After a long break, I am compelled to share a video clip here, because I think, Alain de Botton, in this passionate and fun speech, talks about a ubiquitous issue, namely reasons of marrying the wrong person. In doing this, he argues convincingly that the root of the problem lies in early childhood and gives psychoanalytic explanation for it without using any psychoanalytic jargon.
I truly enjoyed watching it. But, more importantly, it made me think about the nature of “hope”. To me, hope is an essential state of mind, a basic feeling of trust that would make life more purpose-driven. Alain de Button, however, suggests that hope leads to rage because if you are hopeful, you do have expectations that certain things will occur in a certain way and if not, then your whole world is shattered, in small or big ways. It is hard not to see the argument. This is just a tangential part of the whole speech, but it struck me. I hope you will find valuable understanding about the issue by watching this brief video. Enjoy!
“Marry, and you will regret it; don’t marry, you will also regret it; marry or don’t marry, you will regret it either way. Laugh at the world’s foolishness, you will regret it; weep over it, you will regret that too; laugh at the world’s foolishness or weep over it, you will regret both. Believe a woman, you will regret it; believe her not, you will also regret it… Hang yourself, you will regret it; do not hang yourself, and you will regret that too; hang yourself or don’t hang yourself, you’ll regret it either way; whether you hang yourself or do not hang yourself, you will regret both. This, gentlemen, is the essence of all philosophy.” ~Soren Kierkegaard
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.
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.
One of the most frequently asked questions is whether therapy is worth it. Or does it really work? For people who don’t have experience in therapeutic process, these are quite appropriate questions. Therapists have different training background and theoretical orientation. What happens in the therapy hour depends greatly on the theory and the expertise level of the therapist. In the link below, you will find a positive experience of a blogger, who was (or still is) in therapy with a (possibly) psychoanalytically oriented psychotherapist. I think, her experience might answer some of your questions or satisfy your curiosity.
When I created this blog, my intention was to offer some important information to the general public, keeping my clients’ questions in mind. In time, I realize that the blog became a “potential space” to play with and develop some of my own thoughts on arts, science, human behaviors, and so on.
On the eve of becoming officially a candidate in a psychoanalytic institute, my world started to revolve around Psychoanalysis. I came across a wonderful article that explains very well what psychoanalysis is all about and I thought, instead of re-inventing the wheel, I should share it here.
Almost everyday I start my day by reading/skimming through daily news. A few days ago, as I was practicing my “habit”, one headline in the NPR website, caught my attention: Want to Read Others’ Thoughts? Try Reading Literary Fiction. (You can read the article here.)
In the NPR article the emphasis was on the effect of reading literary fiction on someone’s capacity for empathy. Empathy being considered as an important social skill. First I was very interested in what the article would say, but then I became kind of disappointed since the article was not substantial enough for me and my final reaction was “duhh”!
When we read a novel or a short story, we tend to identify with the protagonist. We put ourselves in the protagonist’s shoes and feel the pain, joy, disappointment, sorrow, triumph etc. That is what makes reading fiction so exciting and fun in the first place. The researchers mentioned in the NPR article implies that this is basically an “exercise in mind-reading and mind construction”. This was precisely what gave me the courage to talk about mentalization in relation to reading literary fiction.
Mentalization is a new term in the field of psychology. It is not yet in a regular dictionary. What it means is simply thinking about our thinking and other people’s thinking. When we think about what we think and feel in a given moment, we interpret the whole process of thinking-feeling-behaving and see the connections between them. Therefore, mentalization is the basis of emotional regulation and self-control. In impulsive individuals, be it a child or an adult, there is no thinking between impulse and action, which can impair interpersonal relationship. Another important aspect of mentalization is to recognize the fact that other people have their own mind and they might think differently than how we think.
When reading stories or fictions to children, a simple exercise to help them develop their capacity for mentalization could be to stop and ask them what they think the characters in the story might have in mind; what they think will happen next; and why they think so. That way we are actively engaging them in the process of thinking about other people’s thinking, while at the same time encouraging them to form their own mind.
One distinction that needs to be noted here is that mentalization is not about cognitive skills. It is about understanding our mental state in a given moment and increasing self-awareness as well as awareness about others. These are the cornerstones of emotional intelligence, which is the main ingredient of a successful and happy life. Therefore, when reading a literary fiction, intentionally thinking about characters’ thoughts, feelings and actions gives us the opportunity to understand human behavior in general while providing clues to us about how to approach others in daily life.
