Thoughts on Therapy: The Pros and Cons of Being That Other Type of Couch Potato

"You Americans and your therapy," David said to me while we were watching an episode of Nip/Tuck in which Sean and Christian were attending some sort of couples therapy, being counseled by a shrink played by the bald guy who recently appeared on General Hospital as the Balkan. (Aside from "Three on a Couch," one of the funniest episodes of The Golden Girls, I don't believe I'd ever heard of friends going to joint therapy, but Sean and Christian were probably more intimate with each other than they were with any of their wives and lovers over the course of Nip/Tuck's six seasons.)

David made his pronouncement completely without judgment, adding that back home in England, everyone just keeps it all inside. I'm not sure if he sees this as a good or bad thing, or if it's just a neutral observation, a simple fact of life that he doesn't have the power to/interest in changing.

I didn't take offense to his generalization about Americans. Living abroad for six years, I've heard most of them. We're loud, we're uncultured, we're a bunch of violent, gun-toting maniacs. I'd never encountered the one about how we're obsessed with therapy (outside of New York City), but if all those other character defects that are constantly being leveled against us are, in fact, accurate, then perhaps the whole lot of us could actually benefit from some time on the couch.

My views on therapy and shrinks in general go back and forth. I certainly don't subscribe to the anti-psychiatry stance espoused by Scientologists, who, ironically, could probably use a lot of it. I think therapy can be beneficial when you are dealing with specific crises, and you're looking for a way to make it out safely to the other side. As for recreational therapy -- paying a shrink to indulge our self-obsession for an hour every week because, well, life is messy, and we can't make it alone -- it probably depends on the patient. As someone who tends to be goal-oriented, it's hard for me to throw my full support behind any treatment that doesn't have a clear-cut endgame.

I've had two experiences with therapy. I was diagnosed as suffering from panic disorder in September of 2006 after one session with a therapist in New York City, and the previous summer, I spent three months on the couch. I never thought it would be the place for me, but I must admit that it was helpful. It was good to spend one hour every week talking about nothing but me and everyone who'd wronged me in the past week. My therapist always seemed to take my side, which made me feel empowered, not at all crazy.

He also occasionally doled out some tough love. One session, after listening to my litany of latest complaints, he nodded in agreement as if I had every right to be appalled, and then he diagnosed me as a classic "people pleaser," I was having such a hard time with people, he said, because I wanted everyone to like me. I always had to be the good guy -- the good son, the good brother, the good friend, the good lover, the good everything. I was spending so much time pleasing everyone that I wasn't pleasing myself, and as a result, I was tumbling into an abyss of resentment.

It sounds simple enough, but until he said the actual words, I'd never considered that might be my problem. It was one of those rare moments of true epiphany, the enlightenment that ultimately led to my leaving New York City and moving to Argentina, a country where I had no one to please but myself.

Ironically, it's also a country where people are even more obsessed with therapy than Americans. I'm not sure of the exact figures, but I once read somewhere that the number of people in Argentina with therapists is much closer to 100 percent than in the United States, or maybe it was that there is one therapist for every 30 people. At first, this information surprised me because Argentines never really struck me as being particularly interested in enlightenment or self-awareness, though I always thought they seemed a little bit sad.

That said, if the solipsistic world view prevails anywhere, it would be there. Many local folks I encountered over the course of four and a half years in Buenos Aires treat life as a one-man (or woman) show in which family and friends are guest stars and everyone else figments of an overactive imagination. Why wouldn't they want to spend an hour talking about themselves? That doesn't mean they're digging deep, delving into all that complicated stuff that Brits apparently push aside for detailed analysis some non-rainy day.

Whether you choose to go there, whether you want to spend three months, three years or three decades in therapy, if you can afford it, I say go for it. Even if it's largely just an agent for the indulgence of your self-obsession, all me me me, if you're in therapy, at least you're communicating with someone. And if that someone allows you to talk about nothing but yourself for 60 minutes, there's a better chance that when you re-enter the real world, the one where we don't get paid by the hour to listen, you'll be more than ready to change the subject.