psychoanalysis

[steelwork]

I was ripped open by my breakup, a year and a half ago. Just trying to get back on my feet, I found myself going deeper and deeper into core wounds. I have been seeing a therapist who I think is wonderful and who has helped me like no other. I was seeing her twice a week, but my insurance won't pay for more than once a week anymore. Also, I moved in November, so seeing her has meant taking the bus 5 hours each way every week and staying overnight in my sister's guest room. My therapist and I both feel that the exhaustion of that travel is a counterweight on the benefit of the therapy. I actually considered moving back so I could continue with her

I have an opportunity to begin with a training analyst at a very respected training institute. I have the time, and it's very inexpensive. They ask for a two-year commitment.

Trying to decide whether to commit. Do any of you have experience with psychoanalysis? Would you care to share you experience?

[eeks]

Hi steelwork,

This topic has been on my mind recently.  I can offer some comments, with a disclaimer, that because psychoanalysis is such an in-depth personal relationship, it depends so much on the people involved that any comments I make on my relationship with my former therapist may not be relevant to you.

One of the benefits of psychoanalysis is that rather than telling you your feelings are "irrational" (as CBT might) and to just change your thoughts, there's a different attitude towards emotions, that is more accepting at least in theory.  No matter how disproportionate a reaction may be to the actual facts of the situation, the emotions are seen as having roots in the person's history somewhere, and are (again, at least in theory) coming up to be healed.

I found the idea of anxiety as a defense against other, what I call "forbidden" emotions (in my case anger and sexuality) insightful.  This, however, depends on how good your therapist is at making educated guesses about what's forbidden for you.

Skilled dream interpretation can also be really cool. 

Another benefit is that modern psychoanalysts usually know about attachment theory, which I predict/hope will be the next trend in psychotherapy (a recognition that even though changes occur in the client, it is the relationship, the emotional attunement and empathy of the therapist, that is the catalyst for healing)

I would, however, hesitate to recommend psychoanalysis to someone who tends to be "in their head", cerebral, intellectualize and rationalize things instead of feeling, experiencing and moving through them.  I believe that psychoanalysis exacerbated my worst tendencies in that way.  I would say something, and my therapist would respond that it sounded related to how I felt when my mother did something-or-other when I was a child or teenager.  I would sometimes find these connections helpful, however, I often felt invalidated when I felt I was trying to communicate something important to my therapist about what he was doing here now today and how it was not meeting my needs, and he seemed to not be able to receive that without getting defensive (I now realize that he JADEd on a regular basis) or telling me it must be about something going on with me (not him).  So, yes, he knew about attachment theory, but I wouldn't say he used it sufficiently in the therapy.

The other thing is, I started to wonder if talking about my parents all the time was making me angrier at them, not less angry.  I also began getting angry that the therapy wasn't leading to any noticeable results in my day-to-day well-being, or ability/willingness to start job searching in an active way, and date confidently, believing I have something to offer a man.  My therapist was convinced that my anger about that was actually anger at my parents that I needed to continue to vent at him and "see that he wouldn't disappear".  I told him that he did in fact disappear, because he got defensive.  I also noted that I would be willing to feel this anger for, say, a few sessions, if that led to some insight or resolution, but it just went on and on, and I was just feeling worse.  Eventually I terminated therapy for that reason. 

I just recently came across some references in Harville Hendrix' Getting the Love You Want (I've read his book for singles, this is the one for couples, still relevant to single people who want to prepare for their next r/s!) that may explain this experience I had.  He said he used to have couples vent their anger at one another, based on the psychoanalytic idea that people are containers of pent-up emotions and need to vent them.  But modern neuroscience is showing that experiencing anger over and over can make a person feel even more angry.  Instead, he now has couples look for and express the more vulnerable emotions underneath the anger, like shame or fear.  My therapist did not have any tools to assist me to do that.

In fact, I think being in psychoanalysis had a negative impact on a couple of my friendships, as I began to feel more comfortable with spewing anger and even developing subtle expectations that that was OK.  So what I really needed was not "let it rip", but ways to look for the needs under the anger and express those. 

The only way I would have found it useful to the degree I expected for the time, effort and money I was putting into it, is with an analyst who also used and taught a method like Focusing (which encourages awareness of emotions and sensations in the body) or was skilled at tracking client emotions and empathy.  A member recently posted about a type of therapy called Accelerated Experiential Dynamic Psychotherapy (AEDP) that sounds about like that. 

eeks

[steelwork]

Interesting. Thanks for this response, eeks. It sounds like you didn't have such a good relationship with that therapist, and that maybe he wasn't the best therapist to begin with?

The approach you describe is pretty much what I do in my current therapy. What she practices is psychodynamic psychotherapy, and she'd definitely grounded in attachment theory.

