[guilloche]

I'm trying to put my finger on what kind of therapy would be helpful to me.

I had a good friend in the past who used to enjoy thinking about thinking. We had really interesting conversations about things like... how are we interacting, what did you hear when I said this, why did you react so quickly to this phrase, what does such-and-such mean to you.

Honestly, those conversations were more helpful than any therapy that I've received since then. They were great at helping me see some patterns and things that I was doing/thinking and was not aware of.

(Though clearly, I still have tons of issues!)

Form my very limited knowledge of psychoanalysis, it seems to be similar (maybe?) to those conversations?

Has anyone here done this type of therapy? It seems like every therapist lists it as one of their modalities, but... I'm not sure any actually do it?

(My last therapist listed this as one of his modalities too. But, when I tried to talk about what was happening between us - how we were working, or not, together - he said that it seemed too "meta" to him. He wanted me to focus on things going on in the real world. But, to me, it seems like working on how we were relating could be a window into how I related to other people, especially since the therapist could speak with authority on his end of the encounter, versus just guessing about what people out in the world might be thinking.)

[awkwardlyyours]

Check out the psychoanalytic institute / association in your area (most major metro areas have one) -- they may be able to give you referrals for Ts (the one in my area does) and / or you'd be able to see a member directory of potential Ts to contact.

My current T is psychoanalytically trained (she teaches at the institute here) -- she doesn't do traditional psychoanalysis (few, if any, in my area do it -- I haven't come across any that still do the classic 4x a week + lie down on the couch sort of thing and I interviewed a bunch of Ts who I got as referrals from the psychoanalytic institute).

But, yeah, we talk a heckuva lot about very nuanced stuff between us and it gets gawdawfully meta (not to mention, excruciatingly uncomfortable and intense) at times. She draws my attention to things that are happening / what I say by framing a lot of stuff in psychoanalytic terms -- projective identification, transference / counter-transference, regression, unconscious defenses and so on.

At times, I do roll my eyes at the stuff she says -- I mean, it can be hard to swallow but she usually has some evidence to back it up and so, at worst, we'd agree to disagree.

[guilloche]

Oooh thanks AwkwardlyYours! That's actually kind of fascinating to hear about, and in a weird way, sounds like it might suit me. (I'm sort of kicking myself - my first T, who was not very helpful, casually mentioned that he thought I should avoid psychoanalysis, b/c I'm very analytical about things already - sigh - but maybe it would be a good match b/c of that?)

So you mind if I ask... you mentioned intensity, and I've seen that mentioned before. Do you think it might be too much for someone with a trauma background? I'm a little scared that I might end up stirring up too much, too soon, and crashing. (My coping skills are a bit on the weak side, it appears.)

Thanks!

[itisnt]

Yes, I did psychoanalysis for three years. The T I saw had a PhD in clinical psychology, taught med students through their psychiatric rotation, and was trained for the required years in order to be deemed an analyst. She was past President of the local psychoanalytic institute in the city I was living in at the time.

She didn't practice "classic" psychoanalysis, although she was trained in it and worked in that form for a number of her early years of practice. By the time I saw her, she was in her early seventies. She was more into Relational Psychoanalysis. No need to get on the couch, although if that was your interest, she had one available. I liked her and if I hadn't moved away, I would have probably stayed with her. She was soft spoken but blunt. She was confident enough in herself that she had no problem stopping and contemplating things, saying, "I'm not sure what's happening right now, but give me a minute and let me think on it." She owned her own stuff and never lectured, but if I wanted a psychoanalytic breakdown of things, she'd accommodate me. I have a childhood trauma background and I found her approach calm and unflappable. I was pretty direct that I personally wasn't into exploring all the ins and outs of my childhood and she never pushed. If I wanted to talk about it, she'd follow my lead, but if I said, "I'm not interested in exploring that." she was just as accommodating. She was skilled, smart and well-trained. I liked her and her approach more than others I saw over the years.

