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
50 comments:
Great post. Found you by way of the Psych Arena.
Thanks. I've added a link to that site. Feel free to post your thoughts whenever you wish.
I've found it really difficult to find detailed information about modern psychoanalysis online.
In particular, how is modern analysis different from other approaches that stress the use of the countertransference and the therapeutic relationship, such as the relational and interpersonal schools?
Yes, it is difficult to find material on Modern Psychoanalysis on the web - hopefully, we'll be able to address some of that with this space. I have some understanding of the interpersonal approach from my intensive readings of Harry Stack Sullivan, but less familiarity with the relational approach. Perhaps I could instead point out a bit more of how Modern Psychoanalysis operates and then solicit your input as to what the differences might be?
Modern Psychoanalytic practice uses a wide range of therapeutic interventions; (e.g., object-oriented questions, joining, etc...), based upon the maturational level of the patient. Modern Psychoanalysts would not usually use direct interpretation if a patient would be damaged by it, but might silently interpret instead. As a general matter, no intervention of any kind would be used, unless the analyst determined the patient was emotionally ready for it. Transference (including the narcissistic transference), countertransference, and the resistances of both patient and analyst, are analyzed in detail and used as part of this process.
I guess to compare the differences I'd probably have to choose a few specific areas. Here's two.
1. As I understand it, relational analysts emphasize the idea that the analyst will inevitably be caught in mutual enactments with the patient, and that these ought to be (within reason) participated in and then analyzed retrospectively. What is modern analysis' take on this?
2. Are modern analysts as detached (anonymous, witholding) as classical analysts, or do they, like relational analysts, take a more participatory stance?
Anon:
1). I'm uncertain as to what "participating in a mutual enactment" might consist of - is this a term of art for the relational analysts?
2). Regarding your second question, in addition to my previous comments, I would say the general rule of modern analysis is that the patient's job is to talk and the analyst's job is to facilitate the patient's talking.
Modern analysts use therapeutic interventions to facilitate talking based upon the maturational level of the patient. In most cases, the modern analyst would be guided by the contact function of the patient's ego for making a determination of the patient's maturational level.
Thus, if the patient contacts the analyst by asking questions which demonstrate the object relatedness of a more mature ego, the analyst might then be more direct with the patient.
If, however, the patient asks no direct questions and makes no contact with the analyst, (i.e., indicating a more narcissistic individual), the analyst might only use 0-5 communication per session. In such cases, less intrusive interventions, such as silence, object-oriented questions and occasional joins, might be used as needed.
An exception to this guideline might be the Treatment Destructive Resistance (TDR). TDR's are generally investigated as they arise and dealt with as soon as possible using any intervention which seems appropriate to resolving the TDR.
Hi again.
You write that: "I would say the general rule of modern analysis is that the patient's job is to talk and the analyst's job is to facilitate the patient's talking."
I think analysts of most schools would express agreement with this rule. So it sounds like this is an area modern analysis may share with other schools.
However, you also write that "If, however, the patient asks no direct questions and makes no contact with the analyst, (i.e., indicating a more narcissistic individual), the analyst might only use 0-5 communication per session. In such cases, less intrusive interventions, such as silence, object-oriented questions and occasional joins, might be used as needed."
I'm not sure if I'm reading this correctly. But it sounds like the recommendation is that with patients with "less mature" egos,
the therapist ought to be less "instrusive," and, (put roughly), do less.
There does seem to be a striking contrast here between modern analysis and other analytic schools, many of which recommend almost the opposite: that with more impaired patients, the therapist must be more active, and often say more, than with less disturbed patients. The reasoning for this would be that if (some say) you sit silently with a very disturbed patient, they tend to get very uncomfortable and anxious due to the lack of structure and ambiguity of the situation, and are too uncomfortable to work productively.
So it is starting to sound like modern analysis kind of combines the technical nonintrusiveness of the classical approach with the wider variety of interventions that one might see in an interpersonal or relational approach. Does this sound right?
Anon:
It seems to me you’re on the right track; according to Spotnitz (1985, p.169):
“Interventions in the opening phase of treatment are ... strictly limited, being governed primarily by the need to manage the frustration level (Chapter 4).”
