Anglonautes > Vocapedia > English words, vocabulary, dictionary, encyclopedia > 2000s - 2010s - 2020s > UK, USA > Subject, topic > Mental health > Psychology, Psychologists, Psychoanalysts, Psychotherapy, Therapists

I was giving a lecture in New York not all that long ago. I was talking about ideals. The audience was made up of therapists and therapists in training at the eminent William Alanson White Institute on the Upper West Side. After the talk was over, I was asked a remarkable question. Certainly it was the best-posed question that I have ever gotten at a talk.

The question came from a man wearing an elegant but disheveled suit. It was the end of the day, after all. His tie was loose around his collar. He had an air of friendly exasperation on his face. He was clearly a psychotherapist of some kind. What he said went something like this:

“You’ve been talking to us tonight about ideals and you’ve been trying to make a case for them. You talked about the hero, as he exists in Homer and Virgil. You talked about Aeneas and Hector and Achilles, and described them as three instances of the heroic ideal. Then you went on to talk about what you wanted to call the saint. You pointed to Jesus and Buddha and Confucius. You said they exemplified the compassionate ideal. Then there was one more: the contemplative ideal. And that was exemplified by Plato. Plato, you said, was a figure who tried to get at the whole truth, the eternal truth and nothing but the truth.”

I could see that my questioner was now working a little harder to hold back his impatience. There was something he didn’t like in what I was saying — that he really didn’t like. But he was doing his best to control himself. He wanted to keep matters urbane and he was doing a good job. As to me, I was taking what I thought of as tantric breaths.

My questioner continued:

“And you’re saying that these ideals of yours — courage and compassion and contemplation — aren’t relics of the ancient world. You want us to see them as real possibilities, here and now. You concede that we in the West live in a culture that rewards pragmatism and skepticism. But you think that young people in particular ought to consider arranging their lives around these ideals. This young man might be a thinker; this young woman a warrior; another young person might live for compassion. Is that right?”

I admitted that this was the case. I said that I wanted to use these great works of the past, and the idealist tradition, to help young people (and all people, really) to think about their lives and maybe to change them. I wanted to use what I knew — and all that I knew I knew through others — to help create what the philosopher William James thought of as “living options.”

My questioner was a genial man, clearly. But he was beginning to steam. Now was the moment for him to deliver the bad news.

“If someone came into my office,” he said, “and told me that he wanted to find the enduring truth, or become saintly, or be a heroic warrior, I know exactly what I’d say to him. I’d say, ‘You are suffering from neurosis (at the very least) and you are in need of therapy, the sooner the better.’ For there are no true ideals, only idealizations. Your so-called ideals are merely sources of delusion.”

The room murmured its assent. Actually it more than murmured assent; it all but broke into applause.

O.K., so he really wasn’t asking a question. It was more like an indictment. My talk, and my teaching from which the talk arose, were apparently inducements to mental illness, minor or major. Ideals were myths, and they could lead you into serious trouble. This was Freud’s view, I understood, and though psychotherapy has veered from Freud in many regards, it will not be easy for anyone to find a therapist who will tell you that the best way to overcome your psychological difficulties is to embrace an ideal.

What’s so bad about ideals from this point of view? A psychotherapist might say that ideals make you feel too good, at least at the outset. Embracing an ideal can produce what we might call unity of being. All of a sudden, you know (or think you know) what life is all about. You know what to do in the world. This brings a sense of confidence and purpose. You always know what you are supposed to do. Be brave! Be compassionate! Think and find the truth! You may not live up to these ideals all the time, but knowing what you are supposed to be and do confers an assurance and stability that you probably did not have before.

Most of the time, the descendants of Freud tell us, we are fractured beings. Our various desires move in disparate directions, and often contrary directions at that. For the therapist, we are not one self, but two or three. Psychoanalysts speak of the ego and the id, and also of the superego. These three internal powers desire different results in the world, and they often, to say the least, get in each other’s way. To put it crudely, the superego wants perfection; the ego wants balance and calm; the id wants everything it can get: power and money and sex and maybe a little more sex afterward.

So what’s so bad about a form of belief and commitment that stabilizes the self? What’s so bad about the unity that ideals can bring by drawing all of the individual’s energy in one direction?

To this, psychotherapy has an abrupt answer: It doesn’t work. What you’re calling ideals are really intoxicating untruths. Ideals make you drunk, and the hangover that follows is bitter. To use Wordsworth for a moment: “As high as we have mounted in delight/ In our dejection do we sink as low.” To which the therapist might reply: “As low? I’d say far lower.”

Ideals don’t work, says the therapist. If you follow the compassionate ideal, open your heart completely and say that there is no difference between you and others in the world, people will take advantage of you. And you’ll outrage your own sense of entitlement to the good things in life. You’ll see that your compassionate ministrations don’t do much good for others and that they wear you out.

You’ll discover too that subscribing to the heroic ideal may well get you killed or maimed in a war that is unjust. When you come home, if you come home, people will treat you with indifference and maybe even disdain. What a sucker you were. And the deep motivation of so-called heroes, Freud tells us, is not really courage; it is the narcissistic belief that though others may well be doomed to die, you are immortal.

As to the Platonic desire to know the truth for all time, it is also a form of narcissism, a prideful aspiration. Psychoanalysis even has a name for it: epistemophilia. (Worse than the flu, no doubt.) Though Freud himself may have had a touch of this malady, it is clear that psychotherapy overall considers the claim to know all that is truly worth knowing to be at least on the border of pathology.

Who is right, the idealists or the therapists?

Well, if you judge by our present cultural climate, you would have to say that the therapists are. Though surely there are people who commit themselves to being compassionate, or being brave, or getting at the truth, most people in the West do not. They seek a decent life that is reasonably prosperous and secure and is oriented to family and stability. They try to balance their desires. Even if they don’t use psychoanalytical terms, I think it is fair to say that they try to do a little something every day for the id and for the superego and for the ego. The psyche, says Carl Jung, must learn how to make deals.

The idealist is the one who will not make deals. He puts all his resources on one spot — courage or compassion or truth — and then goes for it. He may triumph. He may crash and burn. He may, in time, do both.

What the great tradition of Plato and Homer and Buddha and the rest tells us is that the measured, modulated life is not for everyone. Some of us need to risk more in order to gain more: “spending for vast returns,” as Whitman said. Certain people who are deprived of the chance to do so will grow weary and sick of life. They need to play for higher stakes than most of their contemporaries.

