Alone no more--thank you Anna Freud!

[Dr. Richard Grossman]

Hi everybody,

Well, I finally found a therapist who, after decades of study and work, came to the same conclusions that I did!  I never would have imagined that that therapist would be Anna Freud!  Obviously, she could have written my book…

This is the very last section of the Wikipedia article about her (https://en.wikipedia.org/wiki/Anna_Freud):

"Opinions on psychoanalysis: From a letter written by Anna Freud
Dear John ...,
You asked me what I consider essential personal qualities in a future psychoanalyst. The answer is comparatively simple. If you want to be a real psychoanalyst you have to have a great love of the truth, scientific truth as well as personal truth, and you have to place this appreciation of truth higher than any discomfort at meeting unpleasant facts, whether they belong to the world outside or to your own inner person.
Further, I think that a psychoanalyst should have... interests... beyond the limits of the medical field... in facts that belong to sociology, religion, literature, [and] history,... [otherwise] his outlook on... his patient will remain too narrow. This point contains... the necessary preparations beyond the requirements made on candidates of psychoanalysis in the institutes. You ought to be a great reader and become acquainted with the literature of many countries and cultures. In the great literary figures you will find people who know at least as much of human nature as the psychiatrists and psychologists try to do.
Does that answer your question?'

In perhaps not dissimilar vein, she wrote in 1954 that 'With due respect for the necessary strictest handling and interpretation of the transference, I feel still that we should leave room somewhere for the realization that analyst and patient are also two real people, of equal adult status, in a real personal relationship to each other."

After reading this, I'm sure she would have welcomed me to her "therapy underground!"

Richard

[Hopalong]

And she'd have been both very lucky and grateful to have you, Doc G!

Glad you've found this affirming piece.
You've walked a lonely road.

love
Hops

[Dr. Richard Grossman]

Thanks, Hops!   I wonder what it was like to be Anna when she was in psychoanalysis with her father, and if and when she ever admitted to him that she was lesbian.  The lack of a real relationship in such a therapy would be mindboggling and damaging.  I’m so glad she “came out” (in a different sense!) late in her career and recognized the value of the real relationship in therapy.

Richard

[lighter]

You sound like your heart's bursting with validation and fellowship, Doc. 

You're so very right about relationship in T.  You've always been right.

Lighter

[Twoapenny]

Oh, Dr G, have you always been the only one?  I didn't realise that.  I'm glad you have found a comrade, in that case!  I knew your views and approach weren't necessarily the norm, I just didn't realise they were seen so infrequently in other therapists.  Hopefully more will climb aboard, you can't be the only person who feels the way you do?  Maybe others aren't brave enough to speak their truth - they might feel more inclined to as they realise they aren't the only ones as well.  Either way, I'm glad you have someone else that sees things the way you do.  Hopefully more will follow xx

[Dr. Richard Grossman]

Hi Lighter and Tupp,

One of my social worker friends/neighbors who read my book but didn’t admit that she did because she disliked it, asked me (in a dismissive tone): “How do you get your patients?’  I bring this up because even if they believed as I do that the relationship is ultimately most important, it would be difficult to persuade patients to come see you.  Understandably, most patients want a “logical” well defined strategy/mode of therapy to help them solve their problems.  In addition, the importance of “the relationship” does not fit into any current academic therapy program for the same reason—it’s not obvious, and it would be very hard to explore in a scientific way.  So, it would be very difficult, if not impossible, to build an academic career around it.   As a result, I know no one who has “worked” in the same fashion I have.  It is wonderful that Anna Freud ended up 180 degrees from her father’s approach.  As you know, Sigmund Freud’s patients lay on a couch and he sat out of their view.  According to Sigmund the relationship was not (and should not) be real, but was shaped by patient “projections” based on early parent—child relationships.   Starting from this point, the world of psychotherapy got off entirely on the wrong foot, and never fully corrected itself in order to find what ultimately made the most significant difference by far in a patient’s life:  the relationship.  It’s not that other “techniques” aren’t sometimes helpful.   CBT, mindfulness, advice, etc., can have a positive effect on some people’s lives.  But the difference is, most often, relatively tiny when compared to a deep, important relationship with a caring, psychologically healthy and knowledgeable human being who is able to listen and take in another person’s world.  And so, yes, I’m glad Anna Freud acknowledged this and wrote about it at the end of her life!

Thanks for your thoughts!

Richard

[Hopalong]

AMEN!!!!

...the difference is, most often, relatively tiny when compared to a deep, important relationship with a caring, psychologically healthy and knowledgeable human being who is able to listen and take in another person’s world.

