Psychology for Dummies (75 page)
Read Psychology for Dummies Online
Authors: Adam Cash
Tags: #Psychology, #General, #Body; Mind & Spirit, #Spirituality
What if psychoanalysis was a sport, and it had its own Monday night television show? Just for fun, imagine that it was more popular than Monday-night football. I hope I didn’t lose any of you football fans — stay with me.
“Welcome to Monday Night on the Couch. I’m Dr. Clearview, and with me is my partner, Phil Good. Tonight we bring you a session of the psychoanalysis of John Smith. If you remember Phil, Mr. Smith felt pretty bad when he left his last session with the Dr. Freud. . . .”
What would these announcers possibly have to commentate on? You might be surprised. There’s a lot going on in therapy. In fact, one of the ways that therapists learn how to do therapy is by watching others do it and then dissecting what they see. The therapists-in-training watch therapy training videos or observe live therapy from another room.
How would you know psychoanalysis if you saw it? It may help to think about psychoanalysis from four different perspectives: the pragmatic aspects, what the patient does, what the analyst does, and the overall process of the analysis.
The logistics are easy. The patient sets up an appointment, goes to the office, and meets the analyst. They work out the fees and schedule. Classic psychoanalysis involves anywhere from four to six sessions of therapy a week, but most people can’t afford this many sessions. Therefore, many psychoanalysts have learned to perform a scaled down version with only one to two sessions per week. Sessions last about 50 minutes in both classic and the shorter version of psychoanalysis. After getting acquainted, the patient and analyst get to work.
The patient talks; the analyst listens and comments. A patient is encouraged to discuss anything that comes to mind and not to filter or edit what comes out. The analyst lets him ramble a bit but periodically will emphasize something the patient says in order to increase his awareness. The typical length of classic psychoanalysis is five years or so. Most people don’t go for that long because they’re involved in a variant of truly classic psychoanalysis, which I discuss in the “Transferencing to the New School” section later in this chapter.
Taking a load offOf course, no discussion of psychoanalysis would be complete without discussing the
couch.
The picture of a patient lying on the couch is one of the most popular images of psychoanalysis. The analyst sits upright in a chair, out of the line of sight of the patient, for technical reasons related to the task and goals of the therapy itself. Freud used the couch but not exclusively, and today most psychoanalysts are no different. Psychoanalysis does not have to take place on the couch, but in order for it to be truly “classic,” a couch is preferable.
Remember that psychotherapy, in general, and psychoanalysis, in particular, are defined by professional relationships with specific goals in mind. The roles of each of the participants are specified to bring about the desired goal of getting better. In other words, there is a certain way to behave in psychoanalysis. But it’s not as strict as I make it sound.
It may seem obvious, but the patient is expected to come to his or her appoint- ments on time and pay his or her bill appropriately. These practices are important in maintaining the professionalism of the relationship because it isn’t just two good friends chatting about life.
A lot of patients come to therapy with a “fix me” or “give me all the answers” attitude, as if just showing up and passively talking about their problems is enough. That’s not going to get the job done. In fact, a lot of people underestimate the amount of work that goes in to being a patient. Patients sometimes leave therapy early in the process because things get too difficult or too much effort is required or them.
It’s not like a psychoanalyst is going to ask you to drop and give her 50 pushups in the middle of the session. But you are asked to think critically about the things being discussed in the analysis. Sydney Pulver provides a good summary of some of the expectations of patients:
Notice how unconscious material arises during the session.
Be willing to experience strong emotions and face negative memories.
Focus on understanding the process of how the relationship between the therapist and patient produces change.
There should be a disclaimer at the beginning of all therapy stating that the therapy may not be all that fun, and it may even be downright painful. No pain, no gain I guess!
Perhaps the most important task that a patient in psychoanalysis is asked to do is
free association.
As the analysis begins, the therapist instructs the patient to lie on the couch and begin talking about anything and everything that comes to mind, no matter how absurd, silly, or embarrassing it may be. The idea is to get in touch with unconscious material by not “editing” what one thinks about and talks about. This process can be pretty difficult and sometimes takes a while to get the hang of. The only rule is to talk about whatever comes to mind, providing the patient, herself, and the analyst access to hidden conflicts and impulses.
Sometimes it’s hard to remember all the things discussed in therapy. Take a pen and some paper! A lot of good information comes up during therapy, and it’s a shame to forget them. Write them down. Take your own notes. This might help maintain the gains outside of the therapy room.