Is psychoanalysis ‘good therapy’? A response

Goodtherapy.org is a new site dedicated to non-pathologizing models of psychotherapy. The question came up as to whether psychoanalysis should be included as a “good therapy.” My response follows, or read the whole discussion here.

I strongly support including psychoanalysis in goodtherapy’s list of approved treatments. The detached, cold, impersonal analyst is just a negative stereotype fueled by countless cartoon and movie depictions. It couldn’t be further from reality.

I practice from a psychoanalytically informed perspective, which was how I was trained, and I aspire to join an analytic institute for postdoctoral training. Meanwhile, to be clear, I talk with my clients. I have emotions and I show them. And I view the relationship as an egalitarian exchange. I’m a lot less interested in insight and interpretation than I am in understanding what’s unique about the relationship I’ve formed with each client, and using that relationship to help the client achieve their potential.

The way I see it, the values of goodtherapy.org are aligned in a broad sense with contemporary psychoanalytic work. I also want to say that such values are held by individual practitioners more so than by theoretical orientations in any collective sense. In my experience, many analysts and analytically-informed practitioners hold the kinds of values to which goodtherapy aspires, and others probably hold different views. The same could probably be said for members of any grouping along theoretical orientation lines. That’s why individual practitioners may self-select their participation in a group such as the one formed on goodtherapy.org.

I have difficulty responding directly to the five questions that were posed. Perhaps others will have an easier time of it. I think my difficulty comes from the dichotomies that are posed and my inability to speak for the totality of analytically informed clinicians. For instance, when asked is our belief in our clients’ potential “unwavering”: Well, if we as therapists didn’t believe our clients could grow, then what would be the point? But “unwavering” sounds kind of superhuman.

The reality of a human interactions is much more of a process. Psychoanalytic approaches are especially helpful as a theoretical roadmap for the clinician to understand when such a belief wavers, to understand why. It provides a map to look within the clinician, to look within the client, and within the unique relationship between the two. So the challenge is to understand the wavering and collaborate as two people to repair it. When such a rupture is repaired within the therapeutic relationship, this can generalize to other relationships in the client’s life.

Among contemporary psychoanalytic approaches, including Modern Psychoanalysis, Object Relations, Self Psychology, and Inter-subjective approaches, the relationship between two people is key. The experience of engaging in such a relationship with another person in psychotherapy is fundamentally a human endeavor, with the twist being that the relationship can be a crucible for change in the client.

In my opinion, this happens precisely because the therapist is actively involved in shaping an interpersonal relationship that will allow the client to develop capacities for growth and development that the course of ordinary life has not provided.