Psych. . . What?

The market of available treatments for psychological problems is shrinking, which is why it is extremely important to know what exactly is on offer and what kind of specialist one wants to see. First of all, let’s talk about the differences between psychiatrists, psychotherapists, and psychoanalysts. These are completely different professions, and you will get radically different treatments from their representatives.

Psychiatrist – this is a person who doesn’t know how to do absolutely anything but choose a diagnostic label to attach to you and prescribe you medication. You will be hard-pressed to get a psychiatrist to remember your name, let alone retain the memory of what actually bothers you. A steady stream of patients flows into a psychiatrist’s office where they get their scrips and are sent away within minutes.

Psychotherapist – this is a person who doesn’t solve any problems either, but at least s/he will listen to you and not shut you up with zombifying medications. Psychotherapists have access to an enormous array of non-medicinal therapeutic practices that help make your problems manageable. The problems never go away because psychotherapy doesn’t touch their roots. Imagine having a lawn that keeps getting overgrown with weeds. You can use a lawn-mower on it but that will require weekly rounds of mowing since the seeds of the weeds will never go away. This is what psychotherapy is like. People end up visiting a therapist for years because life becomes tolerable as a result. However, without those visits, the problems quickly reappear in full bloom.

Many people choose this option, and I think it’s very respectable and has a right to exist. If one doesn’t feel like changing one’s life dramatically and simply wants to enjoy what s/he has better, that is perfectly fine.

 

Sessions with a therapist are usually pleasant. The support and acceptance one gets during them often make one feel euphoric after a session. One problem with psychotherapy is that you never know when you are visiting a quack who will not provide even this modest kind of support and will end up hurting you.

Psychoanalyst – this is a person who will also treat you non-medicinally and will never attach any diagnostic labels to you. Insanity, depression, bipolar disorder, anxiety disorder, schizophrenia – none of those exist in a psychoanalyst’s world. For an analyst, you are neither sick nor abnormal. You are simply a human being who exists in a certain way and who is not better or worse than anybody else because of this. If you want to bug an analyst, just say something like, “I know this sounds completely crazy but. . .”

The goal of psychoanalysis is not to make life tolerable by mowing the lawn of your problems but to eradicate them altogether. This is why analysis will not last for many years (granted that both the patient and the analyst work and not pretend to work.) This is a finite process, at the end of which you are supposed to let go of your problems for good. For instance, if you have an alcohol addiction, as a result of psychoanalysis you will not need to spend the rest of your life going to meetings, confessing your alcoholism, and struggling “one day at a time” with the temptation. Because there will be no more temptation. Alcohol will simply stop being of any interest to you without any effort of will-power.

The downside of the process is that the sessions can be very painful and the time between them can be even worse. This is like removing facial hair with pincers one hair at a time as opposed to shaving. I believe that the degree of pain depends on how well one is prepared for the process and how aware one is of what the process will entail. (More on this later.)

One good thing about psychoanalysis is that an analyst (a real one, that is) always works with a supervisor. This is a person who is there to make absolutely sure that the analyst never projects his or her own problems onto you and doesn’t use you to advance any personal agenda.

63 thoughts on “Psych. . . What?

  1. Interesting that you should say psychoanalysts don’t even attach the label of schitzophrenia. Are you familiar with R.D. Laing? He wrote an interesting book on the interpersonal roots of schitzophrenia. I think chemistry is a component of the actual paranoid thinking pattern, but it’s the interpersonal dynamic that explains the terrible negative emotional valence that usually accompanies it. Paranoia has only one emotional connotation in our society, which is odd because a thinking pattern doesn’t have an emotional valence. In a sane society paranoia would just mean that you think the world is magical and is out to help you.

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      1. It’s a good thing you pronounced his name in your review, because I was way off and la wik has nothing.

        Ralph Ellison’s second novel was also about an explicit Christ metaphor, but it was a really literal one and he never finished it for some reason.

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  2. I think the pattern to healing is through no longer believing in any absolute righteousness, particularly of one’s parents or authority figures (stand-ins for “God”).

    Everything is contingent. One’s parents are/were human. Humanity is not godlike. No point in having any neurosis once you realize what reality is.

