Psychoanalysis Today

Psychoanalysis Today: The Rich & Textured Attributes of Personality

I am a psychologist and a generalist and I am also a psychoanalyst. Psychoanalysis is one of my specialties. Those I see in psychoanalysis are curious about their internal world and willing to invest in the work of understanding themselves. I practice in Milwaukee, Wisconsin.

Psychoanalysis is unique among therapeutic approaches in that it targets enduring structural change in the dynamic organization of the personality — that is, the energies that have formed over time and power your thoughts, feelings and emotions and have become organized as the constellation of your personality. Your personality is based on your unique genetic makeup and biological disposition, and how you experienced and internalized early significant relationships and events. Mind and body interface. This interface means that your personality is complex, rich, and textured.  Trauma, wounds and developmental lapses, along with maladaptive and protective strategies to deal with them, impact your ability to regulate your feelings, to be productive, and to enjoy vocation, love, and play. Many people assume you cannot ameliorate symptoms. They think that the only option is to find ways to better cope with their problems. Psychoanalysis offers a space and a therapeutic relationship to promote the possibility of working on the internal dilemmas that you have and that contribute to your symptoms.

If you knew there was a treatment that aims to provide enduring and substantive change, would you be motivated to work on yourself?

Psychoanalysis is not the treatment depicted and mocked in movies and cartoons. The process and the technique have changed considerably, and theory has developed since the time of Freud. A compendium of research is forming that demonstrates the benefits of psychoanalysis, particularly, how the change you make in psychoanalysis endures beyond other kinds of treatment interventions. Psychoanalysis, however, is not for everyone, nor is it necessarily recommended for everyone’s presenting problems.

The Commitment: The work of psychoanalysis requires a substantial investment from analyst and analysand (clients who begin psychoanalysis) in different ways. While some analysands initially experience the investment of time and money as onerous, the time they spend typically becomes one of the most rewarding decisions of their lives. Once used to the routine of near daily meetings (3-5 times a week), most analysands experience relief, help and support, and fairly early in the treatment symptom reduction. Psychoanalysis may last from two to seven years for optimal outcomes, and while that sounds like a significant amount of time and financial investment, first consider how many decades have contributed to the discomfort you experience and, second, how the time will pass irrespective of your effort to work on yourself.

The Differences Between Psychotherapy and Psychoanalysis: What people talk about in once or twice weekly psychotherapy is different from what occurs in more frequent sessions, and so too are the kind of benefits attained different. In once weekly psychotherapy people tend to detail events since the last therapy appointment and their reactions. With more frequent meetings the focus gravitates to nuanced internal experience, including, to perceptions of significant others past and present, dreams, and to the analytic relationship. The resonance of the work reach deeper, spontaneous layers of your personality with a fuller range of feeling as past experience was laid down in declarative and procedural memory, and as it remains in the present. Analysand and analyst can understand aspects of experience outside of conscious awareness, an understanding that once realized promotes memorable change that is integrative.

In psychotherapy the therapist is conversational, offers supportive interventions, validation, and reassurance. The focus might include problem solving, coping and adaptive strategies, and strategies and tools to ameliorate your symptoms. Psychoanalysis is about understanding you in an intersubjective context of relationship with family and friends. In psychoanalysis the analyst is non-directive and neutral but that doesn’t mean inactive, disengaged or silent. Listening carefully is an essential aspect of the analytic process, specifically paying attention to what goes on in the relationship in room with a close focus on the process of transference and countertransference and the resonance of what is happening with the analysand’s past.

The relationship you have with your analyst will differ from any other relationship you’ve had. It is not “social” in the way you are used to. The treatment does not encourage social niceties. As you become increasingly comfortable, you speak genuinely, raising associations, imaginings, and reactions that are less censored and playful. You come to tolerate beyond your positive feelings, sadness, anger and shame, the “soft underbelly” of the metaphorical monsters in every child’s closet. The analyst is not compelled to fill in when there is silence but rather to consider what might be occurring in those moments. Embracing the unique aspects of your personality and how you came to be you, typically helps the analysand value and accept differences and how that is enriching. With acceptance comes feeling alive.

