The fear of doing nothing

"Did I tell you that I went to Moscow last summer?"

"I don't believe you did, Valery."

"Well yeah, I went."

"To see your family?"

"Yes ... I took a train from Moscow to Tula, went to Yasnaya Polyana, where Tolstoy had lived. A very touristy thing to do. I should show you the video of my tour guide and the 'traditional' Russian singers, you'll like it. Anyway, I met a young woman on the train, she must have been nineteen or so, Anya."

"Okay."

"She was a student, of biology I think, from a town called Oryol, five hours from Moscow by train. She went to visit her parents for the weekend. Never left Russia, father was a retired military man, she was living in a tiny room on the outskirts of Moscow that she was renting from a landlady who was living with her. Old-school style, like in The Idiot, if you remember."

"Hmm ..."

"We started chatting, what do you do, what do you do — stuff like that. She was drinking tea, with lemon, and asking me nice, shy questions. She was curious, I think. A Russian-speaking guy, born in Moscow, grew up in Israel, living in New York, on a train that goes to Oryol — what's going on? I somehow guessed the monthly rate for her room, by the way ... You know why I bring her up?"

"No, I was wondering ..."

"Because when I told her that I'm a psychologist, a psychotherapist, she looked at me as if I were from space."

"Really."

"She never thought that she might need one. She never thought about the fact that she was fighting for her chance in the big city — alone, poor, anxious about whether she'd make it — she never thought, 'Oh, maybe I should go see a therapist. It's been so difficult ...' Nope. She just kept going. Maybe she had been feeling lonely in that tiny room of hers. Maybe she was scared of disappointing her family who put their hopes on her — she was an only child. Maybe dating had been rough. Maybe she felt out of place, a girl from a small town who found herself in the centre of Russia: everyone goes to a party, she can't afford it. Maybe she was missing her family. Who knows? But none of that made her consider talking to a psychologist. 'This is for other people,' she probably thought, 'people with real problems.' And here I am: at a therapist's office. Isn't it weird?"

"What's 'weird' about it, Valery?"

"The fact that I presumably have everything and she doesn't. But who's in therapy — I am."

"And?"

"How can this nagging, terrible thought not crawl up in your mind sometimes that psychotherapy is ... just an indulgence."

"An indulgence?"

"Yeah, something for people who play a lot of tennis and read a lot of novels and know many things about restaurants."

"As opposed to tough Russians."

"As opposed to ... I don't know."

* * *

I was not supposed to be a psychotherapist. Where I was born, such a profession did not exist. Everything was simple: you have a problem, you go to a doctor. Talking to a stranger about private matters would be considered peculiar and inappropriate. Sergei Dovlatov, a Russian writer who lived in New York in the 1980s, once commented that Americans seemed very strange to him: they described their dreams to psychoanalysts but not to their friends. And yet, here I was: in New York, in graduate school, training to be a psychotherapist.

Every Thursday morning, early before school or work, I would go and see my therapist. I imagine that many people who had worked with Dr Zorkin complained to him about psychotherapy: "It's so expensive! What's our goal? Why don't I feel any difference after three years? When I ask a question, Dr Zorkin, could you please just answer it and not ask me a question in return?!" people would protest. But probably not too many of them were training to be psychotherapists themselves.

"It's the basics I struggle with, the things that are maybe supposed to be taken for granted ... How does it work, really?"

"What do you mean, Valery?"

"What's so special about it? Why is it any different from talking to a friend, let's say? Or to a very concerned grandmother?"

"Why is psychotherapy different from talking to a friend?"

"Yes, why? I remember in university they showed us this research, which I think was done in England, where they let literature professors be therapists. You know what they found?"

"What?"

"Absolutely no difference between the professors and the trained 'professionals'. Now, I ask you: shouldn't it bother us? What's there to 'train'? Just be nice and well-read, and empathetic and kind, and — you're a therapist."

"I'm not familiar with this research, but I find it very hard to believe that years of experience and the vast knowledge therapists have accumulated — we're talking about so many theories, so much clinical expertise — I find it hard to believe that it doesn't translate to better clinical results. I'm not sure who performed this particular study or how it was done."

"How do you think psychotherapy helps people change?"

"Valery ... this is such a broad question. We're here to talk about you, about your past, about some of the things that you've been struggling with. I mean, you've recently divorced, you're all alone here in New York —"

"True. But it bothers me, a great deal. I'm beginning my second year of a PhD in clinical psychology and I'm still not convinced that it's not just about learning how to talk nicely to people."

"Perhaps you need to read some more."

"I've started seeing patients and I'm not convinced — sorry, I'm not convinced ... Yes, the theories are nice and they make sense; by the way, that's exactly the problem — all of them make some sense. But then you sit with someone and you talk with him about his problems and say to yourself, 'Oh, he's depressed, let's try to think about — I don't know — his different selves or something.' And you make a comment about these different selves or the 'emptiness' of his object relations or about his negative automatic thoughts or about 'secondary gains' or whatever, and he gently nods back, 'Very interesting point, Valery,' and nothing, I mean nothing, happens. So I'm not sure at all that if instead I were to tell him, 'I love you, Brian, you're an absolutely awesome person and it's so beautiful to hang out with you, man,' the result would be less than what the smart, theoretically informed interventions produce. Where's the proof that it's not so? Generations of self-interested therapists who tell us that it's not so? Why would I believe them?"

"Psychoanalysis is a language, a way to listen."

"That's cool. But who says it's better than a smart literature professor sharing her life experience with you in a gentle, accepting voice over hot cider?"

"When did you leave Moscow?"

"When I was eight."

"Hmm ... How was it to arrive in Israel?"

"I remember two things from the very first day when we arrived. I remember how...