Modern Psychoanalysis

Modern Psychoanalysis is a treatment for relieving mental and emotional distress. Its simple technique heals through the talking interaction between patient and therapist. Join us to learn more or post your own thoughts.

Tuesday, December 12, 2006

The False Self

The False Self



One of the most elegant discussions of the concept of "the False Self" is given by D.W. Winnicott in his article entitled "Ego Distortion in Terms of True and False Self." (1960).

In this writer's opinion that article also presents one of the best ways of understanding the concept, i.e., through a description of its usual origin in early childhood. Winnicott says that in this respect there are "two possible lines of development…" (1960, p. 145):

"(i)n the first case the mother's adaptation is good enough… (i)n the second case… the mother's adaptation… is… not good enough. The process that leads to the capacity for symbol-usage does not get started (or else it becomes broken up, with a corresponding withdrawal on the part of the infant from advantages gained)… in practice the infant lives, but lives falsely. The protest against being forced into a false existence can be detected from the earliest stages. (1960, p. 146, emphasis omitted).
Later, "(t)hrough this False Self the infant builds up a false set of relationships, and… even attains a show of being real. (Winnicott, 1960, p.146).

Thus, the personality structure of an individual may be built on this False Self foundation. Similar ideas have been discussed as narcissistic, "as if" personalities, or other terms of art; though the use of the term "False Self" seems to capture human experience on a root level. Perhaps it has something to do with Winnicott's practice as a pediatrician, which he continued along with his practice as a psychoanalyst.

Individuals operating from the position of the False Self typically experience greater than usual difficulties in connecting to others and forming meaningful relationships. The result is often a feeling of emptiness, as though a huge hollow existed in the center of the person. The person may even have the impression that he or she is "not really living" or "sleepwalking through life."
Winnicott also says that:
"(a) particular danger arises out of the not infrequent tie-up between the intellectual approach and the False Self… The world may observe academic success of a high degree, and may find it hard to believe in the very real distress of the individual concerned, who feels 'phoney' the more he or she is successful. When such individuals destroy themselves in one way or another, instead of fulfilling promise, this invariably produces a sense of shock in those who have developed high hopes of the individual." (1960, p. 144).
Additionally, some have "… a need to collect impingements from external reality so that the living-time of the individual can be filled by reactions to these impingements." (Winnicott, 1960, p. 150).

Like most other defensive structures, the False Self organization is not always unwanted. A certain amount of False Self organization is present in everyone and is necessary for survival. Do we want our police or military interacting with others based upon the spontaneous expression of their True Selves?

Dr. Winnicott explains that "(i)n health: the False Self is represented by the whole organization of the polite and mannered social attitude…" and that "the False Self defends the True Self…" (1960, p. 143); though "… the False Self, however well set up, lacks something…" (1960, p. 152).

A further consideration in treatment is that "(t)he patient's False Self can collaborate indefinitely with the analyst in the analysis of defences, being so to speak on the analyst's side of the game." (Winnicott, 1960, p. 152).

Modern psychoanalysts are well-versed in the False Self organizations that individuals may present. In addition, the techniques of modern analysis are ideally suited to treatment of these individuals. The training and emotional resilience of the modern analyst becomes decisive in the successful analysis.

References

Winnicott, D. W. (1960). "Ego Distortion in Terms of True and False Self," in The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development. New York: International UP Inc., 1965, pp. 140-152.



© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org/

Tuesday, October 31, 2006

Building the Therapeutic Relationship

Building the Therapeutic Relationship

It as axiomatic that individuals seeking psychoanalytic treatment are not prepared to be patients simply because they show up at our offices. In fact, one of the most important tasks for the modern psychoanalyst is to teach the patient how to be a patient. Ideally, this begins to take place from the very first contact made.

Frequently, the prospective patient will make this first contact through a telephone call, or through a third person; and as Dr. Hyman Spotnitz (1985, p. 116) has noted:
Before a firm appointment is made and honored, they may oscillate for a protracted period between an intense desire to be relieved of their misery and what seems to be an unconscious need to defend themselves against the anticipated stress of the analytic situation.
Yet, this initial phase of coming together (including the first tentative contacts between analyst and patient) is not regarded as a mere preliminary, but is “governed by the general plan of treatment,” and is thought to “influence all subsequent contacts between them.” (Spotnitz, 1985, p. 113).

