"Deanachka" asks a fine question: how does the patient evaluate whether the
psychoanalytic therapist is doing his/her job appropriately and
professionally? To this I would add: how does the patient separate feelings
about the therapist which might be usefully explored as part of the therapy
itself, from those feelings, reactions, etc. which might lead the patient to
seek consultation with another therapist? I have no easy answers to these.
However, to start, I would say that a test of the therapist's "analytic
sturdiness" would include his/her ability to handle the patient's concerns,
criticisms, etc.--no matter how vehement--head-on, without acting defensive or
punitive, and with a devoted interest in accepting and working with the
patient's reactions--even if the latter involve thoughts or associations about
ending the therapy, switching to another therapist, demeaning the therapist,
or any other thoughts for that matter (the "complete freedom to think aloud").
I imagine that Deanachka is not addressing herself to the more obvious
measures of professionalism: the therapist's generally being on time for
sessions and ending sessions on time, avoidance of burdening the therapy with
excessive personal disclosures, and respecting the patient's sensibilities,
values, and conscious view of things. Conscious motives of the patient should
not, in general, be treated by the therapist as mutually exclusive from the
unconscious motives of the patient--since this has the effect of treating
conscious experience as less important, or less real, and can devalue the
patient's sense-of-reality--as in the hypothetical, "What you're 'really'
saying is that...".
This makes me think of another distinction: between the issues of
professionalism, "tact and sensitivity," and lack of good-fit with the
patient. Some therapists are quite professional, but lack tact in their
mannerisms and style of approaching patients. In some cases, it might have to
do with a poor fit between the specific patient and therapist dyad, whereas
the same therapist might suit the therapeutic needs of other patients just
fine. To be sure, I certainly cannot work effectively with all patients;
this is difficult to predict, and a decision about it usually comes over a
trial period of a few weeks or a few months, and/or when the patient decides
to terminate prematurely.
From a practical angle, if Deanachka can afford her current analysis, it's not
evident why she cannot take a brief break from it and consult with another
therapist about her predicament for a session or two or three, using the same
funds--assuming she has raised her concerns with her current therapist and
finds it has led to nowhere or to a standstill which she feels she cannot
overcome (in my mind, the latter would be the first step or "test"). That
aside, there are opportunities in analytic training centers where Deanachka
might consult (for free, or a low fee) with a prospective analyst (usually a
candidate in training who's being supervised by a training analyst) about her
situation. In the New York area (since I know that's where she lives),
there's the New York University Post-Doctoral Program in Psychoanalysis, the
New York Psychoanalytic Institute, the William Alanson White (?) Institute,
and others as well.
It might be helpful to hear specific examples of her therapist's apparent lack
of professionalism, so that the listmembers could evaluate more effectively
the nature of her concerns--to the degree that she feels comfortable doing so.
David Mittelman, Ph.D.
In a message dated 98-05-21 18:50:26 EDT, Deanachka wrote:
<<hello, im sorry to inturrupt the self-analysis discussion.. my question is
about my psychoanalytic therapy, i'm having very strong doubts about my
analyst's professionalism, for financial reasons i am unable to see another
analyst about this matter (like u suggested, david). is there any sort of way,
in which i can stay somewhat objective, in assesing my analyst's
professionalism..? (i guess i really did not deviate too much from the
discussion of self-analysis :)>>
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