Subscribe
Share
Share
Embed
We continue as requested by our Patreons with a series on the therapeutic relationship with Dr Aleksandar Dimitrijevic.
Psychoanalysis should be free! From this motto, we're looking at making the insights of more than a century of psychoanalytic understanding available to anyone and everywhere. Our first goal is to produce a package of general introduction videos about psychoanalysis as well as to explain its key concepts.
Support us through our Patreon page! https://www.patreon.com/berlinpsychoanalytic
So we continue with videos and brief series of videos based on the requests that you've kindly sent us by Instagram or Facebook. And this time it's going to be a brief series about the relationship between the therapist and the. This topic is very popular, widely discussed and moments, hugely controversial.
And I will try to cover some aspects of this briefly in three or four videos. The first one is going to be about what the relationship between the patient and the therapist usually is what it should be like, how the understanding has changed over time and so on. So everything begins historically with a patient.
Although we, as professionals like to believe that we are very smart major revolutions in the history of psychoanalysis were initiated by patients. And most often female patients, the first of these. Was the person we know as an all a real name was better. Buttenheim and she was the patient to be yours of broil, the mentor, uh, supporter friends of Sigmund Freud at the time.
And Floyd was very young. Why begin with this patient at this time? And this is 1880. We didn't really know what to do with people who suffered from mental disorders, how to help them. And it was who said to Broyer that more than anything else he was trying, and that was hypnosis diet, baths, various treatments.
Most of which we don't use anymore. She said, what was most helpful was what she called talking about. That he would allow her to talk about whatever she wanted to say and that he would listen mostly be silent, but pay attention to what she was talking. And that's the beginning of a tall, a relationship in which one person will be allowed, will be provided an opportunity to speak about whatever is on his or her mind.
And the other person would listen to that. Even more than this, I'm not sure it was clear that early, this can be the first opportunity for many people to finally realize what it is that they have to say, what it is that they would like to express and share with other people. Because so many things in us, especially in the unconscious are silenced or mute or forgotten, or unformulated.
The relationship became the most important point in the psychoanalytic theory very quickly with Freud's discovery or description of the phenomenon we call transference in transference. And I will now simplify and put it very briefly. Transference would require a very long presentation patients.
Express feelings or opinions or beliefs related to the person of the analyst. Very intensely for long periods of time. Someone's sometimes passionately positive or negative idealizing or denigrating various options are possible, but. In the same or similar or analogous way to what they once experienced with some other figure.
And so every long-term high-frequency analysis will include at least one period when the relationship with the therapist will be the most important thing in the world when the person is just waiting for the next session to begin. And that is. More important than anything else going on in the social world.
And then what will the analysts think about me and what will I think about my analyst and will I be proud and will he, or she be proud and so on. So in the beginning, Freud believed many psychoanalyst followed him in this, that the most important thing was how we understand this transference manifestation. And how we interpret them and in the classical psychoanalytic approach, and this is what you will very frequently see in the movies in character chores, if you read many books that, include descriptions of psychoanalytic treatments, psychoanalysts will be completely absent from the relationship in any unprofessional. They will just provide their interpretations sometimes one per session, four per session, six per session. And not say anything else, not ask anything and not engage in any form of communication before the beginning of the session and after the end of the session.
And there are many, many examples of this that. I don't think I have time to, to describe now, what was the purpose of all this? Theoretically speaking Freud believed that the analyst should be as unknown as mysterious to the patient as possible because this won't enable the unconscious of the patient to be expressed in the relation.
And that is how we are going to understand where the problem comes from and what we should do about think for instance, of the inkblots of any projective tests that is used in psychology, the less structured the material, the more your unconscious is going to speak the same with this. If you don't know your analyst's personal preferences, religious beliefs, political attitudes, family situation, and so on, whatever you think or feel about that person will come from your unconscious and will be revealing of something that potentially hopefully will be helpful for the trip non theoretically. So to say, this came from the very problematic situation.
That took place in the years before the beginning of the world war one, when Freud's closest collaborators, Carl Gustav Jung and Sarando Ferenzi got involved in romantic and erotic relationships with female patients and I'll leave it at this at this moment and then returned that in the next.
