Should Therapists Play Cupid? - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">If you are in psychotherapy, there's a good chance your therapist knows more about your inner thoughts and secret desires than anyone else.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">So, if you're looking for a mate, wouldn't your therapist be a more reliable matchmaker than <a title="Online matchmaker" href="http://www.eharmony.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">eHarmony</a> and <a href="http://match.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Match.com</a> and other sites that rely on impersonal algorithms?</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The idea that therapists might play Cupid with patients tantalizes patients and therapists. An anecdotal survey of my psychiatrist colleagues suggests that the matchmaking impulse is very common.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">A senior colleague, for example, tells me he was treating a young man who was struggling to find a partner. My colleague said he knew someone who was perfect for his patient and wanted to set them up on a date, but didn't because he was afraid — there were too many ways even the most well-intentioned therapist fix-up could go wrong.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Why? Psychotherapy, especially insight-oriented therapy, is designed to conjure intense feelings — on the part of the patient and therapist. Much of what patients feel toward their therapists, the so-called transference, are unconscious feelings that are redirected from important early figures in their lives — parents, family members and teachers. Your therapist mirrors this phenomenon with his own countertransference.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">One of psychotherapy's aims is to use the patient-therapist relationship to better understand the patient's relationships with others and to remedy problems in the little lab that is the therapeutic connection.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Both parties are under constant temptation to act on their unconscious feelings, rather than analyze and understand them. No matter how smart or experienced the therapist, it's easy to follow those feelings and get your patient — and possibly yourself — in trouble. Strict boundaries between personal and professional behavior are meant to insure against such hazards.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">But temptation lurks. I've had matchmaker fantasies myself. A patient of mine, who was divorced, told me she was reluctant to enter the online dating scene. It felt overwhelming, she said, and it seemed improbable that she would meet a plausible mate.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">An old friend and colleague of mine lost his wife to cancer some years ago and I knew — or thought I knew — that he would hit it off with my patient. I began to wonder how I could discreetly bring them together. Could I invite him for dinner and tell him to meet me in the waiting area outside my office around the time of her appointment? Too chancy. Too obvious.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">I thought maybe I should just ask my patient if she would like to meet my friend. That would involve crossing useful boundaries. And would bring my personal life in conflict with my job as therapist, which, among other things, is to help patients understand themselves and discover how to make their own lives as full and rich as possible. I shouldn't find partners for my patient any more than I should cook her dinner: both are skills she has to develop for herself.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Additionally (and why was I thinking this through so fully?) she might feel coerced into something she really didn't want to do. A therapeutic relationship is by definition unequal; therapists have considerable power, and patients want to please their therapists. My patient might be reluctant to decline.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Worse yet, what if the date went badly? My patient might wonder whether I really understood her at all or whether I was setting her up as a kind of test.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">A colleague told me that when she was in training, her boss, a senior psychiatrist, suggested that she go on a date with one of his patients. She thought it odd, but being curious and open-minded, she agreed.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">They went out for drinks, she said, and her date spent the evening pumping her for information about her boss. My colleague's date seemed less interested in her than in learning more about his therapist.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">My colleague later realized that her boss, who was married, had a crush on her.  She thinks he set up the match so that he might vicariously enjoy the experience of dating her. True or not, it seems the therapist may not have been acting in his patient's best interest.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Freud himself dabbled in therapeutic matchmaking and in fact went so far as to encourage one of his patients to leave his wife and pursue another woman. At Freud's urging, Horace Frink, a psychiatrist Freud analyzed and later nominated to head the New York Psychoanalytic Society, divorced his wife and married Angelika Bijur, one of Dr. Frink's own patients.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Whatever else Freud had in mind, it seems he may have had personal and financial motives for the union between Dr. Frink and Ms. Bijur, who happened to be a wealthy heiress. In a letter to Dr. Frink, Freud said of the proposed marriage, "If matters turn out all right, let us change this imaginary gift into a real contribution to the Psychoanalytic Funds."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">A marriage arranged — and sanctified — by Freud himself! That's a proposition hard to defy. Alas, Dr. Frink experienced depression and psychosis soon after the marriage and divorced Ms. Bijur a few years later. Today such psychiatric meddling would be likely to create a public scandal and a malpractice suit.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">Pragmatic psychotherapists continue to wrestle with questions involved in patient fix-ups. The psychologist Clifford N. Lazarus, for example, argues that therapists are in a good position to evaluate personality traits that could make or break a match, and with high-functioning patients, it is ethical to give it a try. He suggests that therapists use informed consent, the same way a psychiatrist discusses the pros and cons of an antidepressant medication before starting treatment. The idea is to inform the patient of the potential benefits (could be a good match) and hazards (rejection; hard feelings toward your therapist, with the potential to wreck the therapeutic relationship) and receive consent. Case closed.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Not quite. This approach skirts the untidy fact of transference and countertransference — the matching sets of powerful and unconscious feelings that patients and therapists have toward each other. You might get your patient to "agree" to any number of contingencies, but there is no bargaining with his unconscious.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The fact is that consent, no matter how well-informed — or well-intentioned — is insufficient to protect against the possible mischief inherent in therapist-driven matchmaking.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Looking to your therapist to set up a date is as ill-advised as it is to look to <a href="http://Match.com">Match.com</a> for help with depression or an eating disorder. Therapists would be wise to leave matchmaking to Cupid, or his online minions.</p><nyt_author_id style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><div class="authorIdentification" style="margin-bottom: 2.8em; "><div style="color: rgb(0, 0, 0); font-size: 15px !important; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 24px; font-style: italic; ">Richard A. Friedman is a professor of clinical psychiatry and the director of the psycho-pharmacology clinic at the Weill Cornell Medical College.</div></div></nyt_author_id></div><a href="http://www.nytimes.com/2013/01/20/opinion/sunday/should-therapists-play-cupid.html?nl=todaysheadlines&emc=edit_th_20130120&pagewanted=print">http://www.nytimes.com/2013/01/20/opinion/sunday/should-therapists-play-cupid.html?nl=todaysheadlines&emc=edit_th_20130120&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Should Therapists Play Cupid? - NYTimes.com

If you are in psychotherapy, there's a good chance your therapist knows more about your inner thoughts and secret desires than anyone el...

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