“Group: How One Therapist and a Circle of Strangers Saved My Life”:

There are two types of people in this world, those who go to therapy and those who don’t. Those who think they need help understanding themselves and their problems and those who think they can buck up, be positive, and maybe with the help of their friends conquer all.

I’m in the former camp.

As for your friends helping you…they’re rarely honest and they’re not professionals, their skills are limited at best.

But to be in the former camp, at first you have to admit you have problems. You’d be surprised how hard this can be, to even say this to yourself, never mind out loud. Social consciousness has changed since the seventies, therapy is no longer taboo, most people don’t think you’re crazy if you see a therapist, although I don’t think you could be elected president if you went through analysis, there’s still a stigma amongst a certain segment of the population, even if you haven’t had shock treatment, like Thomas Eagleton.

Everybody’s got problems, whether you admit it or not. Most men don’t admit it, they just hang tight and sometimes commit suicide. Men are successful if they attempt it, they’re goners. Not that you need to commit suicide if you have problems, just that in most cases with therapy you’d be brought back from the precipice.

But there are good therapists and bad therapists. And the truth is, if you want good treatment it’s expensive, in the neighborhood of $250-$300 a fifty minute hour in Los Angeles. In New York? The 400s are not unknown. But sure, you can look who is covered by your insurance, but I do not recommend this if you want more than a band-aid, because the truth is the greats are never on insurance, I have never seen a therapist that takes insurance, they won’t even file for you anymore, it’s too much of a hassle, as for mental health treatment being covered by your plan…there’s a good chance you’ll have to argue for it, despite the law, you see mental illness and mental health get no respect.

So, there are various tiers of therapists. At the bottom are the marriage and family counselors. Then above them are the licensed social workers. Above them are the psychologists. And above them are the PsyD’s. And at the top of the pyramid are the psychiatrists, MD’s, who can prescribe medication. And in the old days, almost all psychiatrists did talk therapy. But since insurance pays so poorly, many have shifted to becoming medication dispensers. And believe me, medication can help, but you want the most qualified person, a psychiatrist has the most training. But since most people can’t afford an MD for therapy, there is now the aforementioned PsyD, which is like a psychiatrist without the medical degree, as in they learn how to analyze, have similar training to psychiatrists, but cannot prescribe medication.

If you think you need medication, do not get it from your internist or general practitioner unless it’s an emergency, they are not truly prepared to dispense. To see a psychopharmacologist psychiatrist is expensive, in the neighborhood of $350 an hour in Los Angeles, but you don’t go too often, they assess you and prescribe and then you come back a few times for tweaks. As for the medication itself…they’re all so different, some make you calm, others agitate you, some are harder to get off than others, and oftentimes you need a cocktail. And sure, medications all have side effects, each and every one, not only anti-depressants or anti-psychotics, but it’s better than holding on by your finger nails, and sometimes you just need medication to get over the hump, you don’t have to take it forever.

Whew! This was not the path I planned to go down, not at all. But the truth is the mental health world is murky to those not involved in it. And even the best therapist for one person might not work for another. But if you need help…

Christie Tate did, at $70 a pop, back at the turn of the century, for a group!

The beginning of this book is absolutely fantastic, Christie details an existential crisis, she’s #1 in her law school class, but why does she feel so bad, why does she have no romance, why does she have few friends? She runs into an acquaintance who recommends Dr. Rosen and Christie is just close enough to the edge to make the call. Most people do not, she gets credit for taking the plunge. Just to be heard, to have someone listen to your story, helps so much.

But Dr. Rosen is not the typical shrink. Sure, he went to Harvard, sure he’s a psychiatrist, but he does not believe in individual therapy, but group. Christie’s been going for almost two decades.


That’s another thing about therapy, as soon as you start everybody starts bugging you to stop, it takes wherewithal to stay with it, but therapy pays dividends.

Yes, either you’ve had good therapy or you have not. And if you’ve had good therapy you’ll be the first to admit it’s changed your life, opened up possibilities, corralled your worst tendencies.

Oh yeah, there are short term therapies, and they may get you over the hump, but if you want to go deep… It would be great if everybody would go deep. Therapy is a club, and if you’re not in it…it oftentimes shows. The person who loses control at a meeting, the person who doesn’t act in their best interests, all you can do is sit quietly and tell yourself THEY NEED THERAPY! But they won’t go, because they would have to admit they have problems and need help, and that’s anathema.

Last year Lori Gottlieb’s book “Maybe You Should Talk to Someone” was a best seller. I read it and enjoyed it, but I was bothered by the lack of insight Lori, a shrink herself, evidenced. “Group” is written from the perspective of a patient, and Christie Tate lays it all out.

Dr. Rosen does not believe in confidentiality. He won’t reveal your secrets, but you revealing the group’s secrets…IT’S OPEN SEASON!

Furthermore, Dr. Rosen gives prescriptions, and I don’t mean medication, and those make me anxious. That’s how behavioral therapy works, via exposures, it’s the only treatment that works for OCD, but for regular therapy? I made the biggest mistake in my life by doing what a therapist told me to, without his direction I never would have taken this action. My present therapist would never ever tell me what to do, which is why I never call him in a crisis, because all he’ll say is we’ll talk about it the next session, he wants me to improve, but not lean on him.

Christie is constantly calling her therapist. And she’s angsting. And getting angry, breaking dishes, not all the time, but when she’s really frustrated. She’s hates her breasts but doesn’t even realize it. She can’t say no, doesn’t believe in arguing, shows up for everybody, and is subservient in relationships. The group breaks her of these habits, they free her! And along the way she realizes oftentimes she wasn’t the problem, it was the other person, but when you’re on the outside looking in it’s hard to see it that way.

So there are a lot of details here, Christie lays out her entire life, all her feelings. she says she “turned out out perfectionistic, frigid, and borderline asexual,” but from the outside she looks perfect! If you’re not a believer in therapy you’ll probably wince, too much sharing, why doesn’t she get over herself. But the truth is all people feel like Christie, but they hold it inside, they’re afraid to share, but in therapy you share.

So you’re along for the ride with Christie. Her family upbringing, feeling like an outsider, her parents not having enough cash to send her out of state for school, needing to be #1 in school to feel good about herself, but what is that worth anyway if your life itself doesn’t work. Believing she’s not good enough to interview at Skadden. It’s like you’re living inside someone’s brain who has the same feelings and experiences you’ve had, or similar, and that makes you feel connected, not alone.

This is not a highbrow book, and at the end it can be a little sickly sweet, but unlike too many tomes, “Group” is highly readable, and it will call out to you to finish it. If you’re in therapy, you’ll dig it. If you’re not in therapy…you probably won’t read it. But if you’re not in therapy and you choose to pick it up…that’s the first step, you’ll suddenly become aware of your issues, see that they can be addressed.

And enough of “first world problems.” This is why people don’t talk about their issues. Sure, people are starving, struggling to make ends meet, but that doesn’t mean you can’t have problems, no matter how much money you’ve got, no matter how good your life looks from the outside. We’re all human, we’re essentially the same. Some nights we can’t sleep. We’re flummoxed by relationships. We wonder why we do this or that. We can’t make order of our lives. If only more people had therapy the country wouldn’t be in the shape it is. That’s what I believe.

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