Psychoanalysis as a personal encounter.

When Thomas Ogden invited us to “rediscover psychoanalysis for ourselves’ he invited us to discover psychoanalysis as a deeply personal and constantly evolving therapeutic experience. ”After all psychoanalysis both as a set of ideas and as a therapeutic method is from beginning to end a process of thinking and rethinking, dreaming and re-dreaming, discovering and rediscovering” (Ogden).

Ogden’s invitation entices us to think, rethink and rediscover what psychoanalysis can mean for us as a therapeutic method and as a way of understanding human experience.To re-discover psychoanalysis for ourselves is an invitation to create psychoanalysis anew in ways that work for who we are, what we believe to be useful in psychological growth, and utilize our unique capacities and abilities in engaging others in conversation. To an extent we are invited to “throw away the book” (Hoffman), to rely less on the dictates of analytic rules and procedures, less on efforts to offer correct “psychoanalytic” interpretations (which is what we focus on, Bion says, “when we are nervous of not being real analysts”), and more on who we are, what we have come to know from our own lived experiences, and from our learned and earned understandings of what it is that matters in living. To an extent Ogden’s invitation places a significant amount of responsibility on analysts and patients to re-discover themselves in direct conversation with each other and manage the stress we inevitably put on each other as different and unique thinkers and individuals.

The view of psychoanalysis simply as an explanatory system, one that explains people to themselves, and that offers answers to what things really mean, undermine the analysts’ and patients’ own unique ways of understanding the problems that inevitably occur in living and undermine the co-operative and co-reflective activity that can be so healing. When psychoanalysis is seen as a discipline of understanding, of hermeneutics (Stern), of inviting and tolerating conflicting perspectives, rather than that of simply explaining, then a relationship of subject to subject, of mutuality, and of equality, enter the room and a dialogue and cooperative spirit of co-inquiry, co-participation (Fiscalini, Wolstein) can follow. 

We try to understand the patient's problems as they see them, their assessment of what bothers them and what they believe stands in their way of solving their perceived problems. We ask what their reasoning is for how and why this problem persists. We wonder conjointly about its origin and its purpose. As equal subjects with minds of our own, we might be thinking how these issues and proposed solutions compare to our own ways of operating. Would we see things and try to solve them similarly? We draw on our learned theories and knowledge to offer alternate formulations, perhaps different ways of perceiving the same problem, perhaps ways of thinking that diminish the sting of the problem, perhaps our own ideas of where this problem might come from and what it serves. As equals these ideas are put forth as Bollas says: “to be kicked around, played with and discarded if needed”. We do not have, nor is there, a privileged position of knowing or any final say on what something means. Not even of ourselves and our intentions. Just as we offer thoughts to our patients they offer their thoughts to us (sometimes directly and often implicitly) about who we are to them and what we might intend. Just as we don’t have the final word neither do they. This is the negotiation of meaning between respectful and coequal partners. And it is here that psychoanalysis has the potential to offer an experience that almost equals no other. We slow down, we actually look for and perhaps even make problems, in order to think anew and rediscover new perspectives. Rather than rushing on to being “fine” or “great” or “healed” or resolved, as our society might demand, we stop, we think, we feel, we share, we look for life under rocks and we delight in the mystery and vastness of living. 

