Strapped patients are starting to give up their shrink sessions. “A lot of my patients are very anxious about the possibility of giving up their therapy,” says Alan Schwartz, a Chelsea psychiatrist. “Some of them are now going to internists for their meds. They are doing their best to maintain some sense of calm.” Harold Levinson, who specializes in anxiety disorders, says a fifth of his patients have put therapy on hold—at a bad time. “Not only are people under financial pressure,” he says, “but this is holiday season, when depression is at a high.” Stephen Josephson, a psychologist at Cornell and Columbia who has lost 10 percent of his patients, says he’s seeing “more severe symptoms, including suicidality.” There’s already some fee negotiation and spacing out of sessions. “But you don’t want to give therapy for free,” says Levinson. “It distorts the process.”

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