How
much information does a psychologist need to know in order to help a patient?
What is important and what isn’t?
When Sigmund Freud started practicing
psychoanalysis,
he essentially told his patients to lie on the couch, start talking, and
say whatever came to mind without censoring anything. This was called free
association, and it made the question of what to say during the treatment
totally unambiguous: everything.
Now, if you happen
to be in psychoanalysis today, the same rule about free association still
applies. In contrast, if you happen to be in
cognitive-behavioral
therapy, you don’t have to worry about what to say because the
psychotherapist will tell you exactly what you have to do and how to think.
But if you are in
psychodynamic
psychotherapy, then you face the dilemma of what to talk about in each
session. And for many new clients, this is a real dilemma, because they have
to confront not just the question of what to say but also the possibility
of what to leave out. Thankfully, a good psychologist can see through all
of this. And so it can be said that even in spite of yourself the truth will
come out. It is important, therefore, to be committed to allowing it to happen,
despite your fear
of the consequences.
Consider the
following example which illustrates how a casual—and seemingly
meaningless—comment can be the opening into a major psychological
conflict:
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“I’m
really rushin’ today,” said one of my clients, standing up eagerly
as I greeted him in the waiting room. Then, as we walked down the hall to
my office, he looked back over his shoulder to me and added, with a sort
of self-satisfied smile, “I only had three minutes for
lunch.”
In the office,
I sat down, musing. A smile came over me, and I said, “This might seem
like it’s off-the-wall, but tell me—who do you know who’s
Russian?” [1]
His face twitched
in surprise. With a shrug, he said he couldn’t think of anyone. But
I knew the gears were turning. Then, after a long pause, during which I waited
in silence, he said, “Well, there’s my uncle; he was
Russian.”
I asked him to
tell me a bit about his uncle, and it turned out that the uncle had willingly
made a very profound, spiritual choice about his life many years
ago.
Now, at the time,
my client was struggling with many decisions about his own life and vocation,
and he was almost at the point of realizing that he wasn’t a victim
in life and that he had the responsibility—and the freedom—to choose
his destiny. Although he would have preferred to live in all the denial of
the mindless rushing around, it slowly started dawning on him that he had
to start making some serious and responsible choices about his future. And,
believe it or not, that unconscious realization found its symbolism in the
Russian uncle who made a free and willing choice of his own many years ago.
Our discussion of his uncle, based on that flip comment at the beginning
of the session, led to a deep examination of his current emotional
struggles. |
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This illustration,
then, leads us to one key point about psychotherapy: something that you think
is meaningless can hold a profound image of your life’s meaning at that
moment, and something you think is important can be just a
distraction.
So how do you,
the client floundering in the midst of all this confusion, know what is
important? Well, you can’t.
Then how do you
bear the anxiety of sorting it out? Well, just remember that psychotherapy
is not like the adversarial legal system where anything you say can and will
be used against you. Good, competent psychotherapy has only one purpose:
to help you get close to the
unconscious experiences
that you have been running from all your life. If you accept this premise,
then you can relax a bit, for anything you say in psychotherapy can and will
be used to help you. It requires only that you be willing to
be honest with
your psychologist—and yourself. The being honest will come with
training and experience through the psychotherapy itself.
___________
1.
Russian and rushin’ (rushing) sound the same in English.
Word plays such as this can often reveal significant points of unconscious
connection.
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