The Courage to be Imperfect

In these posts I am often emphasizing a similarity between therapists and patients. The reason is partly to de-stigmatize the psychoanalytic encounter from the hierarchical perch it often rests upon and reframe it as a conversation between two equal human-beings. This hopefully does not diminish the usefulness and the complexity of psychoanalysis as a treatment modality and instead introduces an intimacy to the process of psychological healing that is both immensely personal and inclusive of every aspect of both the participant’s personalities. It is very much in line with contemporary thinking in psychoanalysis that the relationship between therapist and patient and its specific quality is of significant importance in the treatment of the patients problems in living. In fact relationships are at the center of psychoanalytic treatments because it is in the arena of relationships with others and relationships to ourselves that much of our problems and struggles arise. We are people in need of other people to satisfy our life’s goals which makes relationships the primary area of importance for psychological change. To speak as I do of similarity between analyst and patient is to actually speak of equality and it is equality that we seek in psychological health. Very often at the heart of our psychological problems lies a belief in our inferiority (Adler), our limitations, which we perceive as detrimental to achieving what we desire. We are too short, too dull, never rich enough, or attractive enough. We compare ourselves and get into problems of emotional turmoil that range from arrogant superiority to depressive inability. Psychoanalysis has always had its eye on the animality of humans and the attempt to rise above the body, sexuality, mortality, and illness. It’s purpose to reintroduce us to our bodies, our animal heritage and our primate needs has been central to bringing us closer to our purposes and motivations. Being human is the “predicament” that psychoanalysis tries to speak to and as such it applies to the therapist and patient, both as people, as human beings living in the world and attempting to achieve what they desire and deal with their limitations. Need, desire, and the ways in which we try to get them met, with, and in spite of other people, are at the heart of psychoanalytic treatments. Relationships are our area of focus because many of our needs are played out with others and require others to fulfill.
One of the needs I’ll focus on here is the need to overcome the anxiety and worry about being insignificant and inferior to others, and how in the face of permanent justifications for those feelings we must find ways to keep trying, keep living and aspiring to what we want.
When we are born into and live with our families, it is often our experience that we are less than others, weaker, less conscious and less knowledgeable. We are dependent on others for care, and our vulnerability is always a source of distress and even shame. Depending on what our experiences are like in these early years of our lives and then consequently, we develop a sense of who we are, what we can do to meet the challenges of life and of getting what we want. We get to have a sense of how others will relate to us and develop expectations and strategies of coping with the world. If the feeling we are left with, and many of us are, is that we are not good enough or significant enough to expect kindness, regard, dignity and love, we will resort to strategies of achieving some of these human needs that can get us in some trouble or distress. Some of those relate to how we are with others and some to how we treat ourselves. One of the consequences is that we lose touch with who we are. We dissociate our needs, our desires and can often remain diminished as people. A large part of the therapeutic experience is helping to learn about what we are as human-beings, what our desires are, what is normal to feel, and to accept our humanity in all its complexities and facets. This includes accepting vulnerabilities, limitations, and ways of coping with life that are not always “nice” or even ethical.
An equal and egalitarian environment, an environment of empathy and compassion towards these many facets of our being is essential to engage in the kind of conversation that would be considered therapeutic. As therapists we must never lose sight of all the ways people choose to meet their needs and seek to achieve their life goals. As Erich Fromm said “nothing human should be alien” to us. As patients we must have a sense that our lives will be given respect and a sense of dignity by the person we are speaking to, even when our lives might appear in chaos and upheaval. This egalitarian environment is essential for us all to speak freely, openly, honestly, and discover our full capacities as human beings.

Erich Fromm, who had a significant impact on contemporary thinking in psychoanalysis, also said that we hide behind hierarchies of superiority and inferiority. We allow others to be superior while we remain inferior so as to relinquish our own responsibility for our choices and our lives. When we choose superiority over others we hide our vulnerability, deny our flaws, and seek acceptance through domination and control. Hierarchies ultimately corrupt our freedom and our self knowledge and too often only provide us with ways to blame others. Unfortunately in blaming others we are diminished because by choosing this option we lose something of ours, our own actions, our own thoughts, and a connection to our own motivations. The psychoanalytic relationship like any other can be weighed down by similar false conceptions of superiority and inferiority and of power hierarchies as defensive options. It takes an effort on both sides of any conversation to listen with respect to the opinions of others, even when we might disagree or not understand one another. A therapeutic relationship is characterized as one in which one can speak freely, where those participating can ask and be asked questions and where hierarchical thinking is uncovered and willingly given-up. This requires cooperation, trust and openness which is always a work in progress and must be earned. It is only in an equal and egalitarian atmosphere that we can honestly and courageously look at our own ways of living and non-defensively examine them. This egalitarian relationship is what a psychotherapy aims to achieve.