This game is not for everyone, to be sure. Many of us, perhaps most, need the life of the balanced self. This is the life that therapists have done a great deal to make available to us. But when the therapist says that ideals are a form of pathology, then I think he is overreaching, cutting off chances for people and maybe even contributing something to making them ill in spirit.

I told my perceptive questioner all this, or something much like it. He sat down and smiled a therapist’s benevolent smile, secure no doubt that in time, I would learn.

But then again, maybe he will.

Mark Edmundson, a professor of English
at the University of Virginia,
is the author of “Self and Soul: A Defense of Ideals.”

The Idealist Versus the Therapist,
AUGUST 18, 2015,
NYT,
https://archive.nytimes.com/opinionator.blogs.nytimes.com/2015/08/18/
the-idealist-versus-the-therapist/

Psychotherapy’s Image Problem

September 29, 2013

The New York Times

By BRANDON A. GAUDIANO

PROVIDENCE, R.I. — PSYCHOTHERAPY is in decline. In the United States, from 1998 to 2007, the number of patients in outpatient mental health facilities receiving psychotherapy alone fell by 34 percent, while the number receiving medication alone increased by 23 percent.

This is not necessarily for a lack of interest. A recent analysis of 33 studies found that patients expressed a three-times-greater preference for psychotherapy over medications.

As well they should: for patients with the most common conditions, like depression and anxiety, empirically supported psychotherapies — that is, those shown to be safe and effective in randomized controlled trials — are indeed the best treatments of first choice. Medications, because of their potential side effects, should in most cases be considered only if therapy either doesn’t work well or if the patient isn’t willing to try counseling.

So what explains the gap between what people might prefer and benefit from, and what they get?

The answer is that psychotherapy has an image problem. Primary care physicians, insurers, policy makers, the public and even many therapists are largely unaware of the high level of research support that psychotherapy has. The situation is exacerbated by an assumption of greater scientific rigor in the biologically based practices of the pharmaceutical industries — industries that, not incidentally, also have the money to aggressively market and lobby for those practices.

For the sake of patients and the health care system itself, psychotherapy needs to overhaul its image, more aggressively embracing, formalizing and promoting its empirically supported methods.

My colleague Ivan W. Miller and I recently surveyed the empirical literature on psychotherapy in a series of papers we edited for the November edition of the journal Clinical Psychology Review. It is clear that a variety of therapies have strong evidentiary support, including cognitive-behavioral, mindfulness, interpersonal, family and even brief psychodynamic therapies (e.g., 20 sessions).

In the short term, these therapies are about as effective as medications in reducing symptoms of clinical depression or anxiety disorders. They can also produce better long-term results for patients and their family members, in that they often improve functioning in social and work contexts and prevent relapse better than medications.

Given the chronic nature of many psychiatric conditions, the more lasting benefits of psychotherapy could help reduce our health care costs and climbing disability rates, which haven’t been significantly affected by the large increases in psychotropic medication prescribing in recent decades.

Psychotherapy faces an uphill battle in making this case to the public. There is no Big Therapy to counteract Big Pharma, with its billions of dollars spent on lobbying, advertising and research and development efforts. Most psychotherapies come from humble beginnings, born from an initial insight in the consulting office or a research finding that is quietly tested and refined in larger studies.

The fact that medications have a clearer, better marketed evidence base leads to more reliable insurance coverage than psychotherapy has. It also means more prescriptions and fewer referrals to psychotherapy.

But psychotherapy’s problems come as much from within as from without. Many therapists are contributing to the problem by failing to recognize and use evidence-based psychotherapies (and by sometimes proffering patently outlandish ideas). There has been a disappointing reluctance among psychotherapists to make the hard choices about which therapies are effective and which — like some old-fashioned Freudian therapies — should be abandoned.

There is a lot of organizational catching up to do. Groups like the American Psychiatric Association, which typically promote medications as treatments of first choice, have been publishing practice guidelines for more than two decades, providing recommendations for which treatments to use under what circumstances. The American Psychological Association, which promotes psychotherapeutic approaches, only recently formed a committee to begin developing treatment guidelines.

Professional psychotherapy organizations also must devote more of their membership dues and resources to lobbying efforts as well as to marketing campaigns targeting consumers, primary care providers and insurers.

If psychotherapeutic services and expenditures are not based on the best available research, the profession will be further squeezed out by a health care system that increasingly — and rightly — favors evidence-based medicine. Many of psychotherapy’s practices already meet such standards. For the good of its patients, the profession must fight for the parity it deserves.

Brandon A. Gaudiano is a clinical psychologist

and assistant professor of psychiatry

and human behavior

at the Alpert Medical School at Brown University.

Psychotherapy’s Image Problem,
NYT,
29.9.2013,
https://www.nytimes.com/2013/09/30/
opinion/psychotherapys-image-problem.html

George A. Miller,

a Pioneer in Cognitive Psychology,

Is Dead at 92

August 1, 2012
The New York Times
By PAUL VITELLO

Psychological research was in a kind of rut in 1955 when George A. Miller, a professor at Harvard, delivered a paper titled “The Magical Number Seven, Plus or Minus Two,” which helped set off an explosion of new thinking about thinking and opened a new field of research known as cognitive psychology.

The dominant form of psychological study at the time, behaviorism, had rejected Freud’s theories of “the mind” as too intangible, untestable and vaguely mystical. Its researchers instead studied behavior in laboratories, observing and recording test subjects’ responses to carefully administered stimuli. Mainly, they studied rats.

Dr. Miller, who died on July 22 at his home in Plainsboro, N.J., at the age of 92, revolutionized the world of psychology by showing in his paper that the human mind, though invisible, could also be observed and tested in the lab.

“George Miller, more than anyone else, deserves credit for the existence of the modern science of mind,” the Harvard psychologist and author Steven Pinker said in an interview. “He was certainly among the most influential experimental psychologists of the 20th century.”

Dr. Miller borrowed a testing model from the emerging science of computer programming in the early 1950s to show that humans’ short-term memory, when encountering the unfamiliar, could absorb roughly seven new things at a time.

When asked to repeat a random list of letters, words or numbers, he wrote, people got stuck “somewhere in the neighborhood of seven.”

Some people could recall nine items on the list, some fewer than seven. But regardless of the things being recalled — color-words, food-words, numbers with decimals, numbers without decimals, consonants, vowels — seven was the statistical average for short-term storage. (Long-term memory, which followed another cognitive formula, was virtually unlimited.)

