Psychology for Dummies (76 page)
Read Psychology for Dummies Online
Authors: Adam Cash
Tags: #Psychology, #General, #Body; Mind & Spirit, #Spirituality
So let me get this straight — I’m going to pay a psychoanalyst, and I’m the one that has to put out all of this effort. What’s the sense in that? I’m sure military recruits think the same thing when they first get to boot camp and have that tough-nosed drill instructor in their face, putting them down and challenging their commitment. The drill instructors will tell you that it’s in the recruits’ best interests. Psychoanalysis is a far cry from boot camp, but you are asked to believe that it’s all in your best interest. Fortunately, analysts play a greater role in the process than just stating, “It’s for your own good.” Patients and analysts alike both have duties in therapy.
The analyst is expected to
Be empathic and communicate a certain level of care for the patient, a professional level of concern.
Be aware of his or her own inner conflicts as well. That way, the focus in the therapy session can be on the patient’s problems and not on the analyst’s difficulties. If the analyst’s problems start to dominate the session, the analyst should seek immediate consultation with his or her own therapist, a colleague, or a supervisor.
Remain objective and morally neutral with regard to the patient’s problems. Classic psychoanalysts used to be expected to be a “blank screen” and to introduce as little of their own personalities as possible into the process. That way, whatever the patient free-associates about is related to the patient’s inner conflicts and not a reaction to the actual person of the analyst. This is a “pure” approach, and most analysts today feel that it need not be adhered to absolutely. It’s okay to be a little more interactive with the patient in order to facilitate change and give a little more personal connection than a blank screen would.
Work respectfully with the patient’s anxiety, not overwhelming or over-stimulating the patient. When a patient comes to therapy, he may be experiencing a great deal of fear about what’s going to happen during the sessions. The analyst shouldn’t push the patient too hard or too fast to talk about things that he may not be ready to talk about. There’s a reason that people are not aware of their inner conflicts, and a good analyst respects this, pacing her comments.
T. Reik in 1948 stated that a good analyst learns to listen with his or her “third ear,” trying to find the unconscious conflict within each statement of the patient. Unconscious conflict can also be observed in the material of dreams, jokes, and slips-of-the-tongue. (Read more about those slips in Chapter 10.) The analyst is supposed to notice these signs of unconscious conflict and make appropriate comments when the timing is right. Analysts attempt to understand what is going on at all three levels of the patient’s consciousness at once: the unconscious, preconscious, and conscious. For more on these levels of consciousness, see Chapter 10.
What the analyst actually chooses to comment on and when he or she comments depend on the particular conflicts of the patient. The analyst makes
interpretations,
explanations that add to the patients’ knowledge and awareness about themselves and the connections between their inner conflicts and current problems. Interpretation is the primary tool in the analyst’s toolbox. It’s his or her best means for increasing a patient’s awareness, and to many psychoanalysts, interpretation is synonymous with psychoanalysis, itself.
Analysts don’t just interpret any little thing in therapy — “I noticed that you folded the tissue I gave you into fourths and not thirds. . . .” It could get pretty ridiculous if that was the case. There are specific things that the analyst finds necessary to interpret and comment on. Because the goal of interpretation is increased awareness, the analyst makes interpretations about unconscious material that is just below the surface of consciousness. Rather than just making statements that seem to come out of nowhere, the analyst attempts to push the patient toward awareness, letting her arrive at the insight on her “own,” with a bit of gentle guidance. It’s not as fun if the analyst gives you all the answers.
Sydney Pulver identifies at least five types of interpretation:
Resistance interpretations:
Pointing out the things the patient is doing to resist the process of analysis and change
Transference interpretations:
Pointing out when the patient relates to the analyst in a way that is similar to earlier relationships the patient has had
Extra-transference interpretations:
Pointing out when the patient is relating to other people in a way that is similar to earlier relationships the patient has had
Reconstructions:
Pointing out the patient’s thoughts, emotions, and behaviors that may “fill in” incomplete memories the patient may have
Character interpretations:
Pointing out maladaptive behavior that seems to be a core aspect of the patient’s personality