It should be obvious that these first contacts will often include resistances, perhaps even treatment destructive resistances, just as in the therapeutic relationship that is eventually developed. (See e.g., Fennessy, 2006).

If an initial interview does take place, the modern analyst “… needs to gather only enough information to help decide whether he could treat that individual effectively and wants to work with him.” (Spotnitz, 1985, p. 118).

In this respect, many modern analysts prefer not to review previous diagnostic records for their patients. Their thinking is that they do not want to be influenced by the diagnostic impressions of others and that they want to use their own feelings in evaluating their patients. As a rule, no pressure is placed on individuals to disclose information that they may have withheld during the interview.

One of the few questions asked during the initial interview might be “why do you want treatment?” (See e.g., Spotnitz, 1985, p. 120; Spotnitz, 1976a, p. 140). Questions such as this help the modern analyst begin to explore the patient’s attitudes and willingness to cooperate.

Practical arrangements may also be brought up in the first interview. Towards the end of the interview, questions such as “have you thought about how much you’d like to pay?” or “have you thought about how often you’d like to come?” are not uncommon.

The discussion of these and similar items may also be viewed as a part of the treatment itself; i.e., in talking about all of these practical matters “(a)rrangements and rules are flexibly formulated as dynamic tools of therapy.” (Spotnitz, 1976a, p. 141).

If an agreement can be reached, the therapeutic relationship will be based upon
… what can reasonably be expected of the patient at the emotional level at which he enters treatment. Provided that he agrees verbally to participate to that extent, the analyst assumes all responsibility for the treatment process… This changes, of course, as the patient makes progress, he becomes more and more capable of assuming an increasing degree of responsibility. Eventually he assumes full responsibility for the success or failure of the treatment. (Spotnitz, 1985, p. 122).
The therapeutic relationship in modern psychoanalysis is therefore built “from the ground up,” similarly to “the mother-child relationship.” (Spotnitz, 1985, p. 113).

This modern approach is particularly useful for those who would have been deemed “unanalyzable” by classical analysts. As Dr. Spotnitz (1985, p. 115, emphasis omitted) says:

The schizophrenic patient who can cooperate… [to a great extent]… in the early stage of treatment is rarely encountered. Nevertheless, the patient becomes capable of making that contribution if the analyst accepts the responsibility for developing an effectual alliance with him.

If the analyst accepts the responsibility and the patient begins talking, the analyst then needs to consider all those other matters in the interest of the patient, such as whether and when interventions might be necessary, whether and how a transference might develop, and what the resulting therapeutic relationship will be.


References


Fennessy, J. (2006). Free Association and Resistance. (Online at: http://modernpsychoanalysis.blogspot.com, August 03, 2006).

Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.

Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.


© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com

http://modernpsychoanalysis.org/

Tuesday, September 05, 2006

The Narcissistic Defense


The Narcissistic Defense
One of the unique offerings of modern psychoanalysis has to do with its understanding of the importance of “the narcissistic defense.” While it is well known that the narcissistic disorders possess a vast range of defenses available for use, something much more particular is meant when modern analysts refer to “the narcissistic defense.”
Dr. Spotnitz first observed the narcissistic defense during his clinical investigations of schizophrenia, and later successfully applied the concept to treatment of other patients:

“When the patient is frustrated, the appropriate way to discharge his feelings is to put them into words. If he is prevented from doing so when frustrated and feeling deprived by the analyst, he usually bottles up the aggression: in other words, he turns these feelings inward and begins to attack the self. This is referred to as the narcissistic defense.” (Spotnitz, 1976b, pp. 56-57, emphasis original).

Freud’s idea was that the “narcissistic wall… brings us to a stop,” and that “…(o)ur technical methods must accordingly be replaced by others; and we do not know yet whether we shall succeed in finding a substitute.” (1917, p.423). Spotnitz, however. “… discovered that the analyst resolves the adult patient’s repetitive self-attacks by changing the flow of destructive impulsivity.” (1976b, p. 56).

