Howard Stern, the ubiquitous satellite radio talk-show host, is a big proponent of psychotherapy. He has noted how he’s been in psychotherapy three times a week for the past few decades, much like Woody Allen. But what kind of psychotherapy is Howard Stern in? And why does it seem endless?
This type of intensive, long-term psychotherapy is almost always psychoanalysis — a specific type of psychotherapy that focuses on how a person’s unconscious conflicts impact a person’s everyday functioning. People who undergo psychoanalysis almost always meet with their analyst 2 to 3 times a week, every week, for years on end. Howard Stern has said he sees his analyst 3 times a week, but sometimes feels like he would like to cut down to twice a week.
Psychoanalysis is considered a specific form of psychodynamically-oriented psychotherapy and is far more popular in European countries than the U.S. And it’s no wonder — it’s the form of treatment invented by Sigmund Freud himself. Contrary to popular belief, there’s been a fair amount of empirical research conducted on psychodynamic therapy demonstrating its general effectiveness (see, for example, Shedler, 2010). Psychoanalysis is indeed a valid, effective form of therapy.
But at three times (or more) a week, who can afford such intensive therapy (other than celebrities like Howard Stern or Woody Allen)? And why would you bother if other forms of less intensive psychotherapy can be just as effective?
Psychoanalysis is conducted by specially trained professionals called psychoanalysts, who are typically a special kind of medical doctor — a psychiatrist. Psychiatrists complete medical school, and then typically spend another 4 to 5 years gaining expertise in psychiatry in residency.
Psychoanalysts go one step further, however. They also spend another 4 to 5 years training in psychoanalysis (at the same time, undergoing their own personal psychoanalysis, which they are encouraged to keep up for their entire professional career). So a typical psychoanalyst may have an additional 12 years or more of post-college education and training. Somebody has to pay for all of that.
Who can afford psychoanalysis in the U.S.? In general, rich people. Insurance companies don’t reimburse for 3-times-a-week or more therapy. Not when there are other more cost-effective forms of treatment available. Most people who are in psychoanalysis pay the fees of their analyst — which can begin at $250/hour and go up to over $1,000/hour — from their own pocket. So Howard Stern could be spending upwards of $1,000/week (minimum) for his treatment. That’s over $50,000 per year!
So why would a person bother with psychoanalysis if it’s so expensive and time-consuming?
In studies conducted about characteristics of people who undergo psychoanalysis, no clear patient picture emerges. They often suffer from similar and severely debilitating mental disorders like depression or anxiety, but have chosen the psychoanalytic route for treatment. Some research has suggested that perhaps people who enter psychoanalysis have fewer interpersonal problems, but in general, research has demonstrated that psychoanalysis is suitable for virtually any disorder of any severity.
The key to good outcomes in psychoanalysis appears to be, not surprisingly, directly related to how good the therapist-patient match is. This is a finding consistently reproduced amongst many types of psychotherapy.
Folks like Howard Stern — who constantly talks on his radio show about how insecure, paranoid and neurotic he can be — may understand some of the unique benefits of intensive psychotherapy. The analyst is always there as a constant, reliable sounding board in his life, allowing him to focus more of his personal time on his career and other pursuits. It may help people like him keep his personal insecurities at bay better than traditional, once-a-week cognitive behavioral psychotherapy.
Howard Stern is a surprisingly vocal and positive supporter of the benefits of psychotherapy in general, and recommends it regularly to his listeners. While you may not find much benefit to pursuing psychoanalysis like Stern, you may be surprised at the beneficial effects that can be realized when you find a good therapist to work with. Whether it’s a psychiatrist, psychologist or some other mental health professional (the research suggests it doesn’t much matter which you choose), the key is to get help when you most need it in your life — don’t be afraid to ask for help.
Is endless psychotherapy of the type that Stern appears to be engaged in ultimately healthy? In most cases, probably not, as it creates a co-dependent relationship that instead of emphasizing and supporting a patient’s independence, fosters a continuing dependence upon the analyst. In my opinion, good psychotherapy should be time-limited and goal-focused — you enter therapy with a specific goal (or set of goals in mind), and when you’ve reached them, it’s time to leave.
Sure, it would be nice to have that kind of professional helping you with life’s ups and downs your entire life. But it’s certainly not necessary for most of us. We can still enjoy a fulfilling, positive and happy life without such constant therapeutic intervention.
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.
For further information
Read our overview of psychodynamic therapy, which includes psychoanalysis, and Sandy Naiman’s Random Thoughts On Psychoanalysis vs. Psychotherapy.