Do Argentines Need Therapy? Pull Up a Couch

BUENOS AIRES -- The cafe, just north of a leafy district affectionately nicknamed Villa Freud, was almost empty. Roberto Álvarez sipped his espresso, furrowed his brow and began ticking off the names of psychologists he had seen over the past decade. He stopped counting only when he noticed that he was running short of fingers.

"Let me tell you something about us Argentines," said Mr. Álvarez, a 51-year-old construction worker, after a tangent on Jacques Lacan, the famous French psychoanalyst who sometimes conducted sessions with patients in taxicabs. "When it comes to choosing a psychologist, we are like women searching for the perfect perfume. We try a bit of this and a bit of that before eventually arriving at the right fit."

Indeed, Argentines often manage a smile upon hearing that psychoanalysis has been on the wane in the United States and other countries, rivaled by treatments that offer shorter-term and often cheaper results than years invested in sessions of soul-searching. Even as Argentines grapple with high inflation and an economic slowdown, many seem to know precisely what they want (at least in one area of their lives): psychoanalysis, and plenty of it.

The number of practicing psychologists in Argentina has been surging, to 196 per 100,000 people last year, according to a study by Modesto Alonso, a psychologist and researcher, from 145 per 100,000 people in 2008. That compares with about 27 psychologists per 100,000 people in the United States, according to the American Psychological Association.

Those numbers make Argentina -- a country still brooding over its economic decline from a century ago -- a world leader, at least when it comes to people's broad willingness to bare their souls.

"There is no taboo here about saying that you see a professional two or three times a week," said Tiziana Fenochietto, 29, a psychiatrist doing her residency at the Torcuato de Alvear Hospital for Psychiatric Emergencies, a public institution. "On the contrary," said Ms. Fenochietto, who has been in therapy herself for the past eight years, "it is chic."

One need not wander far in this city to get a grip on the resilient obsession with neuroses of various stripes. The name Villa Freud is a nod not only to the Austrian founding father of psychoanalysis, but also to the number of psychologists who ply their trade in the buildings along the elegant streets around Plaza Güemes, in northern Buenos Aires.

A short cab ride away, in the theater district along Avenida Corrientes, lines form each night where the local adaptations of two hit plays have opened side by side: "Freud's Last Session," currently an imagined debate between Sigmund Freud and C. S. Lewis, and "Toc Toc," about obsessive-compulsive disorder.

Slip into many bookstores here, and tomes abound written by Argentines about the psychological ills that plague people, and their cures. Malele Penchansky's "Universal History of Hysteria" and Alejandro Dagfal's "Between Paris and Buenos Aires: The Invention of the Psychologist" are among the offerings. A new prizewinning Argentine comic book, "Repairer of Dreams," even blends psychoanalysis into the tale of a dystopian city called Polenia.

Psychoanalysis is not just for Argentina's moneyed classes, with some psychoanalysts in the state medical system offering patients free sessions. And while some private health plans do not pay for psychoanalysis, insurance programs for some unionized workers cover dozens of therapy sessions a year.

"We say no to charity and yes to equal opportunity," said Adriana Abeles, president and founder of the Fields of Psychoanalysis Foundation, which carries out research, trains students of psychoanalysis and provides therapy. When patients cannot afford to pay, they can volunteer in exchange for their sessions, doing jobs like repairing furniture, cooking or painting walls.

The country's growing supply of psychologists also means that consumers have considerable bargaining power. While some of the top analysts here charge the equivalent of hundreds of dollars per session, many work on a sliding scale in accordance with their patients' incomes, offering sessions for as little as $15 an hour.

Despite the continued boom in psychoanalysis, Argentina is not impervious to global treatment trends. Techniques like cognitive behavior therapy, which claim to offer shorter-term results, have gained ground here, and some health insurance plans frown upon the costs involved in drawn-out psychoanalytic counseling. Drug treatments have also made inroads, and some therapists in Argentina have expanded online offerings, turning to technologies like Skype.

But Andrés Raskovsky, president of the Argentine Psychoanalytic Association, recently asserted that psychoanalysis had little risk of extinction in Argentina since seeing a psychologist twice a week is still viewed as being affordable for much of the population.

Theories abound as to why hang-ups, and the professional class that treats them, seem to flourish here.

Martín, the main character in "Sidewalls," a critically acclaimed 2011 romantic comedy about life in the shoe box apartments of Buenos Aires, offers this theory: "Apathy, depression, suicide, neuroses, panic attacks, obesity, fear of heights, muscular tension, insecurity, hypochondria, sedentary behavior -- all are the fault of architects and construction entrepreneurs." (Martín, of course, in a scene worthy of a Woody Allen film, professes to suffer from all of them "except for suicide," and rarely leaves his high-rise building except to attend therapy.)

Others look to Argentina's past for explanations, and not just the sadness bred by the faded glory of a nation that was once wealthier than many European ones.

The country, some say, was long vulnerable to melancholia, or at least an acceptance of sharing those troubles with a patient listener. With its history of immigration, largely from Europe, Argentina has a tradition of drawing inspiration from European intellectual trends, including the rise of Freudian psychology a century ago. Spanish immigrants who sought opportunities away from the fascist rule of Francisco Franco were pivotal in establishing psychoanalysis in the 1940s as a respected profession in Argentina. Nowadays, some of the top psychoanalysts here are Jewish, most of them descendants of European Jews.

Others have sought to tie the appeal of psychoanalysis to the nation's music, like the tango, which can plumb decidedly dark themes. (There is even something here called "psychotango," which explores the use of psychoanalytic thinking and dance as a tool for "self-transformation.")

But Mariano Ben Plotkin, author of "Freud in the Pampas," a book about the emergence of psychoanalysis in Argentina, said the reasons were much more complex. "Sure, we have the tango, but the Portuguese have the fado," said Mr. Plotkin, referring to the mournful music of Portugal, a country with fewer psychologists per capita.

Instead, Mr. Plotkin, whose own parents sent him to a psychoanalyst several times a week when he was a child, attributes the rise of psychoanalysis in Argentina partly to its reception by a large, relatively well-educated middle class in the 1960s.

Despite the rise of rival treatments, Mr. Plotkin said he remained sanguine about what he called the "hegemonic" position of psychoanalysis in Argentina's psychological community. After all, ordinary Argentines readily employ psychological terms that in other countries would be the preserve of psychology majors, and can hold forth on the difference of Freudian and Jungian methods.

Respect for psychoanalysis extends to other realms as well. It is embedded in various state institutions; parents of children at public schools, upon being asked to attend meetings regarding their child's behavior, for instance, are sometimes surprised to learn that one of first discussions is with a psychoanalyst employed by the school system.

And in a sign of its wide acceptance, President Cristina Fernández de Kirchner and her cabinet chief took time out in April to meet with leaders of the World Psychoanalysis Association, which was convening then in Buenos Aires.

Opening a newspaper or cultural supplement here often feels like leafing through decades-old editions of The New Yorker, when cartoons were drenched in psychoanalytic jargon.

Diego Sehinkman, a psychologist who writes a weekly column for the newspaper La Nación in which he describes imaginary therapy sessions with politicians across the spectrum, said: "We are fascinated in Argentina with peering into the suffering of people in power. Especially those who have made us suffer a bit."

Emily Schmall contributed reporting.

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