Dr. Miller could not say why it was seven. He speculated that survival might have favored early humans who could retain “a little information about a lot of things” rather than “a lot of information about a small segment of the environment.”

But that, he concluded, was beside the point. He had articulated an idea that was to become a touchstone of cognitive science: that whatever else the brain might be, it was an information processor, with systems that obeyed mathematical rules, that could be studied.

Dr. Miller, who was trained in behaviorism, was among the first of many researchers and theorists to challenge its scientific principles in the 1950s. He and a colleague, Jerome S. Bruner, gave a name to the new research field when they established a psychology lab of their own, the Center for Cognitive Studies, at Harvard in 1960. Just by employing the word “cognitive,” considered taboo among behaviorists, they signaled a break with the old school.

“Using ‘cognitive’ was an act of defiance,” Dr. Miller wrote in 2006. “For someone raised to respect reductionist science, ‘cognitive psychology’ made a definite statement. It meant that I was interested in the mind.”

That new approach to psychological research came to be known as the cognitive revolution.

Dr. Miller’s first and most enduring interest as a scientist was language. His first book, “Language and Communication” (1951), is widely considered a foundational work in psycholinguistics, the study of how people learn, use and invent language. He collaborated with the linguist Noam Chomsky in groundbreaking papers on the mathematics of language and the computational problems involved in interpreting syntax.

He conducted some of the first experiments on how people understand words and sentences, the basis of computer speech-recognition technology. “Plans and the Structure of Behavior” (1960), written with Eugene Galanter and Karl H. Pribram, was an effort to synthesize artificial-intelligence research with psychological research on how humans initiate action — basically, a book about how to build a better robot. Beginning in 1986, he oversaw the development of WordNet, an electronic reference databank intended to help computers understand human language.

Colleagues said he had a role in framing many of his era’s most audacious thoughts about human and artificial thinking; typically, he then moved on to other projects.

“Like most great scientists, he became interested in some phenomenon or other and then simply jumped in to try to illuminate the problem,” said Michael S. Gazzaniga, a leading researcher in cognitive neuroscience at the University of California, Santa Barbara. Dr. Miller helped create the field of cognitive neuroscience in the late 1980s, he said. “He was exceptionally generous.”

George Armitage Miller was born on Feb. 3, 1920, in Charleston, W.Va., the only child of Florence and George Miller, who divorced when he was a child. His father was a steel company executive.

Mr. Miller and his first wife, Katherine, who died in 1996, married while both were undergraduates at the University of Alabama. After graduating with a bachelor’s degree in English and speech, Mr. Miller received his master’s degree and Ph.D. in psychology at Harvard, serving in the Army Signal Corps during World War II in between.

He taught at Harvard beginning in 1955, heading its psychology department from 1964 until 1967, and later taught at Rockefeller University in New York and at the Massachusetts Institute of Technology. He joined the faculty of Princeton in 1979, founded the Cognitive Science Laboratory there and became a professor emeritus in 1990.

His survivors include his wife, Margaret, whom he married in 2008; a son, Donnally; a daughter, Nancy Saunders; and three grandchildren.

Dr. Miller’s paper on the number seven, which he read on April 5, 1955, at a meeting of the Eastern Psychological Association in Philadelphia, opened with a memorable line: “My problem is that I have been persecuted by an integer.”

He went on to make a topical reference to the Communist scare of the McCarthy era: “The persistence with which this number plagues me is far more than a random accident. There is, to quote a famous senator, a design behind it.”

The paper’s ground-shifting implications made it one of the most frequently quoted texts in the canon of modern psychology (and by Dr. Miller’s account, one of the most misquoted). For better or worse, “The Magical Number Seven” came to haunt his scientific career, overshadowing his many other accomplishments.

It resonated more playfully in his golf game. “He made the one and only hole-in-one of his life at the age of 77, on the seventh green” at the Springdale Golf Club in Princeton, his daughter said. “He made it with a seven iron. He loved that.”

    George A. Miller, a Pioneer in Cognitive Psychology, Is Dead at 92,
    NYT, 1.8.2012,
    http://www.nytimes.com/2012/08/02/us/
    george-a-miller-cognitive-psychology-pioneer-dies-at-92.html

When Your Therapist

Is Only a Click Away

September 23, 2011
The New York Times
By JAN HOFFMAN

THE event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype, and encrypted digital software through third-party sites like CaliforniaLiveVisit.com, have made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

One third-party online therapy site, Breakthrough.com, said it has signed up 900 psychiatrists, psychologists, counselors and coaches in just two years. Another indication that online treatment is migrating into mainstream sensibility: “Web Therapy,” the Lisa Kudrow comedy that started online and pokes fun at three-minute webcam therapy sessions, moved to cable (Showtime) this summer.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say ... curable?

Ms. Weinblatt came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town, who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

“There’s that comfort of carrying your doctor around with you like a security blanket,” Ms. Weinblatt acknowledged. “But,” she added, “because he’s more accessible, I feel like I need him less.”

The technology does have its speed bumps. Online treatment upends a basic element of therapeutic connection: eye contact.

Patient and therapist typically look at each other’s faces on a computer screen. But in many setups, the camera is perched atop a monitor. Their gazes are then off-kilter.

“So patients can think you’re not looking them in the eye,” said Lynn Bufka, a staff psychologist with the American Psychological Association. “You need to acknowledge that upfront to the patient, or the provider has to be trained to look at the camera instead of the screen.”

The quirkiness of Internet connections can also be an impediment. “You have to prepare vulnerable people for the possibility that just when they are saying something that’s difficult, the screen can go blank,” said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. “So I always say, ‘I will never disconnect from you online on purpose.’ You make arrangements ahead of time to call each other if that happens.”

Still, opportunities for exploitation, especially by those with sketchy credentials, are rife. Solo providers who hang out virtual shingles are a growing phenomenon. In the Wild Web West, one site sponsored a contest asking readers to post why they would seek therapy; the person with the most popular answer would receive six months of free treatment. When the blogosphere erupted with outrage from patients and professionals alike, the site quickly made the applications private.

Other questions abound. How should insurance reimburse online therapy? Is the therapist complying with licensing laws that govern practice in different states? Are videoconferencing sessions recorded? Hack-proof?

Another draw and danger of online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient? “A lot of patients start therapy and feel worse before they feel better,” noted Marlene M. Maheu, founder of the TeleMental Health Institute, which trains providers and who has served on task forces to address these questions. “It’s more complex than people imagine. A provider’s Web site may say, ‘I won’t deal with patients who are feeling suicidal.’ But it’s our job to assess patients, not to ask them to self-diagnose.” She practices online therapy, but advocates consumer protections and rigorous training of therapists.

