Wake Up! When Your Therapist is Sleeping

Although not all that common, psychotherapists sometimes fall asleep in session. Probably more common in traditional psychoanalysis (where the psychoanalyst is sitting behind and out of view of the patient), it far harder to do in more modern, time-limited psychotherapies where each session is more of an active, working period between therapist and client.

What is one to do when one is confronted with a sleeping therapist?

Stephen Metcalf, writing in New York magazine, set to find out by going back and talking to his prior four therapists, all of whom had fallen asleep on him. Was it him or them?

Of course, psychoanalysts — who are specially trained to practice a very specific and older form of psychotherapy — defend their sleeping behavior as the patient’s fault:

“In the past I noted a tendency in myself to become drowsy with two patients,” wrote the analyst Edward S. Dean in a now-infamous 1957 paper. “At times this drowsiness became so strong that I desired more than all else that the hour end, that I be rid of the patient and could take a brief nap. I was surprised to observe that as soon as the patient left, I became instantly fresh and alert.” […] Explicitly following Dean’s lead, successive analysts have generated a composite portrait of the sleep-inducing patient as a kind of negatively charged superhero. […]

Browsing through the literature on sleepy analysts, I was struck by how united the analytic community is in interpreting its own sleep. Variations of the Dean defense abound. And yet analysts stand utterly divided on what the sleepy patient might signify. Is it primary narcissism, hallucinatory regression, a desire to retreat into a womblike state? Freud thought each of these at different times; he even thought it could be a repetition of our infantile withdrawal from the pain of our own childbirth. Or maybe it’s a hostile urethral (no joke) reaction to the analyst? Or maybe the desire to be united with the good mother, or a regression to the infant’s inability to accept the nursing breast? The disdain its critics feel for psychoanalysis is not hard to fathom. You pay a handsome sum to sit across from a real, living, breathing human being who, when confronted with your agony, presents you with a toneless expression and the gelid “And how do you feel about that?” Meanwhile, in his notebook, he jots: “Patient exhibits hostile urethra …” […]

My therapist here was a Freudian who pushed me to take more sessions, to become a fully subscribed, five-day-a-week head case. I remember him only indistinctly, as a tweedy-shabby figure, a lifetime of neurotic confession — oh, city of thwarted glory! — clinging to him, the way a lifetime of johns clings to a prostitute. Does it come across how much I looked forward to this reunion? And yet the man who greets me at the door of his office is … Judd Hirsch. Circa Ordinary People. Seriously. An evidently humane and friendly middle-aged Jewish man in chinos and a button-up oxford. He is genuinely puzzled when I tell him how bitterly I recall our working relationship. “Really?” he says. “You speak of transference. Well, there is countertransference. And I remember you fondly.”

Asked about falling asleep during our sessions, he replies, “Oh, after lunch, glucose in the bloodstream, insulin, tryptophan …” I press him, and he says, “Well, why did the English take their tea in the afternoon?” Pressed, he says the question of his sleep “clearly distressed you.” To a man with a hammer, Mark Twain wrote, everything looks like a nail. Sitting across from my old doctor, in the late afternoon, in an old New England mansion, with its soughing radiators and pockets of gray light, it’s hard not to think of psychoanalysis not only as a dying art but as a ball-peen to the right eye.

Two Homer Simpson references in one day — we must be on a roll around here!

Thirty years and four shrinks later, and what have I learned? My personality seems to come with two presets: stentorian bore and class cutup, neither of which exactly enchants the mental-health professional.

It’s a dense and fairly long article (not always the best combination for online reading), but I found it interesting nonetheless. He doesn’t come to any solid conclusions (as you can see). Sleeping therapists could mean anything or nothing at all.

To me, however, it suggests a professional who isn’t being very professional and certainly isn’t acting in the best interests of his or her patients. A professional you pay to see should not be sleeping on your time — to me, it’s that simple. And if I caught my therapist nodding off more than once in my psychotherapy sessions, I would be looking for a new therapist shortly thereafter.

Read the full article: Why Would a Shrink Fall Asleep During a Patient’s Session?

Have you been in session when your therapist has fallen asleep on you? How did it make you feel? What should therapists do to prevent this sort of behavior?