In the early years of psychoanalysis psychotherapeutic treatment was typically conducted six days per week with the patient doing free association laying on the couch out of sight from the analyst. In modern times many question the lack of actual relational contact between therapist and patient characteristic of this treatment situation. However, what is evident is the “deep emotional holding” that that daily sessions can potentially provide to the therapeutic journey. In fact, some patients and analysts doing this form of treatment report on the “Monday crust” that would often follow from having a Sunday break from treatment. Clearly, such treatment was intense and fully involving, even if limited in terms of much current psychotherapy understanding.
Most modern day psychoanalytic psychotherapy is conducted on a once per week basis, with some treatments two times per week, and other treatments every other week. While such treatments are often, in fact, invaluable in people’s lives, it is my current understanding that most psychotherapy inherently provides less than is truly needed; that is, most psychotherapy proceeds with inherent “psychotherapy deprivation.”
“Psychotherapy deprivation” is important because “deprivation in treatment” reenacts the deprivation in our patient’s histories that is so often implicated in our patient’s emotional wounding. At it’s worst, this amounts to a situation where the treatment that is entrusted to heal emotional wounds is itself inherently re-wounding. At it’s least, the “internalization process” that is at the heart of therapeutic healing is lessened.
What is to be done about this state of affairs?
Let me first talk about what is not done. Most therapists are in a state of denial; that is, most therapist, prohibit “their own knowing” about this limitation in the treatment they provide. Hence they interfere with “their patients knowing” about what is inherently missing or deficit in treatment. (to be cont)