From the root of the word narcissism, it might at first appear that the problem is excessive “self-love,“ yet not all narcissism is “disordered:”

“We commonly recognize the value of narcissism, as well as the vital role it plays in creative activity. If we regard sleep as the quintessence of absorption in the self, we agree that narcissism is essential for self-preservation.
Need I point out that ‘narcissistic defense’ does not involve these kinds of normal activity? What we are concerned with is narcissism in a pathological sense, with self-love that serves as a cloak for self-hatred. The polarities of self-hatred and self-love are linked together in the defensive system, but the nuclear problem is the self-hatred.” (Spotnitz, 1976a, p. 104).

How might an individual develop the narcissistic defense? According to Spotnitz, the foundation is likely to be found in early childhood and:

“… is not total emotional deprivation... The defense seems to originate in a relationship which was gratifying to the infant in some respects, especially in meeting his biological needs for the intake of stimuli, but failed to meet the need of his mental apparatus for cooperation in discharging destructive energy. Nevertheless, he was not totally abandoned; he was sufficiently gratified to develop a strong craving for more gratification and, consequently, to place an unduly high value on the source of this bounty.” (Spotnitz, 1976a, p. 104).

Could it be that for the infant it is a question of survival? In the minds of very young children thoughts may have magical properties. If we have horrible thoughts; i.e., that mother frustrates us, or that we hate her, or worse; even for an instant – mother might leave us forever. Or, our violent thoughts might actually kill her; or maybe if we’re so monstrous as to think those thoughts, she might actually die, as punishment for our bad thoughts. We need to protect her at all costs.

Spotnitz hypothesizes that…

“(t)he infant got to understand that his mother might be damaged by his rage; perhaps she discouraged such reactions by withholding her favors. At any rate, the infantile ego which was not trained to release mobilized aggressive energy towards its object in feelings and language responded to prolonged periods of frustration by internalizing its destructive impulses. Much of the energy that would otherwise have been available for maturational processes was expended to bottle up this impulsivity…
The child who started out to console himself with self-love thus compensates for a specific type of damage incurred in the course of maturation by becoming the object of his own hatred. Sacrificially, he attacks his ego to preserve his external object.” (1976a, pp.104-05).
As with all the other defenses, “(t)he survival function of the narcissistic defense is respected. Though primitively organized, it has served to stabilize his mental apparatus in his interpersonal relations and insulate him against unwanted feeling states.” (Spotnitz, 1985, p. 164).

Modern psychoanalysts have a greater understanding and a wider range of techniques available to outflank Freud’s “stone wall of narcissism,” and “…(i)f the analyst provides the proper environment, the patient will re-experience emotional reactions in his relationship with the analyst that resemble those he had at some point in the past when his maturation was blocked.” (Spotnitz, 1976b, pp. 57-58).

With proper treatment, the narcissistic defense can thus be made unnecessary, allowing patients the full range of options and emotions available to mature individuals.

References


Freud, S. (1917). Introductory Lectures on Psychoanalysis (Part 3) in the Standard Edition of the Complete Works of Sigmund Freud, (James Strachey, et al., Ed., 1953-74), London, Hogart Press and the Institute of Psychoanalysis, 16:243-463.

Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.

Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.
© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747

Friday, August 04, 2006

Free Association and Resistance

Free Association and Resistance

Professor Freud (1913, p. 147) insisted that there was one “fundamental rule” the analyst needed to tell the patient “…at the very beginning:

‘Your talk with me must differ in one respect from ordinary conversation. Whereas usually you rightly try to keep the threads of your story together… here you must proceed differently… You will be tempted to say to yourself: ‘This or that has no connection here, or it is quite unimportant, or it is nonsensical, so it cannot be necessary to mention it.‘ Never give in to these objections… say whatever goes through your mind. Act as if you were sitting at the window of a railway train and describing… the changing views you see outside.’”
This fundamental rule of “saying everything” has since been referred to as “free association.” How do modern psychoanalysts implement this rule?

First, we can say that modern analysts accept that “(e)ven the analytic directive to talk must be viewed as resistance-provoking.” (Spotnitz, 1976b, p. 169).

