of eight books on parenting. I have a weekly commentary on parenting on public radio, and a busy private practice. But I worry about the Merediths of the world, because they have a legitimate complaint. So here is my primer for finding therapy (which can be very helpful, according to the outcome research), staying in therapy, and knowing when to leave therapy.

First, no good therapist aims to keep you in therapy. I tell clients I want to work myself out of a job -- and I do. Good therapists listen, become personally engaged, teach valuable life skills -- and yes, they get up and walk you to the door at the end of your allotted time.

Second, good therapy focuses on solutions to problems, not just who to blame. Blame is easy; solutions are more difficult. A really good therapist will teach you to find solutions on your own eventually, without his or her help, and to practice self-awareness. You should feel stronger over time, not more dependent.

Third, therapy is a relationship, not just a business arrangement. It involves respect, dignity, good communication, curiosity, and genuine interest and sharing. If you don't feel respected and you're not learning anything, leave. Find someone new. Don't be put off by voicemail systems: insist on talking to a real person. Ask good questions. And trust your gut. Therapy can be incredibly affirming and helpful, but it should not go on forever or cost you your life savings. And you should feel respected for more than your checkbook.

I love being a therapist. I feel honored that people trust me with their stories, their thoughts and their feelings. Some days I feel powerless; other days I believe I make a difference. Therapy does have its limitations. But I always try to empower the person sitting across the room from me, so much so that the time comes when they don't need or want me anymore. And I know I'm not alone. There are many good therapists out there, people who do more than "smile knowingly."

-- Cheryl L. Erwin, M.A., MFT

Congratulations are due for Meredith Maran's courageous, funny and oh-so-rare piece questioning therapy. As a recovering psychoanalyst, I know from the inside that what she sees from the outside is bang-on. Would that more people could see or those that see would speak out.

-- Jeffrey Masson

Ms. Maran's article is to be applauded for touching on some very pertinent points about the limits and dangers of psychotherapy. First, the process of talking to a therapist is not a "real" relationship and can never be a substitute for an emotionally nourishing one. Second, like anything that soothes our emotions or needs without truly satisfying them, therapy can become addictive, seeming like the only source of comfort in one's life and discouraging the pursuit of others. Finally, whatever the benefits one might get from therapy, they are always at a cost, the most obvious being time and money. Beyond that, though, the cost often has to do with giving up a closely held belief or dream, a cost many are unwilling to accept. These limitations are true regardless of the skill or good intentions of the therapist, and can be exacerbated by a lack of either. Needless to say, this is not discussed openly by therapists with their clients because it would scare most away and jeopardize their livelihood. As with everything in our society, there is a certain amount of self-interested marketing involved.

All this being said, however, and Ms. Maran's experience notwithstanding, I believe "shrinking" has value, and not just for the most seriously dysfunctional. As someone who has been on both sides of the couch (as a therapist in training a while back and as an ongoing client), my experience is that therapy more often than not helps people to become more self-sufficient, not less, and can provide emotional support that is not available elsewhere for some people. Nonetheless, it is deeply imperfect, and perhaps un-perfectable, not unlike its creators.

-- Victor Whitehead, MSW

Meredith Maran doesn't need therapy anymore. She must be getting better. Isn't this how it's supposed to work, or did I miss something?

-- Robert Barth

When I was young I dropped a grilled cheese sandwich on the floor, and have spent the last 38 years crying about my loss. I couldn't accept that it was gone. Only recently have I realized that perhaps this was a waste of time, and the five-story tin-foil mausoleum I constructed for it a tad excessive. I am now, however, attempting to turn this extraordinarily tragic event into a book that shows off my new found wisdom and my growth as a person. In a word, my personal journey.

Also I'd like to make money off my own idiocy; it's the American thing to do, after all. So I was wondering if maybe, as you did with Maran and her insipid whine-fest, you'd allow me to advertise my book, "Grilled Cheesy Melancholy," with an article on Salon. I think you'll find my well-worn faux-contemplative memoir ruminations on loss, acceptance, and four-decade old dust-caked dairy products astoundingly in line with your standards.

