The goal is always to help the client become stronger in every aspect of their being. Reality is not entirely malleable and without allowing the therapist to know what actually happened and how it actually effected you the therapy cannot be effective. Psychoanalytic therapy has been called “the habit of honesty” (McWilliams, 2005) and it is always surprising how much courage it takes to be honest. The two necessary elements that every client needs to bring to therapy (or at least be able to develop) are honesty and courage. This last rule is inflexible and necessary for everyone’s protection.
With the possible exception of an initial handshake, there is absolutely no physical contact between the therapist and client at any time for any reason. Therapists do not and should not make house-calls or meet anywhere but the therapist’s office. There can be no contact outside the clinical office other than coordinating or emergency phone calls. It develops over time and the accumulation of experiences that the patient has with the therapist as a reliable and safe person. The therapist’s office should be the safest place the patient has ever experienced.Įstablishing the “frame” of the therapy is critical for success and begins with the first phone call. The therapeutic frame, those restrictive rules limiting the nature of the relationship between the patient and therapist, creates a holding environment within which such experiences, often quite painful and anxiety provoking, can be contained, endured safely, and overcome.
The therapist interprets in the transference the immediate and primal emotional experience of the patient and it is through the new experience of old emotional patterns that insight is meaningfully achieved. What happens is grounded in the experience of unconscious patterns that are actually lived out in the therapeutic relationship. The patient does not cognitively understand a new way of being and transform him/herself thereby. The therapist does not primarily teach the patient. Psychoanalytic therapy is not an intellectual exercise.
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