Psychoanalysis as well as other therapeutic traditions have taught us to be mindful of our defenses, our competitive emotions, and our wish for control, so as to look beyond them and find ways towards better coping with our life’s problems. The demands of life are constant and for some unmanageable. We resort to domination or submission as ways of gaining some security and yet these coping strategies always require complex manipulations, self-diminishment, and a tiring effort to maintain. It is when we accept ourselves as we are and seek neither domination nor submission that we can live well with others, cooperate, become useful and find joy in our lives. On this road to equality we must keep our connection to the patient within, the needy one, to the child, and to the outcast. Rather than seeing these sides of ourself as bad or unworthy, psychotherapy asks us to incorporate them, accept them and care for them as we would our own children. Much of our suffering occurs where we have given up expecting care for sides of ourselves we deem unacceptable and where we have hardened rather than allow for our more vulnerable sides to speak out and up.
Can we say that to live better has some connection to being kind to ourselves and to be kind to others? How often is one sacrificed for the benefit of the other? Either I am more important than you, my needs superseding yours and I feel hardened, competitive, and envious. Or your needs are superior to mine and I feel depressed, scared, diminished and resentful. We cannot win and should in a sense stop trying to win. We can though try to increasingly feel at one with the world and with others. To be less competitive, less concerned with our status, our standing in the world and live with others in a more honest, respecting and caring way. Maybe it is our task in life to embrace our sufferer, our “misfit” and not cast them aside by favoring only the “ego’s” ideals like to be always a success or to win at all costs. Unfortunately for many of us, we can too often feel thwarted in our goals, encounter more barriers to our desires than some, and are discouraged by some of life’s demands. We overly identify with being incapable. Depending on our expectations of life, of other people and our assessments of our own capacities, obstacles can have the force to dishearten us. The more we encounter that which appears beyond our capacity to handle, the more solidified our disbelief in ourselves becomes and the more life and other people could seem unfriendly at best or like enemies of our well-being.
Therapy is an opportunity to speak about those obstacles, the times in life we’ve been overwhelmed by, and to courageously observe our ways of living and to receive encouragement to observe life differently, ourselves differently, and to make changes that might be novel, frightening and unfamiliar but that can reconnect us to life’s pleasures and challenges with new perspectives.

For many of us the fear of being deficient or insufficient draws us to becoming therapists and to being patients. Our hopes of learning how the mind works and of gaining some mastery over ourselves, our relationships and our feelings of inadequacy are so central to many of us interested in psychotherapy. Many of us are afraid and have a difficult time overcoming our fears of life. We are afraid of not fitting in, of not being good enough to be useful to others and afraid of feeling insignificant. Many of us doubt our capacity to handle successfully the life tasks that are thrown our way and need encouragement, support and a belief in our abilities. Mostly what we need, more than success, is the knowledge that we will still be okay when we fail. As therapists we need to offer that encouragement and support and to try and encourage people to risk failure, to speak their minds and risk someone out there not liking it.

There are so many ways to fail to live up to the many ideals of our culture and we often can feel ashamed of our humble humanity and limitations. As a coping mechanism and defense against feeling “imperfect” we often hide ourselves, create unstable self identities, avoid trying, blame others and pathologize ourselves unnecessarily. Rudolph Dreikurs says that one of the first steps is to recognize that we are “prejudiced against ourselves”. Rather than think too highly of ourselves, he claims, many of us do not trust our own abilities and believe too readily in our insufficiency and powerlessness. Our shame at the exposure of these insufficiencies and fumblings can generate rage, depressive sadness and discouragement from continued trying. Just as our patients resort to these defensive measures and coping mechanisms to hide vulnerabilities and feelings of inferiority, therapists too hide their thoughts, their beliefs and their life choices from patients for fear of rejection and shame. I believe that the more we do so the more we support the idea that superiority, infallibility, power and status are the only roads to security and well being. Rather than therapy being a search to achieve perfection and infallibility in order to avoid the many pitfalls of life, there is strong evidence to suggest that working towards the “courage to be imperfect” brings with it more security and equality with our fellow human beings. 

