Shirah Vollmer MD

The Musings of Dr. Vollmer

“I Love That Man”

Posted by Dr. Vollmer on February 7, 2014

"The term 'vegan leather' makes me think that you peeled a carrot and took the skin and made a jacket out of it," says Tim Gunn, pictured above at the Under the Gunn finale fashion show.


Tim Gunn attributes his five-day a week psychotherapy as an adolescent, lasting for two years, a critical factor in his current success, both as a human being, and as a professional. He ends the interview by reminding the listeners that no one gets through hard times alone. We need other people. Even now, he says, when he reflects on Dr. Goldberg, his therapist, he has tears of happiness, thinking about how important that relationship was to him. Terry Gross asks him if he thinks about Dr. Goldberg now that he is a professor, and Tim quickly responded by saying “absolutely.” In this day of drive-through psychotherapy, I felt so refreshed by Mr. Gunn’s reminder to the public that the benefits of his intensive psychotherapeutic work is paying off every day, decades after the treatment ended. This long view of psychotherapy is so sadly missing from our current day notion of symptom checklists and outcome measures. As I teach psychotherapy to students from many disciplines, and as I teach psychiatric residents and child psychiatry fellows, I have this conversation on a daily basis. “We need to take the long view, and not the short view, of psychotherapy, I say, knowing that my way of thinking is slowly fading out, and newer, seemingly quicker, interventions are replacing the previously held value of long-term intervention for long-term gain. As my bright student said to me recently, outcomes are subjective and therefore not measurable. “YES” I scream loudly back at him. If we cannot measure the value of psychotherapy, why pretend we can? This is what I want to know. As I tell my students, just as insulin-shock therapy and lobotomies are a dark part of our mental health intervention history, so too, I believe, these short-term interventions will also, with time, come to be seen as terribly mis-guided.

2 Responses to ““I Love That Man””

  1. Shelly said

    Tim Gunn is not your average client. Five-day a week therapy for two years is not something most people can afford. In today’s world, health insurance does not pay for psychotherapy, and if it does, it’s only for a small part of it and the rest is out of pocket. It’s not that only insurance companies want quick fixes–clients also do not want to spend every spare moment in therapy either. The bottom line is that people want to feel better. Period. Like when someone is sick and go to the doctor–they don’t want to hear…”You will feel better, in about two years.” The most important person in the Patient-Therapist relationship is the Patient: If the Patient feels better, then he is better. The Therapist can still say, “Oh, we have so much work to do!!” for many selfish (and financial) reasons. The bottom line is this…It is not up to the therapist to measure the value of psychotherapy: it is up to the Patient. And it is up to the Patient to decide when to stop therapy, just as he decided when to start.

    • Yes, I agree with you Shelly on all accounts. Yes Tim Gunn’s experience is fairly unique, but having said that, we can learn from it, that intensive treatment can have long-term dividends. The most exciting part of your comment is that the patient should decide when to stop and in that, I completely agree, and hence I am dismayed to hear that the “T” therapies determine an end-point. As for the affordability of therapy, this is of course, the most important point. Once we can agree that psychotherapy is the gold standard of intervention, then we can focus on payment issues. My fear is that psychotherapy will be “forgotten” as a treatment modality, as the emphasis goes more towards “T” therapies. Thanks.

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