Click Here to Read: By Jonathan Alpert in The New York Times on April 21, 2012.
Click Here to Read: “We Have Nothing to Fear, But . . . “We have nothing to fear, but…”; Makari on the Anxieties in Today’s NYTimes on this website.
Click Here to Read: Jonathan Alpert’s Mis-Statements, And Possible Misconduct by Todd Essig on the Forbes Magazine website on April 23 2012.
Click Here to Read: Is Quick Therapy the Best Therapy? Letters to the Editor in the New York Times on on April 23, 2012.
Response to “In Therapy Forever: Enough Already,” (NYT 4-22-12)
Nathan Szajnberg MD Managing Editor
Imagine retitling Alpert’s OP-Ed “In Therapy Forever? Enough Already”: into “In Medical Treatment Forever? Enough Already.”
This is not entirely wrong; it simply doesn’t make sense. If medical treatment is for a runny nose, of course medical treatment shouldn’t be forever; any Doc-in-the-box can handle this. If it is for a diplococcal pneumonia, of course treatment is not forever; perhaps two weeks.
If it is for Type II Diabetes — oops, (forever or until death do us part). How about Rheumatoid Arthritis — forever. How about Parkinson’s — ibid. Then there are the terribles — leukemia, breast cancer. Would you believe a physician who said that he could treat you in one visit with 88% improvement (as Alpert claims in his article)?
So, the degree to which treating the mind is a clinical practice — which it should be, if we respect our minds as much as our bodies — then treatment should be for as long as the diagnoses indicate, provided the clinician makes good diagnoses.
For Alpert, “anxiety” or “depression” appear to be simple matters, needing perhaps one visit, maybe eleven, he says. But, read Makari’s recent thoughtful reflections on “anxiety”: then decide whom you would want to treat you.
But, psychoanalysts have an obligation to articulate, to show that our work over time benefits our patients. Fonagy and Target did so for child analysis. Leutzinger-Bohleber and colleagues are doing so for adult treatment. American analysts should step up to the plate.
Alpert’s article is typically American: faster, better, sooner and doing something to someone. Nothing completely wrong with that. In fact, Alexander and French pioneered such work in Chicago psychoanalysis. But, when Jean Piaget visited the University of Chicago in the mid-60’s, he bewailed the American tendency to try to get babies to do things sooner, faster (and for American researchers to change research problems to fit their methods, rather than devising to fit the problems). It’s possible to get babies to do things sooner, such as toilet training at six months. But, whose achievement is this? Or in clinical practice, our task is to provide the patient with the capacity to guide her or his own life.