Psychologists say certain conditions might be well-suited for treatment online, including agoraphobia, anxiety, depression and obsessive-compulsive disorder. Some doctors suggest that Internet addiction or other addictive behaviors could be treated through videoconferencing.

Others disagree. As one doctor said, “If I’m treating an alcoholic, I can’t smell his breath over Skype.”

Cognitive behavioral therapy, which can require homework rather than tunneling into the patient’s past, seems another candidate. Tech-savvy teenagers resistant to office visits might brighten at seeing a therapist through a computer monitor in their bedroom. Home court advantage.

Therapists who have tried online therapy range from evangelizing standard-bearers, planting their stake in the new future, to those who, after a few sessions, have backed away. Elaine Ducharme, a psychologist in Glastonbury, Conn., uses Skype with patients from her former Florida practice, but finds it disconcerting when a patient’s face becomes pixilated. Dr. Ducharme, who is licensed in both states, will not videoconference with a patient she has not met in person. She flies to Florida every three months for office visits with her Skype patients.

“There is definitely something important about bearing witness,” she said. “There is so much that happens in a room that I can’t see on Skype.”

Dr. Heath Canfield, a psychiatrist in Colorado Springs, also uses Skype to continue therapy with some patients from his former West Coast practice. He is licensed in both locations. “If you’re doing therapy, pauses are important and telling, and Skype isn’t fast enough to keep up in real time,” Dr. Canfield said. He wears a headset. “I want patients to know that their sound isn’t going through walls but into my ears. I speak into a microphone so they don’t feel like I’m shouting at the computer. It’s not the same as being there, but it’s better than nothing. And I wouldn’t treat people this way who are severely mentally ill.”

Indeed, the pitfalls of videoconferencing with the severely mentally ill became apparent to Michael Terry, a psychiatric nurse practitioner, when he did psychological evaluations for patients throughout Alaska’s Eastern Aleutian Islands. “Once I was wearing a white jacket and the wall behind me was white,” recalled Dr. Terry, an associate clinical professor at the University of San Diego. “My face looked very dark because of the contrast, and the patient thought he was talking to the devil.”

Another time, lighting caused a halo effect. “An adolescent thought he was talking to the Holy Spirit, that he had God on the line. It fit right into his delusions.”

Johanna Herwitz, a Manhattan psychologist, tried Skype to augment face-to-face therapy. “It creates this perverse lower version of intimacy,” she said. “Skype doesn’t therapeutically disinhibit patients so that they let down their guard and take emotional risks. I’ve decided not to do it anymore.”

Several studies have concluded that patient satisfaction with face-to-face interaction and online therapy (often preceded by in-person contact) was statistically similar. Lynn, a patient who prefers not to reveal her full identity, had been seeing her therapist for years. Their work deepened into psychoanalysis. Then her psychotherapist retired, moving out of state.

Now, four times a week, Lynn carries her laptop to an analyst’s unoccupied office (her insurance requires that a local provider have some oversight). She logs on to an encrypted program at Breakthrough.com and clicks through until she reads an alert: “Talk now!”

Hundreds of miles away, so does her analyst. Their faces loom, side by side on each other’s monitors. They say hello. Then Lynn puts her laptop on a chair and lies down on the couch. Just the top of her head is visible to her analyst.

Fifty minutes later the session ends. “The screen is asleep so I wake it up and see her face,” Lynn said. “I say goodbye and she says goodbye. Then we lean in to press a button and exit.”

As attenuated as this all may seem, Lynn said, “I’m just grateful we can continue to do this.”

This article has been revised

to reflect the following correction:

Correction: September 24, 2011

A caption on a picture

in an earlier version of this article

incorrectly described the technology

used by Marlene M. Maheu

to communicate remotely with patients.

She uses video conferencing, not Skype.

When Your Therapist Is Only a Click Away, NYT, 23.9.2011,
http://www.nytimes.com/2011/09/25/
fashion/therapists-are-seeing-patients-online.html

Standing

in Someone Else’s Shoes,

Almost for Real

December 2, 2008
The New York Times
By BENEDICT CAREY

From the outside, psychotherapy can look like an exercise in self-absorption. In fact, though, therapists often work to pull people out of themselves: to see their behavior from the perspective of a loved one, for example, or to observe their own thinking habits from a neutral distance.

Marriage counselors have couples role-play, each one taking the other spouse’s part. Psychologists have rapists and other criminals describe their crime from the point of view of the victim. Like novelists or moviemakers, their purpose is to transport people, mentally, into the mind of another.

Now, neuroscientists have shown that they can make this experience physical, creating a “body swapping” illusion that could have a profound effect on a range of therapeutic techniques. At the annual meeting of the Society for Neuroscience last month, Swedish researchers presented evidence that the brain, when tricked by optical and sensory illusions, can quickly adopt any other human form, no matter how different, as its own.

“You can see the possibilities, putting a male in a female body, young in old, white in black and vice versa,” said Dr. Henrik Ehrsson of the Karolinska Institute in Stockholm, who with his colleague Valeria Petkova described the work to other scientists at the meeting. Their full study is to appear online this week in the journal PLoS One. .

The technique is simple. A subject stands or sits opposite the scientist, as if engaged in an interview.. Both are wearing headsets, with special goggles, the scientist’s containing small film cameras. The goggles are rigged so the subject sees what the scientist sees: to the right and left are the scientist’s arms, and below is the scientist’s body.

To add a physical element, the researchers have each person squeeze the other’s hand, as if in a handshake. Now the subject can see and “feel” the new body. In a matter of seconds, the illusion is complete. In a series of studies, using mannequins and stroking both bodies’ bellies simultaneously, the Karolinska researchers have found that men and women say they not only feel they have taken on the new body, but also unconsciously cringe when it is poked or threatened.

In previous work, neuroscientists have induced various kinds of out-of-body experiences using similar techniques. The brain is so easily tricked, they say, precisely because it has spent a lifetime in its own body. It builds models of the world instantaneously, based on lived experience and using split-second assumptions — namely, that the eyes are attached to the skull.

Therapists say the body-swapping effect is so odd that it could be risky for anyone in real mental distress. People suffering from the delusions of schizophrenia or the grandiose mania of bipolar disorder are not likely to benefit from more disorientation, no matter the intent.