Spotnitz (1976b, p. 159) commented that one of Freud’s first followers,
“Ferenczi had noted many devices used by patients to resist cure. He observed how difficult it was for the patient to follow the first rule of free flow of ideas until the close of the analysis, and that patients could not understand that free association did not demand complete thinking out of ideas, but complete utterance of what was actually thought.”
Dr. Spotnitz (1976a, p. 78) also recounts that attempting:
"… to overcome the resistance to free association by ‘making use of psychical compulsion’… got Freud into various difficulties. Although time-saving, his approach proved traumatizing to the patient, giving rise to feelings of disturbance, strangeness, withdrawal and the like which inhibited or even blocked communication.”
This classical approach to resistance undoubtedly also caused many patients to be labeled from the very beginning as “unanalyzable” or ‘not suitable for treatment.”

I think it could be said that most modern analysts recognize and respect the patient’s need for the “insulation” (or defenses) that result in resistances. They do not try to “smash through” the defenses and may even help reinforce some defenses until the patient is ready to give them up. This same respectful approach is taken with the question of free association.

Spotnitz (1976a, p. 141, emphasis added) indicates that cooperative behavior would be:
“…that the patient lie on the couch and talk. He is not instructed to free-associate. As the opening move in educating him to do so, he may be asked to tell his ‘ life story’ or simply to talk of his experiences; a severely disturbed individual may begin by recounting how he traveled to the office, what he ate for breakfast, and the like.”
In modern psychoanalysis, the patient’s job is to talk, while the analyst bears the responsibility of helping the patient do so.
In most cases, modern analysts rely on the contact function of the patient’s ego in deciding when and how to help in the patient’s attempts to satisfy this fundamental rule of “saying everything.” This approach helps to safeguard the patient’s developing ego from unwarranted intrusion by the analyst. (See e.g., Fennessy, 2008)

The modern psychoanalytic approach to resistance and free association has had the added benefit of expanding the number of people who may be helped by our methods to the point where “… (w)ith our increasing understanding of the psychological reversibility of the narcissistic disorders, the phrase ‘not suitable for treatment’ has been dropped from the vocabulary of the modern psychoanalyst.” (Spotnitz, 1976b, p. xi).

References
Fennessy, J. (2008). Narcissism and the Contact Function, in PRACTICE MATTERS, A Journal of Modern Psychoanalytic Treatment Technique (Vol. 2), Philadelphia, PSP.

Freud, S. (1913). Further Recommendations in the Technique of Psychoanalysis (On Beginning the Treatment) in Freud; Therapy and Technique, (Philip Rieff, Ed., 1978), NY, Macmillan Publishing Co., Inc.
Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.
Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.



© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: analyst@modernpsychoanalysis.org
http://modernpsychoanalysis.org/

Saturday, June 17, 2006

Ambivalence

Ambivalence

"This is one race of people for whom psychoanalysis is of no use whatsoever" (Sigmund Freud - about the Irish)
There were various reactions expressed by others when the above quote first appeared in my printed list of Irish songs for St. Patrick’s Day – some were outraged, while others laughed their heads off.

Possibly either reaction is understandable, or perhaps one person could entertain both reactions at the same time. In fact, I’ve often thought that the ability to tolerate seemingly conflicting ideas at the same time was a peculiarly Irish phenomenon.

Professor Freud has also been quoted as saying that
“Neurosis is the inability to tolerate ambiguity.”
I don’t believe Freud was using “ambiguity” in a conventional American way, i.e., as a synonym for vagueness or uncertainty; but rather more in the sense of “the quality of having more than one meaning,” or “capable of being understood in more than one sense.” (New Lexicon, 1988).

That understanding of ambiguity is closer to how I mean to refer to ambivalence, i.e., as a state where one has disparate feelings (which may or may not be conflicting) at the same time.

In this respect, I am also proceeding from the belief that much of life, or of our human structure, involves ambivalence.

Observably, people may seem to be functioning adequately and yet be unaware of their ambivalence. Those feelings may instead be repressed, or subsumed in our unconscious processes; though this does not rob them of the capacity to affect our actions, thoughts, perceptions and emotional resiliency.

According to Daniel Siegel:
“Excessive rigidity in a state of mind leads to an inability to try new configurations and to adapt flexibly to changes in the environment.… Homeostasis is achieved at the expense of the connections with others and with primary emotional states of the self.” (1999, p. 237).
Modern analysts recognize this inflexible pattern as part of the structure resulting from the Narcissistic Defense, i.e., a question of what the child has learned to do with aggressive (or other “unacceptable”) impulses mobilized in his mental apparatus. Modern Psychoanalytic treatment seeks to restore human flexibility and emotional resiliency through its clinical methods.

