Although it is well known that many people have gym memberships that they never call on and country cottages that they just cant bring themselves to visit (What is there to do in the country, anyway, apart from eat?) it has struck me recently that I know several people who are in full time or at least three times a week psychoanalytic psychotherapy who never actually attend their sessions. They write down their appointments dutifully, these non attenders, in their palm tops or their kitchen calendars, they pay the bills promptly and they genuinely believe,as each session comes and goes, that they intend to go, that they almost made it, that they just missed it by whisker, yet they never quite manage to get their appointments, or at least certainly not at anything like the right time.

Of course every course of recovery is beset with issues of ambivalence.
The fear of improvement has always hampered humans. Patients may worry that if their symptoms diminish they will lose their entitlement to the therapist’s attention; then, of course, the loss of the sensation of loss can feel like the worse loss of all and the forgiveness of the betrayers like the worst kind of personal betrayal. Besides, a terror of the harrowing nature of the material unearthed might put off any sensible soul.

Yet perhaps a more praevalent cause of pscyho-absenteeism in large cities is the feeling that one of life’s biggest problem is too much to do and not enough time. Not going to their analysis feels like cocking a snoop at the system for these types. You cant very well refuse to go to work, but you can skip therapy. Oh the rebelliousness! Oh the sense of freedom, if you are conscientious, in letting someone down!

For many working people therapy sessions
are scheduled for the early morning or after a heavy day. ‘I know the sleep would do me more good’, one friend says ‘To get to Finchley for 7 I have to leave home at 6.15. Do you genuinely expect me to function and thrive on 5 and a half hours sleep?
Why not break up with the therapist ?
‘ It’s complicated. It’s complicated. I don't need big changes right now.
I’m not ready I’ll do it when i feel stronger.’
‘ But why continue with the charade I ask?’ with compassion of course.
‘ What’s in it for you?’

One friend ‘sees’ a Belgian woman in West Hampstead, or at least she thinks she does but they have only spent six sessions together in the past year.

She feels bad about her perpetual absenteeism, of course, this bad feeling turns to guilt and the guilt keeps her away. Yet neither she nor the therapist seems to be able to terminate the relationship. ‘I know it sounds mad,’ she told me, ‘but I know when I am unable to get to a session she just sits in that nice room with her spider plant and her sea scape watrecolour and her bottle of Evian and I feel somehow she is just quietly thinking of me and wishing me well. You know, the thought of her just doing that makes me feel a bit better already.’

This lends in interesting new dimension to the therapeutic alliance. . The idea that a highly trained individual is quietly rooting for you, several times week in a sort of positive inversion of voodoo does sound attractive, not to mention the height of luxury, but could it really have good effects? Who’s to say?

Life coaches charge extortoinate fees to instill in their clients the confidence to land monumental book deals and gorgeous husbands. Could not these intelligent Freudian well wishers provide a similar psychic boon?

‘ It would be fine if this was the arrangement that you agreed on,’ I remark. ‘But all this avoidance feels to me like a lie. You have not entered into an arrangement with a long distance cheer leader. Besides, I reason, there are teams of nuns at the convent at Tyburn at Marble Arch who already pray 24 hours a day for the well being of the people in London. For free.’
‘ I know, but this is more personal,’ the friends chorus. ‘Those nuns don't know my stuff.’
‘ Fair enough,’ I say. ‘It’s a point.’ But can you be certain your shrinks are actually thinking of you in your allocated slots, I almost ask, but who am I to kick away the thin crutches of others? I may picture these assorted bespectacled rejected practitioners drowning their sorrows in Central European style coffee bars, nibbling strudel, thinking quite different thoughts, but I cant actually know. And what about these therapists? Should they be sacking their patients? Are they waiting for them to turn up so the topic can be discussed? Are they fearful of rejecting people who scarcely exist?
I don't know the answers to any of these questions but one thing I know is this: I have not been to my own gym for almost eleven months and I am picking up the telephone right now and cancelling my membership.