Reclining on the couch fosters reflection and also refocuses the typical social conventions associated with conversation and reciprocal visual cues. This may feel strange at first, but for many it becomes quite enjoyable, because while eye contact may be reassuring, it also may be freeing to not have to worry about the analyst’s reaction to what you are saying or feeling.

Please note: that while it is human nature to believe that once or twice a week psychotherapy can give you what you would get in psychoanalysis 3-5 times a week, such an illusion is bound to lead to disappointment in the treatment unless less frequency is the recommended treatment for you. Nevertheless some people simply prefer to get their feet wet, so-to-speak, before they are ready to increase the number of sessions a week for optimal therapeutic effect.

Who Benefits from Psychoanalysis?: Those best suited for analysis have a history of feeling anxious, unsettled, restless, depressed, lonely, fake, or have sporadic low self-esteem. Intimacy issues are common, and so too individuals’ inhibitions that limit optimal creativity and productivity. Those who gravitate to psychoanalysis and respond favorably, are curious about their inner life, dreams, fantasies, slips-of-the-tongue, omissions, and things they do that they didn’t mean to do. What you might cast away as general goofiness is all grist for the mill. It is best if the analysand has strength in some aspects of their work and personal life. Analysands need to be able to tolerate not knowing or having answers. Being curious about oneself is essential, as is refraining from judgment. Analysands think of the process as a journey and shared endeavor with the analyst.

American culture is fast-paced and geared to quick fixes, while understanding and the fluidity of free association seems counterintuitive in healing, to some, and frustrating to others. Some speak pejoratively of understanding as “navel-gazing.” However, growth is not linear per se, but integrative and the psychoanalytic process draws on affect, thought and speech at many levels of the psyche. Our society overvalues independence and undervalues community and relationship. Psychoanalysis creates a space to work on the many presentations of insecure attachment: pseudo-independence, clinginess, difficulty tolerating closeness, and ambivalence, for example. In fact, researchers in child development have shown how attachment disorders and trauma are best healed within the context of a non-judgmental therapeutic relationship where people learn to reconcile past experience and the imbalance between their need for agency and for satisfying interdependence.

No two psychoanalytic processes are alike, just like no journey is the same when taken twice. Psychoanalysis has been life changing for those who wish enduring change and who are willing to invest the time and effort.

Credentialing of a Psychoanalyst: As a credentialed psychologist, social worker, counselor or psychiatrist, your psychoanalyst is additionally credentialed as an adult and/or child psychoanalyst. The psychoanalyst is required to have a training psychoanalysis, supervision of casework and all analysts meet curriculum requirements of the certified Psychoanalytic Training Institutes that they attend. Psychoanalytic Training typically takes anywhere from 4-10 or more years.

Dr. Susan Barbour’s Credentials: Dr. Barbour is a psychologist having received her doctoral degree from Rutgers, The State University of New Jersey. She is licensed in Wisconsin and Pennsylvania. Dr. Barbour received a certificate in Object Relations Theory & Technique from the International Institute of Object Relations in Bethesda Maryland. Additionally, Dr. Barbour trained as an adult psychoanalyst at the Pittsburgh Psychoanalytic Institute in Pittsburgh, PA. Her practice in psychology and psychoanalysis is in Milwaukee, Wisconsin.

References:

Maria, Korducki. It’s Not Just a Chemical Imbalance. New York Times. Sunday July 28, 2019.

About Contemporary Psychoanalysis:  https://www.psychologytoday.com/us/blog/straight-talk/201804/psychoanalysis-today

For information on outcome see these links:

American Psychoanalytic Association: (http://www.apsa.org/content/empirical-studies-bibliography)

Jonathan Shelder Ph.D: https://jonathanshedler.com/PDFs/Shedler%20%282010%29%20Efficacy%20of%20Psychodynamic%20Psychotherapy.pdf

Susan Barbour, Ed.D., Psychologist
Dynamic Psychotherapy Associates, LLC.
827 N. Cass St.Milwaukee, WI  53202
Phone: 414-368-0460