Imagine it's your 20-minute psychiatric appointment

I have become a cold, cruel therapist. Any client sitting before me would never know this. My victims are those who no-show or late-cancel their appointment once too often. Their future-scheduled sessions may get erased. They are notified of this, not asked about it. Shooting myself in the foot has never felt so righteous.

This stand’s inspiration was a principle expressed to me by a clinical supervisor at the beginning of my career. At that time I felt embarrassed being bequeathed it, as any new therapist should. She said: “Your clients’ appointments with you should be as important to them as their appointments with their medical doctor or their psychiatrist.” A new therapist should blush hearing this. I did. Over the next fifteen years her lesson would occasionally pop into my head, triggering a little laugh and the old blush, even though I knew I had actually helped some people find a better life, and maybe saved it. I’m not laughing any longer. I have come to be certain that helping the spirit is at least as important as helping the body. If soma and psyche were in a lifeboat with only enough provisions for one, neither could be justified sacrificing itself for the other. And there are many times when a wounded body will survive, but a wounded soul will die.

To go further, I believe that a Master’s-level therapist can be as powerful and salutary a presence as the best medical doctor. The nature of a good therapist is simply the consistent application of some of the best qualities of a decent person – empathy, nonjudgmental care and perceptiveness – with some intelligence thrown in. These can therefore be some of the most formidable people you will meet.

And the potentially life-saving person you need right now.

So, to my present and past clients: Would you cancel or ditch your doctor’s or psychiatrist’s appointment as easily as you would your psychotherapy appointment? You know you wouldn’t. Pills are easy, fixing the life your parents left you is difficult and unpleasant. Sitting or lying on a couch and moving the chemistry of defeat, of childhood, is painfully paradoxical: Healing is hard, the most desired is the least desirable. It can feel like strength to avoid therapy and handle your life on your own, and like weakness to be a receiver of help. You are fighting the most human urges to become your most human.