Today, discussions about the treatment of mental health problems usually focus on medications and short-term therapies. It is almost as though we have forgotten the matchless healing power of relationships, a power that I can attest to, since I have been on the couch for almost 45 years with the same person.

The long conversation began in the early ’70s, when I was a 19-year-old undergrad at Columbia University. Back then, when the froth of my inner life came to a boil, I had no way of calming myself down and would invariably transform inner theater into street theater. One evening the play took the form of an overdose of Valium, a half-gallon of wine, a street brawl and being clubbed unconscious. Another night, it was something darker. I was on the brink of a transfer from Columbia to Rikers Island.

Now and again, like a somnambulist who finds himself on a ledge, I would be jolted awake to the wisdom of fear and come to my senses about getting help. On one such day, I swaggered over to the university counseling service and signed up to see a therapist.

I was assigned to Beatrice Beebe, who I would come to find was a mere six years older than me and had only to log a certain number of clinic hours in order to take her Ph.D. in clinical psychology. In his Symposium, Plato teaches that erotic desire is the initial pathway to wisdom, perhaps to self-knowledge and a semblance of self-control as well. Beatrice was attractive. After glimpsing her figure, mischievous smile and warm brown eyes, I figured I had hit the jackpot.

I had. Just not in the sense I imagined.

A troubled and troubling kid, I was already a grizzled veteran of the psychiatric establishment. I had been given plenty of Rorschach tests and pills and was used to emotionally remote shrinks with their neatly trimmed beards and squeaky leather shoes. None of them, however, could talk me out of the themes of violence and anger that hypnotized me.

My first meeting with Beatrice took place on a glistening October afternoon. There was no couch, just a couple of chairs in a small cubicle. We sat facing each other. At the time, I dressed like a character from a ’70s crime flick, muscle T and gold necklace. I can only imagine what I blathered about, probably my professional boxing fantasies, raw-edged troubles with my parents, boozing, anxieties about school — it was all monkey-mind stuff. But soon enough I was going through my personal museum. The childhood I described was a confusing cocktail of tenderness and terror. As we talked, Beatrice would lean forward, her elbows on her knees, press a question, perhaps offer a comment, and the conversation would flow along smoothly as oil.

In college, I was so buffeted about by mood that I missed more classes than I attended. But surprisingly, I didn’t blow off many hours with Beatrice, whom I was seeing twice a week. It is a truism to say that those of us who are a little more broken than others are both attracted to and repelled by intimacy. Beatrice was tenacious and beat me to every unconscious exit strategy.

Decades down the line, Dr. Beebe would become one of the world’s authorities on attachment, but even at the outset, it was clear that she had more than a theoretical grasp of the ties that bind. One February day that first year, there had been a cancellation in her schedule and she let our session go on far past its usual hour. Our window looked out over the black tops of apartment buildings. The shadows grew long and lathered the room. For some reason, Beatrice never switched on the light. It was as though there was a connection forming that she did not want to disturb. With great kindness and epiphanic insight, she tendered a story about my inner life that gave me some distance from the mayhem. Still, it was her warmth and consistency as much as her illuminations that were nudging me away from my puppetlike relation to my impulses.

By spring, Beatrice added another session and then sometimes even a fourth. I doubt that her supervisor approved, but she gave me her phone number and invited me to call whenever I was on the razor’s edge. Naturally, I started dialing her up much too frequently. One night, I rang her a few times from a bar and she gently set me straight.

After Beatrice took her doctorate, she could no longer see me at the university clinic. She opened a private practice in New York. I was on my own and could not afford treatment. Of course, Beatrice could have easily passed me off to another doctoral student, but instead she continued seeing me twice weekly gratis.

I eventually managed to control myself enough to graduate and even to begin grad studies in philosophy, but there were always major fires, the smoke from which made it impossible to talk about bedrock issues. There was a disastrous marriage and a divorce. I dropped out of graduate school three times and stumbled from job to job.

At one point, I was hospitalized and plied with meds that purportedly “put a floor” under my depression. Within a few weeks, I was released and went to stay with my brother in Maine. There, I would park for hours, almost catatonic and staring into a space occupied by images of hangings and other suicidal delights. On a hoary winter afternoon, I was sitting on the floor in his cellar and peering over the lip of doom. Teary-eyed, my brother put his hand on my shoulder and asked what I wanted him to do if I chose the rope and beam.

Beatrice was staying in contact with me by phone. Kierkegaard, whom I was dipping into at the time, observed that the despairing individual will often attempt to escape his despair by trying to sink through to the bottom. But hell and despair are bottomless. With endless patience, Beatrice was always telling me, and maybe herself, that it was two steps forward and one step backward.

When I returned to graduate school, in Philadelphia, I commuted to New York for chimney sweeping sessions with Beatrice. Even in the mid-80s, when I enrolled in a doctoral program at the University of Chicago, Beatrice did not let go. Therapy continued via phone with an occasional face to face. My dissertation on Kierkegaard took me to Denmark for three years, and therapy continued on a couch thanks to international long distance.

So it went, our relationship enduring through the hurly-burly of every stage of life: remarriage, unemployment, children, sick and dying parents, life-threatening illnesses and many a meltdown in between.

I have come to think of profound psychological change as akin to the long slow arc of a supertanker shifting direction in mid-ocean. By increments, my relationship to Beatrice changed my relationship to myself. I am not certain of much but I am certain my life would have been otherwise without her, my Freudian bodhisattva.

These days, our conversations are more like the back and forth between old friends than the heavy sessions of long ago. Sometimes we even trade pep talks about entering the gantlet of the not-so-golden years. And yet, when something tips me over, Beatrice is always able to shift gears and bring me back to the couch.

One night not long ago, I was waylaid by a dream that a family member’s cancer had come raging back. I was unable to scream, but with my arm around my wife, I tried to form the words: “Beatrice, help. Save me.” It was the first time that Beatrice had ever bubbled up like that in a nightmare. With her in New York and me in the tundra of Minnesota, where I now live, I called to talk with her about the dream. A virtuoso of self-scarification, I insisted, “The dream is proof that not everyone who dies in their sleep dies peacefully.” Beatrice chuckled and assured: “It was a good dream. Good in the sense that you could allow yourself to call out to me.”

To her mind, it was good that our relationship was that deep and strong. To my mind, too.

Gordon Marino, a professor of philosophy at St. Olaf College, is the editor of “The Quotable Kierkegaard.”

Source: The New York Times