As other bloggers on this site have, and other therapists’ have, I had difficulty swallowing Jonathan Alpert’s recent op-ed piece which appeared in the Sunday, April 22, 2012 New York Times (“In Therapy Forever? Enough Already”).

Mr. Alpert argues that long-term therapy is not effective and the professionals who practice such therapy “sat, listened, nodded, and offered little or no advice, for weeks, months, sometimes years.”

I am not the poster child for short-term or even mid-term therapy. I have been in treatment since I was twenty-three. I am now fifty-one. My first years were spent in traditional therapy where I regressed. Following that experience, I spent fifteen years in Dialectical Behavior Therapy and the last six-and-one-half years in Transference Focused Psychotherapy.

Mr. Alpert states that anxiety and depression are the top issues for which patients seek treatment, but he doesn’t address comorbidity which is so prevalent in our society. According to The National Institute of Mental Health’s (NIMH) National Comorbidity Survey Replication (NCSR) Study, the three most prevalent 12-month disorders found by the NCS-R were specific phobia (9 percent), social phobia (7 percent), and major depressive disorder (7 percent). The most prevalent 12-month disease classes are anxiety disorders (18 percent), mood disorders (10 percent), impulse-control disorders (9 percent), and substance disorders (4 percent). The most prevalent lifetime disorders are anxiety disorders (29 percent), mood disorders (21 percent), impulse-control disorders (25 percent), and substance use disorders (15 percent).

Twenty years ago I was diagnosed with anorexia, major depression with psychotic features and borderline personality disorder. Although I was not formally diagnosed with a substance abuse disorder, I have been addicted to cocaine and Klonopin. I cut myself on my forearms, upper arms and stomach. I tried to kill myself three times.

I’ve had over twenty inpatient psychiatric admissions and spent three-and-a-half years in a 24/7 supervised residence. Additionally, I have participated in numerous day treatment programs and partial hospitalization programs.

Today, I am a functioning, productive member of society. I not only have a full-time job, but two careers in which I am thriving. I haven’t been hospitalized or cut myself since 2007, and I haven’t attempted suicide since 2003.

I haven’t gotten where I am today with passive, sitting, nodding therapists. My therapists were and are engaging individuals, actively participating in the session and making on-target, intelligent interpretations that set me free from false beliefs and misguided perceptions.

If it wasn’t for my therapists, their hard work, and their ongoing commitment to me and my treatment, I know where I’d be right now. At best, institutionalized. Most likely, dead.

From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

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