-- Adam Ferguson

Meredith Maran is smart, opinionated, edgy, breezy and fun. Even when I don't agree with some of her analysis (therapy does not preclude one from having intimate conversations with real people, and may even facilitate that process, and is sometimes worth the expense, even if one is not mentally ill or in crisis) I'm always curious what she has to say, and I love how she says it. I was sorry to see that, at the end of the article, our time was up.

I'd like to read her deeper exploration of why people hurt, and why they turn to therapists for help, and what therapists are trained to do, and what exactly happens (both helpful and not) during those 50-minute sessions. What does research say about the effectiveness of therapy? How much does financial outlay affect one's sense of gratification? What role does love play in the dynamic? I hope you continue to publish more of her work, and I look forward to her next book.

-- Mariah Burton Nelson

Meredith Maran's piece on the addictiveness (and possibly the uselessness) of therapy was simply wonderful.

-- M.D.

You really seem to run a lot of anti-therapy articles. You probably need some balance. For me, a couple-year course of therapy improved my shyness, ability to make important decisions, ability to judge relationships objectively and general outlook. I think you do countless people a disservice by accentuating only the negative. This author probably made the right decision in quitting: Therapy is not for everyone, and frankly, if you're not getting results after a couple years (much less 40!), it is likely not for you. But to disdain the whole practice is unwise and unbalanced.

-- Lori B.

Psychotherapy is a curious institution, no doubt, and I have lost friends because of it. First, there are those who fell away from me as I sloughed off the gloom they inhabited with me. More recently, there are those who think that every time life deals me a blow, I need to call my therapist and go back on meds. I distanced myself from one friend partly because I felt like she was trying to be my therapist.

What strikes me most about Maran's article is that it takes the typical American approach to problem solving: blame. I think Americans approach therapy much the way they do religion: They expect the institution to do all the work for them. They think that all they have to do is show up once a week, shell out some cash, and they're golden. Therapy taught me that while other people did mess me up, I'm the only one who can fix me -- and that's a huge and taxing task. My therapist helped me develop the skills to survive, but it's up to me to use them. Some of that work is done on the couch, but like any education, the most rewarding lessons occur in the field.

-- Judy B.

I can not criticize anyone for deciding to end therapy -- this is a deeply personal decision that is entirely up to each individual. However, to make the blanket statement that therapy is "part of the problem" simply because the author doesn't think she got better, in spite of years of therapy and $100,000, is hardly helpful to anyone. While I could guess at any number of reasons why the author feels as she does -- wrong therapist(s), wrong approach, etc. -- I can not know any of these things. What I do know is my own experience with therapy.

Three years ago, I would have been the last person you would expect to defend therapy. I was fairly happy, functional, introspective, well spoken; in my own mind, I was the last person who needed therapy. However, in order to placate my soon-to-be-ex-wife, I agreed to go to individual therapy (in addition to the couples' counseling that showed both of us how fundamentally incompatible we were). The marriage itself was not salvageable, but therapy did help keep me from making the same mistakes I had been making for the previous decade.

While many problems may not be solved by therapy, I strongly believe that it is still a very valuable tool if used properly. Yes, finding the "right" therapist can be difficult, no doubt more difficult than it ought to be. I am also fortunate that my visits have been covered by my health plan, a fact for which I am extremely grateful. However, those barriers do not diminish the good things that can come out of therapy with the right therapist.

-- Rick Baumhauer

Years ago, Jay Haley wrote an article, "Why Psychotherapy Fails." He gave three reasons. (1) No goals are set. (2) The client forgets the goals. (3) The therapist forgets the goals.

Too bad it took Meredith Maran $100,000 to find out the obvious.

-- Michael Doherty

As a recovering therapy junkie myself, I was fascinated by what Ms. Maran had to say on the subject of breaking loose from the couch. It took me somewhere in the neighborhood of eight years, during which my therapist often helped me and as often hindered me in my quest to be happy.

