As the fates would have it, two weeks ago I was in Washington, D.C., drama central for imploding capitalism. The air was frosty and the cherry blossoms were just appearing as wary buds.
At the time, Barack Obama was mounting innumerable bully pulpits, including a late-night talk show, arguing for his budget and stimulus packages. I, on the other hand, was nestled in a Washington hotel with 3,600 psychotherapists.
They were a comfy bunch. Open, remarkably friendly, trained to talk to strangers, which is of course what they do for a living. We were all attending a conference convened by a psychology magazine, the Psychotherapy Networker (which I write for).
The title of the conference was Seizing the Day: Therapy and the Art of Engagement. It sent a cheery note. But the underlying theme was therapy in an age of meltdown, both financial and emotional.
It's a new unbuttoned-down world out there, Coop, shown here in a 1953 studio handout. (Canadian Press)It's a new unbuttoned-down world out there, Coop, shown here in a 1953 studio handout. (Canadian Press)
I was looking to find out how the financial crisis was affecting the mental health field.
In from the cold
So far so good, it seemed. The economic tsunami hadn't yet completely swept in and drowned these good souls in their offices.
In fact, in the complicated system of health care that Americans endure, some of the private managed-care companies have discovered that they are seeing an uptick in business. More upset Americans are coming in for counselling.
That undoubtedly included people who had been laid off and but could still seek therapy — or that last pair of glasses — before they are no longer eligible for the company-paid insurance anymore.
Layoffs and the anxiety of not knowing if you're going to get sacked sends many people scurrying for meds and counselling. Americans are used to taking pills (not to mention other self-medicating delights) and they like talking about their problems.
The old days of tight-lipped, suck-it-up Gary Cooper are over. Oprah and Doctor Phil are the new heroes of the so-called therapeutic culture.
That is not a bad thing, in spite of the excessive yammering at times. Better to talk-talk, though, than to "go (murderously) postal."
Still, these therapists are not Olympian gods, immune to the mortal distress below. Many of them work for state or community agencies. New York state, for instance, has to cut 6,000 workers from its payroll. Social service agencies may be trimmed; entire programs could be axed. The state of California is almost bankrupt.
Therapists themselves may find themselves unemployed. A whole new specialty may arise: therapists who counsel other (distressed) therapists.
Recession-proofing psychotherapy
Given the economic climate, therapists are beginning to look for advice for themselves, at least on the financial front.
The Psychotherpy Networker is full of articles on surviving the meltdown and "recession-proofing" your practice. One piece in the recent issue suggests that the new, young American client won't have the time or patience to break away from work and wade through traffic for an hour's session across the city.
As a result, telephone consultations may be the new in-thing as well as shorter, more tailored "coaching" sessions.
Some clients don't want even to talk to their therapists in the conventional way anymore. They are used to Twitter-style exchanges and firing off snappish emails. So therapists are being told to become "entrepreneurs" and adjust their practices to the new web age.
Want to survive the meltdown? That can mean organizing your practice so that your clients can check in with you a few times a day by email. Then they can click on your advice. Or they can listen to a meditative, breathing session on an audio podcast just before that rough meeting at the office.
One psychiatrist I spoke with said his business is down 50 per cent. He was an older fellow, not very computer literate. I couldn't imagine him developing new cyber-products for his troubled patients.
The confession business
Therapists are in the confession business and when you open up towards them, they confess back. "What happens when you begin to dislike the whining of your patients?" one man blurted out as we spoke.
He was born poor in the South. He disliked the "oblivious rich" who came to him for therapy. They were in trouble, sure, but they didn't have a thought for anyone else.
"So why don't you work with the poor?" I asked him.
"They don't pay." (That is, unless you go into the Medicaid side of the business but that means filling out forms and dealing with bureaucrats who talk a different game.) So he is stuck, counselling those he does not like.
For a moment, I felt like his therapist.
For years, this shrink was used to "telling the truth" to his patients. He was blunt. He liked to rough up his patients' egos, supposedly for their own good. But now they don't seem to want his tough-love treatment and are staying away.
"Even the rich require consolation," I suggested. He didn't want to agree. So he was in a no-win position. But as an MD, he could at least write his patients prescriptions for anti-depressants if he didn't want to actually talk to them.
Rearranging the deck chairs
That's just one story from the la-la land of psychotherapy, which is the province of mostly non-medical psychologists and clinical social workers.
Nevertheless, this was a remarkable crew at this old, fabled Washington hotel. It seemed like we were all on an elegant ocean liner cruising into the future. At a time when business meetings and conventions are way down or are simply being cancelled, at least 200 more people came this year than last.
In a way, this gathering is a tribal rite: therapists getting together to bathe professionally and emotionally in the company of each other. True, they were 70-80 per cent women (who liked to talk). Even the men, like me, tended to be verbally inclined.
Anywhere you sat down, to the right or the left, you immediately struck up a riveting conversation. Making connections are their business.
But meetings like this are, in some respects at least, alternative reality events. These are humane people who often work alone in offices and consulting rooms and who gather together each spring to bond. The result is a giddy, almost hallucinatory experience.
Then, after four days, they head home, seeming to carry a small ember of psychotherapeutic renewal burning inside them.
In that way, they are like our Stone Age ancestors, nursing a fire as they migrated from campsite to campsite. Only now the flickering flame is supposed to stay lit in thousands of isolated offices, and over the internet, in meltdown America.
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