But those who seek help for relationship problems, in particular, often begin to moderate their behavior only after they have worked to see the encounters in their daily life from others’ point of view.

“This is especially true for adolescents, who are so self-involved, and also for people who come in with anger problems and are more interested in changing everyone else in their life than themselves,” said Kristene Doyle, director of clinical services at the Albert Ellis Institute in New York.

One important goal of therapy in such cases, Dr. Doyle said, is to get people to generate alternative explanations for others’ behavior — before they themselves react.

The evidence that inhabiting another’s perspective can change behavior comes in part from virtual-reality experiments. In these studies, researchers create avatars that mimic a person’s every movement. After watching their “reflection” in a virtual mirror, people mentally inhabit this avatar at some level, regardless of its sex, race or appearance. In several studies, for instance, researchers have shown that white people who spend time interacting virtually as black avatars become less anxious about racial differences.

Jeremy Bailenson, director of the Virtual Human Interaction Lab at Stanford University, and his colleague Nick Yee call this the Proteus effect, after the Greek god who can embody many different self-representations.

In one experiment, the Stanford team found that people inhabiting physically attractive avatars were far more socially intimate in virtual interactions than those who had less appealing ones. The effect was subconscious: the study participants were not aware that they were especially good-looking, or that in virtual conversations they moved three feet closer to virtual conversation partners and revealed more about themselves than others did. This confidence lingered even after the experiment was over, when the virtual lookers picked more attractive partners as matches for a date.

Similar studies have found that people agree to contribute more to retirement accounts when they are virtually “age-morphed” to look older; and that they will exercise more after inhabiting an avatar that works out and loses weight.

Adding a physical body-swapping element, as the Swedish team did, is likely to amplify such changes. “It has video quality, it looks and feels more realistic than what we can do in virtual environments, so is likely to be much more persuasive,” Dr. Bailenson said in a telephone interview.

Perhaps too persuasive for some purposes. “It may be like the difference between a good book, where you can project yourself into a character by filling in with your imagination, and a movie, where the specific actor gets in the way of identifying strongly,” he went on.

And above and beyond any therapeutic purposes, the sensation is downright strange. In the experiments, said Dr. Ehrsson, the Swedish researcher, “even the feeling from the squeezing hand is felt in the scientist’s hand and not in your own; this is perhaps the strangest aspect of the experience.”

Standing in Someone Else’s Shoes, Almost for Real, NYT, 2.12.2008,
http://www.nytimes.com/2008/12/02/health/02mind.html

Vicious Killing

Where Troubled Seek a Listener

February 14, 2008
The New York Times
By AL BAKER

It was just after 8 p.m. in a suite of mental health offices at East 79th Street and York Avenue. One doctor was seeing patients; another was working in her study.

It is a common scene in the offices of countless Manhattan therapists after dark: The lights stay on as paperwork is done and patients are treated into the evening.

Then a middle-aged man in a black cap and sneakers came in from the freezing rain, toting two pieces of black luggage. He said he was there to see a psychiatrist named Kent D. Shinbach. But Dr. Shinbach had another patient, a woman, waiting for him, so the man sat on a couch and made small talk. Then he disappeared into the office of the other doctor, Kathryn Faughey, the police said.

And there — in what investigators described as a furious swirl of violence on Tuesday night — the man stabbed Dr. Faughey in the head, face and chest. Hearing her screams, Dr. Shinbach rushed in and saw her lying still and bleeding on the tan carpet by the foot of her desk.

The attacker turned on him, stabbing him in the face, head and hands, the police said. Dr. Faughey, 56, was declared dead at the scene; Dr. Shinbach, who is in his 70s, survived, but was left in critical condition.

A day later, the police said they did not know the motive for the frenzied attack nor the identity of the killer, though investigators are pursuing the possibility that he was a patient at the offices, where five health care professionals work, or that he was a relative of a patient there or was somehow involved with one.

But even before a motive had been determined, psychiatrists, psychologists and social workers who work in Manhattan — a place long linked in the public imagination with the stereotypical image of an urbanite on a couch discussing his worries — reacted with alarm. Several said the violence in the office at 435 East 79th Street reminded them of the dangers inherent in a career spent helping people, particularly those in emotional pain.

Dr. Faughey grew up in Sunnyside, Queens, and lived across the street from her office. Her husband of 25 years, Walter Adam, said he became worried about 8:30 p.m. because his wife was late. He looked out the window of their 17th-floor apartment and noticed that the light was still on in her office. He called and got no answer. Then he saw police cars on the block.

“I thought it was an automobile accident,” he said. “Finally I said, ‘I better go over and see what’s going on.’ ”

He heard the news from a police officer: His wife had been killed.

“She’s taken very good care of me,” Mr. Adam said. “She’s looked after me. She’s a good and decent woman. Never harmed anyone.”

Police Commissioner Raymond W. Kelly said that after stabbing both doctors, the attacker pinned Dr. Shinbach against the wall with a spindled chair, took $90 from his wallet and fled to the building’s neatly painted basement and out a service exit. He left his two suitcases behind in the basement, where the police found a smear of blood on the door. The woman who had been waiting to see Dr. Shinbach had gone into his office at one point and was unharmed.

During the attack on Dr. Shinbach, which lasted about 10 minutes, the attacker told him, “She’s dead,” the police said, adding that other comments he made did not shed light on his actions.

Mr. Kelly said a key part of the investigation was to determine whether the killer “was a patient of any of the health care professionals in that suite of offices.”

Three knives were later found: one at Dr. Faughey’s left foot; another, a 9-inch blade that was bent in the attack, underneath her desk; and a meat cleaver, also bent and with a broken handle, lying in front of a wall of books. Blood was splashed on the walls and floor. “It was obvious a fierce struggle had taken place,” said Paul J. Browne, the Police Department’s chief spokesman.

Investigators found that the larger suitcase, which had wheels and a handle, held women’s slippers and a blouse, as well as disposable diapers for adults. Inside the smaller bag were eight knives — mostly kitchen knives — three lengths of rope and rolls of duct tape.

Dr. Faughey received a doctorate in clinical psychology from the Ferkauf Graduate School of Psychology at Yeshiva University in 1981. She had been practicing cognitive behavior psychotherapy on the Upper East Side for more than 20 years, according to her Web site.

“My approach is focused and solution-oriented,” according to a quotation on the site. “My sessions move quickly. I am interactive, and I give feedback.”

Mr. Adam said his wife achieved tremendous results for her patients. “The way she turned around people’s lives, saved people’s lives,” he said.