In this sense it might even be said that recognition and acceptance of ambivalence is a good thing; or as Publius Terentius said, "I am a man: I hold that nothing human is alien to me."

References
New Lexicon Ed. (1988). New Lexicon Webster’s Dictionary of the English Language, NY, Lexicon Publications.
Publius Terentius Afer. (185 BC - 159 BC). (Terence). Roman Comic Dramatist.
Siegel, D. (1999). The Developing Mind, NY, Guilford Press.
© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org/

Thursday, June 08, 2006

Modern Psychoanalytic Education


Modern Psychoanalytic Education

Psychoanalytic education in the United States is still mainly conducted in free-standing Institutes, rather than in University settings. Typically, certifications are awarded, rather than academic degrees, though training in Institutes is often years longer than that taken for academic degrees.

Education in Modern Psychoanalytic Institutes usually consists of around 24 courses, weekly individual analysis, supervision, clinical experience, giving and attending case presentations, and presentation of a final case. It would not be unusual to spend 7-8 years working towards certification.

Students in many Modern Psychoanalytic Institutes are permitted to proceed more or less at their own pace. Some Institutes also permit the general public to take courses in psychoanalysis for personal enrichment.

Modern Psychoanalytic Institutes do not require that their candidates be medical doctors. This follows Professor Freud’s thoughts on the subject (1926):
“No one should practice analysis who has not acquired the right to do so by a particular training. Whether such a person is a doctor or not seems to me immaterial.”
On the other hand, most Institutes require at least a Masters Degree for eventual certification. Freud’s statement (1926) would still be true, that:
“Lay analysts, as they are found practicing today, are not chance-comers, recruited and trained without discrimination, but persons of academic standing.”
What should Modern Psychoanalytic Education consist of? Perhaps part of the answer to this question lies in looking at the work modern analysts are being trained for.

According to Spotnitz (1997, p. 36 & 38):
“Most of the work in the analysis consists in asking question after question, following the patient’s unconscious as closely as a shadow in the exploration that will lead to the uncovering of layer after layer, until the point is reached when the patient discovers a truth about himself through his own voice.” And “The fact remains that analysts need to know their own unconscious as much as that of their patients…”
Individual analysis and supervision would, therefore, seem to be indispensable to a Modern Psychoanalytic education. The undersigned writer also highly recommends that all Modern Psychoanalytic Institutes follow the lead given by one of the Institutes – i.e., include Transference & Resistance Workshops in each semester’s curriculum.

Freud (1914) incorporated Transference & Resistance into the very definition of the question; “What is Psychoanalysis?:
“… the facts of transference and resistance. Any line of investigation which recognizes these two facts and takes them as the starting point of its work may call itself psychoanalysis, though it arrives at results other than my own.”
Transference & Resistance Workshops explore these concepts through group discussion in an experiential setting. The experience with using Transference & Resistance Workshops has been greater expression and understanding of feelings by students and less acting out. Having experienced these Workshops myself, it has been difficult for me to imagine Modern Psychoanalytic education without them.


References
 
Freud, S. 1914. The History of the Psychoanalytic Movement; (fr. Freud, S. (1938). Basic Writings of Sigmund Freud, (Modern Library Edition, 1995; trans. Dr. A.A. Brill), NY, The Modern Library).
 
Freud, S. 1926. The Question of Lay Analysis; (fr. Freud, S. (1938). Basic Writings of Sigmund Freud, (Modern Library Edition, 1995; trans. Dr. A.A. Brill), NY, The Modern Library).

Spotnitz, H. (1997). The Goals of Modern Psychoanalysis: The Therapeutic Resolution of Verbal and Preverbal Resistances for Patient and Analyst (CMPS/Modern Psychoanalysis, Vol. 22, No. 1, 1997)

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.

© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: analyst@modernpsychoanalysis.org
http://modernpsychoanalysis.org/



Monday, March 27, 2006

Modern Psychoanalysis and Religion

Modern Psychoanalysis and Religion

One of the first questions on this topic might be: Is it useful to talk about this? The techniques used in Modern Psychoanalysis do not seem to require a religious perspective and the creeds of the major religions do not depend upon psychoanalysis. Additionally, at least some tendencies in each perspective have been noticed to consider the other either unwelcome and intrusive, or with outright hostility.

