My Psychoanalytic Journey

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  sychotherapy “The essence of psychodynamic therapy is exploring those aspects of self that are not fully known, especially as they are manifested and potentially influenced in the ther-apy relationship.” Psychodynamic techniques contain the following distinctive features. (1) Focus on affect and expression of emotion.  Psychodynamic therapists recognize that “intellectual insight is not the same as emotional insight, which resonates at a deep level and leads to change (this is one reason why many intelligent and psychologi-cally minded people can explain the reasons for their dif-ficulties, yet their understanding does not help them overcome those difficulties).” (2) Exploration of attempts to avoid distressing thoughts and feelings.  Psychodynamic therapists explore the many things people do, “knowingly and unknowingly, to avoid aspects of experience that are troubling.” (3) Identification of recurring patterns and themes.  “Psychodynamic therapists work to identify and explore recu

Patient Surveys.  In the 1990s Consumer Reports surveyed 4,000 psychotherapy patients. The report found that most respondents were satisfied with the therapy they received and had “made strides toward resolving the problems that led to treatment.” The report also found that effective therapy took time. “Meaningful change began at about the six-month mark, and clients who stayed in therapy for a year did substantially better.” Psychotherapist Surveys.  Drew Weston (Emory University) surveyed 270 psychotherapists who had been in practice an average of 18 years, and his findings were similar to those of Consumer Reports. When asked when they first saw clinically significant reductions in the patients’ primary symptoms, the therapists provided a median number ranging between 16 and 20. When asked when both “patient and therapist agreed that the outcome was reasonably successful,” they gave a median answer of 52 sessions for patients with panic disorder and 75 sessions for patients with dep

Primitive Emotional Development (1945) Introduction Different analyses for different patients. Different patients require different types of psychoanalysis. For Oedipal patients, the analysis can focus on their relationships to people as well as their fantasies about those relationships. For depressive patients, the analysis must also focus on their fantasies about themselves. It is possible to do analysis with pre-depressive patients. Different transferences for different patients. We use the same analytic techniques with all three types of patients, but we must realize that the transference of Oedipal patients will be different than the transference of depressive and pre-depressive patients. The Oedipal patient believes his analyst’s work is performed out of love for the patient. The depressive patient believes and needs the analyst to understand that he believes that the analyst’s work is performed in an attempt “to cope with his own (the analyst’s) depression” (or the guilt and gri

I’m lying on Laura’s couch, my eyes closed, hands resting on my stomach. I share a dream I had the previous evening. “I’m in the church that Jenn and I got married in,” I begin. “I'm looking at the church altar, and I have this thought: Because my dad refused to go to my wedding, it follows that he’s never going to call me again. And that’s it. That’s my dream.” “It’s weird,” I continue. “I often wonder whether I’m going to ever talk to my dad again. Jenn thinks he could go several years without calling me. But the dream is wrong. My dad did go to my wedding.” Laura doesn’t say anything. Because Laura usually doesn’t say anything. And so I proceed to talk about my dream the way Freud taught his patients to talk about dreams, taking each part of the dream and sharing what associations come to mind when I think of that part. I start with the thought I had about my dad in the dream, and this leads to some memories about my engagement. “My entire engagement was kind of awful. My dad wa

Self and Object There are three main psychoanalytic traditions: ego psychology, relational analysis, and object relations.  Ego Psychology Psychoanalysis originally held that our actions are determined by our drives or biological urges. To be more precise, every action is ultimately (1) an attempt to reduce the tension caused by a drive or (2) a defense meant to repress a drive. (Our unconscious might try to repress drives to prevent us from experiencing guilt or anxiety.) However, this claim has been contradicted by both research and clinical evidence. (1) Harlow’s experiments revealed that young monkeys prefer “a cloth mother-model" that does not provide food to a wire monkey model that does; put differently, they prefer the mother-model that does not provide tension reduction to the mother-model that does. (2) John Bowlby found that children form attachments to figures who do not meet their biological needs. (3) Ronald Fairbairn wrote that children often form strong attachments