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  3. RE Psychotherapist, can’t a smart friend / life partner / parent / oneself fulfill this role, especially after one can Google non-medicinal therapeutic practices? Why can’t other people not solve any problems for free? 🙂

    // One problem with psychotherapy is that you never know when you are visiting a quack who will not provide even this modest kind of support and will end up hurting you.

    Shouldn’t not getting any support clue the patient?

    // If one doesn’t feel like changing one’s life dramatically

    An analyst can’t force one to change dramatically either, right? May be, some people want to understand why and what exactly happened in their lives, rather than seek dramatic changes. But, I suppose, those are the few lucky ones, and most patients suffer horribly to turn to an analyst. Is a simple desire to understand yourself better not a good enough reason for seeking an analyst, but a sign of narcissism and too much navel gazing?

    // For an analyst, you are neither sick nor abnormal. You are simply a human being who exists in a certain way

    What if, for example, one doesn’t want to get married, but live with one’s parents and be a single mother? Will such a person want to create the “normal” family with a husband after analysis? Can’t the process only show roots of desires and make a person undergoing it want the same thing, only while being more sure about the rightness of choice for oneself and after stopping being afraid of “what will society say / do, if I do it”?

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    1. A friend or a partner who is trying to apply psychotherapeutic practices to you is nothing but a manipulator who wants to dominate you. Avoid such people at all costs!! The moment one starts “psychoanalyzing” you within the framework of a personal relationship, they should be shut down immediately and rudely.

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    2. A desire to get to know oneself better is a great reason to go into analysis. Narcissists won’t do something like that because they are really not into turning inward for answers. A narcissist is turned outward and is heavily dependent on the actions and opinions of others.

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    3. Analysis has as its goal helping you to live in a way that is authentic to you. That, of course, is going to be different for every person. The point is not to get everybody to have the same kind of existence but to help people aged anxiety and sadness while they enjoy the kind of life that makes them happy.

      Sorry, I have to answer in these short posts on this device.

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  4. Some years ago a sort of friend needed some work done (and kept me up to date in a very vague way).

    He must have seen a psychoanalyst because he said for the first three or four sessions he spent a lot of time hyperventilating while feeling like he was about second away from puking his guts out. Eventually the sessions became less traumatic and to my surprise he did get better, as in he was able to make some real, substantive changes for the better in his life. He moved away and I lost track of him but it was one of the realest examples I’ve known of a person getting better through therapy (as opposed to working out elaborate rationalizations to feel better about not changing).

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  5. // the degree of pain depends on how well one is prepared for the process and how aware one is of what the process will entail

    Could you write more what it entails, please? If somebody is unaware what he should do during a session, how can an analyst help?

    // A friend or a partner who is trying to apply psychotherapeutic practices to you is nothing but a manipulator

    I was talking about helping similar to a psychotherapist, not like an analyst. After being asked to.

    And, last point, which is still not fully clear: if one already knows the roots of the problems, f.e. low self-esteem because of XYZ, how can an analyst help, if at all? Unless it’s some mental techniques, which resemble your description of psychotherapy and the posts “How To …” which you once wrote.

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  6. I read more and:

    // As a therapy, psychoanalysis is based on the observation that individuals are often unaware of many of the factors that determine their emotions and behavior. These unconscious factors may create unhappiness [ …] as troubling personality traits, difficulties in work or in love relationships, or disturbances in mood and self esteem. Because these forces are unconscious, the advice of friends and family, the reading of self help books […] often fail to provide relief.

    So, if one already knows, psychoanalysis is not helpful? If you already understand where the feelings come from, how will telling this to an analyst make them disappear?

    // Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind.

    What if you try to do it alone for free? Won’t it help?

    // During the years that an analysis takes place

    Those psych- sites mention Years all the time, seems like Huge amount of money. Isn’t there *something* one can try to do by oneself? Why not? The cinical part of me thinks “because the analysts want money”. Even if doing the exact same thing alone isn’t possible, something helpful must be. If you know something, could you write, please? (And about teaching 🙂 )

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    1. “So, if one already knows, psychoanalysis is not helpful? If you already understand where the feelings come from, how will telling this to an analyst make them disappear?”

      – Believe me, everybody has a subconscious. 🙂

      “What if you try to do it alone for free? Won’t it help?”

      – No, of course not. You can’t access your subconscious on your own precisely because it is SUBconscious.