Things changed after the world war two, when the classical psychoanalytic model was challenged by several very important authors and nowadays is not followed or not taken too seriously by a huge number of psychoanalysts, especially in the United States. So it started on both sides of the ocean. In England, mostly by Donald Winnicott and in the United States, mostly by Harry stack Sullivan and Heinz Kohut. And again, these are extremely important authors whose work,, I can not do justice to in this brief presentation, but I'll focus just on, on this aspect of, of their contribution.
When it comes to Winnicott, probably the most important thing about him is that he was a pediatric. And he came to psychoanalysis with this unbelievably rich experience of spending time and helping actual mother-baby diets. Some people believe that Winnicott he caught, could see in about 60,000 mother-infant diets, which is in comparable more than any psychoanalyst will ever be able to treat whether in the adult or child analysis. And when came to believe winnicott as he wrote, there was no such thing as baby alone. There's always baby with the mother.
And he believed that the most important fact about human beings is their dependence. That especially in the beginning of the life, none of us can survive alone. And we depend on other people. And the relationship with other people is the basic fact of our lives. Not so much the drives as Freud or Melanie Klein or many other authors would believe, and many people translated this into, "there is no such thing as an analyst alone", where "there is no such thing as a patient alone". "There is only patient and analyst together". And this is very obvious in all the descriptions of Winnicott's clinic. We don't have many, but what we have testifies to the fact that he was always willing to adapt his technique so that he would be able to help this individual patient. That for instance, in one interview in Berlin, Talks about asking when you called for analysis after Michael Berlin's death, when she was already an analyst and in training analysis in the past and so on. And she went to Winnicott for a year and he would allow her, so to say, to sit on the floor and cry and not say anything, if she doesn't want or need to say anything. And if she would require he would let her hold his hand. And many other examples of this can be found in recent publications, like the paper by James Anderson and how Winnicott conducted analysis published in psychoanalytic psychology in the German psychoanalytic psychology and the recent book finding pivotal, which is when it comes named for one of his patients published by Phoenix. I think last year.
On the other side of the ocean, Harry stack Sullivan and Kohut in slightly different ways came to the conclusion that the psychoanalytic ideals of complete distance and anonymity were first impossible. And then, what potentially harmful for the patient, if possible, in terms that whatever we do is some sort of behavior and expression. If the analyst decides to be silent, that says something about that person. If the analyst decides to say, and then when will the analyst say it in what way? With which tone of voice? And so. All will be revealing about this person. And there are interesting testimonies, not frequent, unfortunately, not, not frequently by patients who say what they have concluded, what they learned about their analysts during the analysis. Although analysts wouldn't say their facial expressions or something else would reveal something about them. But not only that we cannot be robots. Kohut very specifically, very explicitly wrote. We shouldn't be, we shouldn't, try to be completely distant because many people come to psychotherapy because they suffer for not being accepted as children from not feeling loved as children from not feeling recognized when they tried to share their pain or traumatic experiences. And if they have hope to come to a psychotherapist and hope, finally, I will be able to overcome this with the help of this person.
And we are completely distant and without facial expression and not sharing emotion that can even be retraumatizing. So starting probably 1960s, more and more psycho enlists felt their contribution to the relationship was far more important than people believe before. Not just in terms of how we react to what patients feel, tell us, or put, put, put pressure on us and so on.
But in terms that, of course, like everyone else on the globe, we have the unconscious and feelings and insecurities and childhood memories and so on. And all of those play their parts in the relationship now. Very important detail. Or a formula, if you will comes from Lewis era, who although being one of the most important representatives of relational psychoanalysis insisted on it, that the relationship remains slightly asymmetrical.
The analyst has ethical code professional responsibilities, the focus on doing things that will be for the benefit of. So there is a wide, very detailed discussion about the issue of disclosure. Will the endless disclose anything during the session about the private life experiences? What happened yesterday?
What happened 30 years ago? which books I like, uh, how I suffered when this happened to me and. The discussion is long. Again, again, I'm presenting. If you are very briefly, the final conclusion has to be that the analyst can share when appropriate and will be for the benefit of the patient. Not to talk about your own pain with the patient so that the patients will help you.