Third in the series Ink-Stained for Life
When it came time for my therapy I started in the deep end of the pool.
My marriage had ended. It was time for me to change jobs after heading a clinical service at a prestigious teaching hospital. I had a young son who would soon get to know divorce first hand. I felt depressed, guilty about everything, too alone, and staring into a deeply uncertain future. While this was several decades ago, I can readily summon up the intensity of my dysphoria. I was already a psychiatrist and had sidestepped therapy as part of my training. I had waited long enough.
Instead of looking for a psychotherapist, I decided to go for the full Monte. I found a traditional Freudian psychoanalyst, a past president of Boston’s major analytic institute. Psychoanalysis, by the time I entered its pool, did not have the eminence it did in the good old 20th Century, having been eclipsed by the promise of neuroscience and an explosion of medications. But analysis was not dead — Woody Allen notwithstanding — nor were its conceptual roots in the power of the unconscious in driving how we feel and act and its methods of free association (‘say whatever comes to mind’) and dream interpretation.
I was on the couch, four times a week. After four years, I was convinced I was done. That led to another year of analysis after which I pronounced to my analyst that now I was surely done. A year later I was. I paid out of pocket for this treatment, which virtually no insurance covered then and I can’t think of one today that does. For me, analysis was exceptionally helpful where Freud said it counted the most, namely in love and work.
I wonder what helped? Was it the traditional technique of couch, dream interpretation, free association and analysis of the transference (how the demons of our past continue to impale us on the spikes of early, troubled relationships)? Or was it the relationship with my wise analyst who knew every psychological evasion in the book (and I had read the book), demanded that I take responsibility for how I felt and lived, and was deeply kind.
Research has repeatedly shown that active listening, genuine empathy, and support are fundamental healing techniques in therapy, whatever its form: short or long, analytic, cognitive, interpersonal and others.
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