Thus, the therapist will intervene to prevent excessive frustration which might result in psychotic regression or other treatment destructive resistances; and “... in order not to mobilize too much hostility at any one moment, the therapist symbolically gratifies a few positive wishes by asking some object-oriented questions.” (Spotnitz, 1985, p. 175)
In the early stages of a modern analysis, the analyst takes full responsibility for teaching the patient to function cooperatively (i.e, to “work productively”) as a patient. Yet, at this stage, the analyst also remains as non-intrusive as possible - working at the level of emotional maturity where the patient is at the time. Countertransference becomes quite important in this respect.
There may also be a bit of a difference in what we consider to be “productive work.” Any progressive communications are considered “productive work” in modern analysis. These may include any spontaneous statements having to do with past events, sex, dreams or fantasies, and also the patient’s current life activities, as well as what is going on in the treatment relationship.
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Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.
I was working with a non-analytic therapist for the last year, who had pointed out several times that I had a rigid personality, with low self-esteem. A few months ago she said that unless I began to change my negative self-talk, it would be difficult for her to work with me. I asked her if that meant she was discontinuing our therapy and she said no, but that I needed to be willing to change, at the very least. I took this as an "abandonment" threat, which touched a raw nerve in me, and I just went to pieces for the rest of that session. The next week the therapist said I only needed to come every two weeks instead of the every week I'd been coming. The next time I went I didn't feel inclined to tell her anything so we cut the session short, and the same thing happened the next visit as well. By then I knew I needed to end this relationship because I wouldn't trust this therapist again with my feelings.
A trusted source (a clergyman who happens to also be a modern analyst)referred me to a modern analyst. We met two weeks ago just to see how the "fit" might be and I thought we'd be OK. We had our first "real" appt. a few days ago and I feel very conflicted about what I felt when with her. I think what I felt was all the fear and uncertainty I experienced with the initial therapist--as this analytic therapist was asking me "beginning" type questions, what I was experiencing was the same "abandonment" (pratically hysterical) fears that I'd had with the other therapist. So, this new analyst really has to cope with immediate, strong, transference from me. At least I think that's what my feelings amount to.... all the transference feelings I had with the initial therapist, I'm heaping onto this new person. I didn't say all this to her during the session because I didn't really know it at the moment when I was there. Should I tell her all this? I feel kind of foolish, childish, embarassed at having these feelings, at having transference so early in the relationship--- but really, the transference is being "transferred" from the previous therapy relationship. What should I do? Tell her all this or am I really off-track?
Great questions, Anon.
What would happen if you were "really off-track?"
If I was really off-track in my analysis of what was going on last week, then I won't try to explain it to the new therapist. If what I'm saying sounds like it makes sense, then I will explain it to her. But I think I know the real answer: if I'm going to stay with this analyst, I'm guessing I want to tell her all the things I was feeling last week. right?
Anon:
What would happen if you were "really off=track," and didn't make sense, and told her?
:-) If I didn't make sense, I probably wouldn't want to tell her... because I wouldn't want her to think I'm "stupid."
You're making me think, Jim. I guess I'm supposed to tell her everything I think and feel??? Whether it makes sense or not?
Let me share this with you...I am very stuck on having people know I am intelligent. Not that I'm a genius or anything, but I just like people to know I'm smarter than the average bear. It's an ego booster for me, because I've not been blessed with good looks, and because I have always felt inadequate and "not good enough." I don't want to look or sound "stupid." That's why I wanted to know if what I was thinking made sense, and that's why I only want to tell her if it DOES make sense.
What would make a feeling make sense?
Also, if your feeling DOESN’T make sense, what would you do with it?
Jim,
Logic would make a feeling make sense (i.e.-"If...then..." I don't like to sound foolish (translation: "stupid").
If I had the feeling and it didn't make sense, I would keep it to myself and...I guess I'd wonder what is wrong with me...or what is wrong with the rest of the world. But most of the time, what's wrong with me...I'm sorry. I know I'm not that unique a person that "I'm the only one in the world who feels like this." But, I don't seem to have the same feelings that other people talk about. And other people DO talk...I have an exceedingly hard time talking about the feelings I have. I'm afraid to talk. When I think about it, my stomach sort of starts churning and my heart starts racing. And I don't even know what I'm wanting to say.
