Tag Archives: psychotherapy

No Pain, No Gain!

In her exercise videos, Jane Fonda made the phrase famous.  “No pain, no gain.”  This idea captures a core truth in psychoanalysis—so much so that Sigmund might have said it himself!

Freud put forward the idea that there are essentially two guiding methods by which we can approach life.  We all begin with the first, and some of us get the hang of the second as time goes by.

The first way of approaching life is by avoiding pain and seeking pleasure.  It is a very simple system.  If it feels good, then eat it, take it, or do it.  If it feels bad, then spit it out, get rid of it, or avoid it.  This works pretty well for most organisms.  It is a simple, rudimentary system that helps even bacteria survive!  For a little while, it works pretty well for people, too.  During the first few months of our lives–when life is pretty simple and all we need to do is eat, poop, and sleep–the pleasure-pain principle is a winning strategy.  Smile and coo if it feels good; frown and scream bloody murder if it feels bad.  In either case, mom will come running, and all will be well.

The second way of approaching life is to willingly take on painful experiences now in an effort to have gains later. I know, it sounds a little crazy, but bear with me.  This second strategy underlies the psychological concepts of “delayed gratification” and “frustration tolerance” which are so essential as we mature because they have direct bearing on everyday matters like standing in the grocery store line, putting money in your savings account, going to college, and even biting your tongue when you want to yell at the guy on the freeway who just cut you off.  Freud called it “the reality principle,” because he believed that these capacities are necessary if we are to deal with the complex reality of adult life in an effective way.  I call it hard work.

One of the main principles of life is that our attitude toward work makes or breaks us.  If we live out our whole lives under the sway of the pleasure-pain principle, we will never make the kinds of investments that lead to a successful, satisfying life.  We will never learn to walk, speak, ride a bicycle, or bake a cake.  We will eat too much and exercise too little.  We will spend too much and save too little.  We will be taken over by our greed which will never be satisfied.  We will miss opportunities because we are too frightened to take a risk.  We will avoid having intimate relationships (or, really, any relationships at all) because relationships by definition involve conflict, pain, and separateness—which we will not be able to stand, even though that means we will never love or be loved.  Put simply, we will waste away because we never challenge ourselves to do anything that means anything.  Freud also called the pleasure-pain principle the Nirvana principle.  But when you stop to think about it, Nirvana in reality is a pretty miserable place.

Lucky for us, though, we are capable of more than that.  The reason we are capable of more than that is because we have minds.  We human beings have the potential to shape our lives in extremely productive ways so that we can learn, grow, be in relationship, and develop a lasting sense of security even in the face of threats and challenges.   But the mind needs to be developed, and the only way it can be developed is to be challenged.  Like the body, the mind needs to be exercised in order to get stronger.  And the way the mind is exercised is by taking on painful, confusing, and frustrating experiences and building the capacity to deal with them.

Wilfred Bion, a British psychoanalyst who came to Los Angeles in the late 1960’s, thought a lot about how we grow our minds by learning through experience, by facing frustration rather than evading it.  He thought of this process as developing mental muscle. I love that image.  Just like we must challenge the body to develop physical muscle, so we must challenge the mind to grow mental muscle.  It cannot happen in a vacuum.  It cannot happen without pain.  It cannot happen in Nirvana.  We must push ourselves to engage with the real world, in all of its complexities, with all of its challenges, in the face of its uncertainties and even our fears.  We must feel the burn.

Hard work grows the mind.

By growing the mind through this kind of hard work, we reap great rewards.  We develop more capacity to deal with life.  What once seemed difficult now seems pretty easy.  What once frightened us now feels like no big deal.  And if that weren’t satisfying enough, there’s even a bonus!  Because we can see that we have gotten stronger, we have greater confidence that we can grow even stronger still.  This is the basis of feeling capable, which I think is one of the most important underpinnings of mental health.

In putting off today’s pleasures by investing in tomorrow’s rewards, we tend to be healthier, happier, and more successful.  Why is this?  Fundamentally, I think we reap these rewards because we have earned them.  Now, I don’t mean that we’ve earned them like we’ve been good little boys and girls and so now we get our prize.  I mean we have earned them in the sense that we have worked for them and so we can feel confident, deep in our bones, that they belong to us.  Rewards that come by luck are fleeting, because we know we didn’t do anything to bring them about.  But rewards that come through hard work feel more lasting and make us feel more secure because we know that we deserve them—and that, if we keep working, we can even have more of them.

Thomas Jefferson once said, “The harder I work, the luckier I get.”

He sure got that right.

What Really Counts

I think Albert Einstein would have made a great psychoanalyst.  He just seems to have all the best quotes.  In my last post, I explored his idea that “insanity is doing the same thing over and over again, and expecting different results.”  Now I want to delve into another saying attributed to Einstein, “Not everything that can be counted counts, and not everything that counts can be counted.”

