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Why Not Talk to a Friend?

Imagine that instead of going to a psychotherapist a patient went on a regular basis to a friend for help in managing his mental distress, as some critics of psychotherapy have recommended.

The friend might first of all try to offer advice - "Why don't you get a hobby, join a club, leave him/her, stop doing the washing up altogether, take up jogging, pull yourself together...".

If this does not seem to help he might try other tactics. He might listen to what the 'patient' is telling him and realise that his difficulties are actually bound up with his personality as a whole. He might begin to notice that his friend is confused and does not really know what he wants. He might say "It seems that part of you wants this and part of you wants that", or "On the surface you seem to be saying this, but underneath you seem to be saying that", or "You are saying this but really you want that" and so on. Through these interpretations the friend is creating implicit theories about the structure of the mind - that it has more than one level, for instance, or that some thoughts are less accessible to consciousness.

It might happen that within this ongoing relationship the patient talks about his past. The patient begins to look forward to seeing his friend, although sometimes he feels angry and resentful. Why does the friend seem to have everything, while the patient is so unhappy and has nothing to live for? One day the patient becomes angry for no particular reason. He shouts abuse at his friend, who is taken aback. But then the friend remembers that the last time they met the patient was talking about his father. He says: "Hang on a minute, I'm not your father you know!". The friend has realized what Freud discovered many years ago - that something about the relationship to the analyst repeats aspects of the childhood relationship - an intense, dependent, loving and hating relationship - to the parents and family constellation. It is this which provides the emotional force for the progress of the analysis and the influence of the analyst.

Thus it is quite possible that a friend could occupy the place of an analyst, but it becomes extremely stressful for friends to be the focus of such intense and 'irrational' feelings. Perhaps there are some people who have a particular aptitude for this role, but usually it requires extensive training to be able to cope (and, moreover, offer help to the patient). The analytic training is usually at least 5 years, undertaken after the candidate has shown success in another related field.

The other side of the coin, however, is that because human beings are so complicated, an experienced analyst might miss something that a novice notices immediately in the analytic material. And different theoretical schools or personal idiosyncracies may produce theoretical 'blind spots' for certain analysts. The analytic community tries to overcome this inevitable problem by extensive superversion in training and peer discussion. The analytic process is also in part a collaborative process that involves the analyst 'learning from the patient' and not imposing his own views or moral outlook onto the patient. Whether this is always or ever possible, and indeed whether there should be an 'analytic morality' is a moot point.

adapted from the forthcoming book Introducing Psychoanalysis by Ivan Ward, illustrated by Oscar Zarate

Discussion Topic:

Is psychoanalysis 'value-free'?

What would be the 'do's' and 'don'ts' of a psychoanalytic morality?



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