I could, of course, say a whole lot about my experience, but rather than go for that kind of self-indulgence (this is not, after all, a therapist's office), I will bring up one subject that Ms. Maran did not. My former therapist still calls me from time to time and suggests I do some more sessions with him. I don't seem to have been quite as tempted as Ms. Maran, largely because my life is actually happier than it was back then, but the mere fact that my therapist thinks I need more therapy interests me. He once told me that he has, at times, suggested to patients that they don't need any more, a claim I find rather dubious. I suspect, in any case, that such a suggestion is the exception rather than the rule.

Now, if therapists have difficulty ending a therapeutic relationship when the patient wants to, it may be for many reasons, of course. The patient may even need more therapy and the therapist may be simply encouraging a workable solution. I can't help thinking, though, that in any other walk of life, if a person wants to end a relationship and the other party can't let go, we don't refer to this as a responsible or professional or even loving attitude. Rather, it's "codependent" -- or in layman's terms, "creepy."

-- David Zasloff

I'm sorry that Meredith Maran did not find therapy helpful. I'm glad she is seeking what she needs elsewhere.

However, shame on Salon for publishing this one-sided story when there are still far too many people who would benefit greatly from therapy but who don't seek it out because of the stigma that is still associated with it (despite the author's claims that all Americans are now in therapy and see it as a cure-all). I was one of those people myself, and I am eternally grateful to the person who finally talked me into trying therapy when I needed it.

It's true that therapy doesn't work for everybody; it's important to find the right therapist to work with, and it's important to enter into therapy with an honest desire to work.

If you are going to run a negative piece like this, please at least balance it with an article that will send those for whom therapy would be helpful to the right place.

-- Lindsay Smith

My hat is off to Meredith Maran for expressing in words what I have thought about modern therapy for years. Why is it that so many psychologists/psychiatrists, parents, court-appointed guardians, judges, et al., are so ready to point fingers for a person rather than have the person take responsibility for his or her own actions?

I guess there are a lot of reasons. There's a lot of money to be made off of therapy and the drugs that tend to accompany it. But, to me, the bottom line is this: Nobody likes to admit it when they are wrong and placing blame on parents, priests and society is a helluva lot easier than admitting to one's self that, yes, I have fucked up.

-- Mark Bayhylle

I am sorry for Maran's bad therapy experiences: it definitely sounds like she was caught in a bad, narcissistic habit. But I don't think there's a need to paint all therapy with such a broad brush. Like many "drugs" to which one can become "addicted" (Maran's analogy), therapy can be used properly, or it can be abused.

As a person with lifelong depression and anxiety, I've been in therapy since I was about 4 years old (I am nearly 30 now). I have had about 20 therapists in that time, and I have learned a lot. I don't go often anymore, but for me, good therapy is a place where I go to find out that I am healthy, not sick. My goal there is to focus less on myself and my condition -- not more. I've had my share of bad therapy and I got out of it -- it was a "50-minute shot" of solipsistic wallowing. That definitely did not feel helpful.

Perhaps the danger is in seeing "therapy" as a kind of panacea, instead of looking at it critically and realizing that -- like anything else -- it's not a magical mystery. It is what it is, and it's helped me a lot.

-- H. B.

For all of the author's criticisms of therapy and her regret in having spent untold hours and $100,000 on it, could it be that it worked? She seems to be a self-accepting, mature woman ... with one caveat: The kid who just learned how to ride a bike shouldn't call the kids still on training wheels big babies.

-- Christopher Der Manuelian, Jr.

Aarrgghh!! Another over-actualized, self-obsessed writer run riot. Ms. Maran admits an addiction to therapy but unlike real addicts, who at least in theory, take full responsibility for their actions, she continues to blame her parents, the psychotherapy system and whomever and whatever else kept her in therapy, all the while patting herself on the back for finally rinsing out her emotional vomit bucket. If Ms. Maran were truly the addict she claims to be, she'd be busy writing a list of all the persons she had harmed by her abuse of therapy and would begin making amends to them.

-- Elisabeth Greenbaum Kasson