More than most psychotherapists that I know, I am indebted to psychoanalytic roots. I personally love the study of unconscious dynamics, psychodynamic conflict, transference/countertransference, dreams, and object relations, to name just a few fertile areas of psychoanalytic thought. However, as a therapist who typically works in a once or twice weekly model, I also have the therapist’s committment, as distinquished from the five times per week psychoanalyst, to accurately distill what is most essential in psychological theory for effective positive change/growth in our patients lives.
As most other current day therapists, I have long believed that it is relationship that heals. Said differently, since emotional problems are created in relationship, it makes sense that they are healed in relationship. To distill things further, it is attachment that provides the skeletal foundations to relationship. Perhaps it is a bit of an overstatment, but not by much, to say “so goes attachment… so goes relationship.” What this understanding suggest is that an effective working with deep attachment dynamics is the surest way to bring about the deepest therapeutic change, whether it be with individuals, couples or groups.
Though I honor my psychoanalytic roots with ongoing deep attention to unconscious transference and countertransference dynamics, I count myself among that minority of therapists who believe that the therapy relationship is itself, a deeply real relationship; it is every bit as real, often more real, as our patients have in their outside lives. It is my understanding that human beings have a particular ability to make deep human contact every bit as real anywhere else in their lives, even though the context for the interaction is professional fee-for-service. Perhaps akin to the “willing suspension of disbelief” that occurs in the appreciation of literature/movies/plays/video games/virtual reality, the human attachment with the therapist is fully real at a deep psychological level. From this perspective, when either patient or therapist minimize the therapy relationship because “I pay you” or because “I only see you an hour or two a week” they in fact are engaging in “attachment defense” likely analogous to how they defend against attachment wounds in their life generally.
