That Was Then, This Is Now, Shedler (2022)
Jonathan Shedler, That Was Then, This Is Now: Psychoanalytic Psychotherapy for the Rest of Us, Contemporary Psychoanalysis, 58:2-3, 405-437.
Psychoanalysis consists of the following ideas.
(1) Unconscious Mental Life. “We do not fully know our hearts and minds, and many important things take place outside awareness.” This belief is supported by cognitive science; see Joel Weinberg and Valentina Stoycheva, The Unconscious: Theory, Research, and Clinical Implications.
(2) The Mind in Conflict. We “can be of two (or more) minds about things. We can have loving feelings and hateful feelings toward the same person, we can desire something and also fear it, and we can desire things that are mutually contradictory.” “The terms ambivalence and conflict refer to inner contradiction.” An example of conflict: a desire for closeness and a fear of dependency.
(3) The Past Lives on in the Present. “Through our earliest experiences, we learn certain templates or scripts about how the world works (a cognitive therapist would call them schemas). We learn, for example, what to expect of others, how to behave in relationships, how to elicit caring and attention, how to act when someone is angry with us, how to express ourselves when we are angry, how to make people proud of us,” and so on.
(4) Transference. “A person starting therapy is entering an unfamiliar situation and a new relationship and necessarily applies their previously formed tem-plates, scripts, or schemas to organize their perceptions of this new person—the therapist—and make sense of the new situation. There is no alternative other than to view this new relationship through the lens of past relationships; it is not a matter of choice.”
(5) Defense. Not only do we not fully know our minds, “but there are things we seem not to want to know.” “Anything a person does that serves to distract their attention from something unsettling or dissonant can be said to serve a defensive function.” Herbert Schlesinger “described defense in the context of systems theory,” as both biological and psychological systems regulate themselves to maintain equilibrium or homeostasis.” Shedler feels that the term repression is unhelpful and prefers instead disavow. The dictionary defines disavow as “to disclaim knowledge of, responsibility for, or association with; disown; repudiate.” It’s common for people to disavow aspects of their experience.
(6) Psychological Causation. Although symptoms might seem random, senseless, and uncaused, they in fact “have meaning, serve a psychological purpose, and occur in a psychological context in which they are understandable.” “Psychoanalytic therapy helps us recognize the connections that exist between thoughts, feelings, actions, and events.”
To explain this point, Shedler next explains our mental associative networks. Psychological symptoms, he writes, “are embedded in organized networks of thoughts, feelings, perceptions, and memories that contextualize them and give them meaning. This applies not only to symptoms but to all mental events. It is a working assumption of psychoanalysis that nothing in the life of the mind is random. The mind is an elaborate associative network, with mental events linked to one another in meaningful, albeit complex, ways. Within certain broad parameters, all mental activity follows the logic of the associative network, whether or not the connecting links are explicit or conscious. This applies not only to thoughts, feelings, and memories, but also to dreams, daydreams, mistakes, and slips of the tongue (the infamous “Freudian slip”). It is possible to start with any seemingly random mental event and trace the multiple associa-tions linked to it. Often, the event makes sense when the larger asso-ciative network becomes explicit.
“An analogy to an associative network is the internet, where web pages are linked in intricately interconnected networks (Peebles-Kleiger, 2002). We can go to a web page, follow a link to another page, and then another and another. Within a few clicks we can get far indeed from our starting point. We could start on a page about glo-bal warming and end up, a few clicks away, on a page about Shakespeareansonnets.Somebodywholookedatourcomputer screen at that moment might never guess how we got there. If we wanted, however, we could re-trace the sequence of links that brought us from where we started to where we ended, and we could explain why we followed those links.
“Missing from the internet analogy is the role of affect. Unlike the web, where links are based mostly on content, mental associative networks are organized along affective lines. That is, things are connected that bring up similar feelings. Associative pathways tend to lead to what is emotionally charged or problematic. This has profound implications for therapeutic technique: if we allow ourselves to observe our thoughts without editing or censoring them and follow them where they lead, they often lead to what is troubling.
