“More specifically, the analytic task of helping the [patient] become more fully human involves facilitating the patient’s efforts … to experience a greater range (and play) of thoughts, feelings, and sensations that are felt to be his own and that are felt to have been generated in the context of his own present and past relations with other human beings (including the analyst).” — Thomas Ogden, MD
The quotation above is from one of the preeminent thinkers about psychotherapy today, Thomas Ogden, a favorite writer of mine. What he expresses is what I have come to believe about the aim and reach of psychotherapy: our ultimate goal is to help the person “become more fully human” by becoming more fully him or herself. The emphasis is on expansion and fluidity: greater range and motion. In this way, psychotherapy is more about addition than subtraction. While clients come to see me with various specific problems – relationship difficulties, anxiety and depression, substance abuse, career decisions – and we, of course, address these issues to find real solutions, there is something else going on as well. Like some computer program running unobtrusively in the background, in the background of our work is this attempt to find ways for the client “to experience a greater range (and play) of thoughts, feelings, and sensations.” In other words, for the client to feel more alive in his life, more engaged and connected to his vitality.
At the core of the issues that clients bring in is, I believe, this problem of not feeling engaged and fully alive. Depression and anxiety (while complicated conditions with various factors) may be seen in this light as symptoms that arise from disengagement with one’s life. Problems in relationships and problems with substances may also be seen as symptomatic of this underlying problem. Often my work with clients shifts in focus from examining a specific symptom, such as depression or addiction, to looking at what obstacles there are in living a fuller life.
I believe that through the modality of talk therapy, the client not only comes to understand himself better and gain more options for how to live life, but also experiences a greater engagement with life. The “talking cure” is a phrase associated with Freud, but was actually dubbed by Bertha Pappenheim, a.k.a. “Anna O.,” who became Freud’s first psychoanalytic patient. Talking involves relationship; and relationship, as one client of mine said about dealing with his depression, is good medicine. Relationships, especially when marked by trust, generate (as Ogden says above) awareness and expression of a person’s thoughts, feelings and sensations. This is what happens in psychotherapy.
There are many reasons why a person may experience some detachment from his vitality or feel trapped in myriad ways in his life. It may be that there have been serious deficiencies in in a person’s past relationships, traumas big or small, that impeded and did not facilitate development. Psychotherapy provides for an intimate relationship to stimulate the process of uncovering more depth and breadth of thought and feeling. I have experienced clients, including those who have been very depressed and shut down, feel and express more vitality through the course of our work. The process is not quick; it takes time. However, it is very rewarding to see.
Sometimes this change in a client is signaled by language he or she uses in sessions. There is often more of a sense of playfulness (play embodies the vitality of life); a person is more creative in his ideas; and his language may become more symbolic and metaphorical. And of course we can often see this person more engaged in his life outside of my office — in his relationships, work and play.
Oh, about the title of this post. Some of you old enough will recall the very popular live album in 1976 Frampton Comes Alive! I do. I’m playing with the title to suggest that in psychotherapy clients come alive – they experience, feel and think more fully. They engage with life more fully. (Playing the guitar or singing is optional.)
Ogden, T. (1997). Some thoughts on the use of language in psychoanalysis. Psychoanlytic Dialogues, 7:1-21.