Portrait of the Psychotherapist as a Young Artist.

Someone just asked me how I decided to become a therapist.

It’s a question I am asked from time to time. I’ve answered different ways at different times of my life, and understood my trajectory toward this point in different ways.

This is my answer for the moment.

There is of course, a longer, far more complex narrative, of which I am only partially aware. I suspect the unconscious processes, both personal and collective, that set me on this path began the day I was born, or maybe even before.

But there was, in fact, a moment when I actually decided, or perhaps realized, that this was the path I intended to pursue.

I had majored in Theater and Philosophy in undergraduate – and had dropped out, smack in the middle of my senior year – giving my parents a total heart-attack (and completely in keeping with their own history of totally impulsive shenanigans) and certainly disappointing many of my professors in both majors who believed in and supported me.

Why? I only knew that I couldn’t do it any longer – continuing to work to finish my undergraduate degree felt “wrong” and utterly intolerable. In fact, I felt that I somehow needed to “save” my final semester, and any graduate schooling for “later.”

That was the best explanation I could muster.

I could not invest any more energy consolidating the identity I had cobbled together out of scraps and left overs. I could not would not stack one more brick in the construction of a jerry-rigged persona. It would either work or it wouldn’t based on whatever effort I had already put in. “I” was held together with spit and duct tape but I was either “good enough” as is, or I wasn’t. It was time to find out.

I had started therapy the year before dropping out – and was certainly the most annoying, defended, overtly resistant patient that had ever presented voluntarily in a therapists office. Her obvious empathy annoyed me. I didn’t want someone to empathize with my “troubles.” I wanted someone to say I was going to be just fine, I was following my heart and that these instincts certainly meant something important. I wanted her to assure me that there were many roads to happiness, and that I was sure to have a bright future ahead of me if I stubbornly followed my intuition, and so to not be afraid. She said none of those things. She looked concerned. I hated her more than half the time. The rest of the time she scared the shit out of me.

I got a mindless gig in a nearby restaurant, relieved and happier in obedience to the pressing internal mandate. I gazed down on the ceremony from high up in the amphitheater the day my dearest friends and my class graduated without me – without a drop of regret. I had no desire to flip my tassel.

I left that state and that therapist the first chance I had, and never looked back.

The next seven or so years are a blur. I did a brief stint in a regional theater and eventually moved to New York with hundreds of thousands of other 20 year olds to act and act out.

Here is what I remember: the East Village & Alphabet City, waiting tables, various very bad boyfriends, auditions, panic-attacks, bar tending, head-shots, grief, acting gigs, mourning, the Equity Actors union waiting room, flash-backs, and scraping by.

I found my second and final therapist – and used all of my personal resources just to show up regularly. I offered up my cash tips from my black half-apron pockets for what seemed to have become my central task in life: Therapy. Twice a week. I didn’t know why it felt like I was living life in a giant pin-ball machine – buffeted from one misery to the next – and worse: I had the terrible, unshakable sensation that whatever the crap was playing out – it had all happened before.

And I wanted it to stop.

Of course it had all happened before – but I had no idea what a “repetition compulsion” was – I just knew I hadn’t liked it the first round either.

I was pursuing acting as a career. I worked in the restaurant industry. But, it was clear as crystal that showing up for therapy was my real job.

Somewhere in there I met a boy, a stable and kind boy, and would eventually move in with him. His parents had been holocaust survivors, and he seemed completely undaunted by my little shit-show. He remains undaunted and steadfast to this day.

This next part is aesthetically humiliating but true. I paid what must have been seven bucks at the time to see a matinée of the Prince of Tides. I went alone. I remember very little of it. The therapist, played by Barbara Streisand is bad – probably as terrible as the movie, and also bad as in naughty. Does she sleep with a patient? Or just the sibling of a patient? Not that that is okay either. She is categorically a bad therapist in a bad movie – but, I experienced a strange overwhelming confluence:

Here was an actress, playing a therapist. Something shook loose in my head. An actress, one known to have had a lot of psychotherapy, was acting as if she was actually a therapist.


When the movie finished, I spent another seven bucks and saw it again. I next went straight to Samuel French theatrical publishers and bought every little paperback copy of every play I could find with a therapist in it.