“Contemporary research in cognitive science and neuroscience is based on the concept of mind as associative network and cognitive researchers have developed experimental methods to study associative linkages (for example, priming and reaction time experiments). Interestingly, the concept of associative pathways has always been central to psychoanalytic theory and practice. Freud was a master at tracing associative links to discover psychological meanings, untangling associative connections with a detective’s precision. His thinking is most accessible and compelling in his 1904 monograph, The Psychopathology of Everyday Life, which I recommend to all students and therapists. Certainly, there were instances where Freud was carried away by his own cleverness and guilty of reading questionable meanings into patients’ associations. Those with an agenda to criticize will find ample ammunition in Freud’s writings, but they would miss the point.
“To help trace associative linkages, we ask our patients to say whatever comes to mind without editing or censoring their thoughts, encouraging them to observe their thoughts non-judgmentally (as in some forms of Buddhist meditation), without regard for whether or not the thoughts make sense or seem socially appropriate. This is called free association. Its purpose is to help make explicit associative linkages that are otherwise implicit. Every psychoanalytic therapist has a collection of phrases aimed at encouraging the free flow of thought and communication. We are constantly saying things like, ‘Can you say more about that?’ and ‘What comes to mind?’ and ‘What else occurs to you?’ and ‘Where do your thoughts go from there?’ and sometimes just ‘go on’ and ‘uh huh.’
Shedler provides an example of a patient’s “random” slip of the tongue that “ran directly to what was most emotionally charged for him at that moment.” He continues: To the reader who thinks this example sounds implausible, con-trived, or biased by theoretical preconceptions, I say: try it. Next time you make a mistake, a slip of the tongue, or forget a word or a name, try free associating and follow your thoughts where they lead. It helps to write your thoughts down. At the point when you feel you are done and want to stop, ask yourself what comes to mind next. And after that, ask yourself what comes to mind next. Force yourself to push past the inner resistance you will encounter (e.g., ‘this exercise is stupid,’ ‘this is boring,’ ‘my thoughts aren’t leading anywhere’) and follow the chain of associations where it leads. Humor me if need be, but try it. You will never see the data if you are unwilling to conduct the experiment.”
(7) What’s Good for the Goose. Shedler concludes his paper by emphasizing the necessity of psychoanalysts going to therapy themselves, an experience that “may be the most important component” of our training. “There is nothing like the experience of being a patient to foster empathy for our patients and help us understand the powerful and often irrational feel-ings psychotherapy can stir up. We cannot truly understand transfer-ence or resistance by reading about it in a book or observing it in someone else. We must experience it firsthand. Nor is it sufficient to enter psychotherapy or psychoanalysis for “professional development” alone. We must enter it, like our patients, as suffering human beings.”
Moreover, “the more we understand of our own conflicts and relation-ship templates, the better we can resist reenacting them with our patients. Personal psychotherapy or psychoanalysis does not guarantee we will succeed in this but at least it can give us a fighting chance. Too often, I have seen therapists recreate their personal pathology with patients. Therapists with histories of abuse who have not worked through their experience in personal therapy tend to be quick to declare their own patients to be victims, defining their experience for them instead of help-ing them to explore it for themselves. Therapists who have unresolved issues with the other gender may be quick to join patients in blaming, rather than helping them to better understand their own intimacy needs and the psychological obstacles to fulfilling them. Therapists who struggle with self-esteem difficulties may subtly demean their patients or offer shal-low ‘affirmations’ (like the kind caricatured by Stewart Smalley in old Saturday Night Live episodes), rather than offering them an opportunity to explore and rework their attitudes in ways congruent with their own personal history and lived experience.”
Additionally, “meaningful personal psychotherapy engenders faith in the therapeutic process, and we require a great deal of faith when we find ourselves adrift in therapeutic seas.” He quotes Nancy McWilliams: “The experience of an effective personal therapy or analysis leaves us with a deep respect for the power of the process and the efficacy of treatment. We know that psychotherapy works. Our silent appreciation of the discipline can convey that conviction to clients, for whom a sense of hope is a critical part of their recovery from emotional suffering.”
Psychoanalysis consists of the following ideas.
(1) Unconscious Mental Life. “We do not fully know our hearts and minds, and many important things take place outside awareness.” This belief is supported by cognitive science; see Joel Weinberg and Valentina Stoycheva, The Unconscious: Theory, Research, and Clinical Implications.
(2) The Mind in Conflict. We “can be of two (or more) minds about things. We can have loving feelings and hateful feelings toward the same person, we can desire something and also fear it, and we can desire things that are mutually contradictory.” “The terms ambivalence and conflict refer to inner contradiction.” An example of conflict: a desire for closeness and a fear of dependency.
