Magazine article The Spectator

New York's Shrinking Shrinks

Magazine article The Spectator

New York's Shrinking Shrinks

Article excerpt

America's psychoanalysts are becoming an endangered species

New York City

Nothing says New York like a psychoanalyst's couch. Think Woody Allen or those New Yorker cartoons. It fits our perception of east-coast Americans as all neurotic and self-obsessed. But that mental picture needs updating, because traditional psychoanalysis is in dramatic decline in its traditional heartland.

Across the urban US, in fact, the profession is dying out or having to change drastically. New figures from the American Psychoanalytic Association reveal that the average age of its 3,109 members is 66, up four years in a decade. More seriously, the average numbers of patients each therapist sees has fallen to 2.75. Some shrinks now never meet patients, dealing with them only via the phone, Skype or email. In the 1950s and 1960s, therapists could see between eight or ten patients a day. Now they're lucky to see one.

So why are Americans shrinking from the shrinks? Packed modern lives must produce more therapist fodder than ever. But that's part of the reason -- a dwindling number of people now have the time or patience for the classic Freudian treatment of three to five weekly sessions -- each lasting 45 to 50 minutes and costing up to $500.

The real change, however, seems to be in the American psyche. America -- at least elite America -- took psychoanalysis to heart in the post-war years. It helped that many Jewish analysts had fled Europe to New York, but it was also a by-product of tremendous affluence. Many Americans had little to worry about except their mental health. There was a name for such patients: the worried well.

Even then there was a sense that psychotherapy was scientifically wishy-washy, but such anxiety if anything helped the industry: if you can't be cured, you have to keep coming back. Since the 1980s, however, medical insurance companies have been increasingly loath to pay for more than a single visit to the shrink a week, if that. The same decade saw the rise of biological alternatives in the form of psychotropic drugs. Products like Prozac could quickly treat depression, anxiety and panic attacks.

Other forms of treatment have also put the squeeze on psychoanalysis. Chief among these is cognitive behavioural therapy, which teaches people to bypass unhelpful thoughts. …

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