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Source: cc0 Public Domain

Last Saturday, I had the pleasure of attending a conference at the Psychoanalytic Center of California featuring a psychoanalyst from Buenos Aires, Dr. Clara Nemas. Dr. Nemas is a wonderful lecturer—smart, insightful, warm, and funny. It was so refreshing to witness her passionate engagement with psychoanalysis, her care for her patients and supervisees, and her lively interaction with the audience comprised of psychoanalysts, psychotherapists, and students. She gave us a real sense of how psychoanalysis comes to life in the Latin American context.

In the morning session, Dr. Nemas spoke about the importance of imagination for mental health and well-being. She encouraged us to pay attention to moments of imaginative thinking in our work with patients. Imagination, she said, indicates that a space for thinking has opened up, that something new can be thought about. This is vitally important because new thoughts or “imaginable conjectures” lead to change in people’s minds and lives.

Dr. Nemas used a metaphor that really stuck with me, as she described the work of psychoanalysis as akin to the work of gardening. She said that psychoanalysts would do well to approach their work with a balance between “clearing out the weeds” and “nurturing the buds,” giving attention to the forces that block a person’s recovery and to those forces that enhance it. I think this metaphor also applies to any activity that is designed to help someone grow such as parenting, marriage, friendship, teaching, coaching, and even, dare I say, governing.

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Source: cc0 Public Domain

She said that analysts have tended to use an approach with patients that overemphasizes “clearing out the weeds.” She was referring to a classical pathology-based approach to mental health treatment that started with Freud, where the focus is on clearing away the defenses and resistances that block a person from recovery and growth. This approach is based on the idea that clearing away the obstacles would allow a natural growth process to develop and unfold.

But Dr. Nemas said that this approach only takes us so far. When a patient is stuck or frozen, feeling hopeless or helpless, it is important to bring to life the strengths, resources, and possibilities that are there, even if they are very tiny. Using the gardening metaphor, she called this approach “nurturing the buds.” When glimmers of hope emerge in a patient struggling with hopelessness, it is useful to call attention to them. When a patient who has difficulty with trust turns to you for help, it is useful to acknowledge and explore it. When a patient who holds so tightly to his or her way of seeing things responds to your interpretation by saying, “that’s interesting,” a bud has emerged which, if tended, can grow.

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Source: cc0 Public Domain

These days, we hear more and more about positive psychology and a strengths-based approach to psychotherapy. There is good reason for it. It is a correction from the swing of the pendulum too far towards what is wrong and what needs to be fixed, rather than strengthening the resources that are there that can be used.

In my view, a balanced approach is needed. The weeds must be cleared—resistances must be faced; anxieties must be explored; sadness and pain must be shared, received, and understood. And at the same time, strengths must be appreciated, muscles developed, hope encouraged, and helpful connections strengthened. The balanced approach protects us from focusing too much on the negative so that our patients feel bad for having their difficulties while, on the other hand, protecting us from focusing too much on the positive so that we become cheerleaders who do not take the patient’s difficulties seriously.
 
An example of this balanced approach can be found in the new book by Sheryl Sandberg and Adam Grant, Option B: Facing Adversity, Building Resilience, and Finding Joy. Sheryl Sandberg is the COO of Facebook and Adam Grant is her friend as well as a psychologist from Wharton at the University of Pennsylvania. In their book, they share the poignant story of Sheryl’s experience following the sudden and unexpected death of her husband at age 47. Sheryl was devastated in her grief and terrified about how she would help her two young children through this trauma. With Adam’s help, she began to see the importance of finding balance in recovering from this tragic loss: facing grief squarely yet finding ways to go on; developing herself as a wiser, stronger person; and even recapturing and having new experiences of joy. She engaged in a process of clearing the weeds and nurturing the buds in her grief, a process which they call “post-traumatic growth.” To learn more, check out Krista Tippett’s beautiful interview.
 
I offer these ideas not only to psychotherapists but to anyone who wants solid guidance about the change process. We must work to clear the weeds that get in the way of our mental health and nurture the innate strengths that are there. That is what it means to be resilient, and finding a balance is key.
 
Copyright 2017 Jennifer Kunst, Ph.D.

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