      “Those psych- sites mention Years all the time, seems like Huge amount of money. ”

      – It’s much cheaper than the things we use to compensate in the course of our entire lives.

      Sorry, I have to run away again. 🙂 But I will answer all these because I love this subject matter. 🙂

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    2. I wonder why nobody ever asks if it is possible to save money by performing a root canal on oneself. Surely, the psyche is not less complex than a tooth.

      The kind of money I have invested into my teeth over the years could buy me a team of analysts. People pay insane amounts for braces, for example. And have you ever met anybody who actually improved their life dramatically with stupid dentures?

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    3. Today, no analyst will work with you 4 times a week. This is an outdated model that is not sustainable for modern individuals who work. Even twice a week is probably untenable.

      Six months is when dramatic improvement begins. Eighteen months is quite enough for a regular person. So there is no need to imagine years. Unless of course one is highly resistant to change.

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  7. A way to steal money or Do It Yourself?

    АПК “Домашний психоаналитик”- 60 000 рубл.

    На АПК человек сам обучается обнаруживать причины проблем и в процессе работы устраняет их. АПК фиксирует с помощью встроенного кожного гальванометра неосознаваемые реакции для их выявления и коррекции. По психоэмоциональным реакциям можно выявить, что происходит в подсознании человека, что является действительной причиной его неуспехов и неудач, как долго продолжать работу по улучшению состояния.

    http://www.zdorovierus.ru/biomouse/

    // Believe me, everybody has a subconscious.

    Can’t one know from where fears of something come from? Or low self-esteem?

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  8. // You can’t access your subconscious on your own precisely because it is SUBconscious.

    I thought that analysts are taught how to do it for others and there must be good practical books on the topic. So, theoretically, if you read them, there should be a chance of getting some insights independently too.

    // – It’s much cheaper than the things we use to compensate in the course of our entire lives.

    Depends on the severity of the problem.

    And the course of entire life gives chance to earn money during entire life, while an analyst wants a lot NOW, which many people can’t afford. Especially if they aren’t sure they have real serious problems to begin with. That’s why I asked about good books to learn more about the topic and people’s typical problems in general.

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    1. “I thought that analysts are taught how to do it for others and there must be good practical books on the topic.”

      – Even the best analyst in the world cannot analyze herself. 🙂

      “And the course of entire life gives chance to earn money during entire life, while an analyst wants a lot NOW, which many people can’t afford.”

      – Analysis helps people begin to earn a lot more almost immediately, actually.

      “That’s why I asked about good books to learn more about the topic and people’s typical problems in general.”

      – Reading http://www.amazon.com/A-General-Introduction-Psychoanalysis-ebook/dp/B006IZ8VJI/ref=sr_1_1?ie=UTF8&qid=1377277075&sr=8-1&keywords=introduction+to+psychoanalysis always helps one prepare.

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      1. Well I have made an analysis on my own, but it takes many years and much bumping into things. I very much doubt that any progress could have been made by others who operate only within the context of modernity. But my strange feature of the personality is to become a very different person when people make strong emotional or contradictory demands of me. I become in a mode of being at war, which is not surprising considering the context of my upbringing. I can easily conjure up those parameters for psychological existence — saving energy, hiding in the scrub and not revealing one;s whereabouts, repressing intense emotion, calculating the principles for one;s survival.

        Lately I’ve discovered this mode of psychology, the psychology of the extremes, is fundamental to my well-being. When I move into this state, I can process existential material very easily and effectively and make all the right decisions for myself, including moving closer to some people and cutting emotional ties with others. I’m very strong in this mode of expedience, which makes me a aware of different aspects of my personality, under pressure.

        Now, the probable reason I have this capability is my father’s violence. He used to fly at me and hit me or attack in other ways. Thing is, I must have formed an adaptation to it in my very early years. It’s not maladaptive for coping with extreme situations, although it may be so in terms of modernity, as I sometimes read situations that are not yet extreme as if they were so and move very quickly between a normal and defensive state.

        After many decades, I have concluded these things about myself. I understand there are pros and cons to having this kind of a character. It makes me unsuited to much of modernity as I take too much far too seriously, but then I have the power of the depth of insight to go deeply into myself and kind of melt down in such a way that enables me to cope extremely effectively to a new crisis. I’m highly adapted, actually, to any sort of crisis, partly because I can emotionally cut off, whilst clarifying practical issues.

