Classical Psychoanalysis in New York City

I practice psychoanalysis in the classical tradition.  This means that I see patients at least three times per week for at least one year but usually longer.  We begin the process with a few face-to-face sessions to determine suitability and fit.  This is important, because psychoanalysis is not the treatment of choice for everyone, and I am not the best-fit psychoanalyst for all patients.  Some patients require less frequent face-to-face psychotherapy.  For patients who function pretty well in life, who have good frustration tolerance and reality testing, who are open and curious about themselves and others, and who are eager to explore the mind, classical psychoanalysis might be ideal.  Once it is determined that the fit is good and that psychoanalysis is indicated, the patient moves to the couch.  I sit behind the patient in psychoanalysis.  There are a few reasons for this.  Sitting face-to-face requires a lot of cognitive effort (e.g., working memory), which degrades the process.  We get distracted by all of the facial expressions, body movements, and social processes that unfold when two people engage in face-to-face conversation.  We think more flexibly and fluidly when we are laying down. 

In a reclined position, the patient is more able to follow the fundamental rule of psychoanalysis, which is to say whatever comes to mind no matter how trivial seeming or potentially embarrassing.  In other words, the patient free associates during the session.  In this regard, psychoanalysis flouts typical conversational guidelines regarding turn-taking and disclosure.  While the patient says a lot in session, I say very little.  In fact, I might only speak a few times in a session.  This is because I am listening carefully for patterns in form and content.  Through free association, we learn about the repetitive, maladaptive patterns that thematize a human life.  We learn about how the patient developed unhelpful ways of protecting themselves, often as the most adaptive compromises that could have been struck at the time but now very outmoded.  These patterns operate by rules that were written early in life, and they do not tend to change without significant intervention.  Each of us has a few patterns of thinking, feeling, and relating that cause suffering and rob us of opportunities for growth and development.  Humans get stuck in life, in part, because they are capable of desiring several things at once.  This is the cause of internal conflict.  The mind in conflict causes us to suffer.  Psychoanalysis is designed to bring these patterns to light and to work them through, so that mental energy is freed up to deploy in the present.

The goals of classical psychoanalysis are simple but accomplishing them can bring profound change.  First, troubling symptoms should decrease and functioning should increase.  Patients should become much more deeply and productively engaged in work and love.  They should feel freer and more vital as a consequence of participating in the analytic process.  Self-awareness and self-efficacy should increase.  Patients should internalize the psychoanalytic function over time.  In other words, they learn to self-analyze such that termination is not only possible but celebrated.  

For more about my psychoanalytic history, click here.

To learn more about my academic genealogy, click here.