[Ididitmyway]

I worked with therapists who were psychoanalytically oriented and who did what's called "insight-oriented" work which is also broadly called psychodynamic. Two of them were Jungian analysts and the other one had limited psychoanalytic training, not a classic one so he wasn't a certified analyst.

As AY suggested, you can call psychoanalytic institutes in your area if you want to get affordable psychoanalysis. When you see a psychoanalyst who is in training it's significantly less expensive. Otherwise, if you just search independent practitioners you won't be able to afford it.

As to the effectiveness of psychoanalysis, it has its strength and its downsides just like every modality. As I've made it clear on this forum already, I don't believe that the general structure of therapy, as it is currently practiced, is effective or even safe regardless of the modality, but each modality has something to offer and psychoanalysis is no different in that regard. In fact, if I had to choose between the existing methods, I'd go with psychoanalytically oriented therapy because, despite its limitations and shortcomings, to me it taps into something real much more than anything else.

That is not to say that I am advising you or anyone for that matter to undergo psychoanalysis. Not at all. Just like anything else, for some people it may be a disaster. And, yes, it doesn't often work well with those who were severely traumatized in the past. It really depends on the case and on the practitioner. It's impossible to generalize what kind of therapy works and doesn't work for whom. The best way to find out is just to give it a try and to see if this is what you need.

There's someone in 4x a week analysis, felieacan. Sorry if I got names wrong.

[waterlogged]

My T is training to be a psychoanalyst through the local institute. I didn't know that when I started working with her, and my first year/year and a half was less psychoanalytic and more generic psychodynamic. Over time things shifted - I went from 2x/week to 3x/week, and then to 4x/week in September. Finally I started laying down on the couch in December. I think it was definitely an analysis at 3x/week, but adding the 4th session made a huge difference. Laying on the couch has its pros and cons but FOR ME, it's been really helpful. Something about not having to hold myself up and hold myself so tightly on a physical level has helped me open up to relying on and trusting my T to "hold" my feelings.

I've done a lot of extra reading about psychoanalysis and I think that has helped me understand some of how it works. I'm a hugely changed and transformed person.

[feileacan]

I see a psychoanalyst 4 times a week for analysis. I've seen him for four years and I will be probably seeing him many more but even now it has been hugely helpful for me.

I guess if you are looking for the sort of conversations you described then a psychoanalysis session would be a suitable place to look at. I figure that my T would like to have these kinds of conversations where I would be curious about my self and we could freely play about thoughts why I could be doing this or thinking that.

However, this is not the way my analysis has looked like so far because I do have a very early relational trauma and all the effort has gone so far to figure out that and for me to reach to a place where relating with another person would be possible at all. Thus, much of my analysis has been about working with emotions that originate from very early age that have been unconscious for all my life and which are not related to any visual/symbolic memories because probably these originate from the age where the cognitive processing wasn't enough developed yet (first or the second year of life).

But yeah, anyway, it's basically certain that people in therapy develop transferences and a good thing about psychoanalytically trained therapists is that they are really comfortable and willing to work with transference. That is not to say that there couldn't be other therapists who would be comfortable with transference too, but you may never know while with psychoanalysts you do know for certain. You don't have to worry about if or how much you could/should talk about what is happening in your relationship with T because you can freely do it as much and as often as you like and the T would probably be very interested and engaged in these kinds of conversations to help you figure out yourself in this relationship.

[feileacan]

Oh, now I read that you have a trauma background.

My experience is that the intensity certainly draws the trauma feelings out and it means that there can be periods that are quite difficult. I've had several periods of quite intense anxiety during which I was pretty much paralysed and unproductive in my life. The only thing that kept me going was the knowledge that my next session is already the next day and that would enable me some relief (or at least a hope for a relief). The weekends were also quite difficult during the first year.

I'm still working with trauma but the feelings are much more contained now. For a while now already I'm very ok in my personal life. I think about my T often but I'm not anxiously waiting for the next session. Also, strangely the trauma feelings started to be contained in the session at some point. Previously I would go away from my session and really struggle to go on with my life. Now I go to my session and immediately the early emotions appear and even when the session ends so that I'm feeling quite bad then I step out and I'm ok again, leaving the difficult feelings into that room. It strange that it works that way but it mostly does.