(3) The Past Lives on in the Present. “Through our earliest experiences, we learn certain templates or scripts about how the world works (a cognitive therapist would call them schemas). We learn, for example, what to expect of others, how to behave in relationships, how to elicit caring and attention, how to act when someone is angry with us, how to express ourselves when we are angry, how to make people proud of us,” and so on.
(4) Transference. “A person starting therapy is entering an unfamiliar situation and a new relationship and necessarily applies their previously formed tem-plates, scripts, or schemas to organize their perceptions of this new person—the therapist—and make sense of the new situation. There is no alternative other than to view this new relationship through the lens of past relationships; it is not a matter of choice.”
(5) Defense. Not only do we not fully know our minds, “but there are things we seem not to want to know.” “Anything a person does that serves to distract their attention from something unsettling or dissonant can be said to serve a defensive function.” Herbert Schlesinger “described defense in the context of systems theory,” as both biological and psychological systems regulate themselves to maintain equilibrium or homeostasis.” Shedler feels that the term repression is unhelpful and prefers instead disavow. The dictionary defines disavow as “to disclaim knowledge of, responsibility for, or association with; disown; repudiate.” It’s common for people to disavow aspects of their experience.
(6) Psychological Causation. Although symptoms might seem random, senseless, and uncaused, they in fact “have meaning, serve a psychological purpose, and occur in a psychological context in which they are understandable.” “Psychoanalytic therapy helps us recognize the connections that exist between thoughts, feelings, actions, and events.”
To explain this point, Shedler next explains our mental associative networks. Psychological symptoms, he writes, “are embedded in organized networks of thoughts, feelings, perceptions, and memories that contextualize them and give them meaning. This applies not only to symptoms but to all mental events. It is a working assumption of psychoanalysis that nothing in the life of the mind is random. The mind is an elaborate associative network, with mental events linked to one another in meaningful, albeit complex, ways. Within certain broad parameters, all mental activity follows the logic of the associative network, whether or not the connecting links are explicit or conscious. This applies not only to thoughts, feelings, and memories, but also to dreams, daydreams, mistakes, and slips of the tongue (the infamous “Freudian slip”). It is possible to start with any seemingly random mental event and trace the multiple associa-tions linked to it. Often, the event makes sense when the larger asso-ciative network becomes explicit.
“An analogy to an associative network is the internet, where web pages are linked in intricately interconnected networks (Peebles-Kleiger, 2002). We can go to a web page, follow a link to another page, and then another and another. Within a few clicks we can get far indeed from our starting point. We could start on a page about glo-bal warming and end up, a few clicks away, on a page about Shakespeareansonnets.Somebodywholookedatourcomputer screen at that moment might never guess how we got there. If we wanted, however, we could re-trace the sequence of links that brought us from where we started to where we ended, and we could explain why we followed those links.
“Missing from the internet analogy is the role of affect. Unlike the web, where links are based mostly on content, mental associative networks are organized along affective lines. That is, things are connected that bring up similar feelings. Associative pathways tend to lead to what is emotionally charged or problematic. This has profound implications for therapeutic technique: if we allow ourselves to observe our thoughts without editing or censoring them and follow them where they lead, they often lead to what is troubling.
“Contemporary research in cognitive science and neuroscience is based on the concept of mind as associative network and cognitive researchers have developed experimental methods to study associative linkages (for example, priming and reaction time experiments). Interestingly, the concept of associative pathways has always been central to psychoanalytic theory and practice. Freud was a master at tracing associative links to discover psychological meanings, untangling associative connections with a detective’s precision. His thinking is most accessible and compelling in his 1904 monograph, The Psychopathology of Everyday Life, which I recommend to all students and therapists. Certainly, there were instances where Freud was carried away by his own cleverness and guilty of reading questionable meanings into patients’ associations. Those with an agenda to criticize will find ample ammunition in Freud’s writings, but they would miss the point.
“To help trace associative linkages, we ask our patients to say whatever comes to mind without editing or censoring their thoughts, encouraging them to observe their thoughts non-judgmentally (as in some forms of Buddhist meditation), without regard for whether or not the thoughts make sense or seem socially appropriate. This is called free association. Its purpose is to help make explicit associative linkages that are otherwise implicit. Every psychoanalytic therapist has a collection of phrases aimed at encouraging the free flow of thought and communication. We are constantly saying things like, ‘Can you say more about that?’ and ‘What comes to mind?’ and ‘What else occurs to you?’ and ‘Where do your thoughts go from there?’ and sometimes just ‘go on’ and ‘uh huh.’