Healing and our Emotions

Our emotions can often blindside us. We can feel sadness, anger, jealousy, guilt and shame and often not know why or what our emotions are trying to communicate to us. In spite of our best conscious intentions to live in accordance with the “best” values of our time; to be industrious, productive, rational and certain about ourselves and the world, our emotional experiences can fling us quite suddenly into states that surprise and upset our best intentions. It is as if our emotions have a life of their own, never quite allowing us to dominate them and continue to send us a message that we are more than our conscious intentions. Our emotions are complex, often unbidden and at times appear as undesired aspects of our human experience. I might wish to be rational, sensitive to others, helpful and generally see myself as socially attuned and “good”. And yet who among us can claim that they don’t also exhibit jealousies, angry feelings, have petty desires and wish to dominate and control others? When we seek out therapy it is, I believe, quite often a search to understand these emotional experiences that do not coincide with our best selves. We contain multitudes it is said. And indeed our emotional lives can feel as if we are a cast of characters in a play, a movie or story with victims and villains, perpetrators of violence and heroes that can save the day. Often we get to play all the roles and at times we seek others to play some role for us while we stay firmly planted in our preferred or desired roles. I believe that our emotional lives are indeed like characters in our life journey with belief systems all their own that govern with a logic we might not accept, especially when that logic negates other parts of our existence.

Emotions have evolved over millions of years and are “designed” to further our chances of survival and mostly get what we want. They flair up when what is important to us is threatened or when we can sense a desired thing is within reach. They move us towards objects of desire and away from objects of harm. Anger often tries to reverse or correct the wrong done to us by force and by sometimes even getting back at someone we might believe is the cause of the harm. Our anxieties for example try to tempt us away from and to avoid what appears dangerous or unfamiliar to us. This is why the more we can face more fearful situations in life and build our tolerance for being outside our comfort zone, our anxieties will also diminishes. In those cases we learn to trust that we can handle a situation and our belief in our abilities grows.

It has been shown by many researchers and philosophers of human emotion, like Martha Nussbaum, that our emotions are wise companions, not opposed to our thinking but supporters of our thinking. If we listen well enough and with enough compassion to ourselves, our emotional life can serve as an important guide to knowing more about ourselves and what matters to us. Rather than being an aspect of our experience we might prefer to eliminate, our emotions allow us to know what things mean to us, the value we place on them and the goals we aspire to. It is important to remember that quite often we might find that the emotional value we have placed on certain experiences has been overblown or misguided and that what has revealed itself to be of major importance via our emotional reaction need not be as serious after all. What we feel in other words might be misleading and sometimes leads us to act in ways that are not in our best interest. The experience of threat for example can be overly sensitive in us leading to a heightened vigilance and readiness to fight or flee. Our thinking about our emotions, our inner observer can then be used to circle back on our emotions and evaluate our responses and what that assessment and response might mean about what we fear or what we desire. We are so often tormented by our own emotional lives, especially by what we might think they reveal about us that we never stop to listen to what the emotion is telling us about what is happening around us. We can feel ashamed by our sadness, judgmental about our jealousy, embarrassed by our show of anger. We speak about playing it “cool”, of being calm and collected, unfazed, wanting to exhibit calm “rationality” and dreading any show of the irrational, i.e emotional. But if we pay attention we discover what our emotions are revealing about us and about what we might want. For some a slight by a friend could send one into a deep depression, a fit of rage or into questioning the friendship as genuine. For others the response can be less severe and thoughts about the friend”s general demeanor over the course of the friendship allow for a more forgiving attitude. If a person”s threat system is activated and the slight takes on a meaning of betrayal or a threat to one’s sense of belonging and security, the response could reveal the significance of the event for that person. It is here that thinking allows us to evaluate if indeed what our minds have made of the situation is warranted. 

Therapy is designed to be a slow and steady study of the emotional lives we lead and a process of sorting out the complicated judgments and assessments we have towards our emotional states. Our conscious minds are wonderful when it comes to planning for the future or trying to overcome obstacles. Consciously we mostly carry ideas of ourselves as rational, thoughtful and sensitive. In our unconscious minds other forces are at play. It is our emotional lives that give us a glimpse or x-ray vision into what kinds of other beliefs and thoughts we have that might influence us as much as, if not more than, our conscious intentions. 