“She was always a person who was reading and studying,” said Kevin Faughey, Dr. Faughey’s oldest brother and one of her six siblings. “She always had goals in her life that she wanted to do something for humanity, in some way, shape or form to help.”

Dr. Shinbach has admitted patients to Beth Israel Medical Center and Gracie Square Hospital, said Dr. Michael Serby, an associate chairman of Beth Israel. “Clearly he’s a brave individual and a hero.”

Dr. Frederick J. Long, a Manhattan psychiatrist who has known Dr. Shinbach for 14 years, described him as dedicated and caring. “He is the best mentor I’ve ever had,” Dr. Long said, adding that Dr. Shinbach was among the first psychiatrists to take an interest in elderly patients.

Another colleague said Dr. Shinbach’s relationship with Dr. Faughey was limited to the shared office space; they did not see each other’s patients.

The attacker’s entrance and departure were captured by security cameras. He arrived at the first-floor offices just after 8 p.m. He left at 8:59 p.m. through the basement door, on which investigators found blood. Investigators said the attacker might have cut his hand. It is common in such furious attacks, when blood can make the weapons slick. The police said DNA tests would be conducted to determine whose the blood was, but it was unclear how long the tests would take.

In the videotape, the man’s arrival is seen as a doorman holds a glass door open for him; he briskly walks in, stating that he was there to see Dr. Shinbach. Pulling his bags, he then goes up a short set of steps from the lobby to the professional offices.

The videotape of the man leaving shows him from behind, as he rounds a corner in the basement and disappears out the exit, onto 79th Street between First and York Avenues. The police are checking security videos from businesses in the area to see if they can pick up images of him.

At a news conference, Mr. Kelly held up a sketch of the suspect that was based on descriptions provided by witnesses who saw the man before the attack.

Dr. Shinbach, who was interviewed by detectives after undergoing surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, did not recognize his attacker.

Mr. Kelly described the killer as a man in his 40s, about 5-foot-9, with brownish or blond hair. He was wearing a three-quarter-length green coat and sneakers. A baseball cap believed to be the killer’s was found in Dr. Faughey’s office, the police said.

After the attack, Dr. Shinbach yelled for help from Dr. Faughey’s office window. The building’s doorman had left just left on a break and heard his cries.

Later, the doorman, Frank Batista, said he was almost certain he could identify the attacker — “99.9 percent.”

Reporting was contributed

by John Eligon, Dmitry Kiper,

Robin Stein, Stacey Stowe,

Andrew Tangel and Carolyn Wilder.

Vicious Killing Where Troubled Seek a Listener, NYT, 14.2.2008,
http://www.nytimes.com/2008/02/14/nyregion/14slay.html

Working in Mental Health,

the Prospect of Violence

Is a Part of the Job

February 14, 2008
The New York Times
By JAMES BARRON

Therapists — psychiatrists, psychotherapists, psychiatric social workers and other mental health professionals — are as much part of the New York landscape as hot dog vendors. And they have discovered, sometimes the hard way, that delving deeply into people’s feelings can be dangerous.

As police detectives searched on Wednesday for a man who killed a psychologist with a meat cleaver and other knives — and seriously injured another therapist, who heard their struggle from his nearby office and went to help — therapists said they had learned to develop their own physical and psychological defenses against violence.

But they conceded that a shrewd and determined attacker who appears normal could fool them.

“You do this work long enough, and you pretty much see everything, even in Manhattan,” said Dr. Robert H. Reiner, the executive director of Behavioral Associates, a private outpatient psychotherapy institute on the Upper East Side.

The identity of the attacker in Tuesday’s killing was not known, and the police said it was not clear if he was a patient or a patient’s relative, or if he had some other connection to the victims.

Still, therapists said they recognized the inherent risk in treating some types of patients. Dr. Reiner said most of the patients he saw, in six to eight “intake interviews” a day, had anxiety disorders that carried a low risk of violence. But every so often, he realizes that a patient has a severe psychosis.

“Often as not, it’s someone who’s walking around like you and me, and the psychosis is well disguised, and I realize they could be dangerous,” Dr. Reiner said. “And I look at the window and I think, ‘How quick can I get out?’ Every psychotherapist in an urban area knows this feeling.”

Just how much violence is directed at therapists is an open question. Of a dozen therapists in private practice in New York City who were interviewed on Wednesday, only one said he had ever seen violence in his office, and he was not the target: A father and son came to blows, he said.

But when Christina E. Newhill, an associate professor at the University of Pittsburgh, surveyed 1,129 therapeutic workers nationwide in 2003, 58 percent said they had had to deal with violence, though only 24 percent of those said they had actually been attacked. Twenty-five percent of those who had to deal with violence said clients had damaged or destroyed property, while half said the episodes did not go beyond threats.

Gary Arthur, a professor emeritus at Georgia State University, surveyed all 6,400 licensed therapists in Georgia in 2001. Of the 1,132 who responded, 14 had been shot at, 6 attacked with a knife, 209 pushed or shoved, 112 slapped and 87 hit by objects thrown at them. None of the therapists who said they had been shot at were struck by the bullets, he said.

“The results were scary,” he said in an interview. “Our profession remains very high on the list for risk of danger.”

Twice in his years as a psychologist, Dr. Alan Hilfer, now the chief psychologist at Maimonides Medical Center in Brooklyn, has had to deal with violent patients: once when a father and son got into a knock-down-drag-out brawl in his consultation room, and once when a teenager threw a paperweight at the therapist in the next office.

Dr. Hilfer said therapists were not taught precautions — like where to position oneself during a consultation — during training.

He recalled being asked, early in his career, to interview a man seeking treatment. “I allowed him to come between me and the door” in the consultation room, Dr. Hilfer said. “He became agitated and threatening, and I couldn’t get out of the room.”

In some group practices or in hospitals, he said, therapists leave the door open during a first encounter with a patient. They also alert a colleague, who listens for sounds of a disturbance.

Dr. Newhill teaches a class that tells prospective therapists how to do risk assessments and handle patients who turn violent. In a telephone interview, she said she started the class because of a murder in California in 1989. A therapist at a mental health clinic in Santa Monica was stabbed 31 times in her office by a patient, a street person who Dr. Newhill said was delusional.

“Violence is an interaction between the person and their environment,” she said, adding that the best predictor of future violence is a recent history of violence. She tells her students to work out, in advance, a plan that includes a way to signal for help. Some therapists install silent alarms. Others work out a phrase that lets a colleague know help is needed: “Please cancel my appointment for 3 o’clock” could mean “Call 911,” for example.