“In everyday social conversation, we automatically edit and censor our thoughts. We try to stay on topic, structure our thoughts to make coherent sentences, and edit out things that may embarrass or offend. Free association means suspending the usual editing and censoring and it often leads us places we could not have anticipated. Free association is therefore especially difficult for people who like to feel composed, collected, and in control. When patients describe therapy as ‘venting’ or liken it to conversing with a friend (descriptions that have always struck me as deeply devaluing of psychotherapy), it is a sure sign they are not involved in a meaningful therapeutic process. No one who has engaged in genuine free association would ever liken therapy to ordinary conversation. Psychoanalytic therapy takes place at the edge, on the precipice of the abyss, at the border between the known and the unknown. There is nothing ordinary about it.”
Shedler provides an example of a patient’s “random” slip of the tongue that “ran directly to what was most emotionally charged for him at that moment.” He continues: To the reader who thinks this example sounds implausible, con-trived, or biased by theoretical preconceptions, I say: try it. Next time you make a mistake, a slip of the tongue, or forget a word or a name, try free associating and follow your thoughts where they lead. It helps to write your thoughts down. At the point when you feel you are done and want to stop, ask yourself what comes to mind next. And after that, ask yourself what comes to mind next. Force yourself to push past the inner resistance you will encounter (e.g., ‘this exercise is stupid,’ ‘this is boring,’ ‘my thoughts aren’t leading anywhere’) and follow the chain of associations where it leads. Humor me if need be, but try it. You will never see the data if you are unwilling to conduct the experiment.”
The “non-randomness of mental processes” is referred to as psychic determinism. “The term refers to the recognition that thoughts, feelings, behavior, and symptoms are not random or accidental, but are influenced or determined by the mental events preceding them.” Shedler prefers the term psychic continuity, as it “reminds us there is continuity from one thought to the next, and thoughts and feelings are chained in meaningful associative sequences even when they seem unrelated or discontinuous.”
The term overdetermination refers to the fact that symptoms and behaviros have multiple causes. The term multiple function refers to the fact that symptoms and behaviors “can serve multiple purposes.”
(7) What’s Good for the Goose. Shedler concludes his paper by emphasizing the necessity of psychoanalysts going to therapy themselves, an experience that “may be the most important component” of our training. “There is nothing like the experience of being a patient to foster empathy for our patients and help us understand the powerful and often irrational feel-ings psychotherapy can stir up. We cannot truly understand transfer-ence or resistance by reading about it in a book or observing it in someone else. We must experience it firsthand. Nor is it sufficient to enter psychotherapy or psychoanalysis for “professional development” alone. We must enter it, like our patients, as suffering human beings.”
Moreover, “the more we understand of our own conflicts and relation-ship templates, the better we can resist reenacting them with our patients. Personal psychotherapy or psychoanalysis does not guarantee we will succeed in this but at least it can give us a fighting chance. Too often, I have seen therapists recreate their personal pathology with patients. Therapists with histories of abuse who have not worked through their experience in personal therapy tend to be quick to declare their own patients to be victims, defining their experience for them instead of help-ing them to explore it for themselves. Therapists who have unresolved issues with the other gender may be quick to join patients in blaming, rather than helping them to better understand their own intimacy needs and the psychological obstacles to fulfilling them. Therapists who struggle with self-esteem difficulties may subtly demean their patients or offer shal-low ‘affirmations’ (like the kind caricatured by Stewart Smalley in old Saturday Night Live episodes), rather than offering them an opportunity to explore and rework their attitudes in ways congruent with their own personal history and lived experience.”
Additionally, “meaningful personal psychotherapy engenders faith in the therapeutic process, and we require a great deal of faith when we find ourselves adrift in therapeutic seas.” He quotes Nancy McWilliams: “The experience of an effective personal therapy or analysis leaves us with a deep respect for the power of the process and the efficacy of treatment. We know that psychotherapy works. Our silent appreciation of the discipline can convey that conviction to clients, for whom a sense of hope is a critical part of their recovery from emotional suffering.”
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