        This analysis is in accordance with my behavior and introspective findings over three or more decades. As I said, it would have been hard for people not familiar with my autobiographic background to be able to put the pieces together as I have done. As well as this, there is a pronounced tendency on the part of those who only know modernity to pathologize my behavior without understanding its adaptive and enriching possibilities. I understand these myself, from experience, so I don’t intend to flatten myself out and try to become just like everybody else.

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      2. Further to my blurb above, I find it strange that modern people do not move between different levels of the self, to access different potentialities. They seem to consider that what they see in another person is all there is to see, so they make superficial challenges and then are very surprised when their challenges are taken seriously.

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      3. On one of previous posts Z asked:
        “Actually: one of those Ask Clarissa type posts that would be good would be a reading list on current psychoanalysis.”
        I wanted to ask this too. Isn’t there a one, long good book of theory (and practice?) of psychoanalysis?

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        1. It makes no sense to read Jung without first looking at what he was responding to. What’s good about Freud’s Introduction is that it’s extremely basic and everybody can understand it.

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    2. The question one should ask is: how much of the time do I feel ecstatically, blissfully happy? Which percentage of the time do I perceive the world as a beautiful, safe, welcoming place where I can live exactly as I want? If the answer is “less than 80% of the time”, this needs to be addressed. Because what sense does it make to live differently?

      The problem is that it never even occurs to most people that happiness shouldn’t be an exceptional state of being. Religion and marketing come together to convince them that being somewhat anxious, somewhat dissatisfied , somewhat afraid, somewhat needy at all times is normal. So people don’t even consider seeking help.

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  9. // Analysis helps people begin to earn a lot more almost immediately, actually.

    You hit upon The Sentence to make the practice popular among Americans and others, instead of pills or therapy. 🙂

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  10. You wrote “I vastly prefer the Jungian model of psychoanalysis to the Freudian”, so this summarizing book should include Jung’s theories too.

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  11. From another post of yours:

    // And if you fear that the analyst will tell you something like “you suffer from a heightened degree of immaturity due to the fact that your parents were overprotective” […] the son of a gun never will. Because answers only work if you arrive at them on your own.

    So, is the goal of analysis to say this sentence to yourself? What if a patient already knows it before the analysis? What more can be found out, if anything? What more can analysis give, except listing all one’s bad points to yourself?

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    1. No analyst will ever want to make one feel more guilty. The opposite is the goal. So no, there will be no enumeration of why you are “bad”. :-). To the contrary, you are supposed to feel accepted completely during sessions or the process won’t work.

      Guilt is the most destructive of feelings. An analyst who tries to foster guilt is like a professor of literature who burns books. 🙂 🙂

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      1. I meant “except YOU Yourself listing bad things to Yourself during a session”. Self-enumeration of one’s bad points to discover the roots of problems.

        Could you write a post about what happens during a session? F.e. a person comes and says “I am immature due to the fact that my parents were overprotective. In addition, I am XYZ because of ABC.” What next?

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        1. I know my analyst would ask me what made me feel I needed to engage in this self-flagellation at this particular point in time and we would then spend time figuring out what was happening immediately before the session to make me want to castigate myself.

          I think the structure of a session has a lot to do with what the client is like. A client who is quiet and finds it very hard to speak will encounter a very silent analyst. But a gregarious client who can talk up a storm will probably get an analyst who interrupts a lot. The main strategy of analysis has been described as “frustration and support.” An analyst needs to frustrate but to a limited degree and always making sure that the degree of frustration is tolerable.

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          1. The way a session starts is very similar to how creating an article in my field begins. You simply need to mention anything that happened since last session that felt memorable, curious, annoying, etc. Anything that made you feel something, as vague as that feeling might have been. This is like a thread that you pull on and begin to unravel many fascinating things.

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  12. // It makes no sense to read Jung without first looking at what he was responding to. What’s good about Freud’s Introduction is that it’s extremely basic and everybody can understand it.

    Yes, I meant what one can read after Freud. I read big parts of it, but the importance of dreams seems less relevant to somebody like me, who never dreams, unless it’s a dream about an exam / deadline just before the said exam / deadline. Would you have enough to discuss, if you didn’t have dreams? Also, what happens if one hardly has any memories of before 6 years old age?

