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What is contemporary psychoanalytic psychotherapy and psychoanalysis?

Contemporary psychoanalysis and psychotherapy provide a forum and "relational home" where patient and therapist can discover the sources of emotional confusion as well a pathways toward change. It focuses on self, identity, personhood, and experience rather than looking for defenses that must be substituted or limiting the process to reducing specific problematic behaviors or thoughts with pre-determined techniques. Through empathy and attunement, the therapist can enter the world of the patient and collaboratively develop understanding of the dimensions of emotional suffering as well as sources of alleviating anxiety, worry, sadness, hopelessness or non-focused anger. The process aims toward achieving autonomy and sense of choice in one's life as well as the ability to become closer with others . It helps to unravel the dilemnas in making well informed decisions pertaining to self, family and career.

Psychoanalysis has undergone major theoretical and clinical transformation since Freud. Contemporary psychoanalysis stresses self and relational development in complex and changing contexts rather than focusing on "inborn instincts" that develop in uniform and predictable ways. It is a form of psychotherapy usually involving increased frequency and length of treatment but determined mutually between patient and analyst. However, the process remains focused on the partnership and intersubjective experience between analyst and patient: one that does not name "pathologies" or seek to erase troubling emotions but rather to become aware with the patient of how he or she has struggled to make use of what resources were available. Finding ways of expanding emotional resilience, self-enhancing experience, awareness of factors leading to aversive(angry or rageful) states, overcoming guilt and developing empathy toward others provides opportunity for growth. With new emotional understanding addressing specific issues such as couple or marital conflict, divorce, widowhood, chronic illness, difficulty in regulating emotions, making boundaries, interpersonal struggles and career conflict can be facilitated.

What problems can a contemporary psychoanalytic orientation treat? How can it be integrated with psychopharmacological treatment if needed?

Although individuals vary in specific contexts, one may feel that he or she is losing a sense of who they are in the face of pressures from family, employment, cultural or gender role mandates. Past traumatic experience involving loss, death, abuse or rejection may have been dissociated (form of forgetting) leading to enacting the effects of the trauma in present relationships. For example, one may be subject to chronic disappointment in the choice of love relationships based on mental maps of abusive earlier experiences. The lack of family or social acceptance of gay, lesbian or bi-sexual orientation can bring much turmoil to one’s self-esteem. The body frequently can manifest interpersonal demands in the form of eating disorders, body image and illness. Often, depression, anxiety, substance abuse or mood disorders are related to relational trauma, for example, parental deprivation, which combined with genetic propensity can tilt the risk for expression of these disorders. Compulsive behavior, e.g. sexual, may be indicative of a retreat from intimacy within a relationship. Accumulated stress, in general, can lead to a feeling of diminished control and actually change the neurobiology of the brain and the ability to cope within different situations. However, psychopharmocological treatment (medication) alone can bypass exploring underlying sources and experiencial aspects of emotional pain and thus limits avenues toward self transformation and adaptive strategies.

Contemporary psychoanalysis and psychotherapy help to partialize and master stress through the comfort, attachment and regulation of a consistent caring relationship. Each therapeutic process is unique and privileges the patient shaping outcome within the naturally emerging dialogue with the therapist.

How is psychotherapy and psychoanalysis different from other approaches?

Psychotherapy comes in many forms. Most psychotherapists today practice from a cognitively focused perspective, emphasizing containent of emotions through the use of prescribed techniques. However, certain current research indicates that without exploring and understanding emotions or affective states which often cannot be verbally articulated as well as the attachment component that the outcome of psychotherapy is limited. As a result, dissociated experiences can be further blocked from conscious awareness. The burgeoning field of affective neuroscience offers much knowledge on how emotion is inseparable from cognition and provides clinicians with new pathways of reaching emotional pain.

Contemporary psychoanalytic approaches, whether short or longer term, emphasize how one organizes experience and shapes themes about who they are in the world in comparison to who they desire to be . It affords an opportunity to understand and modify one’s experience as far as motivation, intimacy and achievement through the unique relationship that emerges between the patient and the therapist. It values shared experience between the therapist and patient and is not based on formulaic suggestions that assume universal remedies however, can offer practical guidelines and achieving cognitive and affective integration. The therapist/analyst become a team within a field of mutual understanding, empathy and bonding in order to explore alternative ways of relating to each other and the outside world of family, friends and collegues.

NYC Psychoanalyst Dr. Ellyn Freedman

Dr. Ellyn Freedman
Certified Psychoanalyst
Licensed Psychotherapist
Phone: (786) 493-7865
Mobile: (917) 421-9778
85 Fifth Ave, Suite 926
New York, NY 10003
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