Deepening Psychotherapy Into Psychoanalysis

I am sorry to have missed the discussion on Psychotherapy and Psychoanalysis in June, 2019, but I would like to respond to Alan Sugarman’s report published in TAP 53/3, page 6: “Should Psychoanalytic Candidates Be Taught Psychotherapy?”

Analytic identity depends on the conviction that psychoanalysis is the treatment of choice for most people who cross our thresholds. Building an analytic identity depends on doing analysis. The more analysis one does, the firmer the identity.

What was not mentioned in the discussion that Alan summarized was building an analytic practice. How does one deepen psychotherapy into psychoanalysis? Over the past 45 years most of my patients began analysis because I offered it. Many of these patients knew nothing about it and some education was required. Aside from those who came for analysis, nobody leapt onto the couch. My conviction, expressed in ways the particular patient could hear, was the determining factor. Of course, time and money were issues, but what each patient really wanted to know deep down was whether I could tolerate her/him, and a period of testing, taking various amounts of time made sense. In fact, rather than seeing this as resistance, I saw it as quite logical.

Deepening the treatment is a skill and I would like to suggest that every institute offer seminars on shifting psychotherapy to psychoanalysis. Our colleagues-in-learning would be well served as would their patients. After all, the reason for attending a psychoanalytic institute is to practice psychoanalysis. The talk about empty couches is discouraging and so it is incumbent on our institutes to teach how to deepen the work. This often includes preparation for analysis.

Howard Levine’s 2010 paper “Creating analysts, creating analytic patients.” (Int. J. Psycho-Anal., 91:1385–1404), and other writings should be recommended along with discussion. Role playing is one method I have used with good success.

There are specific techniques that can be tailored to the individual patient who has come for counseling and needs the deeper work of psychoanalysis for lasting growth and change. The analyst’s conviction in the method will overshadow the resistance that often takes the form of focusing on analyzability. Neville Symington writes eloquently on this as did Merton Gill and many others.

Jane Hall, CSW, FIPA

Jane Hall, CSW, FIPA, past president of the Contemporary Freudian Society (CFS) developed the CFS Psychotherapy Program, which she teaches and supervises in New York City, nationally and internationally. She is the author of Deepening the Treatment.

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