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The Sleeping Cure

I’d seen four shrinks in my life, and they’d all dozed off mid-session. Was it them—or me? I went back to find out.

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Illustrations by Istvan Banyai  

After I was expelled from boarding school, kicked out one month shy of graduation for boozing and for a condition that might best be labeled “extreme chronic malingering,” I was sent to an old-fashioned psychiatrist on the Upper East Side. This was the early eighties, or halfway between the respective heydays of Holden Caulfield and Prozac. Though the idea of the adolescent hallowed by his suffering had stiffened into a cliché, it wasn’t yet the fashion to put a problem child on meds. I still remember walking into the churchly lit office, with its framed poster of William Jennings Bryan’s “Cross of Gold” speech. To that point, my notion of therapy was informed by little more than Judd Hirsch in Ordinary People.

The doctor was a middle-aged man with a low-slung, do-si-do voice, cowled eyelids, and a silver Cross pen poised above a yellow legal pad. I regarded him as little more than an agent of my parents, and so, aside from a twice-weekly deconstruction of Hubie Brown’s Knicks, refused to engage him. What followed was an old-fashioned Freudian face-off: I sat in a stone-cold silence that he declined to break, a magisterial reticence no doubt meant to open a crawlway to my unconscious mind. We were all but motionless in an all-but-airless room, repaying each other’s muteness in kind. It’s no wonder what eventually happened. The doctor fell asleep.

His eyelids would droop, his head loosen, his chin loll slightly forward, and then—a telltale jerk back into some semblance of attentiveness.

Thirty years and four shrinks later, I’ve come to recognize these signs. I have consulted four therapists in my life, and all four have fallen asleep on me. The ritual—forms, waiting rooms, Kleenex—starts up again, only each time with my own special twist: I pay someone to explore my unconscious mind and instead they sink into theirs. So consistently did I lose wakeful contact with my shrinks that I began to suspect—honest to God—that feigning sleep was a technique for provoking patients to confront their fears of abandonment. “Once in a 40-year career,” said a friend’s shrink, an ancient and cheerful Jungian, when I asked him if he’d ever drifted off while on the clock—making me, I suppose, the Ted Williams of narcissistic monotony.

A little while ago, at a dinner party, I met a prominent analyst, a Kleinian. He is the first therapist I’ve known socially, and I confided in him. “I’d like to go back into therapy, but all four therapists I’ve seen in my life have fallen asleep.” He didn’t laugh. Nor did he ask me how I felt. Instead he took it in, turned it over in his mind, then said, very carefully, “Well, the common denominator here is you.”

The comment lingered, as any stab wound to the chest would. Then, a week later, he e-mailed me a PDF. “In the past I noted a tendency in myself to become drowsy with two patients,” wrote the analyst Edward S. Dean in a now-infamous 1957 paper. “At times this drowsiness became so strong that I desired more than all else that the hour end, that I be rid of the patient and could take a brief nap. I was surprised to observe that as soon as the patient left, I became instantly fresh and alert.”

The sleeping analyst is not common, but it is not unheard of, and Dean’s paper has been cited in most treatments of the subject since. And no wonder: He taught the analyst to interpret his own sleepiness not as malpractice, or even an embarrassing if inevitable bêtise, but as evidence of the patient’s “tenacious and insuperable resistances.” Explicitly following Dean’s lead, successive analysts have generated a composite portrait of the sleep-inducing patient as a kind of negatively charged superhero. He can be so powerfully dissociative, “the analyst feels depleted or half-alive, and thus disorientated and out of touch with the basis of what is most alive, or would be most alive at that time if the patient were truly there.” Typically he suffers from “passive-obsessional and narcissistic character disorders, [using] isolation, inactive rumination, concealment and displacement of affects to control and dull into passivity the patient himself as well as others.”

Therapy is unlike any other social situation. It is a highly ritualized encounter designed to take the immense dead weight of the past and budge it, inch by galling inch, in the direction of change. But therapy is also like any social situation. It is a kind of performance in which we seek to convince, to charm, and, if necessary, to put on the cap and bells of our suffering, to sustain the attention of another. Over the years, my feelings about therapy hardened. But the Kleinian, and his forwarded paper, have made me reconsider. I’ve now gone four for four. Are my own powers of resistance so enormous that the composite portrait of me, as an isolated, narcissistic evader, is unavoidable? Can an abandonment of minimal professional duty—to stay heedful of what a patient says, no matter how stonewalling—really be answered with an evasion, a theory, a cliché? Who are the bullshit artists here? Them or me?


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