It seems as though you have been talking here, about some difficult feelings.
Perhaps we should discuss fees. :-)
:-) Maybe we should....you are comfortable to communicate with.:-)
Actually, I just began with an analyst,for the first time,two weeks ago. I guess that's why I found your blog, and that's why I'm so curious. And,it's easy to ask questions via email, with plenty of time to formulate an answer. I'm so nervous when I see this therapist..... I don't know what to say. I'm afraid that I won't "get it right" and she'll get impatient with me...and then she'll think I really am "stupid." I don't know why I care so much what other people think. Jim,I probably should be telling her all this, right?
Do your clients use the couch? That's a new experience for me, it was quite anxiety-provoking, but once I laid down it seemed comfortable. Does it really lower resistances that much, in your learned experiences?? :-) Thanks, Anon.
Does your analyst have e-mail?
Some have more difficulty with the idea of the couch than others. I tend to look at these issues on a case-by-case basis.
:-) I don't know if she has email or not. Why, do you do analysis by email? How could that possibly work?
I haven't tried it, though I have spoken with others who have.
What are your ideas on it - could that possibly work?
Based on all that I've said to you, I think it might work. I guess you would have a dedicated hour (or 50 min.) where analyst and patient would kind of "IM" back and forth, so it would be private, yet the immediacy of reply would be there. If modern analysis is about getting the patient to "say everything" the anonymity of email would certainly enhance the feeling of safety for the patient. I felt "safe" to tell you a lot about my feelings, based on the anonymity of email. :-)
On the downside, I'm not sure how the transferences would develop, or countertransferences.
I'm not sure myself.
I wonder what might enhance the feeling of safety in person?
Part of my own fear during the session is the knowledge that I "should" be saying everyting. After all, there's only 50 min. to talk, and I know I would be "wise" to use it, and "unwise"to waste it. I also feel that I should be talking about really major, meaningful feelings, experiences, etc. That's a big pressure,leading to major anxiety for me. Is there anything the analyst can say to alleviate that feeling?
Another good question - assuming the analyst knew about the feeling.
:-) Are you trying to tell me that I should give the analyst the opportunity to provide the feeling of safety that I fear is not there?
I'm afraid to trust her too much with my feelings. I will begin to love her, and I don't want to do that. She will not love me in return.
What would happen then?
I would be embarassed. It's humiliating to love someone and need them when they do not love you or need you.
Is there anything the analyst should be doing?
That's where I'm depending on the analyst.... because I don't know where it goes from here. But the analyst must know what to do or say in this situation of transference, to address it and get me get through it... right?? I guess I'm afraid the analyst WON'T recognize what's going on, and I'll just be left to suffer my feelings, kind of "alone" and in pain. Yes, that's the fear.
Is there any way to help the analyst recognize what's going on?
I guess I could/should tell her all this? Would I just tell her this whole story or what?
What if I printed this entire conversation out and handed it to her to read? :-) On second thought, maybe I should print it out and just take it with me to use as "notes" to tell her how I feel, what I'm afraid of. I understand that she can't help with something if I'm not telling her about it.
Actually, I think this morning's email finally summed it up for me--I fear being left alone to suffer with my feelings and fears, I fear that she'll encourage me to have feelings and she won't be able to provide "containment"---is that the right word?---- for me.
What would she need to do to provide containment for you?
Just tell me that she will be there for me, I guess. Just explain to me that even if she feels frustrated with me, no matter how exasperated she may get with me, no matter how much I may not talk (because I have a hard time talking) she will stay with me and not "send me away" or "be angry" with me. She should explain to me that for this 50 minutes each week, she will be "here" with me, for me, and I don't have to be afraid of talking, of saying anything, because I can trust her and she won't ever intentionally hurt me. I guess that's what she should tell me.
Would it help her if you could tell her what she should tell you?
Probably. If you were the analyst, would it help you?
