Psychoanalysis_issue_1_(EC_Comics)_coverAn 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 still associate psychoanalysis with Classical Freudian Psychoanalysis. If you were a fan of the AMC television series “Mad Men”, you can see snippets of a classical (Freudian) psychoanalysis, in the second season. 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 predetermined 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 (meaning the patient is acting out)

Contemporary Psychoanalysis encompasses many different theories and approaches though I would like to focus on Intersubjective Systems Theory, since this is the approach I utilize today. The reason I am drawn to this style is that the therapist/analyst is not an innocent witness nor are they the holders of what is the right or wrong way. This way of working believes the therapist/analyst must incorporate their feelings, attitudes, histories and reactions into what is happening in the room. This is called a 2 person psychology because it believes each experience includes the history, present and reactions of all people in the room. Therapies where the therapist is the authority figure and does not account for how they influence the relationship is called a one person psychology.

“Human beings are by nature relational. There is more to this assumption then meets the eye. It implies that our psychological life cannot be the life of the isolated mind; it must originate, grow and change within the intersubjective contexts in which we find ourselves.” – Orange, Atwood & Stolorow 2001: 27

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.Everyone has a subjective experience, it is our own personal experience and Intersubjective systems theory this subjectivity is understood within the context it was created. Each persons story is different and their own and we should try and undertstand their world view as they understand it. We so often jump to conclusioins and assumptions without really understanding. I see it with myself and clients but also see how hard it is for couples to understand their partner’s view of the world.

The first time I had that aha moment with this idea was when I was on vacation and had gone up to the deck of a restaurant overlooking the ocean to read. It was a cold day and off hours so the restaurant was closed and no one was on the deck. As I sat there reading about this concept a couple appeared who were wanting to take pictures and play around on the deck. I could see that my presence was inhibiting them and they were distracting me from me reading and it all connected for me how we influence one another and this has to be considered in the therapy room. Our influence is different with each grouping, how they affect me and I affect them and this is what is called the intersubjective 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 deepens the relationship. 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.