It was in the early nineties that I purchased my own first book on psychodynamic theory. The title caught my attention as I had been reading Joyce: “The Portrait of the Artist as a Young Patient” by Gerald Alper.

The first paragraphs of the preface sent me straight to the cashier to smooth out a stack of crumpled bills from the bottom of my backpack:

“The artist who appears here belongs to a special population of struggling, non-commercial, artist-patients rarely seen in the private office of a psychoanalytic psychotherapist (as is the case here) for the compelling reason that they cannot afford a normal fee”

and further down the page:

“Here is the common, recurring profile of the artist as patient: someone in their mid to late twenties, more likely female than male…. generally not indigenous to New York City, but arriving and settling in from the Midwest and even California, an aspiring actor, actress, dancer, musician, painter, singer or writer; generally unemployed in his craft and having to fall back on part-time survival work such as waiting tables in restaurants (almost unanimously despised) predominant presenting problem of depression (often narcissistic) work inhibition, creative block, paralysis of initiative, and day to day functioning accompanied by frequent feelings of inner deadness”

Yikes. Was he supervising my therapist?

In it, he discusses his caseload of young artists, in the 80’s, surviving and suffering and acting out in the East Village, in the ten block radius around my fifth floor walk-up.

I had no idea at the time if it was a “good” piece of clinical writing or not – and had never heard of any of the theorists he referred to – Kernberg, Kohut, Winnicott, and Bateson’s’ “double bind.” The book felt like a cold slap: pathologizing, harsh, objectifying. But, absolutely no less objectifying than the restaurant managers or casting directors that dismissed, criticized or hollered at me every single day. The case examples seemed off-point, and unlike any peers I could identify with. Little was discussed about the complexities of creative processes, or career building. No stories of hope or big breaks.

Just stories of symptoms and dreams of loyalty to a creative process going no-where. No Where.

Yet, Alper was clearly familiar and compassionate toward my tribe of misfits when he discussed us in aggregate. All of us thin-skinned folk, hoping to make a creative living off of the utter sensitivity of our exposed, raw nerve endings, bruised and battered by brute contact with the pointed corners of unyielding reality.

Many of us trapped, feeding the insatiable appetites of demanding patrons during the day, while unable to satisfy our own deepest hungers.

He even describes the “waiter’s nightmare” which haunted me for many years:
“gigantic outdoor cafes, peopled by hundreds of clamoring patrons, situated thousands of feet apart”

Re-reading it now for the first time twenty years later, clinically, it’s not my professional language, or model, and doesn’t speak to my practice or approach. The book is too focused on psychoanalytic diagnostics for my taste – all artistic processes redefined as a cocktail of healthy and pathological narcissistic processes – artist’s relationship to his talent/creativity: narcissistic, to the audience: narcissistic, and all artists and participants in the creative act: narcissistic. Kohutian, Kerbergian, or Winnicottian – it seems unnecessarily reductive of what, in my view, are essentially numinous, spiritual, unconscious processes of the psyche.

Of course, there is always danger of inflation and deflation when wrestling with archetypal content and the Unconscious. But in my work over the past 15 years with the same struggling creative population – too many writers, actors, musicians, playwrights, dancers to count – I have come to think of the suffering artist much more as an “identified patient” in a disordered environment. They are the Cassandras, the too willing scapegoats, the canaries in our coal mine. They feel the toxicity in any system first – and often respond before they know what they are reacting to. Artists struggle to give it voice, shape, movement, and symbol so the rest of the community can confront the shadow content that would otherwise be ignored, repressed, disavowed. The artists I have seen, seem to me, not narcissistic enough. Too willing to be dismissed as flakey, as failures, too willing to absorb the collective toxins, take them into their own systems to metabolize, and transform them into something beautiful or communicative or confrontative. Eternally, masochistically hopeful that they can make the deaf hear, the blind see, artists do so at costs to themselves they don’t always recognize.

A little like therapists.

Yet, Alper was clearly a caring and compassionate therapist, and the parallels between creative and clinical inspiration and artistry are not lost on him. Alper mentions that he was a novelist before becoming a therapist, and describes the pursuit of a career in psychoanalytic psychotherapy as a “decision to try and earn a living doing the thing we most love.”

