Therapy: Between Sessions

From the merely mundane to the release of rubble buried in the unconscious, therapists focus on what is said during a session. This is for good reason.

But psychodynamic therapy is not merely talk therapy, it’s relational therapy. And as such it provides an additional means by which change occurs.   

I have been involved with psychoanalysis, as a therapist and a patient, for over 20 years. I have had two analysts, each of whom has impacted me in profound ways with what he has said.^[1]For the sake of clarity and ease I will refer here to analyst in the singular. Each analysis has been its own experience yet they share common threads, which I write about here.

Yet the greatest impact has occurred not through his words but his being, a way of carrying himself in a confident, connected, vulnerable and quiet way that I’ve experienced as intriguing, baffling, compelling, attractive and even, often via my own projections, frightening.^[2]Most of the fright came from how much saner, and therefore how much better, I imagined him to be. There was a feeling that I could never achieve psychologically what he had and so there was also … Continue reading But whatever the feelings associated with him, in time he became a kind of presence that routinely permeated my psyche well beyond the session.

An emerging object

While buying groceries, talking with my kids, hiking for miles with my dog… there in consciousness was my analyst.

At first his presence would feel almost God-like, as in “What would my analyst do?” or “What would my analyst want me to do?”^[3]I have no way of gauging my analyst’s desires as he has been professional, experienced and disciplined enough to not burden me with this. As a result my fantasies of his desires became worthy … Continue reading

In psychoanalytic terms this would be called an imago. My analyst became an embedded object within my psyche. And this competent analyst-as-object took over for the all too painfully flawed ones that were my parents.

In the beginning, he was an idealized object. This type of constructed object keeps one defended against painful feelings that come up when another is less than perfect.

But things would not remain so simple.

An aborted fantasy

Once, while leaving a session, I noticed a bandage on my analyst’s index finger. With curious pity I asked what had happened.^[4]I still question the motive of my inquiry. Was it genuine, or designed to alleviate my uncertainty? Was my pity designed to look good, to appear good and kind enough to take pity? He told me he had injured the finger while cutting a radish. I expressed remorse and said I knew from experience how difficult it is to cut radishes, especially the last slice or two, which buckle under the pressure of the knife, causing the blade to lose control and veer toward the fingers.

I thought nothing of it until many days later when during a walk in the woods a thought-image of him came to me. In this fantasy he was standing in his kitchen listening to jazz or a piano sonata, taking a drink of red wine and then cutting the radish and then his finger, a thin stream of blood spilling onto the cutting board.

My reverie was promptly aborted: He’d cut his finger, I imagined, because he was drunk.

This was unbearably disappointing. It recalled my mother in my childhood and countless nights she spent drunk on red wine while cooking.^[5]It also recalled my own tendency toward this years later but I could not yet place my focus on this. But it also rendered my analyst flawed, imperfect. He was an imposter (a deceitful drunk!) and therefore a symbol of moral ineptitude and betrayal. This recalled countless earlier disappointments, confirming that people, even the most purportedly sacred, cannot be trusted.

Ruminating on this to the point of obsession, I felt pain, rage and a desire to stop treatment.

Yet I knew from years of work what needed to happen.

Return to words

I brought up this matter of the finger at our next session.^[6]For those wondering, no, there was no interpretation of his finger as phallus. I spoke of my pain, crying as I did so, and of the unbearable fear of disappointment that resided here in this relationship, just as in all of them.

I recall only that he listened, that he took in all of it, without an anxious need to change it.

Here was someone who, without defending himself or attacking me, could tolerate all of me, including those parts rooted in doubt, fear and rage that I’d projected onto him.

After this act of psychological proximity I was different: a key other had accepted me, and I now also accepted myself.

But another shift occurred, namely in how I viewed my analyst, and therefore potentially others.

I no longer idealized him as a means of defending myself. I viewed him as I’ve now learned to view others: as a whole person, fully capable of disappointing me, but still fully worthy of love and trust.

The deepest changes in therapy occur not through what a great therapist says or does (as much as we come in hoping that’s the case) but through what he represents, what he stimulates in us—if only we’ll listen and make ourselves vulnerable enough to share it.