[awkwardlyyours]

Originally Posted by guilloche

Oooh thanks AwkwardlyYours! That's actually kind of fascinating to hear about, and in a weird way, sounds like it might suit me. (I'm sort of kicking myself - my first T, who was not very helpful, casually mentioned that he thought I should avoid psychoanalysis, b/c I'm very analytical about things already - sigh - but maybe it would be a good match b/c of that?)

So you mind if I ask... you mentioned intensity, and I've seen that mentioned before. Do you think it might be too much for someone with a trauma background? I'm a little scared that I might end up stirring up too much, too soon, and crashing. (My coping skills are a bit on the weak side, it appears.)

Thanks!

It does bring up really intense stuff and while I'm functional, it takes a lot of energy for me to just remain somewhat emotionally grounded through the week -- especially since I see her twice a week now.

She is solidly trained in trauma (and has taught courses on attachment) and so, sees where my responses are coming from (along with the usual psychoanalytic stuff). But, despite all that, recently, we got caught up in an enactment of sorts and it's been rather hellish (better now and we've been talking about it but her responses weren't super optimal).

I still don't regret it though -- at this point, I can't imagine doing any other type of therapy. I'd get bored out of my mind if I did anything else.

Maybe if you're worried about your coping skills, you might want to spend a ton of time just building up the alliance / relationship with the T (in retrospect, I wish I hadn't jumped into a lot of stuff -- I thought I had this sort of instant trust in her and while that is still valid, the fact is that it can disappear in an instant and so, I really should've been more cautious starting out)?

Good luck

[waterlogged]

I too am dealing with early relational trauma and we have spent a lot of time in very raw, never processed, preverbal states of terror. I've seen 3 other therapists before my current T, and I believe it's the combo of psychoanalysis and my T that has made the biggest difference.

[guilloche]

Oh wow! Thank you guys so much for sharing your experiences, this is really fascinating.

I didn't realize that you needed to go so frequently (4-5x/week?)... I can see how that must be helpful in developing a relationship, in getting in to stuff, and in dealing with scary stuff (knowing you're going back tomorrow) - but I don't understand how you're able to do this with work? I don't think I can miss a couple hours (once you include driving time) of work each day...

I'll have to give it some more thought, I guess. If nothing else, it has made me realize that it's another important thing to ask about when I interview Ts... I want someone who is comfortable with talking about the relationship and interpreting things.

Itisnt - Oh wow, your previous therapist sounds fantastic! "Relational Psychoanalysis" - I'll have to look around for that, it sounds awesome. I *love* that she respected your boundaries around what you wanted to talk about... I had a T (for all of a month or so!) that, on the first session, asked me something that I was uncomfortable answering (re: the guy I was dating at the time). I told him that I wasn't comfortable discussing it with someone that I'd just met... and he kept pushing and pushing and rephrasing the question. I don't understand how a T can think that blowing past boundaries at a first session is a good way to establish trust? At the FIRST session *omg*! Thanks

Thanks, Ididitmyway. I didn't realize there could be an overlap between Jungians and Psychoanalysts - I thought that they looked at things fairly differently (though I guess I'm not very clear on all the types of therapy out there). Thanks for the advice...

QuietMind - thanks! It looks like Feileacan posted below!

Waterlogged - Ooh, that's interesting, thanks for sharing. It's interesting to me that you noticed a difference when you added that 4th weekly session. Do you find it hard to accommodate that many sessions in a week? Do you work also (i.e. a job)? What you said about not having to hold yourself up... that's really interesting, and makes sense to me! You said that you've done a lot of reading... do you find your T is willing to explain things to you too? Thanks!

Feileacan - Thanks for replying. The early trauma stuff is interesting. After reading some of these responses, it sort of makes me wonder about some of my own stuff (I tend to get very stuck and unable to speak sometimes in therapy, and no T has been helpful in understanding it, or maybe in even helping me discuss/explore it). I love the thought of being able to discuss the relationship as much as I want, this seems like a really natural way for me to work through things (but I don't think it is for everyone) - maybe b/c of my experiences with my friend.