Twenty years ago this was perhaps the first time I had the notion that 1) I had a not-so-common sensitivity, receptivity, and a relationship to my own unconscious processes, and 2) It was actually a skill set I had developed – as well as a deficit. Also, 3) that this skill set was maybe even directly transferrable to work as a therapist.

The same year, I was working on a piece of experimental theater – “workshopping” some obscure German Expressionist piece, with a group of other wounded waiters I knew. The two “producers” had hired a “director” with some family funds – and we were using psychodramatic exercises, along with our own significant trauma histories to “flesh out” the sparse, strangely translated text. Putting all our horrors “on their feet” and improving our way through our worst and cruelest “high-stakes” memories. Beatings. Abuse. Discovering suicided family members. Psychotic breaks and involuntary commitments. Drug overdoses.

We thought we were being brave and creative. Now, I can see that it was just so obviously, and on every level: A Very Bad Idea.

When the final actor had exposed his own darkest living nightmare for others to enact, I heard the director whisper to himself:
“This is good…. we can use this….”

That night, I called an old dear friend: She had walked through her own house of horrors – and wasn’t all the way out yet, but she had managed to get her MSW a year or two before and was, as a result, way more gainfully employed than I was.

“Use this??!!” I hollered into the phone, back when people talked on phones. “Use this?! Is this what all actors are doing all of the time!? Use this!! This SHOULD NOT BE USED! This shit is SACRED unto ITSELF! We should only respect it and sit near it and bear witness!”

The first eight words of her response changed my whole life:

“You don’t have to be an actor, you know. There are lots of actors who would kill to be getting the work you complain about.”

“Wait?! What did you say?!!?!? Excuse me did you say: “I DON’T have to be an actor?! I don’t have to be an actor..… ”

I thanked her and hung up. Called someone and quit the hot German-Expressionist mess. The next day I ordered catalogues from every social work program in the city. And called my would-be alma mater to figure out how the hell I was going to finish my degree seven years after dropping out.

Interestingly enough, I found out that my credits were on the brink of expiration, and if I had waited even a few more months, I would have had to start my Bachelor’s degree over. As it was, I transferred some credits back – and completed some research projects for independent study credits: One on the history of the Yiddish theater on the Lower East Side, and another on the Psychology of Creativity, extensively citing my favorite book du jour: Portrait of the Artist as a Young Patient.

One year later: I had tied up my loose ends, and enrolled in a clinical social work program.

So it is with deep gratitude and thanks to my chaotic inheritance, my first half-detested therapist, my disappointed professors, several bad boyfriends, every restaurant manager I ever was oppressed by, my husband, my final and current therapist, a sadistic director, Gerald Alper, my dear friend Julie, a Very Bad Idea, and of course ladies and gentleman, the Incomparable Barbara Streisand, that I exist as I am now:

A psychotherapist, no longer young,
but in many ways walking the same path,
practicing the art of psychotherapy,
with some success and some failures,
still struggling to remain loyal to the inner guidance of my own psyche and the creative process.

copyright © 2012
All rights reserved Martha Crawford

29 responses

  1. I love “aesthetically humiliating but true.” That probably describes 80% of my life so far 😛

    I really appreciated reading this. I dropped out of graduate school only a year ago myself, and have been wandering apprently without direction for the last 5 years since finishing my BA. It’s often easy to assume that those we look up to and everyone in the older generation took the most direct path to where they are now, simply because of how few of them advertise or speak honestly about their struggles and meanderings along the way. Hearing your story gives me a little more hope for myself.

  2. Goddammit, this is beautiful writing. Miss Martha, your patients are blessed by your service. But I feel blessed by your skillful and heartfelt sharing.

    Like you, I endured similar travails in my 20’s Reading your piece, like watching Lena Dunham’s Girls, brings them back in a way that makes me feel both uncomfortable and grateful that I have moved on to a more stable and masterful stage of life.

    Indeed, our greatest weakness (sensitivity) can also be a strength when used to help others.

