"When I go away, I make sure another doctor is covering for me and share their contact info on my phone message and out of office email," Manhattan psychiatrist Carlos Saavedra told me. "A patient's treatment plan may include medication, seeing a trauma specialist or getting more support from Twelve Step meetings, depending on an individual’s needs." But he prefers they discuss it with him first.
My addiction specialist, Dr. W, promoted this type of open relationship, as long as he was "the primary" (as polyamorists and detectives on "Law & Order: SVU" called it). Because I was having a hard time giving up cigarettes, alcohol and pot, he recommended a psychopharmacologist colleague of his, hoping antidepressant medication would ease my extreme withdrawal. It didn't.
Wellbutrin, touted as a stop-smoking aid, almost gave me seizures. The Adderall the doctor prescribed for my potential ADD turned me into a speed freak for 24 hours, proving I didn't have attention-deficit disorder. (If I did, the pills would have calmed me.) He then suggested group therapy and 12-step meetings, but they gave me flashbacks of feeling misplaced as a kid within my big boisterous family. I managed to get clean and sober, improve my career and marriage with the talking cure, preferring to confide in just one person who knew my whole history.
Yet my dependence on him backfired one August, when we had a falling out after I learned that Dr. W had lied to me by treating someone from my life who he'd promised not to. I felt betrayed and told him that he owed me an apology. He replied, "I'm sorry for the imaginary crime you think I committed," which made me want to commit a real crime. Instead, I stopped speaking to him, ready to quit analysis altogether. But his sudden bizarre insensitivity jarred me, causing me to lose sleep and question my sanity. My crisis management strategy became my crisis. I needed a shrink to help me deal with my shrink!
If, as Erica Jong said, "every lover is a reaction against your last," so is every therapist. Dr. W — whose diploma for Ph.D. in clinical psychology hung on the wall of his office in Greenwich Village — was a father figure who I'd seen as kind of my WASP rabbi. For a fresh perspective, I called Vatsal Thakkar, a Connecticut psychiatrist with a M.D. who was younger than me and from a Hindu family. Over a few talk sessions, I chronicled Dr. W's transgression, assuming Dr. Thakkar would take my side.
"It sounds like he made boundary mistakes," he told me. "But if you build up a man inappropriately, he has to fall."
"Do you mean that he's just human?" I asked.
"When he helped you quit your addictions, you imbued him with supernatural power," he opined.
"I did," I conceded. "It felt like magic."
"If he was kind and helpful to you for a long time, his recent behavior is uncharacteristic," Dr. Thakkar calmly said. "What if there's something you can't see that would solve the mystery of why he changed?" He offered the metaphor of a commuter who was angry that a woman in front of him had stopped her SUV in the middle of the street to get something in her backseat. "The furious driver couldn't see that her infant was choking."
The comparison was oddly apt. Not long later, Dr. W emailed me to apologize. His wife had been very sick in the hospital, he admitted, saying he'd lost a whole year. Afraid she wouldn't recover, he wasn't able to compartmentalize to do his job well. If I thought my husband was dying, I wouldn't be able to work either.
"I'm so sorry to hear that," I heard myself saying.
"I'm sure you'll write about this," he commented.
I did. Though I ended our weekly sessions, we later co-authored an addiction book together. Our reconciliation inspired my memoir "The Forgiveness Tour," where I quoted the wisdom Dr. Thakkar shared when he'd become my substitute guru. Ultimately, I realized that taking control of my health and well-being was my job, and looking for Dr. W's replacement saved me. If I'd known it would be so helpful, I might have shrunk around sooner. And it turned out this was a thing; some therapists even vacationed in July to fill the end of summer void.
"I encourage my patients to shop around and try other methods when I'm not available, especially if they want treatments I don't do like CBT, EMDR or grief counseling," Miami psychoanalyst Justena Kavanagh said. "Sometimes, it's helpful to get a second opinion and consider a new approach or multi-layered strategy."
She added, "You're not cheating on your therapist if you're honest about it."
"Look, I don't like when other therapists poach patients, but it's your right to explore other approaches when your regular therapist is away. You should be a smart and open-minded consumer," said Los Angeles psychotherapist and author Dennis Palumbo, who studied Buddhism and has a creative clientele. "If you're stepping out on your therapist in August, try a different modality that might offer illumination. No patient ever came back and told me, 'I liked the other guy better, goodbye.' But they have pointed out something the second therapist suggested they hadn't thought of and wanted to explore with me in September, which enhanced their treatment — and our relationship."
