This week Daphne Merkin, who's writing a book about her lifelong battle with depression, wrote an article called "My Life in Therapy" for The New York Times Magazine. She says that she's been in therapy for 40 years but can't be sure that it's changed her, or at least for the good. (Maybe nobody's "character has been genuinely transformed because of therapy," she writes. "If anything, most people seem to emerge as more backed-up versions of themselves.")

I am a therapist who goes to a therapist and spends most of her mental energy writing and thinking about therapy but also sometimes doubts that therapy is an efficient way to change people. It's likely that changing where you live or who your boss is or what job you're in would change you more radically and quicker. I also tend to think that what Merkin suggests in her article is true: Therapy can be an addictive indulgence, a place to dwell on, so perhaps increase, the very things (a focus on the self, a sensitivity to past injustices) that make you sick enough for therapy in the first place.

Merkin writes that her 40 years in therapy have not proven to be transformative, but they have proven to be interesting. She writes with sometimes masochistic or giddy energy about all of the strange scenes she's participated in during treatment: one therapist's dentures clanged, and he committed suicide not long after she broke off therapy with him; another wanted to talk about Merkin's mother's sexual fantasies; another essentially coerced Merkin to marry and proudly attended the wedding, though the marriage ended five years later.

In this sense, Merkin describes her life in therapy as a life spent enjoying some artistry of the self, if not some real transformation of the self. Therapy was a place to challenge her range of expression, to dare intimacies that might embarrass her in the real world, to practice her beloved language skills every week with an audience. Therapy was sometimes addictive in the way writing is addictive to a writer or painting is to a painter: a method of self-exploration which might not change the self but which confirms it or at least gives it the uplifting release of expression.

I do tend to think that therapy is one of the most interesting things to do with a personality if not the most efficient way to change it. The one experience which transformed me most wasn't therapy--it was forming a relationship with the guy who's now my fiancé. Granted, therapy probably readied me to enter the relationship and to get what I'm getting out of it. But I've spent years with therapists trying to deal with my central issue, which is probably my need for public accomplishment--to become famous or earn awards in my field or write many books or send out other public markers that I'm an important or admirable person. But it was really when I got into a romantic relationship with a man whose values were different than mine were that I started to change more quickly.

My fiancé doesn't care about public accomplishments much, because he's more interested in sensual experience. He wants to travel but not write or read about travel; he wants to have picnics rather than write something publishable on Saturdays; he wants to spend hours walking around the city rather than (as I had pitched to many a publisher) write about the joys of the city. Being in a relationship with him has been like holding onto the ski instructor while he slaloms downhill, so that I learn by being forced to follow the motions that I've never been able to produce by simply telling myself to. I have spent weeks in therapy talking about reducing the amount that I talk about myself, but it was only when I was in a relationship with someone who looked bored when I talked so much about myself that I had strong incentive to stop doing it so much. I had spent years in therapy talking about a desire to enjoy a picnic without a thought about publishing a book, but it was only when I went on regular picnics with a man who was more sensual but less verbal than I was that I felt my register shift.

Of course these changes are probably the effect of immersion: You learn more when you're doing something 24-7 rather than just once a week in someone's office. The changes are also the product of enacting behaviors rather than theorizing about them, and of practicing behaviors through various contexts (on the bus, when drunk, when sick, on the toilet, in the park) rather than simply in the static station of a person's office.

That said, I, a therapist, don't think therapy's useless. I believe in therapy because it is a dedicated time for support and guidance in a world when we can't all demand to have or hire a good lover to hold onto while he skis. Ideally, we'd get enough support and guidance from community, family, and friends, but those people don't always give it. I also believe in therapy as a time for thinking specifically about psychological support, as opposed to the support we tend to get more consistently in other areas of life, like the medical, nutritional, educational, economic, or legal realms. That is: Paying bills is something society insists upon, but no officials check in to see if you're tending to the life of the mind, until the mind blows a fuse. We do need to tend to the mind. I also believe in therapy as a plain old interesting activity, like the movies: If some people regularly spend money on movies because it relaxes or teaches them, why not do something similar in therapy? Why feel guilty for this wonderfully interesting leisure activity? After all, therapy does usher in small changes, or certainly it does so as much as our encounters with art or accountants or teachers or religious leaders do.

I happen to be a literature teacher as well as a therpaist, and I wonder how many people who love art and books are also more likely to love therapy.  In my eyes, therapy and literature hold a lot in common. Both are activities that take a deep look at the grey area of human character--at how emotions lead to behaviors. In both, we are also deeply interested in words, in how internal life gets expressed through language. In both, we are interested in change. All great novels hint that change is possible. Therapy does too. And in both, that change is complicated: Quick reversals are not believable in either.

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