Posted at 2:16 pm in Individual Therapy by jlbworks

Some years ago, I returned to Amherst College, in Massachusetts, for a class reunion. I wrote the following letter, which was published along with those of my classmates:

“Amherst College changed my life. In fact, for 25 years, I thought that I had changed so much that I could never again be happy living in the South, and so I did not seriously consider returning home to Tennessee. I could not imagine that I wouldn’t find the intellectual environment stultifying and the religious climate oppressive. Moreover, I did not think I would be able to develop the quality and depth of close friendships, particularly with men, that had sustained me through 25 years in New England and Philadelphia.

Then a series of circumstances forced me to reconsider. My marriage ended, managed care tightened its grip on the southern New Hampshire town where I was in private practice, and I could see that the hospital where I consulted half-time might soon go under (within a year it did close, laying off all 100+ employees.) I sought an escape from the loneliness of single life in small- town New England, to a city where I might build a new practice and a new community.

Thankfully, I found Thomas Wolfe’s injunction (“You can’t go home again.”) not to be true in my case. I have been able to build a psychotherapy practice. The New York Times is delivered to my home before breakfast each morning. I’ve been able to find people who share my passions—for friendship, for books, for the importance of personal psychotherapy and a spiritual perspective.”

Many of these people I met through the Nashville Psychotherapy Institute (NPI). I think we are indebted to David McMillan for conceiving the idea of an interdisciplinary organization of psychotherapists, aimed at providing professional development and a professional community.

At an NPI Smorgasbord, Gayle Powers facilitated a panel discussion on “The Hazards of Practicing Psychotherapy.” David Yarian, in his remarks on this panel, used the word “dispirited” to describe many of his patients. According to Webster’s Dictionary, to be “dispirited” is to be “deprived of morale or enthusiasm.” Certainly “dispirited” describes most of my new patients as well. Usually they are depressed; they have few, if any friends, and minimal sense of community. Several years ago, I had my first appointment with a patient, aged 45, whose first words to me were, “I’m trying to save my marriage.” As his story unfolded, he told me, “My wife says our only friends are her friends—that I don’t have any close friends…she wants me to develop friends of my own and invite people over…even the neighbors are her friends.”

Recently, I had my first appointment with another new male patient. He said to me, “I’m turning 40 this month. It’s really bothering me. My support system is non-existent. I haven’t been able to make many friends. I’m alone most of the time. I go out to bars, but I don’t meet any people.”

David McMillan has raised the issue of our responsibility as psychotherapists to assist our patients in building community for themselves. For most of my adult patients, overall improvement is usually correlated with a decrease in their feelings of social isolation. I refer the majority of my adult patients to group therapy in Nashville, TN, and what I observe is that they begin to build a community with others in their groups, and sometimes contact other group members for support.

I generally subscribe to the idea that I can only take my patients where I have been able to go myself. One of my goals is to continue to work with NPI in encouraging our building of community, with the hope that we will continue to better learn how to encourage this for our patients as well.