Jeanne Safer Ph.D.

The Last Taboos

Addicted to the Quick Fix

In praise of long-term therapy

Posted Aug 19, 2013

Freud's couch

the Freudian couch: still the treatment of choice

          I, for one, am relieved that San Diego’s almost-ex Mayor Bob Filner’s sex addiction therapy has been so successful that he’s already reportedly completed the “intensive two-week program”  at a treatment facility in Los Angeles, and has moved on to less-intensive outpatient treatment. He joins Anthony Weiner, Eliot Spitzer and (in case we’ve forgotten) Tiger Woods in this revolting charade. The clinic bills itself as the only one in the country to “cover the same territory in half the time” as the typical month-long residential treatment for this malady. Weiner set a world speed record in rehab, not having completed even three full days of evaluation at another similar establishment before his misadventures were “behind me.”

          The absurdity of these so-called therapies is offensive to any therapist, and to every patient, who has struggled with sexual compulsions—whether  such behavior meets the criteria for addiction is highly questionable—or  any other deep-rooted, complex emotional problem.  Real therapy takes time, and effort, and commitment. The internet age and shortened attention spans haven’t changed human nature.

          There are indeed effective brief treatments for many psychic ills; phobias, some sexual malfunctions and assorted anxieties can often be alleviated in a few sessions. Hypnosis in particular, in the right hands, works wonders in a short time, sometimes in a single session. These interventions are an excellent auxiliary to longer-term treatment, and I recommend them regularly; I’ve benefitted from several myself. But the deep angst, self-esteem woes, relationship difficulties and other heartaches (let alone more serious diagnoses like borderline personality, bipolarity or narcissism) that drive people to seek psychological help are simply too complicated and ingrained to give up so easily. They are woven into the fabric of our selves, and unweaving is usually a complicated, painstaking process, involving grief, patience, and trust—all of which happen in real time, lots of it.

          Authentic therapy, the kind that profoundly and permanently changes your relationship not only to others but to yourself, usually takes months or years; it took you a long time to accrue your character—how can it take nano-seconds to change it? It took decades for me, even with my years of professional training. And even though both my therapists had their limitations, they gave me the tools to lead an examined life, the most precious education I had, and the one I’m most grateful for. I plan to continue the process, on my own now, for the rest of my life. I’m very glad it’s not “behind me.”