“Psychoanalysis is wacky. You’re just going to want to talk about my penis, aren’t you?”.
I have had numerous patients come in to their first session of psychotherapy, asking similar questions. They are unsure of how psychoanalysis might be incorporated into their therapy, and they have only heard wacky things.. Sometimes, a patient will question whether I will talk at all, because that is what psychoanalysts are trained to do…to not talk.
Patients have shared concerns that my practice of psychoanalysis would cause me to solely focus on sex, or worse, to not communicate whatsoever. They have brought up their vision of psychoanalysis, one that includes an analyst trying to force them to lie down on a couch, or sessions where they will be hypnotized into revealing their deepest secrets.
The term psychoanalysis has come to mean different things to different people. Unfortunately, to some, it has become synonymous with a cold, detached, predominantly silent therapy that has been deemed “Freudian” in nature. Psychoanalysis used to mean that patients would meet with their analyst 4 or 5 days per week. The analyst would not make eye contact with the patient who was often lying down and facing the opposite direction of the analyst. Myths developed that psychoanalysis was a never-ending monotonous discussion of your past history, and it was a therapy that only wealthy people could afford.
Between films and TV shows depicting psychoanalysts in this manner, many have come to believe that all psychoanalysts are only concerned with mothers and sex, your Oedipus complex, focused on your unconscious and your dreams, and are of the belief that you must have experienced a dark childhood that has yet to be uncovered.
Practicing classical or “Freudian” psychoanalysts have become much more difficult to find in the last few decades. There are some analysts who still work to keep a veiled emotional range that remains imperceptible to their patients, or they maintain strict boundaries in which they attempt to not share any information about their lives outside of their offices.
However, most psychoanalysts today are typically more relational in the way that they work. They are more connected to their patients, and they do not believe that they are the authority for what may be best for their patients. The truth is that we are each the best authority of our own selves.
Psychoanalysts are supposed to be a "neutral" party, but not in the way that Freud alluded to neutrality, where it became known as a “blank screen” approach to therapy. In theory, being a blank screen meant that you tried to reveal as little about yourself as possible. But psychoanalysts have personalities and each person has their own set of morals and ethics, and today’s analysts understand that. Even Freud himself was noted to often be warm and have a sense of humor with his patients, so the blank screen approach didn't actually apply to him either.
Pyschoanalysts no longer ascribe to this idea of a “blank screen” neutrality, as it is widely accepted that even attempting to be a "blank screen" would be an impossible task. Instead, therapists offer support by being a neutral party in a different sense.
Acting as a neutral party can simply mean that the therapist is situated outside of the relational dynamics that someone has with their friends and family. This can have a great impact on someone's capacity to feel heard and understood. People need support from a person who works to remain objective. Simultaneously, we also must acknowledge that we are all human and our own subjectivity will always be part of the work.
We have come a long way from the era of therapists who envisioned themselves as the holder of absolute truth. Now, therapists strive to empathize with what someone may be experiencing, and the goal is to acknowledge when you may not know the answer. Most therapists will not hold back from intervening at times when it is clear that someone needs that intervention. The work is seen as a collaboration, with contributions from both individuals.
I have been clinically trained to use various treatment modalities, and I have also been trained to use psychoanalysis. I spent four years in a psychoanalytically focused training program in order to become a more clinically informed and more deeply attuned therapist.
After I was working in the field, I craved to be challenged further. I wanted to gain more awareness in order to better know myself, and to better know and be able to help my patients. Psychoanalytic training programs require a rigorous application process, and they only accept a small handful of people each year. Even though the program requires a huge time commitment and effort, I found that it was going to allow me a clinical experience that I could not find in any other realm. Everyone I know who completed the training did so because they had great passion for the work. And I will say that none of my colleagues remotely resembled Sigmund Freud!
It is somewhat ironic that Freud has become an icon for negative perceptions of psychoanalysis, because we would not have any of the newer models of psychotherapy that we have today, without his enormous contributions to the field. The various theories that therapists now use, like attachment theory or self psychology, have all been built on Freud’s initial discoveries.
Although many poke fun at some of Freud’s theories, the reality is that we all have drives and motivations, and we all have an unconscious. It is important to be able to hold the past, present and future within ourselves, as we continue to grow as therapists – and as people.
- Amy Calmann