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Freudian Snips

Shrinks on break get "a little work done" -- and hope patients won't notice.

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Think your therapist's off basking in Wellfleet? Don't be so sure. She may not be on the beach at all; she may, in fact, be under the knife.

Turns out that a surprising number of therapists use the off month to do something about their own self-esteem issues: get plastic surgery.

"I did it August 1st," says "Samantha," a Long Island analyst, of last year's eye-, face-, and neck-lift. "I take August off. Freud did" -- giving her time to recover without her patients wondering about all those nasty bruises. "If not, I knew it'd be another year of being depressed."

And while most plastic-surgery patients don't mind coming back from "vacation" with a noticeably cuter nose, therapists are adamant about looking . . . the same. "Please make sure I look like myself!" is the most common refrain, says Dr. Z. Paul Lorenc, who does about ten therapists every August. They fear that looking too good could destroy the patient-analyst relationship.

"I really -- and this could be my own self-deception -- am hoping that people aren't going to notice," says "Sarah," a 51-year-old Manhattan psychotherapist. "It seems to fly in the face of what we're telling people: to accept yourself." The worst outcome, she says, would be "a complete loss of faith -- patients will decide I can't help them."

Last August, one 48-year-old therapist got new glasses, changed her hair, and bought a new wardrobe to camouflage the fact that she'd had her eyes done: "I pretended that I went on vacation." The deception was necessary, she says, because "I'm supposed to be a mirror for patients to look at themselves -- not me. Besides, it gives a really bad message. I don't believe in the world that makes women have to do this. It's sick."

According to cosmetic-surgery consultant Wendy Lewis, some surgeons refuse to operate on therapists. "They do tend to be more introspective," plastic surgeon David Hidalgo says with a laugh. He estimates that therapists make up one third of his August procedures -- about twenty each year. "They want to talk about every aspect of it so they have a comfort level with the process. It's all about process."

"I had one client who answered every question with a question," Lewis recalls. "I'd ask, 'How do you feel about your lower eyelids? Are they a little crepey?' " -- as in crepe paper. "And she'd say, 'What do you mean by crepey?' They pay big attention to detail. They'll say, 'You told me. I've got it right here in my notes!' "

Luckily, therapists' attentiveness doesn't seem to be matched by their clients'. "I made up my mind that if people asked, I'd say I did," says Samantha. "If you lie to a patient, you're a bad therapist." But she hasn't had to worry. "Nobody has said a word -- and I've been seeing some of these people for twenty years! Maybe they're so narcissistic that they don't notice."


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