Individual Psychoanalytic Psychotherapy
Often difficulties that compel us to seek individual psychotherapy may be found to recur over and over in our lives, like the same lousy relationships and the same old problems or fears that never go away. The ego has learned to adapt over time to defend against these continuing destabilizing factors. But in psychoanalytic psychotherapy we “drop below the surface” of our current problems, to examine our earliest memories and emotional conflicts that are mirrored in the present circumstances. In the safety of the therapeutic setting we may find, for example, the roots of our earliest mistrust of others, or our fear of depending upon anyone, or our tendencies to love people who always go away. These recurrences may suggest the presence of something other—something utterly unconscious that may be acting autonomously to our conscious will and intentions, compelling us to repeat the same old behaviors. This indicates the strange feeling shared by many people seeking psychotherapy--the feeling of being divided in ourselves and disconnected from life.
The root of the word individual stems from the notion of indivisibility - that which cannot be divided. Over time, the work of individual psychoanalytic psychotherapy may help at mending our emotional wounds that cut us off from the deeper dimensions of the psyche, thus bridging the unconscious core of our being with conscious awareness. This cohesive process may assist in maturation, the development of will, and self acceptance. These are all essential qualities needed to bear the difficult changes in life: for instance, learning to set boundaries with those who don’t respect our right to sovereignty; awakening our capacity to love; and surrendering ourselves to being loved. It may bring into focus the problem of balance between such contrary ideas as intimacy and individuality in relationship, in all their complexities. In the process we might discover our own creative voices, and a sense of value and meaning to our lives.
In my work as a couples therapist I find that both psychoanalytic psychotherapy and counseling that centers on listening and communication skills are useful approaches when used in combination.
Psychoanalytic psychotherapy for couples. In working with couples in a psychotherapy modality I utilize the same methods and orientation listed in the previous section. The only difference is, instead of working on an individual basis, both people are present while one, then the another, shares their intimate life experiences. In sharing and witnessing their partner's revelations, even couples who have been together for decades learn things about one another that they had never known before. Somehow, when a third party is in the room, for example, a partner who has always been accused of "never expressing his feelings," may feel safe enough to bring up memories that he has buried for a lifetime. The emotional opening that often follows can create a level of compassion and intimacy between the two that neither the spouse nor the husband have ever experienced before.
Listening and communication skills couples counseling. I am frequently asked to explain the difference between ‘psychoanalytic psychotherapy’ and ‘counseling.’ Unfortunately, you will receive a different answer from every professional that you ask this question to. But for me, counseling looks for solutions to practical problems. With couples these problems often are rooted in communication. There are endless conflicts arising from what we mean to say verses what our words actually say, and how the one listening interprets those words. Each individual is born into a family with it’s own unique ways of communicating: some families like to argue and debate, others would never raise their voices and are therefore more quiet and reserved, while other families may have lived with a tyrannical parent who would rage and terrify their children into silent submission, etc. Take for instance a girl who grows up in one of these different family systems, leaves home and gets married. She may assume to know the negative intent behind her partner’s tone of voice, gestures, emotions, and uses of words. However her assumption is usually not based on the partner's own explanation of his words or behavior, but rather upon her learned responses to similar cues from her original family of origin that were painful to her or negative. While this interpretation may not be at all what the partner had intended, the couple is soon trapped in a deadly loop that is brought about by completely unconscious factors. There are times I think it’s a miracle that we can understand one another at all.
So it is important in couples work to develop ‘counseling techniques’ for couples to talk and to listen to each other—without interruptions, attacks, or judgments, and learn to become aware of these patterns in communication and family of origin triggers. When these verbal entanglements can be unraveled, defensiveness lessons and emotional intimacy and resiliency are enhanced, which are often the precursors to sexual intimacy.
My theoretical orientation and the techniques I use serve as frameworks of understanding, however they are secondary over the importance I place upon relationship and experience. No theory can be useful unless we can relate it to what is meaningful in our immediate experience. Despite the unique nature of every patient’s treatment, I hope that this section has provided you with a general and realistic description of my thoughts and approaches to the process of psychoanalytic psychotherapy and couples therapy.