  3. I am still thinking about this post and I wanted to add how much I related to what you said about artists in general, and your own discovery that what seemed like a deficit was also a gift and a skill set. For years I really bought the idea that I was “too sensitive” and “melodramatic” and was exaggerating my feelings for attention, and if I could only “snap out of it” all my problems would be gone and I could be a contributing member of society. Being good in math and science, everyone thought I should have a productive career in one of those, so I couldn’t understand why I kept losing interest. At times I was pretty far along the road to self-hate and self-destruction. It’s taken a long time to consider that maybe I do have some genuine perceptiveness and self-awareness which not everyone has, and which could actually be of use in some way. Therapy helps. Reading your blog helps. Thanks again.

  4. Your words leave me glad that the tortured artist found her way into the you of today, serving as the key keeper to the canaries’ cage. And, as someone else mentioned….this gives me hope for my own fitful bits of rage at my inability to help as much as I’d like (and still have a business.) Thank you, Martha. When are you scripting your memoirs to be acted out on Broadway with you as yourself? 🙂

  5. Ha! One of the strange things that happened the split second I quit acting was that I discovered what an introvert I really was!

    Thank you for reading and for taking the time to make such a kind comment.

  6. This? All of this captivated me.

    I identified strongly with the moment you exploded about using our sacred secrets.

    I’ve had times lately that I struggled against letting out my sacred secrets in a position of profit. Oh, heck no. It was too painful and unavailable for any number of silver pieces. I did learn, however, that is was usable in another capacity.

    Rather than to profit from the scenarios of my past, I have empathized from my experiences. I discovered that words powered with emotion are mine to give to help heal someone else.

    I enjoyed this so much and there is so much to be left with to think over.

  7. I am very touched by your story.

    I really admire how you’ve given us a detailed answer to such a usual question. I’ve been asked this too and answering in person, on the spot, even if I manage a sincere answer it’s only a tiny, tiny bit of the picture. I once wrote a story about how I chose this profession, and it wasn’t nearly as insightful as this one, mostly stating facts even as they still didn’t seem to relate (as may be expected for the first-year student in psychology that I was then … I could probably say more today).

    I find a whole lot of coherence in your chaos, a narrative thread that I found very easy to follow. I realize that this is your path the way you understand it now, when you’ve been through it all and have become an experienced therapist. Still, I do really appreciate how you can find the order and logic in your life while acting on impulse, it’s a sort of very powerful intuition. Maybe we all have that and in most cases we just don’t have the courage to listen to ourselves and change our lives so suddenly.

    This gives me perspective, on a personal and professional level (which seem so tied to each other in psychotherapy practice).

    I also relate to this. I may not have had any part time jobs as a waitress, I don’t hope to write poetry for a living anymore (this one was kind of obvious a decision to me), I found psychology and therapy early, however I do feel like a poet at heart and I see the use of metaphors, poetry, and psychotherapy, as being able to come very close together in a transformative process. I do find that the use of metaphors and poetry in therapy works for me as a client and, when appropriate, as a therapist.

    Also, really well-written story. It really gives me a strong sense of your career path and choices and there are many points that touch me here, such as showing up for therapy being your real job and respecting someone’s personal struggle too much to “use it”. This kind of writing makes me long to write a story as well, very inspirational. Thanks for sharing!

  8. Thank you for reading so closely – I think it is true that at the time I believed, and from this vantage point I still do – but for different reasons – that there was no other route for me to take. I could not get here from anywhere else – and I do have deep gratitude for the intuitions and even the insurmountable obstacles that led me here.

    I love what you say about metaphor and psychotherapy – On my busiest days I think of myself as a little metaphorical metaphor factory churning images and parallelisms all day for people who seem to find them useful.

    Thanks for your thoughtful comments.


  9. You’re welcome, thank you for writing.

    I love your metaphor-factory metaphor. I do appreciate creativity and hope to find my own analogies and metaphors when the time is right for my future clients 🙂

  10. i love this concept of psychotherapy as artistic/creative expression. as always, your writing is so wonderful and though-provoking. thanks!

  11. Thank you for your great post.
    I am thinking about becoming a therapist myself but am troubled by the fact that I didn’t go through any trauma, of course I have minor problems but my childhood and growing up was quite normal. Do you think going through really hard times is necessary for becoming a therapist?

