Welcome to Conversations From the Couch
A Blog Created to De-stigmatize the Use and Treatment of Psychoanalytic Psychotherapy.
My intention for creating this blog was to inspire understanding and help de-stigmatize the use of Psychodynamic/Psychoanalytic Psychotherapies (I will be using both terms interchangeably, but they do differ from Psychoanalysis- I will discuss the difference at a later time), specifically when treating individuals struggling with Eating Disorders and personality concerns. It’ll be useful to first give a little background to what led to the blog’s creation.
During my first, two-year post-graduate training program, specializing in Eating Disorders, back in 2013, the first course was on the treatment of Psychodynamic Psychotherapy with Eating Disorders- I was blown away by the amount I didn’t know, and wasn’t taught. In graduate school, we spent maybe one class on psychoanalytic and psychodynamic treatments, and the rest of my graduate education, including internships, were focused on treating individuals from one of the many behavioral models of therapy. This continued to be a theme in my first couple of jobs, where the “goal” of therapy was always on solutions, managing symptoms, and figuring out alternative ways an individual could cope, but never really asking why is this person doing what they are doing, and why are they so attached to their behaviors or ways of thinking that drive them to continue to harm themselves.
Through my own experiences, I’ve learned it takes time to truly know ourselves as individuals and as clinicians, and knew I needed to take the time to further my education, to better understand the patients who work with me. This led to me completing a second two-year post-graduate program in 2019 that specialized in Psychoanalytic Psychotherapy, and I’m currently a second year candidate at a psychoanalytic institute to become a Psychoanalyst (This will take me years to complete!).
A Psychoanalytical Approach to Eating Disorders & Personality Concerns
I guess the question remains ‘why do I believe in this treatment approach so much?’ Especially when many other clinicians have deemed psychoanalytical work antiquated. And more specifically, ‘why do I believe in working this way with individuals who struggle with Eating Disorders or personality concerns?’ The answer is I truly believe people are more than just the symptoms they present with in therapy sessions. When we decide to work in a way that only treats what’s on the surface, we leave out so much emotional content which lessens the ability for true understanding and doesn’t allow room for an individual's internal world to materialize.
It’s difficult to put into words a process of therapy that unfolds organically, isn’t concrete, and will look different with each individual who is treated. It’s also tough when the models of care indicated for Eating Disorders and personality concerns have been centralized on behavioral therapies. Behavioral approaches often offer the promise of quicker relief, and are focused primarily on decreasing symptoms, or behavior use. Who doesn’t love instant gratification, or want to feel better right away!? I know I do!
Going Beyond Behavioral Therapy
Unfortunately, this isn't the reality of life, and lasting change or relief doesn’t occur quickly, or overnight. It’s taken my own experience studying the psychoanalytic process, working with people struggling with eating disorders and personality concerns for over a decade, as well as being a patient of psychoanalysis to understand the tremendous amount of patience needed for both the therapist and patient to be in this type of treatment.
I won’t be disclosing my personal experience as an analytic patient (I will be using ‘patient' instead of client, because it takes patience to be a patient), or any confidential patient information from my practice. The topics discussed will be from my own knowledge and experience as a psychotherapist specializing in Eating Disorders and personality concerns, and as Psychoanalyst in training. This blog is solely for educational purposes, and those with curious minds who want to deepen their understanding of psychoanalytic thinking with digestible bite-size posts.
Connecting the Dots
My hope is that anyone interested in knowing more about ‘why you do the things you do,’ what drives you to act in certain ways, and how to start making meaning out of your life by connecting the dots from your past and present, will find these posts useful. If you are a clinician, this could be an invitation for you to ask more emotionally driven questions of your patients to help both you and them understand why they keep getting stuck, or aren’t where they’d like to be.
If you are someone in therapy, the content here could support you in asking more questions about yourself, then you can bring these thoughts and feelings to life in sessions with your therapist to deepen your treatment. For those contemplating starting therapy, maybe something discussed will give you comfort, assure you that you aren’t alone, or provide you with the courage to take the next step to seek support.
Whether you’re someone seeking therapy or a mental health professional, I don’t believe you can or have to do this work alone. This space is not intended to replace therapy, or act as a substitute for a provider that needs additional training to treat individuals using a psychoanalytic approach. I would encourage mental health professionals to seek additional continued education through training, courses, supervision, case consultation, and peer group support, if future topics discussed here interest you.
I believe that with each patient a new theory emerges, which is why a psychoanalytic approach to treatment with any patient is the most individualized form of care a person can receive. This approach doesn’t put people in boxes, label them with diagnoses, or fit them into worksheets, but rather creates space for someone to be deeply understood, and cultivates more impactful, sustainable growth and change.