    Btw, so far, it seems like Freud –> Jung –> others wrote long books each about the field and if one wants to learn, one should read all of them in succession. However, we don’t usually study math or psychology (?) like that, there is some sort of unified theory, or at least a summary.

    You wrote “My Romantic Journey: series, what about “My Psychoanalytic Journey: the way to there and impressions / lessons” or is it too private?

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    1. Everybody has dreams and everybody has early memories. A specialist can very easily help one recover them. This is a very basic, easy part of the process.

      To give an example of how discovering what really causes a problem removes the problem: I always found it impossible to talk to people on the phone with the exception of very close relatives. I would go to extreme lengths to avoid talking on the phone. I’d cross the city to see an individual in person and ask a tiny little question that could be answered in a 2-minute long phone conversation.

      And I knew exactly why I had this problem. Only I still couldn’t make phone calls. What does that mean? That I only thought I knew. I was kidding myself, hiding from the truth. When I finally did uncover what the problem was with the phone, then it finally went away. And now I can call anybody I need and not even stop to think about it for a second.

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  13. // I know my analyst would ask me what made me feel I needed to engage in this self-flagellation at this particular point in time

    It’s your first session. You’re paying lots of money and want to get results, so it makes sense to give an analyst as much info about problematic parts of you as possible. While you’re hiding problems, time is ticking and money is being spent. To help, an analyst must know lots of bad or/and uncomfortable stuff about you.

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      1. Are feelings about money the most important part here? What if one really doesn’t have much money now?

        I wondered whether telling all problems on the first session, what you called “self-flagellation”, is most productive.

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        1. The way you feel About the sessions is what’s important. That should never be held back.

          Resistance to analysis makes one come up with the weirdest fantasies. They should always be reported directly to the analyst with no fear if offending or hurting his feelings. Even the belief that his feelings can be hurt is already a form of resistance.

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  14. // the degree of pain depends on how well one is prepared for the process and how aware one is of what the process will entail. (More on this later.)

    Do write about it. I began thinking about “self-flagellation” because you mentioned pain and lots of it. The repressed has to be bad, otherwise why would seeing it be hard?

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  15. Among last questions, from one forum (still can’t find a good Russian forum):

    В анализе есть ориентир – 20% от дохода клиента. Для клиентов с разным уровнем дохода стоимость сеанса различна. Исходя из этого можно договориться. Нормальные аналитики так и работают. Конечно, у всех есть определенный минимум, ниже которого они цену не опускают. Два раза в неделю это один из вариантов. Для аналитически ориентированной терапии норма 1-2 раза в неделю. В анализе надо встречаться чаще, и не факт, что вы подходите для этого формата, там лучше иметь более-менее крепкое эго))) У меня, к примеру, эго уязвимое, я в классический анализ и не рвусь.

    20% это допустимый максимум. Деньги в анализе это инструмент терапевтического воздействия, аналитик может повышать стоимость сеанса в процессе работы (иногда в несколько раз), но может и вернуть деньги за сеанс, такое бывает. Я по этим вопросам не заморачиваюсь. Главное – можно договариваться.

    Is it true about money? I agree with another commenter, who answered:

    У меня вызывает некоторое недоумение и сомнения в адекватности человек, который при первой встрече со мной начинает трясти мои карманы и высчитывать %. На уроки анг. языка есть четкий ценник, а не %. Он же не налоговый инспектор, такие вопросы задавать. Ну так можно и данью обложить, как в старые добрые 90-е.

    What if you can’t afford 20% from total salary? Need to save money to buy a flat, raise children, etc?

    And is her devision between analysis and 1-2 weekly therapy a right one? You did what she calls analytical therapy and it helped, right? Does your analyst ask about your salary and aims to get maximum money? Had I begun anything and paid a lot for me only to see the analyst suddenly raise payment (several times!) under the pretex of helping me, I would’ve stopped working with this analyst.

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    1. All of this sounds completely bizarre to me. In North America, analysts have a fixed hourly rate that they reveal during the very first session. It never changes and I have never heard of an analyst asking how much a person makes. They operate just like any doctor or lawyer. Most have the hourly rate listed on their website so there are no surprises.

