Psychoanalytically oriented psychotherapy – or psychoanalytic work as I refer to it – is a method of self exploration – finding out how we tick by looking inside. This does not mean that the ‘outside’ is not important – but when we look carefully we begin to see that much of our external world is shaped by our earliest wishes and fears. For instance, someone who has experienced abandonment in childhood (loss, lack of attention, divorced parents) will usually grow up with degrees of wariness about making new attachments. This wariness will effect a person’s willingness to connect with others. Connecting feels dangerous and so avoiding closeness becomes habitual. The tendency to avoid is not usually conscious but in analytic work, this same wariness is usually played out in the analytic dyad (therapist and patient) allowing both parties to examine and experience what goes on between them. Wariness wears many costumes: seeking out people who disappoint; making excuses to stay at home; falling ill when intimacy threatens; behaving in ways that keep people away; thinking that people are critical when in fact they are not. These are just some of the ways we can maintain our isolation – even when we think we want to connect. Psychoanalytic work give us the chance to become aware not only of our fears but also gives us insight into how we protect ourselves.
The main motor of analytic work is what transpires in the dyad. What goes on between therapist and patient is called transference and counter transference. The analysand has feelings about the analyst that have roots in the past. Love, hate, anxiety about intimacy, anger, sexual yearnings, are feelings that can be traced to early childhood people and events. And the analyst can experience these feelings too. But the analyst, because of his/her own analysis has hopefully grappled with her transferences enough so that she can be as neutral as possible. Pure neutrality is impossible but the ability to listen for many sides of story is necessary. One analysand came in hating her mother. By the end of her analysis she was able to experience a whole range of feelings about this once hated mother. The analyst in this case was careful not to reinforce or deny the hatred. When the analyst starts to feel a strong emotion towards the analysand or even towards someone analysand is talking about this is called countertransference. Both transference and countertransference phenomena are very useful when explored but if not understood can lead to action and a breaking of the frame.
Analytic work requires a frame or structure so that safety can be insured. — (to be continued)