Implied in what I’ve been saying but important to remember is that our emotions are an evolved evolutionary system. One of the many reasons that remembering our evolutionary past when thinking about our emotions is important is because it is significant to remind ourselves that much of what we feel and much of what we respond positively and negatively to, is outside of our immediate control. It is not our fault that we feel what we feel. This does not mean that we are without responsibility or merely puppets of a biological fact, but it does introduce hopefully the notion of a more compassionate (Paul Gilbert) attitude towards what we experience. In psychotherapy one of the main tasks of the therapist is to help build a more compassionate attitude towards our emotions by recognizing their biological significance and “normalcy”, creating a more self accepting tone towards our multifaceted and complex heritage. In order to become more compassionate towards ourselves (and others) it is also important to remember that we are also historical beings. In other words we all come from families and from certain cultures that shape us significantly. Who we are and how we perceive the world and our place in it has been shaped to a large extent by our early environments and has been for the most part laid down before we could have a say in our destinies. Psychotherapy is also built to track or connect our present attitudes, beliefs, and what we seek for ourselves to the “rules” we might have learned earlier on in life. If we were treated with respect and love, a secure base from where we could explore our surroundings without excessive anxiety or whether we were brought up in an environment of fear, sadness and loneliness, will lead to different beliefs about what is normal and what is not, what we feel we deserve, how open to others we will be and our degrees of protectiveness versus trust. Psychotherapy takes it as a matter of great importance that when we can understand the connection between our present to our past, both our personal past as well as our evolved human-species past, new possibilities can open up. Without that knowledge we are more unconsciously driven by forces we cannot know and then possibly feel very confused or frustrated that we cannot simply change our behaviors and emotional states by sheer will power. 

Healing our emotional lives is in large part understanding what our emotions are telling us about ourselves, our values and what we expect. It is one of the most courageous things we can do because looking at where we place our values, what we hold to be important will reveal that we are all vulnerable to hurt, all doubtful about our worth and all desiring of love and acceptance. Because the human condition always has aspects of those qualities and because those concerns are never fully relieved our best course is to be more accepting of them, more friendly towards them and with that will come a kinder, more loving attitude towards ourselves and to others who are just like us.    

Reflections on Therapy

Freud offered us a fascinating account of our emotional and cognitive lives that made anyone who was interested stop and reflect on the complexity and hidden dramas that reside in our minds. His account was unique, dramatic, full of intriguing desirous and vengeful plottings of possession and rage which shocked as well as intrigued his Viennese contemporaries. The enlightened beings we imagined we were, children of the gods, was merely an illusion built upon denials of our true nature. A process of healing psychological difficulties as Freud envisioned it was to accept these dramatic plots of unconscious desire in the many forms they take in everyday life and finally renounce these infantile narcissistic longings.  

When it became a matter of debate whether Freud had really captured the mind “as it is” and whether renunciation of “infantile” needs was a necessary aspect of healing, psychoanalysis splintered into schools of thought that offered different conceptions of the human mind and how to heal it. Rather than seeing our human existence purely as a negotiation of our inner drives with a society that attempts to quash our inherent selfishness and sublimate it with more “appropriate” and socialized behavior, developments in psychoanalysis followed the person as she is formed in the context of her relationships, with the social arena of family, culture and language. The person is formed in relationships and continues to exist in relationships that confine, inform, facilitate or negate its continued existence. As the child’s relationships to the familial surround and other social groups became a more important area of study in answering some of the questions mentioned earlier, human existence, ones emotional life and identity, could no longer be seen as something to outgrow or be seen as simply illusory. A more relative and idiosyncratic view of life as its lived and experienced by any particular person took the place of the person in relation to “reality” as an objective and fixed entity. With the social, intersubjective and co-created dimension of the “self” becoming a central focus of identity, the psychoanalytic arena was also seen as one more area whereby the individual negotiates (Pizer) and seeks the gratification of his various (and conflicting) need to connect, belong, be accepted, grow and flourish. “Therapy” of one’s psychology became  more like a study of, or an understanding of how a particular person came to be as they are, with certain beliefs, desires, expectations and with values that she holds dear and which become of primary concern to her well being. Her emotional life towards others, the analyst, and her life circumstances will reveal the values she holds to be significant and will tell a tale of wishes, desires, hopes and fears that an analysis will seek to question, expand on and make explicit. 