Dr. Reiner, of Behavioral Associates, said patients who turn violent had often “scoped things out in advance.” He said they would figure out whether a therapist worked alone or in an office with secretaries, other therapists or even video surveillance cameras.

But therapists who work by themselves, as many do in Manhattan, cannot turn to a colleague or a subordinate for assistance when a session degenerates.

“There is no warning system” for solo practitioners, Dr. Hilfer said. “We can try to use our clinical awareness and our knowledge of the patient, and if we are concerned about a patient, we will send them for a consult with someone. But in terms of protection, there’s none. It underscores the vulnerability that many of us understand.”

John Eligon and Anthony Ramirez

contributed reporting.

Working in Mental Health,
the Prospect of Violence Is a Part of the Job,
NYT, 14.2.2008,
http://www.nytimes.com/2008/02/14/nyregion/14pysch.html

Man Sought

in Psychologist’s Stabbing

February 13, 2008
The New York Times
By AL BAKER

Armed with a suitcase full of knives, an unidentified middle-aged man unleashed a rampage of violence inside the offices of an Upper East Side psychiatry practice on Tuesday night, fatally stabbing and slashing a well-known psychologist before wounding her colleague when he tried to come to her aid, officials said on Wednesday.

The assailant had not been identified as of Wednesday afternoon, the police said, though investigators were pursuing a theory that he was either a patient at the suite of offices, at 440 East 79th Street, or that he had some kind of ties to the establishment or the services it provided.

Originally, the assailant had arrived at the offices, about five seconds after 8 p.m. on Tuesday, asking to visit Dr. Kent T. Shinbach, 70, a psychiatrist there, the police said.

But at some point he disappeared inside the office of another counselor there, Kathryn Faughey, 56, the police said.

There, he unleashed a barrage of violence, fatally stabbing Dr. Faughey. At some point, when Dr. Shinbach heard the attack and went to the office of his colleague, the assailant turned on him and Dr. Shinbach was seriously injured, officials said.

The scene was marked by blood and upended furniture, the police and neighbors said.

“We could see in the office where the blinds had been ripped off and were hanging at a strange angle and the entire office was in disarray,” said Alexandra Pike, 20, a student who could see into the office where the attack occurred from the window of her apartment across the street. “Papers were strewn around and there was overturned furniture. And it was clear there was some kind of scuffle.”

It is unclear what the man’s motive was, and Police Commissioner Raymond W. Kelly released a sketch of the suspect after a news conference at 1 Police Plaza on Wednesday, saying detectives were seeking him. The sketch was based on descriptions provided to detectives of those who saw the man in the moments before the attack — including the surviving victim — but who could not identify him by name.

“Obviously there is a forensic evidence aspect to this case,” Mr. Kelly said. “We’re getting information from the doctor and other medical professionals in the suite to determine if they have any information to add as the investigation goes forward.”

He added: “We’re fully engaged on several fronts.”

Mr. Kelly described the assailant as a man in his 40’s, about 5 feet 9 inches, with brownish or blond hair. He was wearing a three-quarter length green coat, with sneakers and a baseball cap, said Mr. Kelly, as he held up the sketch before a bank of television cameras.

The first sign of the man’s entrance at the building was captured on videotape —as he walked in the front door about five seconds after 8 p.m., passed by a doorman and went into the counselors’ suite of offices, the police said. He was inside for about an hour: A videotape showed him leaving through a basement door about 8:54 p.m., the police said, and it showed a view of him from his back.

Blood was found on the door — a panic door that locks on its own when it shuts — indicating the assailant might have been wounded.

Before he fled, the assailant left two suitcases in the basement. Inside one was assorted women’s clothing — some shoes, a top, as well as diapers for adults. He other had about eight knives, the police said. Upstairs in the room of Ms. Faughey, investigators found three other weapons, including two knives and a cleaver with a broken handle, the police said.

A female patient was in the lobby of the counselors’ suite when the assailant showed up, the police said. She apparently left before the attack on Dr. Faughey became known, but detectives tracked her down and interviewed her, the police said. Dr. Shinbach was also interviewed after undergoing surgery at New York Hospital/Weill Cornell Medical Center.

Man Sought in Psychologist’s Stabbing,
NYT,
13.2.2008,
https://www.nytimes.com/2008/02/13/
nyregion/13doc.html

Albert Ellis, 93,

Influential Psychotherapist,

Dies

July 25, 2007

The New York Times

By MICHAEL T. KAUFMAN

Albert Ellis, whose innovative straight-talk approach to psychotherapy made him one of the most influential and provocative figures in modern psychology, died yesterday at his home above the institute he founded in Manhattan. He was 93.

The cause, after extended illness, was kidney and heart failure, said a friend and spokeswoman, Gayle Rosellini.

Dr. Ellis (he had a doctorate but not a medical degree) called his approach rational emotive behavior therapy, or R.E.B.T. Developed in the 1950s, it challenged the deliberate, slow-moving methodology of Sigmund Freud, the prevailing psychotherapeutic treatment at the time.

Where the Freudians maintained that a painstaking exploration of childhood experience was critical to understanding neurosis and curing it, Dr. Ellis believed in short-term therapy that called on patients to focus on what was happening in their lives at the moment and to take immediate action to change their behavior. “Neurosis,” he said, was “just a high-class word for whining.”

“The trouble with most therapy is that it helps you to feel better,” he said in a 2004 article in The New York Times. “But you don’t get better. You have to back it up with action, action, action.”

If his ideas broke with conventions, so did his manner of imparting them. Irreverent, charismatic, he was called the Lenny Bruce of psychotherapy. In popular Friday evening seminars that ran for decades, he counseled, prodded, provoked and entertained groups of 100 or more students, psychologists and others looking for answers, often lacing his comments with obscenities for effect.

His basic message was that all people are born with a talent “for crooked thinking,” or distortions of perception that sabotage their innate desire for happiness. But he recognized that people also had the capacity to change themselves. The role of therapists, Dr. Ellis argued, is to intervene directly, using strategies and homework exercises to help patients first learn to accept themselves as they are (unconditional self-acceptance, he called it) and then to retrain themselves to avoid destructive emotions — to “establish new ways of being and behaving,” as he put it.

His methods, along with those of Dr. Aaron T. Beck, a psychiatrist who was working independently, provided the basis for what is known as cognitive behavior therapy. A form of talk therapy, it has been shown to be at least as effective as drugs for many people in treating anxiety, depression, obsessive-compulsive disorder and other conditions.

