Contemporary Psychoanalysis

“An analyst trained in contemporary psychoanalysis focuses not just on past experiences, but also on the here-and-now of an individual's experiences and relationships. Attachments, separations, and losses beginning in infancy influence one's personality, as do current contexts of living, working, and loving. A contemporary psychoanalyst is interested in mutually exploring your past and present experiences and relationships. He or she participates in a dialogue with you to develop understandings about your life.” -- Institute of Contemporary Psychoanalysis

I think most of us have associated psychoanalysis with Sigmund Freud, whom is considered the Father of Psychoanalysis. If you are a fan of the current AMC television series “Mad Men”, you can see snippets of a classical (Freudian) psychoanalysis. Classical Freudian analysis has a clearly defined path of which the patient should follow for a successful analysis and the interpretations are all directed at achieving this goal. The analyst is an innocent witness to the patient’s progress through the required steps of awareness to complete the analysis. The analyst will perceive any deviations from this path as the patient’s own resistance to awareness or reenactment of problems from the patient’s own past.

Contemporary Psychoanalysis encompasses many different theories and approaches though I would like to focus on Intersubjective Systems Theory, since this is the approach I ascribe to today with a mixture of attachment theory and few other schools of thought.

In this theory the analyst is not seen as directing or instructing the patient through the desired steps as with Classical Freudian analysis and many other psychotherapies but as a partner in the (therapist) analyst – patient relationship. In a paper by Donna Orange she defines intersubjective clinical sensibility as having 3 components. Let me try and explain the 3 components as I understand them.

1) The analyst does not assume the role of all knowing but recognizes the process of engagement, the need for self-reflection and the understanding that their presence influences the relationship.
2) The theory focuses on the emotional beliefs that create the lens through which the client (patient) views their world (organizing principles).
3) The analyst respects the reality of the patient and their view of the world and tries to come understand it and explore it.

The understanding and training of the analyst opens up an area of exploration for the patient where they can consider and understand how they came to view the world and themselves. Attachment theory considers the effect the mother (primary caregiver) has on her infant, how her emotional state, ability to relate and respond to the infant establishs a pattern of how the child will relate to the their world experience and themselves. An anxious mother will often create an anxious child and one who is trying to please others to establish a safe connection. Whether they feel they have a secure attachment to mother and view the world as a safe place or whether they have an inconsistent attachment and fear depending on others, is a simplified view of attachment theory and hopefully enough to give the general meaning.

Psychoanalysis means a commitment of 3 to 5 sessions per week, psychoanalytic psychotherapy can be 1 to 2 times per week. I have found it to be an amazing experience to develop such a close relationship with my analyst and feel the safety of the multiple sessions. At first I was concerned I wouldn’t have enough to talk about. What I found is that like with any relationship where there is a lot of consistency, the other person knowing your world the relationship becomes deeper. When we have grown up without this safe consistent relationship it can also be frightening to have someone so close, our fears and anxieties will surface. Here the work can begin, to have a healing experience with someone who knows us, to understand our fears and anxieties and to feel we are not alone. I think most of us come to therapy because we didn’t get the support, encouragement or interest that young children need to feel valued and vital. It wasn’t that our parents purposefully didn’t give us what we needed but most likely they themselves didn’t get it so couldn’t give it. It is within this relationship that deep beliefs can be challenged and changed. We can never change what our history is but we can become aware of it and realize that some of what we believe to be the truth may not really hold up. It might have been the truth in our families but not be the truth for the world at large.