Certainly, Sigmund Freud's own ideas towards religion would fit in the latter category and at least part of the issue from the psychoanalytic view has been the inability of some to disentangle themselves from Freud's idiosyncrasies on the subject. (See e.g., Zilboorg, 1950; see also Becker, pp. 173-75, 1973).

On the other hand, it is reported that C.G. Jung "... had never, he claimed, had a patient whose neurosis was not due to his lack of religion, nor had he ever cured a patient whose cure was not due to his return to religion." (Bartemeier, p.12, 1995).

Thus, some would agree that there at least enough of an "overlap" between the goals of religion and those of psychoanalysis to warrant discussion. But, if there is to be such a discussion, what should it consist of? Alternatively, what should it not consist of? Who might be benefited by this dialogue?

In this writer's opinion, the only really useless area of inquiry concerns one trying to prove or disprove the other; i.e., advocates of religion and psychoanalysis each adhere to self-sustaining teleological tenets as part of their individual belief systems. By their very nature, these tenets are neither provable nor disprovable by outside sources; though even this should not interfere with an open dialogue if the participants are willing to respect the feelings of others. So, perhaps the dialogue should include anything the participants wish to discuss.

While one would not expect religious instruction to be included in the curriculum of psychoanalytic institutes, or psychoanalysis to be required in seminaries, it would seem to me that each could benefit from some knowledge of the other.

Modern analysts have their own spiritual existence to consider; as well as many patients who come from a religious perspective, or even have religious components integrated into their difficulties with the world. Likewise, religious leaders have their own psyches to consider; along with some followers who would be helped by being able to talk freely in a modern psychoanalytic setting. The institutional structures in place in each of the perspectives could also be broadened by further dialogue.

As a methodology, Modern Psychoanalysis should be well-suited to a dialogue about psychoanalysis and religion because of its emphasis on the role and importance of emotional communications. Individual belief systems are often highly charged with emotion, as part of the person's self-identification process with the world.

These root emotional processes have caused some to notice a correlation between the emotional forces at work in either arena, which "...emerges as the reflective awareness of powerful affectivity rather than as a purely intellectual grasp of logical relations between concepts and symbols." (Cousins, p. 36, 1995).

Perhaps it is time for us to jointly explore these powerful emotional processes.

References

Bartemeier, L.H. (1995, 1976). "Psychoanalysis and Religion," in Psychoanalysis and Catholicism. Wolman, B., ed., NY, Jason Aronson, Inc.


Becker, E. (1973). The Denial of Death. NY, The Free Press.

Cousins, E. (1995, 1976). "The Many-leveled Psyche: Correlation Between Psychotherapy and the Spiritual Life," in Psychoanalysis and Catholicism. Wolman, B., ed., NY, Jason Aronson, Inc.

Zilboorg, G. (1950). Psychoanalysis and Religion. NY, Barnes & Noble.

© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org/

Monday, February 27, 2006

Long-Term Treatment in Modern Psychoanalysis

Long-Term Treatment in Modern Psychoanalysis
Psychoanalysis is often criticized for taking too long, and for being far too costly when the money paid over all those years in treatment is added up. This brief writing contains just a few thoughts on the uses and resistances involved in thinking about long-term treatment.
The average time of those staying in psychoanalytic treatment in the United States is estimated to be somewhere over 5 years. Yet, when our patients first come to see us, it is unlikely that many plan on staying in treatment for over 5 years; let alone for the 10 or 20 years that some do.
As Dr. Hyman Spotnitz notes: (1985, pp. 112-13)
When contemplating treatment… pathologically narcissistic individuals are rarely interested in change. What they want primarily – and immediately – is relief from emotional suffering. They are more likely to feel that they would be investing time, money, and effort just to prove they are incurable.
So, how long is too long to be in analysis – how much time and money should one spend addressing life-long difficulties? Perhaps our views about therapy before we enter it would help with the answer.
Arnold Bernstein (1995, p. 52) contends that:
The expectations of both the therapist and the patient are derived from their preconceptions of what psychotherapy is, and of what it means to be cured. Foremost among these preconceptions is that the patient is ’sick’ and that the treatment is to be regarded as medical in nature.
Prior to entering treatment, patients can entertain a variety of other ideas about what treatment means and what might happen during the treatment. (See e.g., Strean, 1985, pp. 110-112).
Modern psychoanalysts generally try to create an analytic space or “holding environment” where it is safe for the patient to “say everything.” In this context, resistance most often refers to whatever interferes with saying everything (talking) and the modern analyst works at whatever level the patient is at.

