The Professionalization of Friendship

There are 77,000 clinical psychologists in the US today. In the late 40s, there were 2,500. Now there are 50,000 "marriage and family therapists;" then, 500. Now, 192,000 "clinical social workers;" then, 30,000. Other categories like "mental health counselor" (105,000) "nurse psychotherapist" (17,000), and everybody's favorite, "life coach" (30,000) did not even exist.

I glean these figures via the Hoover Institution's Policy Review, from "The Rise of the Caring Industry," by Ronald W. Dworkin.* It's an interesting, suggestive piece, with the requisite references to honorable ancestors like Phillip Reiff and Christopher Lasch (although I note the absence of my own favorite antipsychiatrist, the gnarly old Thomas Szasz). Dworkin tries hard to individuate his own views. He stresses, for example, a conviction that we are not all a bunch of self-indulgent narcissists; that we are mostly ordinary people with ordinary kinds of loneliness, doing what we can to find a way out of the labyrinth.

Beyond that it seems to me Dworkin cannot sort out in his own mind the different roles of (a) the decline of the family; and (b) the rise of the (ahem) helping professions. I feel for him there although I think this nostalgia for an older, simpler way can be overdone. I grew up in an almost picture-postcard small town with a stable and attentive family and lots of non-axe-murderer neighbors. Yet I doubt that ever again have been quite so bored and lonely as I was before I got shed of that joint. I'd certainly agree that we need context and contacts but I suspect that one is as likely to find it on the fly--workmates, bartenders, superannuated racetrack greyhounds--as in any received and predetermined structure. Note "as likely," not "more likely;" human contact is, was and remains a tricky business and the idea that it might not always (or even "often") work is not just an artifact of the age of Craigslist.

What has fascinated me more over the years is the growth of what I referred to in the tagline as "the professionalization of friendship." I'm fascinated in two senses: one from the standpoint of the "patient," "client," customer or whatever you choose to call the "recipient" of care. And two, from the standpoint of the "professional." I'm surprised at the number of people who will pay good money for a commodity--advice--that almost anybody in the universe will give them in plenitude for free. And I'm even more impressed by the number of people who look like they aren't capable of getting their garage door open in the morning, yet who are willing to take money from others for telling the others how to run their lives.

This is no pose of Byronic indifference to the world. I cherish my friends, with some of whom I even seem to share some DNA. I cherish all unterrified listeners who will give me the gift (!) of their attention, their sympathetic detachment, sometimes even their flashes of insight. This sort of thing is invaluable but it is not easy come by. And that's the point: it is never easy come by, in the family, on the job, or down at Moe's Tavern; almost never (and then, by sheerest chance) do you get it dropped in your lap. You may get it from a licensed professional but my guess is that if so, it's more good luck than good planning; enjoy it while you can but don't be surprised if it doesn't work any better here than down at Moe's.
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*Not that Ronald Dworkin, this Ronald Dworkin.