Elephant in the Room Psychotherapy

09/12/2023

It took years for me to realize that the structure and boundaries of therapy — what we call the frame — don’t just protect the patient and the therapeutic relationship, but also provide a blueprint of what healthy boundaries in a relationship could look like.

Of course, I don’t mean the obvious boundaries of no touching, etc, that belong in other kinds of relationships. I mean things like consistency, showing up, returning texts and emails, timeliness, honesty, and respect.

When I allowed my boundaries to be trampled over in previous personal relationships, I asked myself how is it that I could reinforce the boundaries of therapy with my patients, but I can’t even reinforce my boundaries with my partners?

And I realized that doing so as a therapist meant that I had the capacity to do so as a partner or friend. I had it within me. I only had to look towards my practice for guidance on how to do it, and how to speak about it — how to communicate it.

I also had to “clean up” my practice by reinforcing the frame wherever I was being lax with my patients. Yes, it requires you to master the art of being “gentle, yet firm”.

09/10/2023

Our emotional capacities in one area of our lives can be geared towards other areas of our lives.

10/25/2022

“Against the ambivalence about the efficacies of online and tele-forms of therapy, we might focus instead on making a demand for a more collective, low-cost psychoanalysis and psychotherapy, and an argument against the state’s de-prioritization of mental health. The reason that it is important to insist that psychoanalysis is for everyone is not simply to highlight the fact that many people cannot access treatment. The issue is more fundamental. What is at stake is who has the right to an inner life — whose interiority gets mapped, who is allowed to dream, collectively, and whose collective dreams count.”

Often associated with the middle class, psychoanalysis is a means of reflecting on human suffering that should be accessible to all.

08/17/2022

In the age of narcissism, messages of “self-healing” saturate the social media landscape. We’re told that reading self-help books and learning the right “tools” can heal us from past traumas. We’re told that we just have to learn to look at things differently. We’re even encouraged to work through our relationship issues alone.

It’s true that sometimes we do have to look at things that happen to us in a different light. But that’s not in itself what makes it stick. It’s in the connection we have with another person that makes it stick, that creates change.

Did you ever hear something helpful from someone else that seemed obvious to you only in hindsight? You’ve always known it deep down, but just needed to hear it from someone. And yet, that’s the tip of the ice berg.

There are whole layers of wishes, fantasies, thoughts and feelings that you can only learn about yourself from someone who knows you deeply. And once you hear it from them, you will know yourself a little more, your connection to that person grows, and your capacity to connect with others grows, too.

Because that was how we developed in our very first relationship. It was our mothers’ attunement to us as infants that gave us our sense of self. What she saw in us, she reflected back to us. And we realized we were our own person.

The mother-infant relationship is the first site of growth. But not the last. As adults, through our unconscious longing to recreate that relationship, we grow with others — provided we land in safe and trusting relationships. That’s the real site of emotional growth and wellbeing. Not the self-help books, and not you as a “self-healer.”

04/05/2020

“Anna Freud’s famous research found that during World War II the children left in London to endure the bombings suffered less trauma than the children who were sent away from their families to the country for their ‘safety.’ She determined that the physical injury is often not the harshest part of trauma; it’s the breakdown of relationships during and after.”

The struggle between fear and comfort.

04/04/2020

“My silence prompts him to say, ‘You’re hiding something from me! You’re sick!’ He thinks I’ve come down with the corona virus infection. I reassure him that in fact I’m well but he persists in telling me that I’ve coughed and adds that my voice has changed, that it’s raspy because I have a sore throat. Sure signs of the potentially deadly illness, he insists.”

We have moved on to remote analysis. No longer—for the time being, at least—do analysands enter the consulting room and lie down on the couch for the duration of their session. They speak to us from afar, and in different positions (stretched out, sitting, or even standing), from places we may b...

04/05/2019

“Many of the ongoing problems we cannot resolve are, in fact, symptoms of deeper problems we may not be aware of. In fact, Hari analogizes this to the smoke of a burning house: You can keep waving away the clouds, but without putting out the fire, your efforts will be futile.”

Human connection is an important part of recovering from trauma and thriving. Understanding how connection works and giving it authentically can help us connect to others and ourselves.