By Dora Ghetie
It is 7 p.m. on a Friday night. I am sitting at the bar, in one of my favorite restaurants, waiting for my date. This is my first date with Andrew. Normally I would be nervous but I have been on so many first dates lately, I feel totally confident. Being on a first date is strangely similar to conducting an intake. I cannot help it-as a fifth year doctoral student, soon to become full-fledged psychologist, I am immersed in therapy: doing therapy, being in therapy, and reading about therapy. This is my life. My fondness for psychoanalytic therapy is a further problem. All day long I listen for what is not being said and I try to look for patterns and how they show up in the transference. I cannot turn it off. So before long I ask my dates: tell me about your family. What's your earliest memory? What kind of relationships have you had? Do you dream? Just like an intake. Hmmm…maybe that's why there have been so few second dates.
Andrew arrives. After the initial awkwardness, we get down to it. Tonight, I tell myself, I will not act like a psychoanalytic therapist. I resist the impulse to ask lots of questions and instead I volunteer information about me. I keep going even when I feel I've talked way too much. I force myself not to take care of Andrew. Yet I notice that he is playing with the silverware. Nervous, I say to myself. I also notice that when I comment on the silliness of the whole dating process, he interrupts me to say he thinks it is great fun. Defensive, maybe? A bit histrionic? Later, he tells me in great detail about how much people at his job like him. Red flag here, narcissism alert! Well, at least he seems to be using higher-level defenses. No, no, no, don't do this, stop it. This is not an intake! I keep these thoughts to myself, confident that I have perfected the art of the blank screen. He will never know what I'm thinking. I do feel a bit guilty though, like I have this special knowledge. Of course, I could be wrong.
An hour later, I am feeling pretty good about this date. He hasn't even asked me how I can sit and listen to people's problems all day. On my last date, just for fun, I answered that it's because I get sadistic pleasure from it. Never heard from him again. Eventually though it happens-Andrew is talking about his last girlfriend and I say, "wow, she sounds a lot like your mother!" Oops! Luckily, he takes my comment in stride, jokes about me playing therapist, and moves on. But I am deeply disturbed. Can I please have just one date without thinking about dependency conflicts, castration anxiety, and character structure? Without reading between the lines? Without noticing body language and wondering how it relates to what's being said? In the beginning, I used to think these skills were very useful because I could use my clinical intuition to assess a potential mate. But now I feel burdened by trying to figure out how to be, just be a woman and not a therapist. I just want to be on a date!
Towards the end of the evening, Andrew does ask me one inevitable question. "So, have you been analyzing me all night?" Well…yes. I am exposed. I use a classic technique: "What do you think?" Andrew smiles and nods. "So what's the verdict?" I appreciate his sense of humor but somehow I don't think a full explanation of Alice Miller's theory on narcissism is appropriate. Instead, I smile and tell him it's too soon to tell. He seems satisfied. At the end of the night, he kisses me good-bye. In that brief moment, I forget to think. At least for five minutes I stop being a therapist. Then, I am driving home and back in therapy mode: I wonder what his father is like? Was he acting too confident because of anxiety or an inferiority complex? What did it feel like to sit with him? It never ends.
Dating is only one of the many challenges I have encountered in my quest to become a psychoanalytic therapist. My worldview has become fundamentally different over the past few years. I have always been curious about people, about the unconscious, about the things we do that do not make any sense. But now, it seems that I literally see the world with special glasses. And strange glasses at that. A month ago a friend visited from out of town. As I was rushing to get to my therapy appointment, she seemed puzzled. So what if you're a few minutes late, she asked. No, no, then I have to talk about it, who knows what it could mean. What?? I explained to her that actions often have hidden meanings. She looked at me as if I were an alien. Of course, I had already diagnosed her as an obsessive character, with much isolated affect and poor insight. So, I knew her dismissal of my explanation was defensive.
