Psychoanalytic and Existential Therapy
A Radical Form of Listening
The core of my approach is to listen closely to your words, symptoms, behaviors, memories, and even your dreams. In attending this way, we will likely notice unexpected things about you, of which you are not fully aware, that may be contributing to your psychological symptoms.
Highly Individualized
Because this is about listening to you, there is no other course of therapy that will be quite like yours. We chart the course as we go.
Many people think of therapy as being like getting the right pill prescribed for your specific problem. Therapy with me is more like a creative process.
The filmmaker David Lynch compares his creative process to putting a puzzle together, except that unlike the usual method, someone in the next room has the whole puzzle, and is tossing you one piece at a time. It is left to you to make sense of them as they show up. In therapy, you will not know in advance what the picture should be, what all the pieces are, or exactly how you might want to arrange them. But we will collaborate to find the pieces and empower you to put them together.
A Treatment for Mental Health Problems
Creative though it is, psychotherapy is about treating diagnosable psychiatric disorders, such as depression, anxiety, panic, and trauma reactions. In fact, I only accept patients who are suffering with a diagnosable psychiatric disorder.
Evidence-Based
Psychoanalytically and existentially derived therapies have a robust body of theory and research dating back more than one hundred years, as well as more recent scientific evidence that has gained them the status of evidence-based treatment in the current scientific literature.
Hard
You will be asked to confront painful memories, thoughts, and emotions, rather than being offered ways to avoid them.
My goal is to help you become freer to decide the solutions to your problems, not to get you to comply with my suggestions. Therefore the onus is on you to make decisions about how to improve your circumstances.
This will be harder for you than simply receiving advice or "strategies," but it is also a way to pursue a more significant and human kind of growth.
See below for more about psychoanalytic and existential theory.
(Or contact me to set up an appointment at: millermi@upstate.edu)
The Psychoanalytic View of the Self
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 got stuck there, pining away for an illusion of his own beauty.
Like Narcissus, we 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.
Because of this, we miss a great deal about who we are, and of 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.
(Painting: Narcissus by Caravaggio)
The Unconscious
Clinical psychoanalysis was the first of the modern psychotherapies. All of today's psychotherapies--even CBT, DBT, and ACT--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.
One major difference is the notion of "the unconscious."
Because we see aspects of our psychological life as ugly, undesirable, or threatening, we keep ourselves unaware of some of our own thoughts, beliefs, wishes, and impulses.
Remaining unconscious of 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.
As a therapist, it is often these unconscious things that concern me most, and my work is to encourage you to encounter them. You will likely find some things that aren't flattering, and some that suprisingy beautiful.
(Pictured: Jacques Lacan and Salvador Dali)
Existentialism
My practice is heavily influenced by existential philosophy and psychology. Though it's extremely diverse, this body of theory was quite influential on psychoanalysis, and dealt with many of the same issues and ideas taken up by people like Freud and Lacan. Existential thinkers and clinicians have been concerned with issues such as authenticity vs. conformity; the true nature of anxiety; the common elements that unite all of us as human; the (in some ways terrifying) importance of human freedom; the question of meaning; our relationship with death; and the way a frank encounter with our own pain and alienation can lead us to grow.
In therapy you can expect that I will be attuned to the issues I just mentioned, and that I am well-versed in scholarship about them. Perhaps most importantly, I am on the side of your freedom as an individual human being, and I try to marshal everything else we do in therapy to increase that freedom.
Scientific evidence for existentially-oriented therapies such as ACT, and psychological theory, such as Terror Management Theory, is ubiquitous.
(Pictured: Friedrich Nietzsche)