The Therapist We Deserve

We have the therapist we deserve. Today, that means, Esther Perel. Subject of an extended New York Times profile, apparently written by a fan girl named Sarah Lyall, Esther Perel seems to be fount of wisdom and an intrepid clinician. 

We have the right to doubt gushing profiles, especially when they distort reality.

Strangely, Times reporter Lyall neglects to mention that Perel is all about storytelling and psychodrama. If you want to learn how better to tell stories and to turn your life into psychodrama, Perel is for you. If not, she is not. 

Perel’s approach has much in common with psychoanalysis. She imagines that life is a story, that we are all actors and actresses, playing roles that were allotted us in narratives we ignore. 

When we undergo therapy, we want either to discover the story we have been playing out, or, better yet, to rewrite the narrative in order to produce a happier ending.

Of course, if human beings are not actors, this all becomes rather cheap. Life is about moral dilemmas, situations we face where the outcome is not assured. In a story, in a fiction, even in a drama, the ending is always assured. We do best when we get out of our minds and out of our storytelling, and into the game... of life.

When Maya Binyam profiled Perel in New York Magazine, she emphasized the psychodramatic aspect of her treatment. Binyam wrote this in April, 2021:

Today, Esther Perel identifies as a scriptwriter, the person who propels a plot forward when life’s main characters are otherwise paralyzed by self-doubt. But when she speaks to her audience, a population of millions, it is from her position as America’s preeminent couples therapist.

Anyway, the Times article begins with Perel’s appearance before a conference led by one Bessel van der Kolk. You know the name because he’s a best selling author and a leader of the trauma industrial complex.

Obviously, trauma is all the rage these days. It makes a certain amount of sense. In a culture where we define ourselves by our grievances and our suffering, it feels natural that we have become obsessed by trauma. 

That we have most likely gotten it wrong, seems not to have crossed too many minds.

Nevertheless, one is intrigued to read this at the opening of the Lyall profile of Perel. Apparently, it is supposed to count as a nugget of superior wisdom:

Alluding to the Mexican poet Octavio Paz and the Argentine writer Jorge Luis Borges, she asked: “What if accessing the erotic is the catalyst that helps the recovery from the trauma?”

Obviously, this is reconstituted Freud, though it merely shows why Freudian treatment has consistently failed to treat trauma and depression effectively. No serious clinician today believes that a trauma victim should be subjected to Freudian psychoanalysis. 

If we are dealing with depression-- clinical phenomenon that Perel apparently does not deal with-- one of its defining characteristics is an absence of desire. Absence of sexual desire; absence of appetite. If an individual suffers a depression brought on by a trauma, then one might imagine that accessing the erotic would help him recover. Perel has mangled the thought, though we can see where she is coming from.

Of course, if we assume that trauma victims are suffering from depression, we know that someone who is depressed cannot access the erotic. He might imagine that he can do so so through storytelling or psychodrama, but such is not the case. 

As it happens, and as we have known for decades now, the best treatments for depression, those that are classed as cognitive therapy, do not try to access the erotic. They consider depression to be caused by automatic self-deprecatory thoughts. And they assign homework exercises that work to undermine the hold that these thoughts have. If you think that you have never gotten anything right, the homework exercises will invite you to conjure up those times when you might have gotten something right.

As for Freud, his first theories of hysteria claimed that these patients were suffering for having forgotten, that is, repressed their traumas. Note well, that the origin of psycho analysis lies in theories about overcoming trauma.

Anyway, Freud quickly discovered that remembering a trauma and folding it into a narrative-- his initial effort at treatment-- was largely ineffective. So he went looking elsewhere. And he thought he discovered the solution in desire, of all things. That is, in the erotic.

Sad to have to put it this way, but Freudian theory posited that a trauma victim was having a problem overcoming the trauma because she-- in the cases Freud was treating-- could not accept that she had wanted it to happen.

Hmm. This is so appalling that generations of psycho analysts have forgotten it completely. But, when it comes to accessing the erotic, Freud imagined that his hysterical patients could not accept that they had really wanted to be sexually molested. Ergo, having discovered where their desire was leading them, they chose to shut down their erotic desire. 

One needs to mention here that despite the trauma industrial complex, most trauma and sexual abuse victims overcome their problems without undergoing any therapeutic interventions.

This means, when we are thrilled by the wondrous clinical results that certain therapists obtain, we need to mention that doing nothing works rather well in many of these cases. (See the work of Columbia University professor, George Bonnano on resilience.) To which one must add, in fairness, that sometimes nothing works at all.

As for trauma, consider this. There are two sides to the issue. First, what happened. Second, who knows what happened. The second is far more difficult to manage than the first. It’s one thing to forget the trauma and even to understand that it does not say anything about you. It is more difficult to eliminate the image of your traumatized self from other minds. How do you put the trauma behind you if people are looking at you as a trauma victim, that is, with pity. The more people see you as a victim the more difficult it will become to believe that the trauma says nothing about you.

This tells us that trauma is something that is best discussed with someone who does not belong to your everyday life, or your entourage. If you tell your story, as a Perel would want, you are inviting other people to see you as a victim, and to look at  you accordingly. This tells us why so many trauma victims choose to keep their stories to themselves, or else, only to share them with professionals. 

When the #MeToo movement was starting, more than a few women explained that they had not told the world what had happened to them because they did not want other people to envision them undergoing the trauma. 

Sadly, the new trauma industrial complex suggests that trauma is the meaning of your life and that, pace Freud, you ought to integrate it into your life history. In truth, people who chose to keep it to themselves, or only to share it with one or two others, had a better idea about how to overcome it.

One does not want to comment on the brainwork that some therapists prescribe, but one does want to add one’s suspicion that those who do best in overcoming trauma belong to communities where their entourage, even when people know about what happened, put it out of their minds and do not belabor the point. 

Trauma makes people feel alone, detached, unmoored and bereft. Evidently, the solution to the problem is for one’s community to make one feel attached, connected and valued. It is very difficult to do this by undergoing brain stimulation or even psycho dramatic storytelling.

Turning your life into permanent psychodrama, coupled with a compulsion to tell everyone what happened, is precisely the wrong path.

Also posted on my Substack--