Thus, a patient with difficulties which may have developed in the pre-verbal (or pre-oedipal) stage of maturation might be helped to develop a narcissistic transference before moving further.
According to Spotnitz, (1985, p. 121), in most cases 2 years would be “… the minimum duration for significant change to occur” and “(a)lthough the effective reversal of the schizophrenic reaction requires a minimum period of 5 years, the treatment may continue for a longer period.”
Freud (1913, p. 130) similarly stated “(t)o shorten analytic treatment is a justifiable wish… unfortunately, it is opposed by a very important factor… the slowness with which deep-going changes in the mind are accomplished.” We can certainly see the point where serious difficulties, such as schizophrenia, are concerned.

However, our minds often reject the idea of creating such intense long-term emotional attachments to strangers.
As Bernstein (1995, p. 51) says:
A prolonged therapeutic relationship is more likely to be a source of embarrassment… than a cause for rejoicing. Quite the contrary is the case when other personal human relationships come to an end. When marriages, families, friendships and loveships break up, it is generally conceded that something went wrong.
So it may horrify one, looking at it from the outside - to hear of an individual spending many thousands of dollars over 5, 10 or 20 years in analysis - but, if it helps that individual achieve a real and meaningful life, was it all worth it? Only that person can say.
In the end, perhaps its all a question of value and connection. How do we view our attachments, ourselves, and our value as human beings? What are those things worth?
References
Bernstein, A. (1995). Some Clinical Observations Upon the Emergence of the ‘Wonder Child” (CMPS/Modern Psychoanalysis, Vol. XX, No. 1, 1995).
Freud, S. (1913). On Beginning the Treatment. Standard Edition. London, Hogarth Press, 12:121-144.
Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.
Strean, H. (1985). Resolving Resistances in Psychotherapy, NY, Wiley.


© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail:
njanalyst@hotmail.com

Friday, February 17, 2006

About Modern Psychoanalysis

The Talking Cure

Psychoanalytic Therapy is a treatment for relieving mental and emotional distress. It is often known as THE TALKING CURE because its simple technique heals through the talking interaction between patient and therapist.



Modern Psychoanalytic Services are therapeutic services based on an understanding of the unconscious and how unconscious processes affect the human mind as a whole, including actions, thoughts, perceptions and emotions. The major function of the psychoanalytic therapist is to listen carefully and attentively to the patient in order to understand and facilitate communication. When a patient can get in touch with and express all of his or her feelings, good and bad, emotional healing can take place.



This form of treatment for mental and emotional troubles was first developed by Sigmund Freud in early part of the last century. Later psychoanalysts expanded on Freud’s work and enlarged the range of problems that could be treated. New treatment techniques and insights into human behavior have also developed.



The science of Modern Psychoanalysis has demonstrated its ability to successfully deal with mental and emotional difficulties through its studies of early parent-child interactions, frustration, social relations, family dynamics and psychosomatics.


Modern Psychoanalysis


Modern Psychoanalysis, as expressed by its founder, Dr. Hyman Spotnitz, has gone beyond Freud, and addresses modern needs, since it “...has been reformulated on the basis of subsequent psychoanalytic investigation.”


Modern Psychoanalysis utilizes a wide range of interventions including ego reinforcement, emotional communication and resistance resolution.

The modern theory of treatment considers most emotional, mental and personal achievement problems to be reversible through our techniques.


The modern analytic therapist does not usually give lectures or advice about how the patient ought to manage his or her life. Instead, the analyst prefers to help the patient understand why he or she is unable to solve problems and internal conflicts that might be preventing one from knowing what to do in life.


Our goal is to help people improve the quality of their lives and their relationships.


James G. Fennessy, M.A., J.D.
Matawan, New Jersey
Email: njanalyst@hotmail.com