We're on a break... when psychiatrists go on holiday

When you’re in therapy, it’s hard not to flinch when people start talking about the August ‘silly season’. August is the month that shrinks traditionally take off, leaving their patients — people like me — to fend for themselves.

The convention of the August break dates back to the origins of psychoanalysis itself: many of the early analysts (Freud included) were either Austrian or Swiss and were simply used to taking a month off during the summer. However, as psychotherapist Julia Bueno explains, the break also has a purpose: ‘Therapeutic work, which may have lasted years, will eventually come to an end. The patient will ultimately have to tolerate his or her own distress alone with the skills learned, and breaks in the therapy allow for a chance to practise this.’

Not all therapists take an extended break: it’s typically the preserve of psychoanalysts — who, in strict analysis, will see their patients up to five times a week — and psychoanalytic psychotherapists, who also work intensively with patients over a much more extended period than is the norm in other forms of counselling (essential in order to develop the therapist/patient relationship that is at the heart of this kind of therapy). But given that there are nearly 200 psychoanalysts working in London, my situation is far from unique; even if the capital’s streets are unlikely to succumb to a sudden surge of madness.

‘It’s funny, isn’t it?’ mused a friend. ‘I mean, the idea of all those crazy people, suddenly let loose simultaneously.’ I wasn’t sure whether he was including me in the ‘crazy people’ cate-gory: I like to think I’ve graduated to at least semi-sanity since I started seeing my Harley Street-based therapist, Jane, five years ago. But I also know that it’s because of her I’m able to lead an increasingly uncrazy life, which makes the thought of a month without our three-times-weekly sessions somewhat alarming.

I began psychoanalytic psychotherapy soon after the death of my mother from cancer. She was my best friend and died when I was 28, but I was already familiar with counsellors and psychiatrists as a result of my anorexia, which began when I was 12. As a 24-year-old I spent several months in an eating disorders clinic when my weight slipped to five-and-a-half stone: I discharged myself just as soon as I’d gained 10lbs and without addressing any of the issues that had led me there. When my mother died I knew that it was make or break, psychologically. Fortunately, after a few false starts, I found Jane.

I’m better now than I was at coping without Jane. I’m approaching this August without the same sense of intense dread that I did during the first years of therapy and am fully committed to my eating plan of small, regular, balanced meals — this week, I’ve even started to get my head round full-fat yoghurts. I’ve also developed a range of coping mechanisms, the most effective of which has proved to be writing a diary: it’s both an instant emotional release and, in retrospect, a reminder of the fact that I’ve survived tough times before.

However, experience has also taught me that the next month won’t be fun. As a single, self-employed journalist I find it all too easy to go days without talking to anybody, especially now that the person I could always pick up the phone to speak to, my mother, is no longer there. August for me can feel like a double bereavement — plenty of opportunities to practise those ‘skills’, then.

Three-times-a-week therapy provides a structure to my life and there’s nothing anorexics love more than structure: we don’t really do spontaneity. NB: never throw an anorexic a surprise birthday party; it’s bad enough without the cake. Trying to resist substituting the framework provided by therapy with the framework provided by rigid calorie-counting is hard, even after five years.

That doesn’t mean that there aren’t upsides to the summer break. For one thing, I actually find myself feeling flush in August. Private psychotherapy isn’t cheap: Jane operates a sliding scale and while I’m firmly at the bottom of it, a 50-minute session still costs £50. Moreover, I never take a holiday in August, although that’s mostly down to superstition: if Jane and I both head off to the beach at the same time, a nagging voice insists, disaster will follow. We can’t both stop concentrating on holding my life together: that would be like both pilots on a plane taking a nap at the same time. Not that I really regret staying at home: because holidays, like surprise parties, involve eating and spontaneity. Anorexics tend not to be as enamoured of them as the rest of the world. Besides, I know that the money I’m saving is vital if I’m to pay for another year in therapy.

Of course, I have no idea if Jane really spends her August on a beach: as anyone who has ever watched an episode of In Treatment will know, therapists don’t answer questions about their personal lives. Jane is a New Yorker, so I tend to picture her in the Hamptons, the holiday destination of all New York therapists in American author Judith Rossner’s 1983 novel August. Rossner’s plot focuses on the relationship between a young woman, Dawn, and her analyst. But while Dawn’s experience of the summer break rings true to me, I prefer to think that Jane’s vacations involve considerably less familial angst than those of her fictional counterpart. No, in my mind Jane spends the month on a picturesque New England verandah, the sea breeze tousling her hair as Chopin plays in the background. Being at least a little in love with your therapist is obligatory; the idea that they might have issues, too, is inconceivable. Also, obviously, a bit worrying.