Psychoanalysis as a Dialogue

Many people, including those in the field of psychotherapy and psychoanalysis continue to debate the nature of psychoanalysis. With so many schools of thought, and within those schools, so many different personalities and individual interests, psychoanalysis has become anything but monolithic. At its core it offers a space in which to speak about the life of the patient in as depth as the two participants can accept for the purpose of promoting the best life the “patient” could hope for. Psychoanalysis, I believe, is enriched in this regard by drawing more explicitly from fields like philosophy, religion, sociology, linguistics, and other fields of study to offer people not only a place to vent their difficulties, but a direction, some guidance and a framework in which to understand ones life choices and one’s deepest motivations.

It is highly problematic when an analyst’s world-view overshadows that of her patient. For obvious reasons of respect for difference and for the multiple ways in which people seek fulfillment in life, the patient’s world view should always be the primary focus of any psychological treatment. Understanding and expanding on the “patients” life choices, circumstances and motivations though has not always been the primary goal of psychoanalysis. From its early days and deeply influenced by its historical time of inception, psychoanalysis as a practice was more about aligning patients with “reality”. Freud believed that people’s problems in living were related to their fixation, their arrest in early infancy needs that never matured to an adult level of acceptance of “reality”. The analyst’s role was to help the patient overcome their infantile desires and fears, and accept a more mature and less narcissistic, self involved life.

Today psychoanalysis is highly aware of the ways our personal and individual ways of growing up, living within families and social conditions and within certain cultural surrounds impact who we are as people. It is highly aware of the needs of children to adapt to these worlds and thrive as best they can within them. Part of that thriving is to learn the ways of the world from the people we rely on the most. We learn how to be and we learn who we are from those who care for us and from the world around us internalizing rules, lessons, identities and possibilities for ourselves and our futures. Psychotherapy seeks to become aware of these influences and how they might have shaped us and confine us to limited ways of being.

It was an interesting development in psychoanalysis (psychotherapy I use as a synonym) when it included within its sphere the ways in which the therapist’s own ways of being and her own values, learned from their own upbringings had an impact on the therapeutic setting. Inevitable as this was it placed an interesting responsibility on the patient to speak directly to the “analyst” as to how that personal impact impacted them. Therapy became then highly influenced by metaphors of dialogue between equals, discussions, a mutual challenging and expanding of minds in both directions. While the patient might have lost an “all knowing” “expert” therapist who could tell them what to do and to distinguish between right and wrong, they gained a thinking partner and would have to accept more of the responsibility of their life choices, their agency and freedom.

As opposed to some who preferred to keep psychoanalysis an esoteric and mysterious practice of psychological treatment, therapy’s healing potential derived more from a down-to-earth humanistic person to person dialogue that it offered. The psychoanalyst/therapist offers themselves as a mentor, friend, sometimes parent and fellow traveler on the sometimes difficult paths of life. Even though some might still wish the therapist be a magician of sorts, a medical doctor one brings an ailment to and is offered a cure, the psychological therapeutic relationship now requires both people to engage in a deep discovery of what it means to be alive and how one’s emotional life is deeply connected to one’s past and to one’s hopes and goals for the future.

When Freud developed his method of psychoanalysis he was under the influence of the thinking of his time. Victorian, repressive and very rational Vienna was observed by Freud as masking other more irrational forces in the human mind and he believed the repressive nature of his culture was a cause for many of the psychological problems people faced. His focus primarily was on sexuality and how culture forced a repressive hand on this natural and biological force. He was also influenced by the very optimistic belief that science and the rational mind could access “reality” as it is and that there was a clear distinction between reality and its distortion by the “sick” mind. His method of treatment was to allow the irrationality of the patient’s mind (the patient’s sexual and aggressive drives) to unfold and through “interpretation” (telling people what was really the case) have rationality conquer the irrational. The childish would give way to the adult.

