Shrunk

New York City

Nothing says New York like a psychoanalyst’s couch. Think Woody Allen or those New Yorker cartoons. It fits our perception of east-coast Americans as all neurotic and self-obsessed. But that mental picture needs updating, because traditional psychoanalysis is in dramatic decline in its traditional heartland.

Across the urban US, in fact, the profession is dying out or having to change drastically. New figures from the American Psychoanalytic Association reveal that the average age of its 3,109 members is 66, up four years in a decade. More seriously, the average numbers of patients each therapist sees has fallen to 2.75. Some shrinks now never meet patients, dealing with them only via the phone, Skype or email. In the 1950s and 1960s, therapists could see between eight or ten patients a day. Now they’re lucky to see one.

So why are Americans shrinking from the shrinks? Packed modern lives must produce more therapist fodder than ever. But that’s part of the reason — a dwindling number of people now have the time or patience for the classic Freudian treatment of three to five weekly sessions — each lasting 45 to 50 minutes and costing up to $500.

The real change, however, seems to be in the American psyche. America — at least elite America — took psychoanalysis to heart in the post-war years. It helped that many Jewish analysts had fled Europe to New York, but it was also a by-product of tremendous affluence. Many Americans had little to worry about except their mental health. There was a name for such patients: the worried well.