By Gretchen Gibbs
The front page of The New York Times featured the sad tale of Dr. Donald Levin, a psychiatrist who once provided “talk therapy.” Now, he prescribes only medication to 1,200 clients seen every few months for no more than 15 minutes. Dr. Levin, like most psychiatrists these days, says he cannot afford the time to provide any form of psychotherapy. The article speaks of a “telling loss of intimacy between doctors and patients.”

Of course, Dr. Levin could allow his salary to plummet to the level of the psychologists and social workers to whom he refers his clients. The math is easy. If you have 40 clients a week who pay you $100 a session, you’re grossing $200,000 a year. Dr. Levin did not reveal his salary, but with four clients an hour and working more than eight hours a day, he easily is quadrupling that $200,000.

So partly the loss of intimacy is due to the desire to make money. There are other factors, however. For instance, the field of psychology is also changing. Psychologists themselves are seeking prescription privileges, and in several states have already obtained them.

Training in many graduate schools focuses on “manualized treatment,” meaning that the psychologist is following a manual telling her or him what to say after each type of comment from the client. It’s easier to prove such treatment is effective. Models of treatment are primarily cognitive-behavioral; there’s no attention paid to the causes of one’s problems, only to the treatment plan. The therapist doesn’t want to hear about your past.

I started this piece with the notion that the public is being cheated out of the kind of personal contact they want and need from mental health workers. Then I saw the headline this week in the Times entitled “Teachers wonder, why the scorn?” and I began to wonder if we really honor those whose professional role involves sharing who they are as a person. Why is the country so concerned to cut teacher salaries? Is there a profession that’s more important?

Of course, teaching also has become more technological. On the college level, I have walked the halls and noted the darkened rooms as professors present their Power Points and as students text and play solitaire. Distance Learning is a catchword, and classes are larger. Other providers of human services, like nurses and nurses’ aides, complain that their work has become more technological, with less patient contact. So perhaps as a society we are in some ways complicit with the loss of intimacy caused by these increases in technology.

I heard an interview on NPR with Sherry Turkle, about her book Alone Together, which deals with the isolation that technology is producing. She provides the ultimate example: the use of robots with children and the elderly to carry out the role a person, or at least a pet, would have had to perform previously. There’s Furbie for children and the Paro, a cute baby seal that moves in your arms and makes pleading noises, for the elderly in nursing homes. The illusion of unconditional love, without any bother. Turkle feels technology isolates us, citing adolescents who say they don’t like phoning now, it’s too intimate; they just text.

So the loss of the “human” in human services may be linked to the growth of technology and interest in making money, but many of us seem to welcome it. It’s more comfortable. Perhaps we are redefining what relationships mean. What’s a friend when you have hundreds of them on Facebook? I am too much of a psychologist to believe that people can do without intimate relationships, or that they want to. What’s the impact, though, of a world where it’s increasingly hard to find that connectedness? Perhaps we think we’ll “save” intimacy for those few we really care about. But then, when we’re in an intimate relationship, will we know how?

Tags: gibbs

This entry was posted on Friday, March 11th, 2011 at 8:36 am and is filed under Gretchen Gibbs. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.