I have been working with children for many years now and if you asked me what issues I see them the most for, my answer would be ADHD (Attention Deficit/Hyperactivity Disorder) and related behavioral problems. The typical age that a child is diagnosed with ADHD is somewhere between five to eight, which means, at the time the behaviors interfere with the child’s learning at school. Although there is a lot of information out there about ADHD, some misconceptions still persist. In this post, I will try to clarify some of them.
Myth: ADHD is just a lack of willpower. Persons with ADHD focus well on things that interest them.
FACT: ADHD is essentially a mental disorder with strong biological components. It is not a matter of willpower or desire, but a matter of ability.
Myth: ADHD is simply a label for behavior problems; children with ADHD just refuse to sit still and are unwilling to listen to teachers or parents.
FACT: Three major symptoms of ADHD, namely “inattention”, “hyperactivity” and ” impulsivity” cause some problematic behaviors that impede learning, concentration and social interactions. That in return reduces the person’s chance for positive experience at home and in school.
Myth: ADHD is a childhood disorder and children usually outgrow it as they enter their teens.
FACT: Most people do not outgrow ADHD magically. They continue to struggle with the disorder, however the symptoms might be different. For example, hyperactivity tends to diminish in time. Inattention, on the other hand, may be disabling the adult with ADHD without proper self-management skills in place.
Myth: Medication for ADHD is likely to cause substance abuse or other health concerns, especially when used by children.
FACT: Research shows that there is no indication that taking stimulant medication leads to substance abuse/addiction. For more information please click here to read an article from ADDitude magazine.
Myth: ADHD does not cause much damage and is not really a big deal.
FACT: Untreated, people with ADHD typically struggle in all areas of life. This disorder severly impairs learning, family life, education and social interactions. Many experts agree that an adequate treatment should consist of medication and psychotherapy simultaneously in order for the person with ADHD to learn self-management skills.
To my observation, a big dilemma for parents with children with ADHD is whether they should “medicate” their kids. This is certainly not an easy call. Some parents first try to manage the situation by structuring their home life, which is quite helpful. In school, they cooperate with teachers to help them find the best behavior management system for their offspring. However, in severe cases, medication is necessary along with all these strategies mentioned above. If you closely work with the prescribing physician (your PCP, pediatrician or a child psychiatrist) to find the right type of medication and the dosage, your child will be able to be successful in school, to have a better sense of self and to develop better social skills. However, remember, it is not the medication per se, but the effect of medication on the child’s brain to use his/her executive functions combined with a series of “skill-building” in therapy that makes the difference. A child with ADHD using medication is more able to listen, take in, observe, make connections & inferences and conclude. Therefore, such a diagnosis is not the end, but rather the beginning of a course of action that you need to consider to take to help your child blossom to be who she/he could be.
Many people enter therapy at their wits’ end with the expectation of a quick relief. There is this widespread belief that the therapist has magical tools to help them fix the problems or see the world anew, happy and peaceful. Well, the magical tool here is the uninhibited and honest talking of the client. For this particular reason, psychotherapy is also known as the “talking cure”.
In psychodynamic psychotherapy, everything is essentially in the client’s talking. The well-trained therapist’s role is to listen non judgmentally; to make links between the past and the present symptoms; and to interpret what he/she thinks is going on with the client in order to increase the latter’s awareness. The rest is almost all up to the client: Is he/she able to think about therapist’s interpretation? Can she/he agree/disagree with the therapist? Does he/she have enough ego-strength to face the pain of the process? We can add several other questions to this list to show the essence of psychodynamic psychotherapy. The questions above also show why most people quit prematurely.
Take a look at the list below to decide whether this kind of in-depth therapy is for you.
You realize troublesome patterns in your relationships or behaviors.
You want help with feelings/ issues that have bothered you for a long time.
You want help for a problem that is unclear to you.
You tried other type of therapies in the past or medications that didn’t help as much as you had hoped.
You are curious about yourself and open to explore your feelings.
You are open to a less structured, collaborative exploration, which would not require “homework”, exercises or worksheets.
If you answered “yes” to most questions above and are ready for a long-term therapy process, which will lead you towards a less defensive and more courageous life, psychodynamic psychotherapy might be for you.
The purpose of this blog is to give you a glimpse of the field of psychotherapy and related issues, including information about different therapeutic modalities, answers to questions I often hear from my clients, child development and developmental disorders, strategies that might help in dealing with stress and such. You will also find some writings about Psychoanalysis and related topics.