(Re. whether I have the right outlook for it: actually, one of the things that makes me feel I've made progress is that I understand now that my intellectualizing and pushing for "insight" at all costs is a survival skill I learned very young--a way of doubling down on my strengths to compensate for my weakness in terms of directly experiencing certain emotions--and that it doesn't always serve me well. And re. anger: I have to admit that I am angrier at certain problematic people in my life than I was a year or so ago. But I'm not sure that isn't totally appropriate!)

Really, I think the biggest change would be that I would be going four times a week. It seems like a real project to embark on.

How many times a week were you going?

[Grey Kitty]

Classic psychoanalysis (as I understand it) is pretty unstructured, and takes a LOT of time (multiple sessions per week for a year or years).

My wife (long before anybody thought that BPD might be an issue, and before it was particularly bad) went to see a series of doctors. She had a history of depression, and a kinda messed up FOO with an alcoholic mother, and a father with NPD traits. Anyhow, upon having psychoanalysis suggested and described, her reaction was along the lines of "You want me to spend how much time and pay WHAT for it? And I'm supposed to be the crazy one, not you?" She wasn't behaving in full-blown BPD stuff during those years, and I agreed with her.

I've also known several people who had a LONG therapy relationship (years of weekly sessions, or more... .), and while it might have helped at first, it also seemed to help them get stuck. One guy I know said that it ended when his shrink retired, and that is what saved him, as he finally found a new one who was effective... .after bleeding his trust fund dry and spending 10 or 20 years of his life stuck in pretty much the same place.

So yeah, I'm skeptical. Even people with really traumatizing childhood issues seem to be able to make a lot of real progress in a year or three, and people who are healthier than that seem to get real results with a few months of therapy.

I don't know that going for a training analyst because it is cheap. It might well be worth paying full price for somebody who is experienced and really GOOD.

I'd suggest you back up a couple steps and look at what you need/want here, and what you've already learned. And look to hire the right person for the job to get you there. Allow yourself to go shopping.

I've not really done individual T myself, but I've seen six different couples counselors with my stbexwife. I think the list helps illustrate a bit about what you might look for or find when shopping for a therapist:

• We went to see the first one not in crisis, but because we went to my wife's coworker's 10th anniversary celebration, where they thanked their therapist and described going in for an annual "tuneup" whether they thought they needed it or not. I think this is a great idea for any marriage. (Looking back now, perhaps things would be different today if we had kept at this plan... .sigh... .)
  
  He one was great. Found him on the personal recommendation of a wise friend. He was older than dirt and had seen it all. We called him "Yoda" (behind his back). We moved, and I'm sure he's retired, and probably died by now).



• Next time we found one it was a crisis, and she somehow seriously triggered my wife. We didn't go back, but two therapists later, talking about this experience was helpful.



• Found another one, and decided that he was "nice" but wasn't going to push us to do anything. [Later heard from a friend that she discovered the same thing after many sessions, confirming what we figured out after one!]



• Third one was a charm. Not sure if she knew about BPD or not, but she was good. It was also clear to me that she had my wife's number--understood the flavor of emotionally abusive games my wife played, blaming me for stuff, and was able to help us deal with it better. She did seem to be looking to figure out my issues, but what she was trying to get me to address didn't seem to fit very well. Perhaps she would have got me to some good stuff had we continued longer. But we moved and she retired.



• A year later we were looking again, and found another good one. Got some really good stuff from her, mostly some powerful active listening/validation exercises that really helped. While we were interviewing her, I privately told her that I suspected BPD in my wife, and asked what she would do about that. She indicated that she wasn't sure having talked to my wife, but would do the same treatment in either case. Once again, we moved away and didn't continue.



• My wife cheated, we split, and we were working to attempt reconciliation. Found another T. This one was also good. He got my wife to the place of acknowledging that she didn't want to be in our marriage / was unable to stay there. (I was pretty clear--I was willing to keep trying, willing to negotiate anything but her staying in contact with the guy she cheated with.)

I've also gotta say that we both did a huge amount of personal growth outside therapy over the years--Mindfulness meditation, including long silent retreats; I did more than my wife, but we both did that. I learned a TON here on these forums, and my new boundaries and validation gave her room to learn herself. She did a lot of CoDA and Al-Anon 12-step meetings. We both have some AMAZING supportive friends who were really there for us. Some of those friends actually were retired mental health professionals, and others seemed as good if not better, without the credentials. I joked that I got thousands of dollars worth of therapy from one of them in particular. My wife also had a breakthrough at a "Large Group Awareness Therapy" weekend workshop.

Interestingly enough I seem to be doing a bit of "paying it forward" supporting some of my close friends.

Had it not been for all these things, I'm sure that I would have needed individual T to get where I am. Perhaps it would have been a faster/better path for me anyhow.

I am also considering it for some old lingering issues I've got regarding procrastination / indecisiveness.