His admirers credited Dr. Ellis with adapting the “talking cure,” the dominant therapy in extended Freudian sessions, to a pragmatic, stop-complaining-and-get-on-with-your-life form of guidance later popularized by television personalities like Dr. Phil.

Dr. Ellis had such an impact that in a 1982 survey, clinical psychologists ranked him ahead of Freud when asked to name the figure who had exerted the greatest influence on their field. (They placed him second behind Carl Rogers, the founder of humanistic psychology.) His reputation grew even more in the next two decades.

In 1955, however, when Dr. Ellis introduced his approach, most of the psychological and psychiatric establishment scorned it. His critics said he misunderstood the nature and force of emotions. Classical Freudians also took offense at Dr. Ellis’s critical observations about psychoanalysis and its founder. Dr. Ellis contended that Freud “really knew very little about sex” and that his view of the Oedipus complex, as suggesting a universal law of human disturbance, was “foolish.”

A sexual liberationist, Dr. Ellis collaborated with Dr. Alfred C. Kinsey in his taboo-breaking research on sexual behavior, and his writings about sex drew complaints from members of the American Psychological Association.

As a base for his work he established the Institute for Rational Living, now the Albert Ellis Institute, in a townhouse on East 65th Street in Manhattan. He lived there on the top floor.

The article in The Times described Dr. Ellis at 90, hard of hearing and recovering from abdominal surgery, coming downstairs one day in the spring of 2004 to lead one of his Friday sessions, just as he had for 30 years.

“Do you know why your family is trying to control you?” he asked a volunteer who had joined him in front of the audience. “Because they are out of their minds!” he said, inserting an unprintable adjective.

Another participant recalled the murder of her sister years ago by a drug dealer. “Why can’t you understand that some people are crazy and violent and do all kinds of terrible things?” Dr. Ellis declared. “Until you accept it, you’re going to be angry, angry, angry.”

Some critics complained that his seminars were more stand-up comedy than serious lecture. Still, despite his iconoclasm, or perhaps because of it, rational emotive behavior therapy became one of the most popular systems of psychotherapy in the 1970s and ’80s. In 1985, the American Psychological Association presented Dr. Ellis with its award for “distinguished professional contributions.”

Dr. Ellis was the author or co-author of more than 75 books, many of them best sellers. Among them were “A Guide to Successful Marriage,” “Overcoming Procrastination,” “How to Live With a Neurotic,” “The Art of Erotic Seduction,” “Sex Without Guilt,” “A Guide to Rational Living,” and “How to Stubbornly Refuse to Make Yourself Miserable About Anything — Yes, Anything.”

He often went back to his own life experiences to help explain his positive frame of thinking. Albert Ellis was born on Sept. 27, 1913, in Pittsburgh, the oldest of three children. As a child, he wrote, he had a kidney disorder that turned him from sports to books. His parents moved to the Bronx and separated when he was 11. He once wrote that he had limited but amiable contacts with his father, a traveling salesman, and that his mother, an amateur actress, was not interested in domestic life.

He maintained that the experience had left no scars. “I took my father’s absence and my mother’s neglect in stride,” he wrote, “and even felt good about being allowed so much autonomy and independence.”

He did well in school, skipped grades, won writing contests and, he said, was pleased with his accomplishments.

But at 19 he was painfully shy and eager to change his behavior. In one exercise he staked out a bench in a park near his home, determined to talk to every woman who sat there alone. In one month, he said, he approached 130 women.

“Thirty walked away immediately,” he said in the Times article. “I talked with the other 100, for the first time in my life, no matter how anxious I was. Nobody vomited and ran away. Nobody called the cops.”

Though he got only one date as a result, his shyness disappeared, he said. He similarly overcame a fear of speaking in public by making himself do just that, over and over. He became an accomplished public speaker.

Dr. Ellis studied accounting at City College during the Depression and took up some entrepreneurial schemes after graduating. In one, he paired used men’s jackets and pants of similar colors and sold them as suits. He wrote fiction but found no publishers. He had read a good deal about sex and set up a bureau in which he counseled couples.

His first marriage, to Karyl Corper, an actress, in 1938, ended in annulment. His second, in 1956, to Rhoda Winter, a dancer, ended in divorce. For 37 years, from 1966 to 2003, he lived with a companion, Janet L. Wolfe, a psychologist who had been executive director of the institute. More recently he married Debbie Joffe-Ellis, a psychologist and former assistant, who survives him.

After receiving a doctorate in clinical psychology from Columbia in 1947, Dr. Ellis spent several years undergoing classical psychoanalysis while using its techniques in his job at a state mental hygiene clinic in New Jersey. He quit in 1950 to begin a private practice specializing in sex and marriage therapy and soon started drifting from Freudian orthodoxy, finding it, he said, a waste of time.

He turned to Greek, Roman and modern philosophers and considered his own experience. Out of this came rational emotive behavioral therapy, which he decided would focus not on excavating childhood but on confronting the irrational thoughts that lead to self-destructive feelings and behavior. He founded his Manhattan institute in 1959.

“I was hated by practically all psychologists and psychiatrists,” he recalled. They thought his approach was “superficial and stupid,” he said, and “they resented that I said therapy doesn’t have to take years.”

In 2005, Dr. Ellis sued the institute after it removed him from its board and canceled his Friday seminars. He and his supporters claimed that the institute had fallen into the hands of psychologists who were moving it away from his revolutionary therapy techniques.

The board said it had acted out of economic necessity, asserting that payouts to Dr. Ellis for medical and other expenses were jeopardizing the institute’s tax-exempt status. Dr. Ellis was by then hard of hearing and required daily nursing care. Some board members said they were uncomfortable with his confrontational style and eccentricities and saw him as a liability.

In January 2006, a State Supreme Court judge ruled that the board had been wrong in ousting Dr. Ellis without proper notice and reinstated him. But his friend Ms. Rosellini said Dr. Ellis’s relations with the board had remained strained afterward.

Despite his failing health, Dr. Ellis maintained a demanding schedule late into his life.

“I’ll retire when I’m dead,” he said at 90. “While I’m alive, I want to keep doing what I want to do. See people. Give workshops. Write and preach the gospel according to St. Albert.”

Albert Ellis, 93, Influential Psychotherapist, Dies,
NYT,
25.7.2007,
https://www.nytimes.com/2007/07/25/
nyregion/25ellis.html

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