Family gatherings have become an opportunity to practice family therapy. Actually, I served as my family's therapist long before discovering psychoanalysis; I suspect this is true for many of us. But now it is quite a different ballgame. I am equipped with knowledge of boundaries, alliances, enactments, and transgenerational patterns and they are ready with one simple phrase "Stop psychoanalyzing everything"! My family members are the reasonable sort-they are scientists and avid believers that what you don't know can't hurt you. I have always been an oddity among them, with my desire to know more than was being said and my need to acknowledge feelings. Thus, I found it very comforting to discover through my training that they're the weird ones and not me! My world is richer, more honest, and filled with insights.
Sometimes I wonder though about this world I am now living in. A world in which people fall in love because their neuroses are compatible, in which altruistic acts are motivated by anxiety, or a depressive character, or even repressed sadistic urges. A world in which faith in a supreme being exists to defend against existential anxiety. In this world, people often say one thing but mean another, act in ways that contradict their explicit desires, and are often unaware of what they are really feeling. This is a strange world indeed. As one my clients recently said to me "are you saying that I could actually be angry at you but not know it? Now that's a mind-f***"!
I spend most of my time surrounded by fellow psychoanalytic clinicians. Our reality rests upon many assumptions that we take for granted. Assumptions about human nature and the value of self-awareness guide us. Therapy seems to be the answer to every human struggle. Can't find a meaningful relationship? Problems in your marriage? Difficulty at work? Go see a therapist, or better yet, consider psychoanalysis. Mourn your past losses, understand your inner conflicts, and work through the therapeutic relationship. I find it paradoxical then to discover clinicians whose ability to self-reflect appears to be severely impaired. Surely we all have our blind spots but hopefully they are not too large. Most psychoanalytic clinicians have participated in long-term therapy or analysis, but clearly with limited results in some cases. Maybe they had a bad therapist. Or maybe they were even less aware before therapy. But maybe it is wrong to assume that therapy is always the answer.
I don't know how to give advice anymore. Within our psychoanalytic community, conversations with friends are easier because we operate according to similar principles. A problem occurs, we empathize and analyze. We speak the same language. But I still have non-psychologist friends. They appreciate my willingness to listen and my desire to be helpful. However, I am finding it increasingly difficult to be a friend and not a therapist. I cannot listen to someone relate a story to me without relating it to what I know about him or her and wondering what would be the helpful thing to say at any given moment. I have lost a great deal of spontaneity. "Why does this always happen to me?" a friend might ask. I have some ideas about that, but should I really tell her? Would she be able to hear it? Should I empathize with her or would it be better to comment on her role getting herself into the situation? I do not know. What I do know is that I feel less genuine because there are all these things I am thinking that I cannot share with her. Another time she tells me she is in love. She is happy. I feel certain the relationship is doomed; I look ahead and feel confident in my predictions of what will transpire. But she is happy right now. If she were my patient, I would not hesitate to share my reservations, even as I validated her current feelings. As a friend, I don't know what my role is. Of course I know that friends often tell each other things that are difficult to hear and I believe if I were not a therapist, I would not hesitate to tell her my concerns. The very fact though that I am a therapist makes me cautious and self-conscious about sharing my knowledge of her.
Sometimes I wonder if my current struggle to exist as a psychoanalytic therapist is a function of my status as a student. As I have tried to learn all I could about the theory and practice of psychoanalytic therapy, I have often felt overwhelmed. The lack of simple answers is difficult to tolerate for a beginning clinician. The desire to impose some structure upon the therapeutic relationship has encouraged me to give too much weight to diagnostic issues. I find that the longer I work with someone, the less able I am to give a clear diagnostic conceptualization. The uniqueness of the individual emerges over time and takes precedence over any attempt at categorization. This is as it should be. But the drive to organize complex information is quite strong. Perhaps this is why it has taken over my life and led me to hypothesize about my dates, my friends, and my family members. Armed with this new body of knowledge, I have come to know myself and those around me in a different way. However, I realize that I am at times using my new skills to avoid being present. Beginning treatment with a new client is difficult and so I search for artificial categories to guide me. Having relationships with other people is also quite challenging and so I analyze their dynamics in order to feel a sense of control. And, I must say, it can also be great fun.
