What to expect from Psychoanalytic Psychotherapy
By: Joe Hovemeyer, AMFT
Sync Counseling Center is a community of therapists who are informed by, study and pursue training in contemporary psychoanalytic psychotherapy. However, for the average person looking for a therapist, it can be difficult to know what this means. When someone is looking for a therapist and reading through many different therapist descriptions, there are a dizzying array of different approaches presented. From Cognitive Behavioral Therapy (CBT), to EMDR, to ACT, to Narrative Therapy, and Somatic Experiencing therapy, the list goes on and on. How can I have any idea whether this person behind these varying approaches can help me?
I’ve often had friends ask me for help in knowing how to find a good therapist. It is a daunting endeavor, indeed. The piece of advice I give them is this: Look for signs that the therapist is someone authentic that you can genuinely connect with. Then, schedule a consult call and see if this holds true. I want to cut through all the noise of the different approaches, theories and techniques to focus on just that one piece. Research has shown that this one piece, that you feel the therapist is someone you can trust, who is genuine and tries to connect with your experience, is the greatest predictor of real help in overcoming your difficulties.
I relay this anecdote as a way to introduce what therapists at Sync Counseling Center focus on. Psychoanalytic psychotherapy leans into this understanding that the heart of effective psychotherapy is about the relationship between the therapist and the patient, rather than any technique that the therapist is trying to utilize. Rather, the therapist’s empathy, genuineness (they show up as a real person), and attempts to understand are what further the patient’s growth and change. But I want to take this even further. Empathy, genuineness and attempts to understand all sound good and helpful, but psychoanalytic psychotherapy clarifies how these tools help in a particular way.
When a person comes to see a therapist, they are often suffering from some difficulty. Perhaps they suffer from anxiety or depression, they feel lost in life, or they feel lonely and isolated with difficulty connecting with others. A psychoanalytic perspective holds that these difficulties stem from how the person relates to their own self and their relationships with other persons. When the patient enters into a relationship with a new therapist, those same difficulties affect how they relate to the therapist. The work of contemporary psychoanalytic psychotherapy is in using this new relational experience to surface or bring to light these difficulties and to help the person to pursue change. Empathy, authenticity and the therapist’s deep commitment to understanding the patient’s inner world are the tools that accomplish this process.
I find examples and stories helpful here. A straightforward example would be a patient who struggles with people-pleasing and thus feels anxious when they disagree with or believe they are disappointing the people around them. A person who has this tendency can often feel either anxious or depressed and decide to seek out therapy. What can then happen is that the very same tendency to accommodate others can show up in how they relate to the therapist. The work of therapy is in noticing these patterns occurring. Perhaps the therapist shares some thought about the client’s experience and the client disagrees. Rather than challenging the therapist, the people pleasing client agrees. A well trained psychoanalytic psychotherapist, however, is looking for clues that this is happening and helps the patient to notice this occurring in the therapeutic relationship. And in so doing, the pattern is brought to light and the exciting, although perhaps scary, possibility of trying something new emerges.
A second example may be a high achieving patient who feels intense pressure to perform in life and a corresponding fear of failure or vulnerability. Perhaps they had a parent who drove them to succeed and was very critical. However, something about this way of living isn’t working and the person pursues therapy. And in some way, this same fear of vulnerability or fear of failure finds its way into how they experience the therapeutic relationship. Again, the work is in noticing this occurring and being able to explore together with the therapist what is happening. As you can imagine, this kind of therapy is unique from many other relationships because of its emphasis on the connection and relational directness between the patient and the therapist.
Perhaps this approach might sound uncomfortable or intense. Many of the theories and strategies that technique oriented therapists utilize are ways that we defend ourselves from this kind of direct relating to a patient. It’s easier to focus on my anxiety as a symptom to manage, rather than notice how my anxiety is directly related to how I experience the “other.” However, if we can get past that discomfort about this kind of direct examination of what is happening between us, I get truly excited because real change can be unleashed. Rather than working at the surface, on symptoms, or managing our anxiety, we’re bringing to the surface our direct experience of the relational “other.”
In summary, psychoanalytic theory utilizes this direct relational experience to help a person get under the surface of their symptoms to the often unconscious relational processes that give rise to our difficulties. It is a transformative journey, and one that I am excited for more people to experience. My hope here is that writing this piece helps someone who may be put off by dense terminology to understand in clearer terms what it means to pursue this kind of therapy. If this intrigues you, I encourage you to consider reaching out to one of our therapists!
~Joe Hovemeyer, AMFT