Theoretical Guidelines Informing my Psychotherapy Practice

One essential guideline of psychoanalytic psychotherapy is that, as a learning process, it can shed light on internal states of mind and body that generate stagnancies and conflicts, and how these challenging types of internal conditions can impede the ancient, innate push towards emotional health and growth across the lifespan. Many of these internal states can reside outside of one’s conscious awareness, making them difficult to both see and change without a therapeutic process designed to illuminate. To guide my psychotherapy practice, I use five basic ideas, all grounded in psychoanalytically-based theory.

                       

Innate push towards wholeness and growth:  I believe that, like all living things, we have a powerful innate drive towards growth and balance. Internal conflicts and past traumas can interfere with this instinct towards wholeness. With the analytic process of therapy, the conflicts and traumas of the past that interfere with this push towards growth can be resolved, allowing the instinct towards growth to once again lead the way.

                       

Focus on bodily-based, here-and-now experience: Emotional experience is alive most of all in the immediate, here-and-now moment of existence, and our physical body is where the initial experience of emotion takes place. This means that using thought that is attuned to one’s bodily-based experience is an essential part of the therapeutic process. In sessions, I will ask with some frequency about this area of your experience as each session unfolds. I have found that curiosity about physical, bodily-based experience can often shed light on previously unseen emotional processes and conflicts.

                       

The body and unconscious states of mind are closely related: Much of our emotional memory and internal experience goes unrecognized. This is necessary. If all we felt was conscious all the time we would be overwhelmed and unable to function with direction and focus. However, we pay the price sometimes when unconscious, conflicting emotions or past traumas remain hidden, because they can still exert the tension that comes from conflict and injury on both mind and body.

                       

Relationship: The patient’s relationship with the therapist is one context in which old, problematic patterns of relating can become reiterated. Stated in another way, previously hidden feelings, rooted in patterns from the past, can become re-activated in the here-and-now of the sessions. When this occurs, we can notice what’s happening in the moment, share thoughts about it, which can then, in turn, open the door to insight and change.

                       

Developmental factors: I believe that both genetics and environment influence our development as human beings. Everyone of us, from the moment of birth and even before that, is subject to environmental influences that affect development. Additionally, there are particular emotional and relational milestones we all face, beginning in infancy, continuing through childhood, adolescence, and the different phases of adulthood. Traumas and losses can significantly impact one’s capacity to navigate these difficult milestones, leading to problems related to these developmental stages. It is one task of the therapy process to explore the patient’s experience of navigating these developmental milestones, and to work towards resolving any emotional injury that impacted the capacity to move through these stages.  

                       

Emotional conflicts: Each one of us harbors a wide variety of emotional experience, and amidst this complex diversity, internal conflict is inevitable. Sometimes these conflicts do not find resolution with natural supports in place, and lead to persistent, repetitive feelings and behaviors that don't change, and create problems.

Reflective capacity and talking: In therapy, talking is an essential part of the process. Talking requires thinking, and linking thought with the complexity of emotional experience is arguably the most powerful aspect of the healing process that psychotherapy can provide. In other words, as the patient builds his or her capacity to think calmly and carefully when faced with overwhelming storms of emotion, the drive towards growth, integration, and wholeness is allowed to take hold. One overall goal for the therapy process, then, is to strengthen reflective capacity to the extent that the patient will eventually not need the help of the therapy. Therapy is finished when the patient is able to consistently reflect upon and better understand emotional situations that were previously overwhelming and problematic. Ultimately, from this development of reflective capacities comes the internal mental space that enables more choices.

 

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