Today we have a much different cultural environment. Authority is questioned, diversity of thought is valued, individualism is prized and one’s true “nature” is more complex than the couple of drives Freud postulated should be relinquished for the sake of maturity. Our concepts of right and wrong are in flux and our ideas of what ails people and makes life difficult have become more tolerant and humanistic. In addition and as a major cultural force, postmodernism and feminist thinking has allowed for a much more pluralistic notion of life and the values we hold dear and has recognized the hubris in any dominant cultural thinking. With those changes, psychoanalysis has gone from a profession that seemingly “knows” what is healthy and what is sick, that places the authority of the psychoanalyst above the authority of the “patient”, to a profession that allows and invites plurality of meaning and makes the reality of the patient be the central narrative. The curative aspect of psychoanalysis under this new focus is to hear (some might say to “bear witness”) as much as possible about the patient. Their thinking, their beliefs, values, fears and desires must unfold in the context of a safe and curious environment. Then we must help understand with the patient the function of these beliefs and values. What purpose do they serve? What are their benefits? Which beliefs and values lead to some of life’s difficulties? What might be the cost of giving some of them up? Where do they become overly rigid and where can a degree of flexibility be introduced? Rather than fix (or shrink), we try to learn more and expand.

The belief in psychoanalytic thinking that has influenced my opinion the most is that people are conflicted between their need to have secure and loving relationships with significant others and their need to become more themselves. Our identities, who we are to ourselves, is something we seek to be affirmed and even admired and yet we all have our identities and beliefs challenged by the world and by our day to day life. Others opinions of us, what we fear others will think of us, the fear we will lose the close connections we rely on significantly impact our self esteem and sense of worth. Self worth, connection to others, a sense of competence and usefulness is of central primary value and the extent to which these are threatened people can suffer psychological difficulties. We are after all a social animal that require connection, love, support, safety and a healthy degree of competition to maintain our sense of well being. It is sometimes this desire for connection to how we see ourselves, to what we have learned from our parents and culture that can keep us stuck in old ways of living that have passed their use-by date.

Emotionally speaking one can understand that a person (“patient”) might wish to seek out an expert in living. Someone who knows all the answers and can tell you what is “wrong” with your life and “know” how to fix it. It makes sense that we would all seek that out. Even psychoanalysts might turn to their books, their theories and hold on for dear life because it offers a direction. Answers. It offers authority and a clear sense of what one should do. In relation to that Id like to have two thoughts that seem to contradict each other. One is that we as psychoanalysts are responsible for having some ideas of what makes life problematic. We are obligated and should actually be hungry for the many answers that our cultural histories have offered us in relation to what makes life hard for us as humans. Eastern and Western religious and philosophical practices have taught us a lot. Buddhism, Existentialism, the multiple philosophies of language, ethics and consciousness, sociology, and anthropology have all given us so much to think about and apply to our work with people seeking life guidance. But the second thought is that we must be humble too. Practice humility when it comes to answers. There are many answers. Some better than others. But the beauty of psychoanalytic treatments, as they are hopefully practiced today, is that it allows the patient, the one seeking help to also become an expert on their own lives. To know themselves and become the authority in their own life that can make important decisions, live courageously and become a loving presence to others who might see the world also a bit differently from them.

For my colleagues reading this I believe I am advocating that our main task be to help people feel more alive and courageous in their lives. Courageous to think for themselves, become themselves, to be more caring of themselves and of others and for this we must do the same. I am advocating here for a wise, rational, human and kind form of psychoanalysis that sees the value in people, in their efforts to live a good life (as misguided as they might be at times) and for the heroic attempts to face the challenges of insecurity, heartbreak, disappointment, tragedy and even death with courage, love and compassion.