Being new to the blogging world, I started off by doing a little research.  I googled “best psychology blogs.”  Turns out, there are a lot of them—and a lot of good ones.   I found it interesting, though, that the psychology blogs at the top of the list have a lot to do with research psychology.  It made sense to me because there is a clear trend in my field toward a more scientifically-based psychology.  For example, there is a fascination these days with the function of the brain and how it affects our emotions and behavior.  Likewise, we seem to be enamored with scientific research; we believe things really matter if they can be measured in a laboratory.   Even within my own field of applied psychology, there is a strong movement toward “evidence-based treatments.”  A particular set of psychotherapeutic techniques is applied to a person with a particular symptom, and we measure whether or not the treatment “works” by whether or not the symptom is alleviated—and how much so and for how long.

Surely there is a place for such psychological science, but I fear that it is taking up nearly all of the space these days.   We overvalue measuring, counting, proving, and guaranteeing.  And so much that makes for a meaningful life cannot be quantified in such ways.

So I am heartened that one of the greatest scientists of all time said that counting is not everything.  Einstein understood that there are mysteries, that there is beauty, that there is meaning that transcends correlation and calculation.  This is true for so many aspects of life and especially for a depth psychology such as psychoanalysis.   While there is a growing body of research that demonstrates the effectiveness of psychoanalytic psychotherapy, its effect and value cannot be captured within the confines of the scientific method.

I turn to a poet to help me convey what I mean—to Rainer Maria Rilke who wrote, “Ultimately, and precisely in the deepest and most important matters, we are unspeakably alone; and many things must happen, many things must go right, a whole constellation of events must be fulfilled, for one human being to successfully advise or help another.”

An effective psychotherapy treatment is a mysterious and sacred set of experiences between two human beings, dedicated to understanding the unique life of a single person in all of its complexities.  It is both science and art, aimed not only at reduction of symptoms but at lifting unconscious resistances so that we can face life on life’s terms and become our best selves.  The process of psychotherapy is difficult to measure because the things that matter most in life are difficult to measure.  Yes, we want to be free of the worst of our anxiety, depression, addiction, and dysfunction.  Yes, we wish to be more successful by having lasting marriages, good salaries and grade point averages, and high self-esteem as measured on a scale of 1 to 10.  But what of love?  Or joy?  Or gratitude?  Self-respect, self-control, generosity, hope, or, dare I say, peace of mind?   These are the things that we value most, deep in our heart of hearts.   These are the things that make life worth living.

I remember a particular moment during my psychoanalytic training when one of our instructors asked us what psychoanalyst Melanie Klein’s theory was essentially about.  We young candidates were flustered, trying to find the center of such a complex model of the mind.  “The unconscious?” one of us asked.  “Projective identification?” asked another.  Or the big kahuna, “Envy?”  Our instructor shook his head.  Gently, he said, “It’s about love.”  That was it for me.  That was my moment, when the deep and often confusing models of psychoanalysis began to make real sense.  It’s about love.  Love of self, love of other, love of life.  While it is nearly impossible to measure, it is ultimately what counts the most.

INSIGHT: Understanding what makes us tick…

Albert Einstein defined insanity as doing the same thing over and over again and expecting different results.  By that definition, we all are sometimes, if not often, insane.  How can it be that perfectly intelligent people do such obviously counterproductive things so much of the time?  Why do we do the things we know we shouldn’t do, and why do we fail to do the things we know we should do?

So much of ordinary life is a mystery to us.  Why do children tend to repeat the mistakes of their parents?  Why do second marriages often wind up just like the first?  Why are self-help books so rarely helpful?  In short, why do we make the same mistakes, over and over again, seeming never to learn?

The simple answer to these questions is that our unconscious mind greatly influences all that we do.  Understanding the features of the unconscious mind is a key to making changes that last.  We cannot work to improve something we do not understand, and this is the basis for the psychoanalytic idea that insight leads to change.  We first need to understand what makes us tick.

One of the basic principles of psychoanalysis is that the mind is like a glacier.  So much of what motivates us and concerns us–holds us back and pushes us forward–lies beneath the surface.  We do our best to work with what we know–the tip of the glacier, the conscious mind.  But powerful forces lie beneath the surface, the unconscious mind.  Psychoanalysis is one of the most developed ways to gain access and understanding to the unconscious mind, and thus to have an opportunity to influence it for the better.  Meditation, deep love connections, spiritual experiences, dream work, and other practices also are avenues to working with unconscious life.

Melanie Klein, a psychoanalyst who developed the ideas of Sigmund Freud in London, believed that the unconscious affects us from the beginning of life.  Each of us comes into the world pre-programmed to experience life in certain ways.  Some of us are more sensitive than others.  Some are shy, others outgoing.  Some are more prone to aggression, others withdraw in the face of conflict and anxiety.  Some lean more on the intellect, others on emotion.  This hard-wiring that is commonly known as temperament is the nature side of the nature-nurture balance that shapes how a personality develops.  If you have any experience with babies, you know exactly what I’m talking about!

