by Jane Hall, CSW, FIPA
Overheard conversation between two diners at a neighborhood restaurant:
Q: What kind of work do you do?
A: I'm a psychoanalyst.
Q: I thought that was dead. Who can afford to go lie on a couch five times a week where the shrink hardly speaks and nothing happens? And wasn’t Freud proven wrong anyway? They should have called him Fraud. Also, I’ve heard that it’s painful. Who needs that?
A: OK. I get your point, and I can see where you’re coming from. But here’s what you might want to know. For starters, yes, psychoanalysis is still around. And yes, it can be expensive. But you’d be surprised at the availability of low-cost treatments. And many analysts believe that frequency is a decision for the analyst and patient to make together.
Lying on a couch is not necessary — some feel that it is useful, and others prefer sitting in a chair. I know someone who paced around the room at times. And things do happen, and shrinks do talk — but they need to listen to you in order to say anything meaningful.
As for Freud, yes, he was wrong about some things. But give him a break: He did give us a whole lot to think about. In fact, he inspired all kinds of people, not just clinicians. Some of his ideas made so much sense that we have incorporated them into our everyday lives: ideas like the Freudian slip, when you accidentally say something other than what you meant to say.
Basically, Freud recognized, explored, and gave some evidence for the fact that a big part of what motivates and even bothers us takes place at the unconscious level — that is, unknown to the person.
Q: So how do you find what's hidden? Give me an example.
A: OK, how about this: A ballplayer having a slump started talking to a therapist and discovered that he was conflicted about success, because his twin brother was failing in business. This surprised him, because he was not aware of this connection with his slump before talking. In fact, his dreams had been about this brother for several weeks. Today, we take the unconscious for granted and accept that it exists. Talking helps us find it.
Q: What about the cost?
A: Money is not the biggest obstacle. There are experienced, well-trained analysts who accept reduced fees, and there are students in supervision who will accept low fees. Time seems to be a bigger issue today, but many analysts offer telephone or Skype sessions when necessary.
Q: So, what do you analysts do, and how does it help?
A: First of all, it’s really what we do together. I may be an expert at understanding how human beings develop and what makes them tick, but everyone ticks differently, and it’s what you say and how you say it that helps me tune into you. If you say what you're thinking about as you think it — what we call free talk — we get to see what's on your mind and then make connections.
For instance, once, during a first consultation session, a person said she hated my waiting room. When she talked about it, we learned that the real issue for her was waiting. She had been kept waiting all her life — and the very idea of a room for waiting was upsetting. My waiting room is pretty comfortable — magazines, bathroom, closet, etc. — and no one had ever complained before, so the first consultation gave us both a big clue to her whole life, from starting school, work, friends, and even sex. This lady in waiting became fascinated as she began to explore the myriad feelings that waiting evoked.
Q: How do I know who is a good analyst?
A: Most of the time, you sort of click. You feel listened to in a special way. And you should ask about her training. A lot of folks have trouble in relationships. A major aspect of psychoanalytic work is the connection between patient and analyst. As that connection grows and deepens, it both reflects and affects relationships outside the analysis. What happens in the office is a microcosm of what happens in life.
One more thing: Psychoanalytic work is tailored to the individual. Some people take to it quickly, others go slowly. But there seems to be a force in all of us that wants to explore, and the analyst makes a good guide.
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Jane S. Hall, LCSW, FIPA, Past President of the Contemporary Freudian Society, member of the IPA, ApsaA, AAPCSW. A Training and Supervising Analyst who teaches, lectures, and consults around the world on how to deepen psychoanalytic work and other topics for the past thirty years. Hall is the author of: Roadblocks on the Journey of Psychotherapy (2004), Deepening the Treatment (1998), and various articles, and is on faculties of three NY institutes. Hall is in private practice in New York City.