Probably.
So I should tell her all this then. I should just tell her.
What would you say to your patient if one of them told you they were depending on you to provide them this safety and certainty? Would you think they are being childish and immature?
You know, scratch that last msg. Of course patients with certain fears seem childish and immature. But analysis is about going back and re-experiencing, right? So, it's OK if my fears are childish and immature. So, I need to summon up my courage and tell her all this, and hope for the best response, right?
Does it seem right to you?
Yes. Seems like the only thing to do. How can she know what I'm thinking unless I tell her?
(Did you get my other msg.?)
Whatever is posted here is what I've seen - was there more?
I did send another msg.before that last one...but I didn't sign it as from "Anon." I signed my first name on the msg. and left the "identity" button as "Blogger." Apparently that was an incorrect thing to do.
ANYWAY, what I wanted to tell you was that I saw my therapist on Wed. afternoon. If you recall, she was new to me, I had only seen her two times, after a disastrous experience with a previous (non-analytic) therapist who cut me loose when I developed a strong transference. I told this new modern analytic person about the feelings I'd been discussing with you, how I wanted to feel safe, needed to know that she wouldn't "abandon" me, etc. We talked about it for quite a while, until I felt OK to "let it go" and get on other business. So, I think I'm going to be alright with her.
I wanted to thank you very much for all your responses these last two weeks. It was incredibly kind and patient of you to "stay with me" and I appreciated it VERY much. I wondered if you wanted me to send you a check for "services rendered" as you really did do "online therapy" or counseling. It would only be fair to you.... :-)
I want you to know that you really said things that helped me think about what I was saying, about how I was thinking (e.g.- I talked about my feelings "making sense" and you responded, "What would make a feeling make sense? And if a feeling didn't make sense, what would you do with it?") That stopped me dead in my tracks, because I'm only just beginning to learn about modern analysis, but I've heard about "wanting to have ALL your feelings." I'll remember that especially. I've thought A LOT while communicating with you. Maybe you SHOULD look into this online therapy idea!! :-)
Sincerely,
Anonymous
Thanks for sharing your thoughts.
:-) Bye.
Nice conversation... Anonymous made a good job by exposing his/her thowghts. There is a lot to learn from this virtual therapy session. Good job! Maybe psychoanalysis interested people should see more of this kind of talking...
why are people indoctrinated in spotniz's modern psychoanalysis intent on believing that they have invented or discovered something that is already contained in many other schools of analytic theory for some time?
Modern Psychoanalytic education includes most major developments in Psychoanalysis starting with Freud and continuing until the present day.
Yet some of the differences between Modern Psychoanalysis and other schools have been pointed out by others; such as the comment earlier on this blog: "There does seem to be a striking contrast here between modern analysis and other analytic schools..."
But, perhaps I missed the indoctrination class - Did you have something specific in mind "that is already contained in many other schools of analytic theory for some time?"
Hi Jim,
I would find it very helpful if you would briefly discuss the important differences between modern psychoanalysis and classical psychoanalysis. Thank you.
Thanks for the question, Neo. I've posted a brief article with some of my thoughts (entitled "More About Modern Psychoanalysis").
THANKS JIM,
YOUR NEW POST,ADDRESSING THE SIGNIFICANT DIFFERENCES BETWEEN CLASSICAL AND MODERN,IS VERY CLEAR AND HELPFUL IN UNDERSTANDING HOW AND WHY IT WORKS. MY PERSONAL ANALYSIS CONFIRMS THE PROCESS BECAUSE I HAVE EXPERIENCED THE IMPACT ON PROGRESSIVE COMMUNICATION OF VARIOUS TYPES OF INTERVENTIONS. I REALLY ENJOYED READING YOUR DESCRIPTION OF THE SILENT INTERPRETATION AND RECOGNIZE HOW I AM BEING CAREFULLY LED TO MAKE THE CONNECTIONS BETWEEN MY HISTORY,BEHAVIOR AND FEELINGS, SUCH THAT RESISTANCE IS DIMINSHED. IT IS ALL MAKING COGNITIVE AND EMOTIONAL SENSE TO ME.
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