I have to say, that's *amazing* to me that you're at a point where you can leave emotions in the room. My experience, even without getting into scary stuff yet, is that therapy stirs up/activates some of my trauma-related stuff, and then puts me in a place where I fall apart when I get out. That's been really awful for me... and not helpful. It generally feels like someone making a mess in my head, then leaving me to try to clean it up alone - week after week. Ugh!

AwkwardlyYours - Thanks! Ha.... I think it sounds silly, but I didn't realize you *could* spend time building up the relationship in psychoanalysis (specifically, I know that you can do that in other types). That makes so much sense, I just (somehow) imagined these Ts to be a bit more push and blank-screen type. Your T sound wonderful, by the way. I wish I could find someone like that - someone who can do the psychoanalysis but who also has a solid understanding of the trauma stuff!

And, that's interesting that you say any other type of therapy would be boring to you now! I hate being bored . Did your T ever talk to you about coping skills, or did you pick those up elsewhere?

And, ugh... I'm so sorry that you guys had to go through that negative enactment - I can imagine how hard that must be, especially if your T wasn't really getting it or responding well while it happened. Ugh. Hopefully that's more or less resolved now...

Waterlogged - Thanks for posting. That sounds so hard to deal with... how do you deal with the preverbal stuff when you're in psychoanalysis (if you don't mind me asking)? I tend to get freaked out and unable to speak in therapy, and I'm not sure how a psychoanalyst would deal with it. Maybe if they have experience with trauma type stuff they're better? That was one good thing about my old T... he was terrible at some things, but when I was in that freaked out place, he was good at a) not getting louder (I've had some Ts do that, which is scary and makes it worse) and b) throwing me a conversational lifeline, something that helped me start talking again, which helped bring me back, so to speak.

Everyone: Thanks so much! This is really, truly fascinating... I'm going to do some more reading and looking around. If nothing else, it's helped me clarify what I need in therapy, I think (which is incredibly helpful).

Thank you all!!!

[feileacan]

I wanted to answer to couple of more questions you raised:

1) How can one go 4xweek? I'm working in academia, which means that my working time is in general quite flexible. However, I actually have very early morning slots on two days - my session starts at 6:45 and by 7:30 I'm already done.

2) How to work with preverbal stuff? My experience is that initially you don't know and it's possible that the T doesn't know either but over time you two figure out a way to relate. For me it is so that when I can't speak then I don't tolerate silence either - I will lapse into huge stress, my pulse raises into heights and I start experiencing intolerable feelings I can't describe, which make me want to run, smash everything, scream or do anything to get rid of that feeling. Over time we have figured out that in order to avoid it my T cannot let the silence go on for too long and if it seems that I'm unable to talk then he starts talking for me in a soothing voice (like what he currently observes about me and what he thinks I might feel). His voice helps me to regulate until I get to the point when I'm perhaps able to say something. But it took quite a while to figure out what's best to do and then it is really helpful when the sessions are frequent because you don't have to suffer alone meanwhile too long. Although, during the hardest periods I have actually also called to my T in the evening when it seemed that the morning is still too far away. But as I said, I don't experience those anxieties anymore.

I was working with a psychoanalyst regularly for about a year and recently reconnected again and have been going to a few sessions. I typically went 1x or sometimes 2x a week, no interest in spending more money on it even though I do see the value in the intensity. My feeling imagining doing multiple sessions per week in the long run is that perhaps it can be counterproductive to some people like myself, who is analyzing things on my own all the time already and gets a lot of "meat" from relatively little experience. It might also not allow enough distance for more unbiased, thoughtful reflection. Again, this is just my feeling.

I definitely find it interesting and suits my generally very analytical way of thinking even though I personally disagree with quite a few of the psychoanalytic concepts and like to challenge the therapist (which is interesting on its own as I frequently do that with many people in my life).