I find myself standing in the corner at a party and watching people. I become fascinated by their interactions. Ideas about relational patterns and group dynamics are swimming in my head. Being a psychoanalytic therapist has provided me with a unique kind of knowledge. I always suspected that appearances are deceiving and that what lies beneath the surface is what really counts. Discovering that there is a whole community of people that share this belief and that there are thousands of books and articles written about this made it real for me. I was so excited to delve into the different theories and to experience first-hand, as a therapist and as a patient, the power of the unconscious. Every once in a while I have come home, after a particularly powerful session, and thought to myself "wow! They are not kidding. This stuff really exists, and it really works". Despite my (hopefully) humorous questions about the nature and value of psychoanalytic thinking, I know it is often right. I can step away and notice how it fits with my personality, and I can wonder if that's what makes it feel right to me. I can also look at psychologists who are vehemently opposed to anything psychoanalytic and see how other approaches suit them better. In doing that, however, I am being a psychoanalytic therapist. The constant wonder of what motivates all of our actions is the essence of psychoanalysis.
However, it is lonely sometimes. At this party, I feel privy to a world to which my fellow non-psychologist party goers do not have access. It is an interesting world but quite different than the one most people live in. Sometimes I feel privileged and superior, other times I feel like a lunatic. All psychologists are crazy, aren't they? It is not hard to see how this popular belief arose. There are certainly enough psychologists who are crazy, even by our standards. But even those of us that consider ourselves more or less "normal" can appear quite odd to the outside world, with our talk of unseen forces at work, hidden meanings, and defense mechanisms. The first time I heard about projective identification I wondered if my professor was losing it. Put feelings into someone else? Then elicit them by compelling the person to feel a certain way? In order to recreate a past dynamic? Excuse me, I wanted to say, but I just learned about psychotic processes and this sounds vaguely familiar. At a later time I was taught about parallel process. Let's see, I feel a certain way about my patient but I am not aware of it. However, my behavior in supervision stimulates the very same feelings in my supervisor, and it is all related to the patient's childhood relationships, and maybe to my own. It is like transference and countertransference, but weirder. Yet, over time, these and other such mysterious concepts have come alive for me because I have experienced them. Aside from the possibility that I am slowly slipping into psychosis, I have to believe that no matter how strange some psychoanalytic ideas may sound at first, they do describe human interactions quite well. So I don't think I'm crazy. Still, I wouldn't want to be the one to explain the theory of Melanie Klein to a roomful of non-psychologists or even non-analytic psychologists. The layperson would think that it's true, all psychologists are nuts, and the other therapists would feel comforted that they chose a more reasonable approach. After all, who is ever going to prove in an experiment that projective identification and parallel process exist?
Living as a psychoanalytic therapist can be a lonely existence even among psychologists. We are a minority and we are dismissed and even despised by a large number of fellow clinicians. We are forced to justify ourselves in so many ways. A great rift exists within the field of clinical psychology. There are those psychologists who have science on their side, manualized and empirically-validated treatments, specific techniques, concrete methods of evaluation, and claims of short-term success. We are on the other side. We have some research too but it is not great. We will never be able to prove in a scientific way that there is such a thing as projective identification, or even something as fundamental as transference. We have become more creative in our research but still, we cannot compete. Our therapies are long, ambiguous, without much structure. We believe they work because we have seen it. But we will never be able to come up with an empirically-validated treatment. Even if we could somehow operationalize our concepts and design complex long-term research studies, we do not want to. Nancy McWilliams (1994) points out that in general, clinicians have very different temperaments from researchers. We prefer studying people one at a time. More importantly, we are not willing to subject our patients to that kind of scrutiny. All healers struggle to balance the need for giving people treatments that work with the need for privacy. Using human beings for research may be necessary but it raises a profound ethical dilemma. I believe that most psychoanalytic clinicians have resolved it by choosing to implement treatments that make sense theoretically and have proven efficacious in their work. It is most definitely not a perfect solution but it does afford the kind of freedom that is sacrificed by the scientific method.