Each of us comes into the world with expectations of how the world will treat us and how we will respond, and then our early experiences confirm or challenge these conceptions.  A particularly warm family experience can soften the sharp edges of a prickly porcupine temperament.  A hostile and perfectionistic family experience can intensify that same predisposition.  An abusive environment can weaken the resolve and resilience of even the most optimistic little personality, and a supportive, challenging environment can foster her great success in life.  We are a blend of our hard-wiring and the software operating system of our early environment.

The power of the unconscious is in its tendency to repeat these patterns that get laid down in the earliest months of our lives.  We live out these inner and outer experiences over and over again, and often we don’t know it and can’t see it.  Psychoanalysis seeks to help us understand how we operate unconsciously–why we do the things we do–so that we can know more and more about these unique strengths, weaknesses, blind spots, and vulnerabilities.  By understanding what makes us tick, the unconscious is brought into the world of consciousness.  Only then can we begin to make different choices and to make changes that last.

One of Freud’s famous phrases is where id was, there ego shall be.  The modern version of this idea is that where the unconscious was, the conscious shall be.   There are secrets that we keep, even from ourselves.  The wisdom of psychoanalysis can bring these secrets out of hiding, into the light of day.   Understanding ourselves is the beginning to changing ourselves.  By itself, insight is not enough; but it is the essential first step in changing our ways.

Relax… It’s just analysis.

Over the years, I have noticed that the mere mention of the word “psychoanalysis” strikes fear in the hearts of many.  It is equivalent to Harry Potter’s Lord Voldemort–it is the profession whose name shall not be spoken!

I am reminded of this idea whenever I attend a dinner party with new people.  Inevitably, the dreaded question is asked of me…”so what do you do for a living?”  I gulp.  I look for an escape route.  I wish I were a teacher, or a television editor, or a software engineer, or even an IRS agent.  Because I know how intimidated people feel about psychotherapists–and psychoanalysts in particular.  They have fantasies that we have x-ray vision and can see the deepest, darkest secrets of their minds.  They expect harsh judgment and a kind of detached superiority from us.  They wonder if we are always psychoanalyzing everyone in the room.

So, in the face of the question, I try to smile and come across as casually as possible.  “I’m a head-shrinker,” I say.  It’s the least intimidating way I know how to describe it.  They usually laugh.  A good sign.  They usually give me a chance.  Another good sign.  And then after awhile, as they get to know me, they get a chance to see that while, yes, I may have special powers, I’m just an ordinary human being, too!

While these anxieties are dispelled a bit through experiences such as these, it is important to admit there is some basis in reality for them.  Intuitively, we know that psychoanalysis is a model for thinking about people that is deep and insightful.  We feel kind of vulnerable in the presence of someone who is listening so intently, thinking so carefully, and wholly dedicated to understanding our inner world.  When we feel vulnerable like that, we try to protect ourselves.  We become suspicious.  Maybe even defensive.  It’s natural.  We worry that we are going to be harmed in some way–that the powerful insights of psychoanalysis and the skills of its agents will be used against us.   Because of its presumed power, we assume that psychoanalysis is a dark art.  Better to keep it at a distance.  Better safe than sorry.

If things go reasonably well by the end of such dinner parties, my new-found friends often express their farewells by saying, “It was so nice to meet you.  You’re so easy to talk to.”  I might respond with a wink and a smile and say, “See, I told you that I try to use my powers for good and not evil!”  I hope that experiences like these are corrective for people, giving them a chance to challenge their stereotypes and have a positive experience with a real, live, decent psychoanalyst.  My profession sometimes has a bad reputation, and I hope to help restore its good name.

This is the way that I approach my work with patients in my private practice, as well.  I hope that they, too, will find in me a person who is interested in using whatever talents, education, and training I have for their good.   That is the motive from which psychoanalysis emerged, even as far back as Freud’s day when he was trying to treat patients who were not responding well to other treatments available at the time.  He wanted to reach the unreachable, to grasp the deeper meaning of their symptoms in order to give them relief.  Psychoanalysis is a theory of how the mind works, yes; but it is fundamentally a clinical technique designed to help people change for the better.

In my experience on both sides of the couch–as patient and analyst–I have discovered that psychoanalysis is not dark magic, as even I had once feared.    In fact, it is not magic at all.  What analysts “shrink” are these very illusions–the illusions that there is some magical, powerful way to be in the world that allows us to transcend ordinary human struggles and life.  Analysis fundamentally embraces the idea that life is hard work.  Good work but hard work.  Psychoanalysis can feel magical, in the sense that it taps into the unconscious which can seem so mysterious.  But the unconscious is just one part of being human–the part that is hardest to reach and most difficult to understand, but still just an ordinary part of who we all are.  As I hope to show in future posts, psychoanalysis is indeed  one of the most penetrating, insightful, and useful models for understanding the psyche and making meaningful and lasting changes in life.  But it isn’t magic.  And it doesn’t bite.  It’s just psychoanalysis!