One thing that I sometimes found frustrating in psychoanalytic therapy is that it's hard to stick with specific goals and work on those consistently as so much stuff comes up all over the map (I can do that free association thing very easily) and the T often wants to push other things than what I am mostly interested in, and when I go along with this because I am curious, I am left dissatisfied and as though the main issue I bring to therapy is not addressed enough. Perhaps this is just related to the specific T I've worked with, not psychoanalysis in general. He also has a tendency to jump to conclusions too quickly and easily, more based on what interests him, rather than truly following my tracks.

I don't really have serious trauma history but do have lots of repetitive and challenging issues, bad habits etc that I like to address in therapy. I never found the therapy traumatizing, more sometimes very annoying how well it brings up repetitive patterns and behaviors over and over that are hard to change even with a lot of self-awareness. Lots of the same before some significant change occurs usually. I believe that's the point though.

I would say give it a go and see if you find it interesting/helpful. On finding a psychoanalyst, where I live some of the Institutes have training programs and offer relatively low cost analysis with trainees, which does not always mean young/inexperienced Ts, often people with a lot of experience as Ts that are trying to expand their horizons. I've never tried these though and found mine on the internet.

[guilloche]

Feileacan - thanks for following up, I appreciate the help! You're lucky that you've got the flexibility to do sessions so often (though I'm sure you know that!). I have a little flexibility (I work from home), but I have an unpredictable boss - I tend to get called into meetings 3 minutes before they start, and trying to book off that much time during for that many days would be difficult.

I'm not a morning person at all... the thought of attempting therapy at 6:30 in the morning is just... wow! That's great to hear that it works for you though, and that you have a therapist who's available at that time! (I often don't fall asleep until about 2 am... so trying to get up at 5 or 5:30 to make it to an early session sounds - really painful!) Thanks again!

Xynesthesia - That's so interesting that you said you get a lot of "meat" from very little experience, I can completely relate to that. Even my old T mentioned, when I was talking about what I got out of an interesting class (acting class, so lots of interaction with people) that he was amazed how much I got out of the experience.

That's a good point about goals... although I feel like I don't have very specific goals, and have trouble coming up with them, so maybe in that sense it would suit me well. I can imagine how frustrating it would be though to want to work on something specific, but to have random stuff popping up instead (and a T that was making connections that felt like they didn't relate to your goals)!

Thanks for telling me about your experiences! I'm trying to put together a list of Ts now, and I think I may call a few and try to talk to them. I will probably not do full analysis, b/c of the time commitment, but I'm thinking someone who has that kind of trying and mindset might click with me better than the people who I've been seeing. I hope so anyway!

Thanks!

[awkwardlyyours]

guilloche -- T didn't give me coping skills (although she'll sometimes give me straight-up advice / suggestions on how to deal with family etc that just make me roll my eyes because of how banal it can sound). My main way of coping with stuff (well before I started therapy) was to meditate the crap out of my mind (I follow a particular method that's rather involved and works best with a 2-hour-per-day commitment, but sadly I rarely keep up that schedule).

In therapy, we've talked a little about how my basic self-care (I hate that term but oh well) like eating, sleeping, exercising, meditating goes for a toss at times -- my emotions really go kittywompus then (see enactment) and she's tried to figure out what might be triggers. I cut her off on the identifying-triggers bit because I know it's largely lack of sleep + work schedule + general laziness. There's no great mystery there and I just need to have some basic discipline and faith in a routine -- so, there's no point in spending therapy time on that.

Also, I see my T at 8.30pm or 9.30pm (Wed and Sun). She is very unusual in keeping odd hours, yes (I've even done 10.30pm sessions) and I do count myself rather lucky that I found her and that she was able to accommodate me for both my sessions at these odd times.

[guilloche]

Thanks AwkwardlyYours - sorry if I misunderstood about the coping skills. Those long meditating sessions... wow, I'm impressed. I've tried a little bit, and woah... I'm happy if I make it 5-10 minutes.

The late sessions would be perfect for me too! No risk of interfering with work, and I could come home and relax/sleep after! But, I'm guessing that's pretty rare.

Thanks!