Rachel Sokol doesn't like ruptures to her routine. She was the only one in her office, for example, who disliked the company policy of summer Fridays off.
That philosophy extends to her talk therapy.
She's missed two of her usual Tuesday evening sessions with her therapist so far this summer and the self-doubt has already crept in: "Am I doing OK without her?"
Now it is August, a month when therapy is traditionally on hiatus and die-hard patients can become agitated at the enforced autonomy and abandonment. It's what set off a panic attack in Bob Wiley in the movie "What About Bob?" -- leading him to trail his psychiatrist to Lake Winnipesaukee, N.H., to squeeze more therapy out of him.
For people who are in crisis, or suffering severely from depression, a break from counseling can be crushing and can represent a true emergency, mental health specialists say. But for those whose issues are not severe and acute -- those, perhaps, for whom a weekly therapy session has become a long-standing, hard-to-break (possibly even self-indulgent?) habit -- lying on a lounge chair instead of the couch may do some good.
The August break tradition first took hold during the Freudian heyday, when many of the analysts were either German or Swiss and were culturally accustomed to taking the month of August off, as they did back home. "In analytical circles the August break was -- is -- almost tradition," says Stephanie Rasband, a psychotherapist in West Los Angeles. The tradition has broadened to all varieties of psychology today, she says.
Some mental health professionals stress that the break is very important. "Caregiver burnout is a real threat," says Linnda Durre, a psychotherapist in Winter Park, Fla. "It can be very depressing if you don't take care of yourself and recharge." She says that time off every year should be de rigueur for any therapist who wants to stay sharp, fresh and focused for the rest of the year.
Some therapists prepare for the break beforehand, aware that their patients may suffer or complain or abandon them for other therapists whose summer schedules are more accommodating.
"I usually do extensive work prior to the break around talking about their feelings and how to handle the loss of me and our relationship during that time," says Rebecca Roy, a West Hollywood therapist. "Though often painful, they are able to work through a core issue with the knowledge that it will come to an end when we reconvene."
Dr. Ankur Saraiya, a Manhattan psychiatrist, never punches out in August. He's heard too many instances of patients who drop therapists who do that.
"I've heard of patients specifically choosing a therapist who does not have a routine August break," Saraiya says. "Some of my own patients chose to see me because I'm around in August and my vacations are generally not longer than two weeks."
The doctor has even picked up some new business when the interim patients he's treated in August while covering for vacationing colleagues switched over to his practice.
Hard times may be eroding the therapy-vacation tradition. This year, Rasband will be working straight through August because of the need to keep her business healthy in this strained economic climate.
Some therapy junkies seize the opportunity to open eyes and broaden horizens. Four years ago, journalist Susan Shapiro created the popular "The Shrinks Are Away" series, after her experiences when her own therapist fled town. It's a reading event that began in New York, in which people gather for book readings and discussion. Shapiro will be bringing "The Shrinks Are Away" tour to L.A. on Aug. 20-22 (more information at susanshapiro.net.)
But it surely would be a bonus if the August break could lend itself to an actual breakthrough. Maybe it did for Sokol. "The separation makes me realize that I am kind of dependent on my therapist, which I don't think is entirely mentally healthy," she says.
By trying to tackle her difficulties on her own, Sokol says she learns to fight off feelings of agitation and build her confidence.
Cecilia Lum of Palmdale similarly sees breaks in therapy as healthy and useful. "I think some folks depend on their therapist and use them like a crutch," says the 51-year old health insurance sales rep, who writes in her journal when her therapist's away.
She sees the break as an opportunity to "take the time to focus on an idea and thought process and try to implement a new idea the two of you are working on."
Mental health practitioners can also feel torn about leaving patients during the break -- and Roy says the time away is a pivotal part of therapy for them, as well.
"It taught me to handle my own anxiety and need to take care of another person who really needed to learn to take care of themselves," she says. "The break serves as a learning tool for both of us."