Psychoanalysis is Alive and Well By Kim Chernin, PhD on 3/28/13 - 11:55 AM

Although we have evolved many schools since Freud articulated psychoanalytic theory at the turn of the 20th century, in almost all of them conspicuous analytic features remain. These are so familiar that for the most part they exercise their dominance without our being aware of them or their origins. We may think psychoanalysis has been discredited and that almost no one practices it any longer, but there are ways psychoanalytic theory is present in our listening and thinking because of the vocabulary we employ and have come to take for granted.

An example, from an older use of language. Freud’s German word for cathexis (a word that goes in and out of fashion) is besetzen, which literally means the occupation of an area by a military force. The metaphoric atmosphere is of course lost in our translation, but not perhaps in our understanding of the supposedly aggressive way we take hold of an object and occupy it with our attachment. Even when we use a different vocabulary, when we say someone is “over-attached” to something, or “fixated” on it, we import the negative psychoanalytic attitude. Of course, a cathexis might also be viewed as a passionate interest in something; then we would not have to burden it with a military metaphor.

Or the word resistance: A number of implications reside in this word, most often hidden. Clients use the word, therapists who have never been trained analytically also use it and succumb to its seductions. It is tempting to believe that we, the therapist, know the right thing for the client to be talking about, and if she isn’t talking about it, she’s resisting it; that is, she is avoiding a thought or feeling we think she ought to be discussing. Our meeting together has been turned into a battle: between the client and the content supposedly being resisted. I try not to use the word, although my clients do. I tend, instead, to talk about self-protection. If someone seems to be venturing forth, then cutting herself off, then taking off on an apparent tangent, she might say: “I just can’t figure out what I’m trying to say. Am I resisting it?” I assure her that the timing of this discussion is entirely up to her. The choice is hers, to go forward now or to save it for another time. People tend to take this permission much to heart. I have noticed how often they touch back on a subject they didn’t feel ready to discuss, perhaps to mark it, to hold it as potential, to keep track of it. Eventually, when they feel safe enough the self-protection no longer seems necessary and the content emerges. Best of all, the timing of this important moment has been left to them. I see no reason to call this process of hesitation and caution, of delay and postponement, a resistance.

And then there’s the concept of repression, another word that has entered our common language. A wary, watchful, guarded, unexpressive, anxious and withdrawn person is said, even by people who do not know the technical meaning of the word, to be repressed. But known or not, the word carries implications. It is also used in our political discourse, where it evokes the circumstance in which a group of more powerful people is repressing another. We know this circumstance; it costs lives, evokes rebellion, is most often an affair drenched in blood. Our clients also have these associations to the word. Is it useful to bring this imagery into our understanding of an individual who has come to talk with us?

People coming into therapy for the first time seem to know the rules, the lingo, the appropriate behavior and much of this is, I think, a carry-over from psychoanalysis. They often expect a fifty-minute hour, as if this length for a therapeutic session had been written as law. I’ve had people say to me “Are you sure you’re doing this right?” because I invite them to go on past what they assume is the set time. “I know I’m not supposed to ask you questions,” is another popular assumption. “Or well, I guess I can ask but I know you’re not supposed to tell me the answer.” Who says? It is important for my clients to know the worldview I hold because, obviously, it is going to influence the type of listening I do. Having left psychoanalysis behind we are no longer constrained to be detached listeners. But do we sufficiently tell our clients who we are in our listening? I mean, really take pains to inform them? To explain the school we adhere to? And what its assumptions are? And if not, is that not still the shadow of psychoanalysis falling upon our work?

File under: The Art of Psychotherapy