This blog curates the voices of the Division of Psychoanalysis(39) of the American Psychological Association. Dana Castellano, PsyD, submits this post.


As the balmy days of spring begin their evolution into the heat of summer, as children across the country say goodbye to their classrooms and hello to the freedom of the outdoors, it is perhaps a good time to think about transition. Some people thrive on change and tend to adapt well to new circumstances, while others tend to have more difficulty tolerating the insecurity of the unknown. In fact, many people seek out therapy in order to better navigate major life transitions. Our coping skills are created through a combination of genetic predispositions, environmental triggers, and the ways in which we learned to negotiate interpersonal dynamics in childhood. As adults, many of us tend to become stuck in fixed patterns of being and relating to ourselves, others, and the world around us. If these aspects of our experience were immutable, perhaps such inflexibility would be beneficial. Unfortunately, life tends to regularly force us to adapt to varying circumstances (as the saying goes, the only thing constant in life is change). So, perhaps one of the most important goals in any psychoanalytic treatment is changing recurring and undesirable patterns that perhaps were useful to us at an earlier point in our lives but now seem to get us into trouble or have less than ideal outcomes (Shedler, 2010). Few other types of therapies go beyond the symptomatic manifestation of these issues and attempt to get underneath the behavioral aspects of underlying maladaptive patterns. This ideal in any psychoanalytically informed therapy, among other unique objectives, sets the stage not only for the process of what treatment itself looks like but furthermore, helps to harness and build strengths upon which patients can access and utilize in their lives post-termination.

Unfortunately, the longer-term nature of psychoanalysis and psychoanalytically informed therapies are often in conflict with a rapidly shifting society which prioritizes short-term gratification over long-term impact. On the bright side, increasingly the psychological literature is recognizing that it is the so-called “non-specific factors,” most specifically the relationship between therapist and patient, that is the single largest determinant of whether or not a therapy is deemed to be successful by the patient at termination. Contemporary analysts have known this fact for well over thirty years by now. Through the co-construction of a relationship that is asymmetrical but mutual (Aron, 1996), patients can begin to understand how they relate to other people, and unlike in most other relationships, process together how it feels for both parties when one of these recurring patterns (otherwise known as procedural memories) emerges in the treatment room. Perhaps one of the most mutative experiences in a psychoanalytic therapy is when both patient and therapist notice themselves caught in one of these moments, often described as enactments, in which the therapist finds herself responding to the patient in a way that is rather similar to that which the patient reports feeling with other intimate people in his or her life. What makes the therapeutic relationship so rich and so different is the ability, initially by the therapist and in time the patient as well, to use the ability to reflect, or make use of one’s observing ego, to trace back how these moments may have emerged and what the experience engendered emotionally and cognitively within each party. Over time, and after continued exploration of such encounters, individuals can learn new ways of engaging that are more flexible, less destructive, and more attuned to both their own interpersonal needs and those of others in their lives. Eventually, new procedural patterns can replace the old ones, and coping styles can become less rigid and more suited to the ever-changing challenges with which life presents us.

So, as the temperature rises, the days get longer, and you begin to make the transition to summer, it may be a good time to stop and think about some of the reflexive patterns in your own life that might be getting in the way of your day to day functioning. Whether this observation leads you to make changes for yourself, take some time to relax, get more physical activity, communicate differently with those around you, or even enter into therapy, remember that change is something to be embraced, not shied away from. Change is the bedrock of growth; it is what allows us to learn something new and interrupt our routine, providing us diversity of experience and challenges to overcome. Now you will have to excuse me, as my two children are trying to accommodate to a later bedtime now that it is 8 p.m. and the sky is still light. And as a result, I am learning to adjust to having less down time at night.

Aron, L. (1996). A Meeting of Minds. Mutuality in Psychoanalysis. New York: Analytic Press.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65, 98-109.

About the Author

Kristi Pikiewicz

Kristi Pikiewicz, Ph.D., is managing editor of the American Psychological Association's Division of Psychotherapy DIVISION/Review.

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