  12. I don’t think trauma is necessary – what is necessary, in my view, is that the therapist come to a place where they realize that everyone is vulnerable, everyone is wounded in some way, we all suffer, have emptiness, hunger, needs that scare us – and that the therapist is no exception. We have been thwarted, have over or under adapted to others. We have all been hurt. We all will be hurt. We are all capable of deafness, of blind spots. Of rejecting things we don’t want to see or hear about ourselves, the other, and the world.

    With out examining this, and an awareness of where our own unmet needs and blind spots lie- the therapist becomes, in my view, dangerously inflated by the illusion that they have abundant “health” that they are capable of bequeathing to “sick” patients.

    It is the therapists ability, or lack of ability, to face their own Self with all its treasures and terrors which strengthens others as they attempt a similar task.

    Guggenbuhl-Craig’s book Power in the Helping Professions is a good book to read for more on this subject.


  13. Thanks to you and to Tamara!

    And, when treating older adolescents and young adults, I subsequently have all the room in the world to let them fall apart and meander and get lost and found and lost and found again. Which, frankly, drives their parents crazy – as they often want me to “get them back on track” as soon as possible.

    I think it is part of the individuation process, and part of the way some sort out their true selves, from their compliant selves, our core needs from compliance to parents wishes and legacy (explicit or not)

    It is terribly hard for some parents to watch their 20 somethings drift – but from my own experience, and from the clients I’ve treated over the years – some young adults, especially the very intuitive, take longer to ripen into their true vocations and right work.


  14. > “I’m afraid I would be a complete failure as a psychotherapist who practiced from a scientific/medical model”

    I have what might be a very different path. Perhaps we passed each other going opposite directions. I always knew I wanted to be an IT nerd, from age about 13. I spent 40 years doing that, very succesfully. And then something changed, and I wanted to do something different. I cook at a shelter for homeless people, and I remember thinking, if being a cook paid enough, I’d do that for a living. But I seem to be training as a therapist, in my mid 50s. And the truth is, the IT work was never a “scientific” thing, always an aesthetic one. People outside the field may not get that, but the best books on software have titles like “the ART of computer programming” and “the psychology of computer programming”.

    > “I didn’t go through any trauma, of course I have minor problems but my childhood and growing up was quite normal”

    LOL, I used to think that. As I am training, of course I have to be in therapy myself, and I’ve been looking more closely at some of those “normal” minor problems…. being a child IS a “hard time”, you may be surprised what you find

    > “It is terribly hard for some parents to watch their 20 somethings drift ”

    And again, the opposite: mine are all very purposeful and not drifting, and I worry about that

  15. Thanks for furthering the discussion Mike.
    Yes, I do understand from mathematicians and physicists I have know that a “beautiful, elegant” equation” code or formula is considered part of its validity – I think that is a lovely thought – and I’m sure that awareness of pattern, formula, shape, code -is going to be deeply useful in your work as a clinician.

    As for your kids, they can drift later too! Many do! As you did. There is no one path. As parents we are doomed to worry no matter which route they take. My goal is to just keep my more cloying worries to myself! 😉

    Thanks for reading and sharing your career path – there are MANY routes up the same mountain.


  16. Thanks for sharing this piece of writing. The stories of how we arrived where we are fascinate me. And the experience of the light dawning onto a new path certainly feels familiar. I think it takes some lived life to arrive at the place where those of us walking this path can see our own wounds clearly enough to use them as medicine for others. I like/dislike the image of transforming toxins into something worthwhile. So beautifully and painfully true – both for artists and therapists – most times I think the two are not all that very far apart.

  17. Thank you for sharing your journey. I’m one of those drifting 20 somethings, but when I see others my age who seem to have it all figured out, I think I should, too. But the more stories I hear, the more I think that this job I’m in now (which is definitely not what I want to do forever – I at least know that much) may actually inadvertently lead to what I’ll end up doing for the rest of my life.

    It’s hearing stories like yours that help me realize that, so thank you. 🙂

  18. I have no clue who you are, but if your clinical work is as honest as your writing, your clients are lucky to have found you.

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