Lori Gottlieb, the author of this NYTimes article talks about her experience transitioning from a journalist to a psychotherapist. She explains that “empty hours” are best met with marketing one’s practice to a specific need, as opposed to remaining generally interested in the internal psychic world. Have we arrived to a world where therapists need publicists? I wonder. Do we need to search for niche markets? I also wonder. This is a stimulating article which poses the question of supply and demand. Is there a demand for insight-oriented psychotherapy, or is the demand for a relatively quick-fix to a very specific problem? Does marketing one’s practice create a harvest from which to pick out more long-term patients? Does the publicity serve to overcome the inhibitions of psychotherapy, such that once the patient gets comfortable, a deeper experience can be had? In other words, does the promise of seeing a “specialist” give the patient permission to unleash one’s fantasy world? As usual, I have no answers, but only ideas and possibilities. As Ms. Gottlieb states, as our antidepressants go generic, there is much less direct to consumer advertising for medication, which may mean that there are less patients seeking mental health assistance. This, combined, with a variety of both licensed and unlicensed professionals seeking to help people guide their way through the messiness of adult life. The patient, suffering from ill-defined issues, is at a loss as to where to turn. The media, friends, relatives, and their primary care physicians, serve as referrals. The patient in pain trusts their referral source and then they land in an office, of which they do not know what will happen next. They could end up on medication, engage in long-term psychotherapy, engage in short-term behavioral techniques, or a combination of the above. There is no good algorithm. I am glad Lori Gottlieb brought this issue to her readers. I am left stimulated and confused.