In 1959 – 1960, Marilyn was in and out of psychiatric clinics seeking treatment for her diagnosis of borderline personality disorder. Marilyn was also being treated for her severe addiction to barbiturates and alcohol, which she used to escape the severe emotional pain she suffered and to help with her insomnia. During that time, she began to develop a professional relationship with a new psychiatrist named Dr. Ralph Greenson. It would prove to be a rather unusual relationship built on dependency and uncommon medical practices. He was a fine man, strictly interested in Marilyn as a client and one whom he tried desperately to help but ultimately failed. Perhaps that was due to his use of psychoanalysis with his famous client rather than psychotherapy or cognitive behaviour modification or so many other forms of counselling he could have used that may have been more useful to Marilyn. I am no counselling or psychiatric expert but a general, superficial perspective on various therapies allowing for drawbacks of each type, on various can be loosely applied to Marilyn’s history.
Coognitive Behaviour Modification
CBM seems like a very plausible form of therapy for Marilyn. CBM involves analyzing one’s negative behaviour and working to change these behaviours into positives. For instance, Marilyn’s legendary lateness would be a very good behaviour to improve with the help of her doctor. She might have analyzed it in such a manner as to identify why she was continually late, then worked to reduce the number of incidents this occurred. The same would apply to her absenteeism although Greenson wouldn’t overwhelm the actress by working at both negatives at once. Beginning with her late arrivals might have been a sensible move. In that manner and not only would Marilyn have been more compatible to work with but she would have found herself more functional, which is the ultimate goal of CBT.
One positive that came from psychoanalysis was talk therapy. Freud believed allowing his clients to simply talk and relay to him the issues that they suffered in their lives was brilliant, I’ll give him that. He, however, abused this privileged since he was so-called “man for his times” (misogynist). Talking to Greenson about both positive and negative developments in her life may have been of great value to Marilyn. Consider some valid discussions that she and Greenson probably had:
- A plus for Marilyn was the clause in her contract with Fox that gave her permission to work with the directors of her choice. This was a turning point in her career and one that did indeed help instill her with confidence. This may have been an idea of Greenson’s.
- Marilyn proved she could act very well as a dramatic actress, a skill she could use as she aged.
- Greenson likely believed Marilyn’s claim that she was sexually abused. By the 1960s this was much more plausible than the 1920s. Supporting her experience could have allowed for her to analyze them without accepting responsibility and placing the blame squarely where it belonged: on the perpetrator.
- The avoidance of the Strasbergs and Method Acting. There are so many reasons for Marilyn to have escaped the clutches of Paula Strasberg that they won’t be listed here. I have detailed these facts in other blogs and in particular The Prince and the Showgirl.
- .Acknowledgement of Marilyn’s pain in not identifying her father.
- Her placement in an orphanage and the trauma it caused her as a child.
There are many more issues in this woman’s life that could have been sorted through with psychotherapy, rather than psychoanalysis. Let’s hope this was a technique of Greenson’s. However one technique that was questionable was including Marilyn personally in his family. Greenson crossed the line when he took Marilyn into his personal life. Marilyn had struggled with the concept of not having family but a pseudo-family and especially that of her therapist was obviously not a technique that helped her. In addition Marilyn’s growing reliance upon Greenson with daily visits for months of her life before her death was obviously a negative. The point of therapy is to become more independent, not less so.
It wasn’t enough to simply acknowledge Marilyn’s childhood trauma. There is a specific counselling known as Trauma Therapy whereby a client is treated while the emotions that surface as counselling continues or from incidents that happen to the client. This therapy usually involves medication that is used for the moment of trauma only. Counselling is intensive and doesn’t involve the analysis of previous, distant memories.An exmaple of this counselling would be to tell the client what he or she is feeling and why,then to detail how that person will handle it. A support network of reliable friends would be set up before trauma counselling is put in place and the client would contact various people from this network for their assistance. Failing that the client is told to go to the ER of the closest hospital and seek help from the trauma ward.
Often group therapy is of comfort to the client because it is a chance to relate to other people who experience similar emotional issues. Knowing that there are people who suffer and seek help can be therapeutic. For instance, the group may help one another to make solutions for current difficult issues. Sometimes the group partakes in brief meditation, seeking relaxation and freedom of stress.
This is an expressive therapy that uses an individual’s relationship to the content of books and poetry and other written words. Bibliotherapy is often combined with writing therapy It has been shown to be effective in the treatment of depression. These results have been shown to be long-lasting. Biblio (meaning libary) therapy would be especially applicable to Marilyn as she frequently wrote poetry as a form of self-expression. She was also an avid reader and had an extensive library.From a psychodynamic perspective, fictional materials are believed to be effective through the processes of identification, catharsis and insight.Through identification with a character in the story the reader gains an alternative position from which to view their own issues.
Using music experiences such as free improvisation, singing, and listening to, discussing, and moving to music to achieve treatment goals. Music is currently being studied as a form of painkiller.Referrals to music therapy services may be made by other health care professionals such as physicians, psychologists, physical therapists. Music therapists may work with individuals who have behavioral-emotional disorders.One therapy model based on neuroscience, called “neurological music therapy” (NMT), is “based on a neuroscience model of music perception. Marilyn’s participation in music and dance would have made this therapy particularly applicable to the actress.
(Written dramatherapy in the UK) also known as expressive therapy) It exists in many forms and can be applicable to individuals, couples, families, and various groups It is the use of theatre techniques to facilitate personal growth and promote mental health. Dramatherapy is used in a wide variety of settings, including hospitals, schools, mental health centers, prisons and businesses. Nine core processes at the heart of drama therapy including projective identification and dramatic distancing. Projective identification is the process where a person feels the feelings that the other is unable to access themselves. Dramatic distancing refers to the way that emotional and psychological problems can be accessed more easily.Being an actress in both serious drama and comical farce would have allowed Marilyn a variety of uses in dramatherapy.
If ever there was a form of therapy that would have been of use to Marilyn feminist therapy has to be it. Feminist therapy is a set of related therapies arising from what proponents see as a disparity between the origin of most psychological theories and the majority of people seeking counseling being female. It focuses on societal, cultural, and political causes and solutions to issues faced in the counseling process. It openly encourages the client to participate in the world in a more social and political way. Marilyn was a feminist in spite of the fly-away dress and her image as a sex symbol although she may not have recognized it in herself. Her refusal to abandon her career and be dominated by a male patriarchy in her personal and professional life are a testament to her strength as both a woman and a scholar. Physical and sexual abuse is an important focus of feminist therapy.
Play therapy is generally employed with children aged 3 through 11 and provides a way for them to express their experiences and feelings through a natural, self-guided, self-healing process. As children’s experiences and knowledge are often communicated through play, it becomes an important vehicle for them to know and accept themselves and others. Marilyn missed a childhood due to so many traumatic episodes in her early life. Play therapy would have offered her the means to experience a childhood as she should have: a child.
There are so many legitimate, helpful forms of therapy that could have benefited Marilyn far more than psychoanalysis that it is a shame she wasn’t offered any of these alternatives. It may be that some of these techniques weren’t proven as particularly helpful in the 1950s and 1960s. or it may be that Greenson felt they would be of no use to his client. Either way Marilyn may have found far more progress in alternative therapy than she ever did in psychoanalysis.