The date was August 26th, 1910. The place, Leyden, Holland — better known as the “City of Discoveries” owing to its long scientific heritage.
The people present were two giants of Viennese society, composer Gustav Mahler and psychoanalyst, Dr. Sigmund Freud.
By the time of their meeting, the method Freud had pioneered for the alleviation of mental and emotional distress was well-established. Its form was influencing clinicians around the world, best represented by the presence of a couch, free association, and years of contact carried out in frequent, but strict 50-minute “sessions.”
Mahler telegraphed Freud from Munich multiple times requesting help. The situation was dire. Mahler was “impotent,” and his wife, 19 years his junior, was deeply unhappy.
Much of what happened next is lost to history. What is known for certain is that Mahler did travel to Leyden and met with Freud, and that the composer’s sexual functioning was restored following this single meeting.
Bottom line? A great deal of good could be accomplished in a brief period of time and outside of traditional psychotherapy settings. Indeed, Freud did not meet with Mahler in an office. No couch was involved nor sacrosanct time limit. Rather, the two talked while, “strolling about the town—the stocky, confident doctor and the thin, intense composer— smoking the cigars both adored” (Sorel, 1982).
I was reminded of the foregoing story while interviewing Dr. Ed Jones for my blog and YouTube channel. Ed is a psychologist and consultant with an uncanny ability to “see around corners.” Over the years, I’ve learned to pay attention whenever he talks about trends in mental healthcare service delivery. And lately, he’s been focused on the “50-minute hour.”
“Multiple developments — including the rapid increase in the use of digital technology during the pandemic, and integration of behavioral and medical care — are challenging mental health professionals to think and act differently,” he says, then continues, “Instead of relatively circumscribed treatments episodes, delivered across multiple sessions lasting 50 minutes, therapists will need to be helpful on an ongoing, but likely intermittent basis over the course of people’s lives in interactions lasting a handful of minutes.”
Importantly, Ed does not see this development as the end of something, but rather an opportunity to expand the field’s ability to meet with, engage, and help more people in need. Let me know what you think in the comment section below.
Until next time,
Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence