The Perilous Month

"New York is full of people who are crazy till Labor Day," complained Woody Allen in the movie Play It Again, Sam. Allen was one of them. "If I only knew where my damn analyst was," he wailed. "Where do they go every August?" The answer, of course, is that they go on vacation. Some psychiatrists say they choose August because Freud did, though others debunk that notion as too Freudian. "An August vacation," explains Dr. William Frosch, a Manhattan psychiatrist, "is built into your training from the start. Your analyst took August and so you start doing so yourself."

Psychiatrists are also trained to give their patients plenty of advance notice of their departure. "If a patient falls apart when his doctor is away, the physician is not practicing psychiatry. He is instead a babysitter," says Dr. Jules Masserman of Chicago. "We strive to make patients self-sufficient." Some doctors arrange to have their practices covered or leave their phone numbers for emergencies. "Woody Allen is wrong," says Boston's Dr. Henry Friedman. "Everyone doesn't just depart and leave a group of neurotics marching around the city."

The doctor's absence may actually be therapeutic for the patient if he is coached to take advantage of it. According to a study of vacations made by Detroit's Dr. Alexander Grinstein, "The ego utilizes periods away from analysis to consolidate, assimilate or synthesize the insights that have been made."

Still, many patients feel resentful the minute their therapist leaves town. Explains Dr. Jacob Swartz of Boston: "It has to do with the mythology of the godlike physician, the fantasy that doctors are monklike hairshirt types who never need a vacation." Moreover, because a patient tends to establish a close parent-child relationship with his psychiatrist, he feels abandoned during his absence. Vacationing on Cape Cod last August, Manhattan Psychoanalyst David Mann received several phone calls from patients who had read about the novel Jaws. "They asked if I have been eaten by a shark. What they really wanted to know was whether I was coming back for their therapy sessions."

Fantasy Father. Some patients hope to punish their absent therapists by performing impulsive, even dangerous acts. Suicide attempts or threats are not uncommon. People under treatment for psychosomatic illnesses like asthma or ulcerative colitis have experienced violent flare-ups of their diseases while their psychiatrists were away. Swartz recalls that one debt-ridden patient suddenly took out a loan for a new Mercedes.

Other patients have rushed to the altar, returned to heavy drinking or started gambling wildly. One Manhattan analyst recalls that over the years, three of his patients have unexpectedly become pregnant in August. Admits the doctor: "I am the fantasy father of all three."

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