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      1. Russian analysts, like Russian Tarrot cards readers, are more costly. Guess, it’s Russian way of doing business. 🙂 I also read on that forum about an ugly looking male analyst bragging about sleeping with clients. He was mentioned as a bad example, but still.

        Out of curiosity, does a language in which the analysis is done matter? If it isn’t one’s mother tongue, like English isn’t mine. Does personality of an analyst matter? F.e. before session and after it you think s/he is unpleasant.

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        1. Yes, this guy is a total creep who has been abusing patients for years!

          In the introductory session (which is free), the analyst and the prospective patient determine if they click enough to work together. This is a process that will influence them both on a profound level and nobody should force themselves into working with a specialist they don’t really like and feel comfortable with. If you don’t feel comfortable for absolutely any reason, just move on. You are entitled to your discomfort. I, for instance, always knew I’d never be able to work with a woman unless she was over 80. And they usually don’t practice at that age.

          Also, at the introductory session the analyst will gauge the degree of “melodic comfort” you have in the language of analysis. It might work in a non-native language but it might also not work depending on how you relate to that language. This is all highly individualized.

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  16. One of the great benefits I have had through self analysis is the reduction of guilt and confusion. I had both, and there were related to each other, because of the different way in which modernity frames reality. People would say to me that I was acting in a certain way because my ego was sensitive, but that was far from being the case. Sometimes my ego just withdraws itself and I am no longer relating personally — that is, with sensitivity. I am relating pragmatically, in terms of what has to be done to handle a situation in the most effective way.

    They would say, “you should feel bad about responding too sensitively.” But at that time, I would feel nothing personal about the matter, as I was already in an ego-retracted mode and acting impersonally (and quite effectively, so solve a problem).

    I found it very confusing that contemporary people kept asserting I was doing one thing when I was doing the other, but now I see that my inclination to become impersonal is triggered by a sensitized reaction to threat. In modern society, the threat of actual violence is minimized, but I was brought up in a society where the violence was real and learned to respond accordingly.

    So I’m over-reactive to a threat, certainly. But I find modern people quite under-reactive and oblivious. They don’t read their environments well or scan them for any possible danger.

    In any case, I’m not feeling guilty anymore, because I understand that my adaptation is not a moral failure, but has to do with being oriented to different circumstances. Also the perceptions moderns have about my level of reaction has to do with their assumption that modernity is the only possible society one can live in. They judge on the basis of one’s adaptation to modernity and try to turn that into a moral question.

    Definitely no counselor I ever saw was able to develop insight like I have, even when the different circumstances were explained to them. The modern idea is that we all are individuals, who at the most are influenced by one’s nuclear family, but certainly not more than this. Adaption to the environment is not considered to play a role, except in a way that is deemed to be extraneous to the development of an individual self. So therapists have a fundamental cognitive block, it seems.

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    1. “Adaption to the environment is not considered to play a role, except in a way that is deemed to be extraneous to the development of an individual self. So therapists have a fundamental cognitive block, it seems.”

      – A therapist who makes his or her considerations and beliefs influence the process are unprofessional. Like doctors who refuse to treat patients of religious persuasions they don’t approve of. So yes, such pseudo-specialists wouldn’t have been of any help!

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      1. definitely there are either no, or few, good therapists in Australia. People have narrow minds. The most common dogma is that one’s responsibility it to adapt to what others require of you and that failure to do so is pathological. This notion is everywhere.

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      2. I think a lot of the issues with less than stellar therapy are related to social class. The therapist takes the view that you are a worker level person, and therefore you do not need to have more than rudimentary self awareness, etc.

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  17. I’d add cognitive behavioral therapist to this list. Not quite covered otherwise, and that particular type of therapy works extremely well for some individuals without the use of medication.

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  18. What’s your opinion on transactional analysis, Clarissa? I couldn’t find an accredited psychanalyst in my town, but I did find a psychotherapist trained in transactional analysis, which I hear takes elements from psychoanalysis. I’m on my second session, and I’d find it worthwhile for the insight in my relationships and the change in my behaviour and feelings in one situation that I had found problematic, but I do wonder if a) this rate of improvement will maintain itself and b) if this will help me develop as vigorous a psychological health as yours.

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  19. Thank you for inspiring me to get my ass in analysis btw. I’ve changed more in this past year than I’ve changed in any other year, including adolescence, and they were all very needed and useful and happiness-improving changes.

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