[Grey Kitty]

OK, that was long  And it was all about therapy growth, and how I've got where I am today. You mentioned a couple things here.

my intellectualizing and pushing for "insight" at all costs is a survival skill I learned very young--a way of doubling down on my strengths to compensate for my weakness in terms of directly experiencing certain emotions--and that it doesn't always serve me well. And re. anger: I have to admit that I am angrier at certain problematic people in my life than I was a year or so ago.

Pretty sure you are on the right path on both things--going analytical is a way to avoid your feelings, and that answer won't get you very far.

So let yourself FEEL the anger. Without acting on it. Your feelings are always right. They are there for good reasons. And if you've been stuffing anger for years regarding problematic people in your life, it will eventually bubble back up and may be pretty powerful.

The anger is a powerful source of energy, and you can use it to do the right things. It will tell you when you are letting somebody roll over your boundaries, and give you the energy to stop them. It can also give you the energy to punch somebody, and that probably isn't a good idea. (Do you get the difference?)

[steelwork]

Grey Kitty, thanks for taking the time for this really thorough response! I hope you don't mind a thorough response to your response.

Re. your wife's experience: I've heard that analysis is not recommended for personality disorders. That makes sense, since it requires a lot of creative participation from the patient (as opposed to more structured therapies like CBT or DBT). I could see that it would be hard if there were too many thought distortions and fears and impenetrable defenses getting in the way.

I've had a lot of experience with "regular" therapy, usually on the psychodynamic model--which is closer to classical psychoanalysis. As I said, the main difference in this case would be that I'd be meeting more times a week, and I guess that was what I was really curious about-- I wanted to hear people's experience with that.

I've also known several people who had a LONG therapy relationship (years of weekly sessions, or more... .), and while it might have helped at first, it also seemed to help them get stuck. One guy I know said that it ended when his shrink retired, and that is what saved him, as he finally found a new one who was effective... .after bleeding his trust fund dry and spending 10 or 20 years of his life stuck in pretty much the same place.

I've been in therapy before where it pretty much just felt like it was keeping me sane. I think because I really had a life crisis this time (with current T), I went into it with a balls-to-the-wall (can I say that?) determination to get better, which is to say, I was ready to give up my conceptions of how therapy was supposed to work. I remember saying at my first session, "I have plenty of insight. Insight is not a problem. I just want to not be so sad!" Months later it occurred to me that I had sneakily gotten some real insights when I was not seeking them, and that the things I thought were "insightful" before were all about other people and not about me.

I think this time I was just more ready, needed it more, and found a better therapist. It's been over a year, but I can feel myself getting more unstuck and I have hope for the first time that depression is not something I just have to manage.

So yeah, I'm skeptical. Even people with really traumatizing childhood issues seem to be able to make a lot of real progress in a year or three, and people who are healthier than that seem to get real results with a few months of therapy.

They are lucky! Or else their progress is not what I would consider sufficient for myself.

I don't know that going for a training analyst because it is cheap. It might well be worth paying full price for somebody who is experienced and really GOOD.

Okay, this point I want to address because it might really help others here. A training analyst is someone who is qualified as a therapist already, has years (sometimes decades) of experience, and has applied to and been accepted to a psychoanalytical training institute. This is a vetting process that the average patient would never have access to. Yelp reviews and recommendations from friends are no substitute. And, yes, at as low as $10 a session, this is something I can afford, whereas I simply would have to forgo analysis at standard rates.

Then there is my current T. She's not in psychoanalytic training, but she is a postdoctoral fellow. I found her through a low-cost training program as well. Again, the principle applies: as a licensed therapist, she applied for and was accepted to an extremely competitive postdoctoral fellowship program, where she is mentored by senior faculty. I've had five or six therapists at this point in my life, and she is by far the smartest and most intuitive and (for me) best I've come across.

So please, everyone, do not turn your nose up at a low-cost alternative because it's a training program. You may be missing out on a far superior therapist to the one your boss or your friend or an online review site recommends!

Sermon over.

I've also gotta say that we both did a huge amount of personal growth outside therapy over the years--Mindfulness meditation, including long silent retreats; I did more than my wife, but we both did that. I learned a TON here on these forums, and my new boundaries and validation gave her room to learn herself. She did a lot of CoDA and Al-Anon 12-step meetings. We both have some AMAZING supportive friends who were really there for us. Some of those friends actually were retired mental health professionals, and others seemed as good if not better, without the credentials. I joked that I got thousands of dollars worth of therapy from one of them in particular. My wife also had a breakthrough at a "Large Group Awareness Therapy" weekend workshop.

That's so great! I've attended some CoDA meetings and not found much there to keep me coming back... .maybe later on... .

Interestingly enough I seem to be doing a bit of "paying it forward" supporting some of my close friends.

Had it not been for all these things, I'm sure that I would have needed individual T to get where I am. Perhaps it would have been a faster/better path for me anyhow.

I am also considering it for some old lingering issues I've got regarding procrastination / indecisiveness.

You're definitely paying it forward here--for instance, right now. This site is a goldmine. It's just not an alternative for therapy, for me.