Psychoanalytic Therapy
The Problem as Psychoanalysis Sees It
The ancient Greek story of Narcissus makes a good metaphor for a basic concern of psychoanalytic therapy. Narcissus never loved anyone--until he saw his own reflection. He became so captivated by his own image in the water that he was frozen in place, longing for his own beauty, until he died.
We are a lot like Narcissus--all of us at least a bit narcissistic--in that we tend to invest in a misleading image of ourselves. Our self-image--the one in the mirror, or on social media, or zoom, or around family and friends--is shallow, distorted, and incomplete. And yet we feel desperately attached to it.
This tendency leads us to miss a great deal about the truth of who we are, and the truth about the people and world around us. Much of what we do not see in our idealized image becomes frightening, "other," or frustrating and confusing, and finds ways of making itself known that are disturbing to us.
What Makes Psychoanalytic Therapy Different
Sigmund Freud developed psychoanalysis as a discipline that offered a novel appreciation of the breadth of human experience and behavior. Psychoanalysis is therefore often used in the understanding and creation of art, literature, music and film--for example, as a way to reinterpret the story of Narcissus! But it is also used clinically, as a way of treating human suffering.
Clinical psychoanalysis became the first of the modern psychotherapies, and all of today's psychotherapies, including CBT, DBT, ACT, and others, are descendants of, reactions to, and variations on it, even simply by virtue of their being "talk therapies."
But not all therapies are psychoanalytic therapy.
Essential to psychoanalytic therapy as I practice it is the notion of the unconscious. That is, I am concerned with what gets left out of Narcissus's reflection. In therapy, I am guided by the idea that most of us are motivated to hide things from ourselves, because we see aspects of our psychological life as ugly, undesirable, or threatening, and so we keep ourselves unaware of some of our own thoughts, beliefs, wishes, and impulses. What might Narcissus have seen and heard if, instead of staring at his reflection, he talked to someone? Maybe some things that were less flattering than he would have liked. Maybe some things that were more beautiful than he would have expected.
Remaining unconscious of such important things--leaving them left unsaid, even to ourselves--is what psychoanalytic theory argues leads to symptoms like depression and anxiety. In fact, it sees the symptom as its own kind of speech: a way of saying what we prefer to censor.
Psychoanalytic therapy, then, can be described as a way of listening to our symptoms differently, in order help us say what it seems cannot be said.
Psychoanalytic Therapy Is..
A Radical Form of Listening
Psychoanalytic therapy is essentially a form of listening extremely closely, and questioning what the person--and their symptoms, dreams, daydreams, and behaviors--has to say. The goal is to allow the person to speak more freely, relate more fully to their own desires, and to make psychological symptoms less necessary. This can be a powerful, deeply affecting form of psychotherapy that can lead to lasting and profound change, not just in our symptoms, but in our ways of being-in-the-world and our relating to others.
A Treatment for Mental Health Problems
While it's popular to think of "no problem being too small" for therapy, the truth is that it really is suited to treating diagnosable psychiatric disorders, such as depression, anxiety and panic, trauma reactions. and others.
An Evidence-Based Treatment
Psychoanalytic therapy has a robust body of qualitative research dating back more than one hundred years, as well as more recent scientific evidence that has gained it the status of an evidence based treatment in the current scientific literature.
A More Difficult, Longer-Term Treatment Option
This form of treatment, because it is dependent on a highly individualized form of self-exploration, as well as a particular kind of therapeutic relationship, takes a longer time to take shape than some forms of therapy (CBT, for example). It is also somewhat more difficult for the patient, since it assumes that many of the solutions to your problems already rest with you, rather than residing in a prescribed list of activities or strategies. Those solutions take time to find.
As a patient in this form of therapy, you will be asked to confront painful memories, thoughts, and emotions, rather than being given ways to avoid them.
Psychoanalytic Therapy Is Not..
A Source of Validation
While it is true that any good therapist will listen openly and nonjudgmentally to what a patient says and feels, "validation"--in the sense that the therapist agrees with and tries to bolster your own views of yourself and others--is not necessarily a goal in psychoanalytic therapy. Why? Because psychoanalysis knows that what is conscious for us--what belongs to our "ego"--is often misleading, or at best, a very small part of our story. So, rather than "validation" of what the patient already believes about themselves, we seek to explore and give a real hearing to what they don't yet know.
Venting
Venting, while it can be gratifying, seldom leads to change of any sort. What we seek to do in therapy is rather to listen and become curious about our own feelings, discourse, and actions in a way that opens us to new understandings and the possibility of change.
"Self-Care"
While psychotherapy is indeed a form of care, the idea of "self-care" has some overtones that don't apply here. "Self-care" as a way to make yourself feel good in the moment, or a thing that you add and subtract to and from your week according to how you're feeling, or that is dictated by your comfort level, is not what therapy is about. Rather, it is the kind of care that is sometimes challenging, sometimes even painful, and requires a commitment to attend to the work even when it feels stressful or anxiety-provoking.
Online Services and COVID-19
I am currently offering all psychotherapy in a HIPAA-Compliant, online format due to the pandemic. As a New York State-licensed clinical psychologist, I am able to offer remote services to any patient who resides in New York State.
Inquiring About Therapy
If you are interested in pursuing therapy, here are some basic things to know:
1. I will only speak with the potential patient. I do not arrange treatment or answer questions through third parties such as parents or romantic partners, and I am not likely to respond to their inquiries.
2. I work only with adults.
3. Whether I am "taking new patients" is only part of the picture. Whether I am a good fit for you is dependent on a number of factors, which we will discuss and explore.
4. I often work with people 2-3 sessions per week. I do not schedule less than once per week.