What is Psychoanalysis?

Many people, who are  already in therapy may be puzzled, when they are offered by their therapist/analyst to consider psychoanalysis instead of less intense form of psychotherapies.

The video below clarifies very well the transformative power of psychoanalysis for those, who are seeking an internal, permanent change v. symptom relief.

https://www.youtube.com/watch?v=WiLtQATY_1s

Psychotherapy: A Zone of Experiences

When I see children spending so much time inside in front of their mini screens, I can't help but notice the stark difference between my own childhood and theirs. While for today's children outside activities  mostly revolve around semi- or fully structured sports- for my generation it was completely free, most often without adult supervision. I remember spending hours "making cakes and cookies" out of mud and decorating them with carefully smashed brick pieces or climbing the trees and watching the bugs that would walk on branches. I loved this free time outside, knowing that I would go back to the warmth of home at sunset. Bedtime was another special time for me to wander in the  equally-infinite realm of my inner world before falling asleep. Aside from school, chores, and such obligations, my childhood was an oscillation between these two external and internal worlds of play. I can't tell which one I liked the most.

When I read this article, "The Architecture of Psychotherapy", I was reminded of this oscillation. The therapy  and psychoanalytic process is essentially very similar; the patient comes in and lies on the couch and usually starts with something external (may be a fight with a significant other or the pouring rain or the jammed traffic) before the therapeutic space (the consulting room and the presence of  therapist/analyst) envelops her/him like a swaddle. Then the swing between the external and the internal begins.

Most of the therapeutic work takes place in-between, which renown psychoanalyst D.W. Winnicott calls "transitional space". It is in a way where external and internal come together; a bridge between the subjective experience and objective reality. According to Winnicott, all creative expressions find their way out to the external world through  transitional space. A therapeutic/analytic work bears a certain creativity whereby meaning emerges. In other words, the therapist and the patient create together "meaning" out of patient's conscious and unconscious communication, which in return help the patient re-construct a new narrative for her/his life. That does not happen in a vacuum. It does happen as a result of an ardent oscillation between the internal and external world of both the patient and the analyst.

The article mentioned above, The Architecture of Psychotherapy, talks about the therapeutic frame, which connotes the optimal conditions for such a transformation in personal narrative to occur. The therapeutic frame is essentially the defining lines of therapeutic situation, which includes specific time and duration of sessions, the specific consulting room, the fee, the roles of each participant and the set of rules that governs the therapeutic relationship. But the word architecture brings to mind another concept: The Analytic Site coined by a French psychoanalyst J.L. Donnet. To my understanding, the analytic site, which includes the therapeutic frame with all its components, plus what happens between the patient and the therapist/analyst, is the engine of the transformation that is expected to occur in treatment. The interpretation of the therapist/analyst that helps the patient transform is a function of the analytic site. Therefore, in my mind, the architecture of psychotherapy might also be considered as the analytic site, where all the external and internal factors come together in a special way to promote growth and understanding. "A zone of experiences between an unknown beginning and unimaginable end", as the author of the article, Esther Sperber says.

What Does A Psychoanalyst Have In Common With Detective Columbo?

Last winter, when I discovered a French television police and legal drama series called Spiral, I was mesmerized with the intricacies of the story lines, terrified with the cruelty that human beings are capable of, and most importantly astonished by the thorough investigations of the Judge Francois Roban. Watching Judge Roban pay attention to all seemingly trivial details made me think that there is a parallel between his way of acquiring information and a psychoanalyst’s way of listening to his patients. The most pertinent piece of information, which would later on turn out to be an essential piece,  always lies either in un-uttered ones or in those that appears to be negligible. Therefore nothing is actually negligible when your job is to construct reality out of thousands of bits that are scattered in every corner. 

I am still waiting for series 5 of Spiral to be on Netflix. 

Meanwhile, I turned to my old, childhood “friend” Columbo. The first season of Columbo was shot in 1968 and it continued -with some interruptions- all the way to 2003 and received numerous awards and nominations. For me personally, it is the all-time best detective series. 

Columbo has an inverted detective story format, which means you don’t watch it just because you are  so darn curious about who did it, but you are darn curious about how Columbo will find out the truth. There is also a sociological component in the audience's attraction to watch the series; namely it is always about the victory of a seemingly ordinary man over a wealthy, entitled, usually narcisistically characterized one. It is always a great relief that there is justice for all. 

For me though, the spell is about the Columbo character. Columbo’s personality somehow speaks to all of us through his unapologetic pursuit for truth. He acts apologetically in many scenes, but in a close analysis, it is not hard to realize that his apologies come from his genuine respect and concerns for others, although he may also often seem to be careless and annoying. There is a lot of paradoxes in Columbo. He is very respectful and polite, but at the same time very insistent and never shy to speak if something is on his mind, such as an unfit piece of information that bothers him. He is very intelligent, however the murderer amuses for quite some time with Columbo’s external stupidity until a turning point. This bum-looking detective always throws a punchy question at his super-confident prey at the beginning of the story, which later on becomes key. His physical appearance is in stark contrast with his inner strength and intelligence that often fools the murderer.

What fools the murderer is not only his appearance though. Columbo, when bringing the pieces together, is not alone. His main assistant is the mind of the murderer. Here things get really interesting for me, as a psychoanalyst-in-training. Columbo obtains most clues from the murderer's feverish attempts to mislead him towards another target.

In therapy/analysis, although patients display a conscious desire or motivation to get better or to  improve their situations, therapists/analysts constantly observe a phenomenon called “resistance” as if they are dealing with an "unconscious” murderer. Yet, analysts' sole assistant is the mind of their patient. More accurately -as in the case in Columbo- the two minds working together; sometimes in accordance, but more often in a pull and push dance. Like Columbo, therapists should never give in to the pressure to collude with the facade, but should be unapologetic in the pursuit of the truth. 

I learned a lot by just watching Columbo. I learned how to be benignly curious about the details of my patients’ lives. I learned not to be shy to go back to  things that are not clear to me, which also conveys my desire to understand my patient. I learned how to be compassionate when my patients are in distress and I learned to be patient when my patient are not yet ready to hear a piece of truth about their way of sabotaging themselves. Everything is a matter of timing, both in Columbo and in psychoanalysis, but sooner or later the truth is appreciated.