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Sorry, Your Time Is Not Up

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My analyst sucks in her breath. "Don't tell me," she groans, "that The Sopranos has gotten to you too."

The Sopranos? It hadn't even occurred to me that Dr. Melfi's efforts to send Tony into behavioral therapy in season three would have led to a citywide uprising of frustrated analysands.

"Um, I don't think so. Why? Are other patients suggesting they go into behavioral therapy this week?"

"Uh-huh."

"Really?"

"Let's get back to your sleep troubles."

A few weeks later, I phone Charles Tolk of NYU. "There's a lot of Sopranos material that comes into the office during those Monday sessions," he says. "Some patients seem to have wishes that you would please do for them what Dr. Melfiis doing for Tony. Or they'll basically say, 'We've been in therapy for months, and we still haven't reconstructed the capocollo fantasy that's the key to my neurosis.'"

I hang up, wondering whether I have been unduly influenced by HBO.

Funny: I seldom hear stories about people leaving therapy under mutually agreeable circumstances. No doubt, this is partly because the malcontents scream louder than the satisfied. But I think it's also partly because analysts have a habit of dismissing all arguments for termination with a psychoanalytic explanation, creating a maddening, self-referential logic loop that completely obliterates the possibility of rational conversation. My friend Nina, for example, tells me about an unhelpful, unimpressive sixty something Freudian who insisted, on their final visit, that the reason she wanted to discontinue was because she couldn't tolerate her attraction to him. "It was so implausible," she sputters. "He was this fat old man." She politely tried to explain to him that their arrangement simply wasn't working; he countered that she was . . . resisting. "These people," she ruefully declares, "are like well-managed swat teams. They bar every door."

Ah, resistance. Freud wrote copiously, endlessly about this concept. In his introductory lectures, first published more than 80 years ago, he catalogues its many varieties -- repeating the same stories over and over, recovering no new memories, putting psychoanalysis itself on trial -- and that's pretty much what I'm doing today. I thought it was because I'd reached the point of psychoanalytic poop-out -- I'd become so boring I was boring myself. Apparently, I was mistaken. A plateau, according to Freud, is never just a plateau.

I understand the psychoanalytic value of resistance. The closer we get to our own hobgoblins, the more apt we are to run away from them. (Another friend once told me that whenever he touched on a particularly harrowing topic in therapy, he'd abruptly switchgears and start weighing aloud the virtues of different kinds of cell phones.)

The trouble is, shrinks often use the notion of resistance as an all-purpose cudgel to keep uscowering in place. (I mean really: If the subway breaks down and we're ten minutes late, is it resistance? Or the incompetence of the MTA?) More important, the notion of resistance doesn't allow for the possibility that we're stymied in therapy because we really have gone as far as we can go -- or that our analysts are no longer appropriate for us -- which renders both psychoanalysis and our analysts impervious to criticism.

"Analysts are often trained to think about patient objections as a resistance," acknowledges George Frank, a training analyst at the National Psychological Association for Psychoanalysis and a member of iptar, the Institute for Psychoanalytic Training and Research. "As if their competence or appropriateness could never be an issue until the analyst says so."

"There's always a kernel of truth to the criticism," adds Leon Hoffman, co-director of the Parent Child Center at the New York Psychoanalytic Society. "Your office is too messy or too neat. You take too many vacations or you're always here. You make comments that are incorrect."

What probably nags me most, though, is how resistance serves the economic self-interests of our therapists. Without it, I have no idea how they'd pay for their summer places in Wellfleet. Joshua Wolf Shenk, a friend who's currently writing a book for Viking Press about Abraham Lincoln and depression, recently wrote me a memorable e-mail on this subject. As he descended further and further into an analytic slump, he grew angrier and angrier at his therapist for urging him to stay the course, which at the time was costing him $460 a week. "My therapist felt I should 'tolerate' the rage," he wrote. "I felt he should go fuck himself.

"Of course," Shenk continued, "I did feel rage at him, and he helped me see it and feel it -- probably saving my life. But there came a time when I needed to act on my feelings." So Josh lived out every indignant patient's fantasy. He didn't show up for a session, believing it was his only way to make himself heard. "If you go to therapy to argue that you should leave," he points out, "you've already conceded you're wrong."

I wish I had the guts to do that. Instead, I just complain a lot -- and privately suspect that my therapist is taking advantage of me. Because let's face it: A psychoanalyst has no more financial incentive to tell you you're finished with therapy than a car mechanic has to tell you there's just one tiny thing wrong with your engine. (I often think of a cartoon I saw once, in which a bearded Ur-shrink stares at his patient and says something like: "You can't terminate now. I haven't finished paving my tennis court.")


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