One other major advantage of seeing the world through psychoanalytic glasses is that greater understanding fosters a non-judgmental attitude. Every day I see how the inability to take another person's perspective results in heartache. People hate one another without stopping to wonder why. Relationships end because of lack of communication. Parents abuse their children in so many ways and feel entitled to it. Over and over I am struck by how primitive emotions combined with limited self-awareness lead us into personal, social, and political failures. Maybe I do see love as two people fulfilling each other's childhood needs, or altruists as closet sadists, or religious fanatics as driven by the failure to acknowledge existential realities, but I also know that all these things are part of human nature. Furthermore, the understanding of what may be operating under the surface does not diminish the rapture of love, the value of an altruistic act, or the experience of religious faith.
Ironically, psychoanalytic therapists are often seen as very judgmental. We are accused of pathologizing people. Although some clinicians do use psychoanalytic theory to justify their authority over others and to create distance, I believe the vast majority of us have become more empathic and tolerant as a result of practicing psychoanalytic therapy. We understand that human beings need to come up with solutions to somehow resolve intrapsychic conflicts or developmental deficits. Such solutions are sometimes misguided or destructive, but they represent an effort to negotiate the vicissitudes of human existence. Thus, we do not judge and we make an effort to reach out and see the world through different eyes. Surely we have our own biases that at times impact our personal and professional lives, but our guiding philosophy teaches us to respect differences among our fellow human beings. We know that human emotions are often powerful and seemingly undesirable for they threaten our preconceived ideas of how we should be.
Psychoanalytic theory challenges us to accept that well-being is not about happiness, strength, moral fortitude, or perfection. Instead, well-being has at its foundation compassion for oneself and for other people. Such compassion arises naturally when we understand that our fears may represent desires and our wishes may conceal past hurts. Though psychoanalytic thinkers are often criticized for holding a negative view of human nature, this criticism arises because of the very fact that certain human emotions are judged to be inherently negative. In fact, the ability to have complex and often contradictory feelings is what makes us human. Ethel Person writes:
We are all too easily seduced away from the truth, the reality, of our own inward experience, which may often seem beyond communication and hence beyond respect or value. Too easily, in the name of the good, or the rational, or the moral, or the Christian, or the democratic, or even the merely socially acceptable, we blink away the actualities of our condition-the feelings, drives, dreams, and desires that express, with painful accuracy, the depths at which we really live. Not where we think or imagine we should live, or where society advises us to live, but where our lives are fueled and our deepest satisfactions experienced-this is what we disregard (Person, 1988, p. 19).
And so, what shall I conclude about the perils and joys of living as a psychoanalytic therapist? It seems silly to conclude anything considering that I am such a neophyte. As I look over this essay, I wonder whether my feelings of alienation, which have accompanied my development as a psychoanalytic therapist, are especially salient because I felt isolated within my own family. I have to shake my head and smile-obviously, I am now stuck with this new way of being in which seeing connections and asking questions is automatic. There are certainly times when it is cumbersome and perhaps even costly. Yet, I would not have it any other way. Being a psychoanalytic therapist has enriched my world in a myriad of ways and has enabled me to live authentically. So, to all my future dates I say, be forewarned: I will analyze you and I will say really strange things sometimes. But you will see, life is much more interesting this way.
References
McWilliams, N. (1994). Psychoanalytic Diagnosis. New York, NY: The Guilford Press.
Person, E.S. (1988). Dreams of love and fateful encounters: The power of romantic passion. New York, NY: Penguin Books.
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