Back in college I had a therapist who didn’t seem to do much. She would sit across from me in her armchair, staring at me blankly as I recounted various tales and woes. Even after I finished my stories she would continue to look at me, expressionless.
The silence would be awkward, and I would feel the need to fill it with something – anything – and so would go off on some random, pointless tangent that didn’t have to do with anything. More blank staring. This went on for a couple months, and I can’t say I got anything out of it.
In retrospect, now that I have some psychiatry training under my belt, I understand that her technique was a form of a specific type of therapy, called psychoanalytic psychotherapy, and that if I had understood what she was doing I probably could have learned more from the experience. (That being said, no good therapist will let you do 100% of the talking – if they do, get another therapist).
Hence I wanted to share with you the theory behind the technique, so if you are in a similar position it can be more valuable for you.
What is psychoanalytic psychotherapy?
Psychoanalytic psychotherapy has in origins in Freudian analysis. Think you, lying on a couch facing away from the therapist, talking about whatever comes to your mind for an hour a day, 4-5 days a week for years.
For most people this type of therapy is not practical (nor helpful). Psychoanalytic psychotherapy takes some of the same principles and distills them down into a more practical experience. There is no longer a couch (you sit face-to-face with the therapist), and meetings are limited to once or twice a week.
There can be variability in terms of how the therapy is structured based on the personality of the therapist, but a few things will remain constant:
- You will be encouraged to free associate and say whatever comes to your mind.
- The therapist will reveal few personal details about him or herself.
- The therapist won’t give you specific advice but will make interpretations about what you say and how you say it.
So why is this helpful?
Psychoanalytic psychotherapy is like having a mirror held up to you; it reveals back to you what you show it.
You are the center of the therapy. With the therapy process being largely neutral, the direction you chose to take it reveals core qualities about yourself.
The therapist isn’t there to tell you what to do or to directly solve your problems, but to show you the underlying factors that are driving your behavior, so you can confront and deal with them in a head-on way.
It is part therapy, part crash-course on learning about yourself.
Ideas you have about your therapist become material to analyze and work with
Because you know few personal details about the therapist, you are able to project your own ideas and fantasies onto them.
You will make assumptions about their age, if they’re married, if the have children, where they live, what personal experiences that have in common with you, etc. These assumptions and projections are fodder for analysis, and can reveal subconscious drives and motivations.
If you ask your therapist personal questions, they may not tell you the answer – but you should still ask. They will probably say something like, “What made you ask that question?” You may be annoyed they sidestepped the issue, but what they’re doing is trying to understand why the question was important to you. Talking about this issue together can be a valuable process.
Your relationship with the therapist becomes a microcosm for your relationships in the outside world
If you’re in therapy, one could safely assume that you’ve identified some sort of problem in your relationships, your work, or some other area of your life. And you could also assume that you’ve had difficulty solving this problem on your own.
Many problems have to do with difficulty in your relationships with others. Maybe you have trouble connecting in romantic relationships, or always bail when things start to get serious, or have trouble asserting yourself to your boss at work.
With the therapist largely acting neutral, major forces in the relationship are largely dictated by you, the patient. Do you always get angry in therapy? Do you acquiesce to the therapist? Are you seductive? Do you make negative assumptions about what the therapist thinks of you?
By observing and interpreting these patterns, the therapist can point out unhealthy patterns and help you develop healthier ones.
Your associations become fodder for analysis
Free association is encouraged in this type of psychotherapy, which means you can say whatever comes to your mind, when it comes to your mind. The idea is that there is a reason you say what you do when you do, even if you’re not aware of it.
As therapy progresses, the therapist can look for clues in these associations to understand what issues you may have bubbling underneath the surface. The goal is that over time, you will learn about yourself on a deeper level, and begin to understand your subconscious motivations and drives.
Psychoanalytic psychotherapy is not just a type of therapy, but a form of education where you learn about yourself.The benefits won’t necessarily be seen on a session-by-session basis, but instead come over time, as unhealthy patterns of relating with the world are revealing, and you can work on shaping new ones.
Question for all you readers out there: Have you even been in therapy? What type of style did your therapist have? Was it helpful or not? Let me know in the comments!