“The best lack all conviction, while the worst are full of passionate intensity.” ~ W.B. Yeats, The Second Coming
In 1986 through 1988, I studied “The Aesthetics of Authority” with Philip Rieff at the University of Pennsylvania. In Professor Rieff’s book The Triumph of the Therapeutic, he prophetically posited that “Psychological Man” (that’s us) doesn’t commit to things — he samples smorgasbords of things as if he’s in Las Vegas going buffet to buffet. Psychological Man relates to institutions the way consumers relate to apps – always expecting free trial periods – and to Amazon, always expecting money-back guarantees. Someone asking for a free consultation from a psychotherapist “to see if we’re a match” is behaving exactly as the Internet culture has trained them to behave and just as Professor Rieff predicted.
From my point of view as a psychotherapist with 18 years of private practice experience, if a potential patient thinks that their time is too valuable for them to come into my office and sit eyeball to eyeball with me, then I can tell in advance that we’re probably not a match.
Here are the 5 reasons why I stopped offering free telephone consultations:
- “The eyes are the windows to the soul.” UCLA psychologist Dr. Albert Mehrabian’s well-known 7-38-55 rule found that when people are communicating feelings and attitudes, only 7% of the message comes through the actual words spoken — the remaining 93% comes through tone of voice (38%) and body language and facial expression (55%). A 15-20 minute phone consultation in the best case scenario would only give the potential client 45% – tone plus verbally transmitted data – of the information that they need to make a decision.
- 15-20 minutes is not sufficient to determine if someone is “a member of your tribe,” which is what the patient is testing for subconsciously. To be able to truly trust a psychotherapist with your darkest secrets and be assured that they will understand and respect your mental and emotional experiences, you first have to subconsciously sense that they speak your language and can empathize with you. Therapists know that rapport and trust-building — especially with patients who have had their trust violated or betrayed early in life — can take up to a year or more. 15-20 minutes on the phone is not enough time to determine what needs to be determined subconsciously.
- The essential service that psychotherapists provide, in my humble opinion, is mirroring and matching: mirroring the patient’s facial affect and matching the patient’s body language. As I wrote in How To Survive Your Childhood Now That You’re An Adult: A Path to Authenticity and Awakening, “Mirror neurons do not fire via text message.” We are trained to validate our patients’ emotional experiences and get the mirror neurons firing so that the patients know that they’re not the only ones who feel this way. The world is a crazy place and in our “normal” interactions with other human beings our emotions are often inadvertently invalidated; on one level, therapy provides a safe space for emotional tune-ups, to have another human being empathize with you. As Krishnamurti famously said, “It is no measure of health to be well-adjusted to a profoundly sick society.” Therapists hold and contain your maladjustments.
- Nobody truly understands the psychology underneath financial transactions, but Freud had a rule that many of his heirs have forgotten: Freud believed that money was an important part of the therapeutic container, the “frame”. Without a real cost, the patient had nothing at stake and a relationship with nothing at stake produces resistance, not progress. If you remove the money then you turn the analyst from a professional into a benefactor and the patient from an agent into a charity case. In “On Beginning the Treatment,” Freud argued that an absent fee increases resistance and undermines both the patient’s motivation and the therapeutic relationship.
- We’ve all heard of the paradox of choice… do you think you’re overwhelmed choosing between Hulu, HBO, AppleTV, Paramount, Disney, Netflix and all of your entertainment options? A free trial period may be a perfectly reasonable expectation to help you decide on a movie app or a dating app but I don’t think it’s appropriate for a licensed mental healthcare provider.
And speaking of dating apps… if you haven’t noticed, PsychologyToday.com vaguely resembles Match.com with a grid of headshots and seductive bios. For people who have been trained on Tinder and Hinge to treat profiles as invitations to swipe (reject, avoid), the medium is the message and the interface instructs the behavior.
Obviously being a good “match” with your therapist is incredibly important, but hundreds of my articles, thousands of my videos, hundreds of interviews are available online for free… why is it that someone will summon AI to summarize Reddit reviews and spend twenty minutes hunting down the best new gourmet pizza joint in the neighborhood but can’t be bothered to Google my name?