I've seen kind Ts in the past who definitely related to me also on an emotional level, not just a theoretical one (unless I was deluding myself, which is entirely possible). But I do know that your inspiration for your books, your plays and this board have to come from a deeply empathetic place--a beautiful and safe one.

Thank you, Doc G! The gift you've given me for almost a couple decades now has been life changing.

love
Hops

[Twoapenny]

Hi Lighter and Tupp,

One of my social worker friends/neighbors who read my book but didn’t admit that she did because she disliked it, asked me (in a dismissive tone): “How do you get your patients?’  I bring this up because even if they believed as I do that the relationship is ultimately most important, it would be difficult to persuade patients to come see you.  Understandably, most patients want a “logical” well defined strategy/mode of therapy to help them solve their problems.  In addition, the importance of “the relationship” does not fit into any current academic therapy program for the same reason—it’s not obvious, and it would be very hard to explore in a scientific way.  So, it would be very difficult, if not impossible, to build an academic career around it.   As a result, I know no one who has “worked” in the same fashion I have.  It is wonderful that Anna Freud ended up 180 degrees from her father’s approach.  As you know, Sigmund Freud’s patients lay on a couch and he sat out of their view.  According to Sigmund the relationship was not (and should not) be real, but was shaped by patient “projections” based on early parent—child relationships.   Starting from this point, the world of psychotherapy got off entirely on the wrong foot, and never fully corrected itself in order to find what ultimately made the most significant difference by far in a patient’s life:  the relationship.  It’s not that other “techniques” aren’t sometimes helpful.   CBT, mindfulness, advice, etc., can have a positive effect on some people’s lives.  But the difference is, most often, relatively tiny when compared to a deep, important relationship with a caring, psychologically healthy and knowledgeable human being who is able to listen and take in another person’s world.  And so, yes, I’m glad Anna Freud acknowledged this and wrote about it at the end of her life!

Thanks for your thoughts!

Richard

I didn't realise any of this!  I wonder if it was different here in the UK?  The first two therapists I saw - who were by far the ones who helped me the most and made such a big difference to me, and to me it was because of the relationship?  I don't know if it was meant to be, but they were the first people I'd ever really met who didn't have an expectation of how I ought to behave or what I ought to say, who encouraged me to think for myself, who sometimes gave me different perspectives to think about but never told me what I ought to do or how I should see a situation.  One felt like a caring parent and the other like a caring older sibling (which again, I don't suppose that was their intention, but for me it was a huge difference in my life).  And I think the reason I've not found therapy as satisfying or useful since that time is because all of the others I've seen have an 'approach' which basically required me to see or experience the situation differently - and I just don't find that as helpful and I don't feel I can build a relationship with them?  Hmmm.  Much for me to think about.  It seems I may have just got really lucky with those initial ones and with finding you as well?  I hadn't really realised it was such a different way of doing things.  I live in such a bubble!  Lol x

[Dr. Richard Grossman]

Hi Hops and Tupps,

Thanks for your responses and sorry for the delay in getting back to you.  I’m so glad both of you found therapists who could relate to you on an emotional level—and, just as importantly, were emotionally healthy human beings!   When I think about the human beings I trained with, both faculty and students, from graduate school to my Harvard Medical School post-doc, there were so few who would who would have met these crucial criteria.  And, of course, in my day, students were taught not to make an emotional attachment to patients, but to apply techniques, whether they be psychoanalytic, cognitive behavior therapy, mindfulness, or others.  Furthermore, the need for status was a prevalent part of the characters of almost all faculty and students.  This is why I had to escape to the “therapy underground” and create a new world for myself and my patients.  Tupp, I’m not sure if you got lucky or whether the “nature” of therapy was different in your “neck of the woods”—but, again, I’m so glad you found the two therapists you did early on.  Hops, thank you so much for what you wrote!  I’m so glad my “work” in its many forms has had a significant effect on your life.   Making a significant difference in the lives of others has always been of crucial importance to me—and I’m so glad I could extend it beyond my patients.  Of course, as I’ve written before, your “work” on this message board has had a significant effect on the lives of many as well, and we have been so lucky to have you!

Richard

[Twoapenny]

I'm very glad you side stepped the conventional, Dr G, and made your own way   I have encountered therapists since those early days who use a specific technique - CBT, mindfulness, Gestalt?  I think one of them was.  None of which I've found particularly helpful.  The two early ones I had did use specific techniques in certain situations (usually things they would teach me to help manage anxiety, depression and so on), but ultimately yes, their approach was really to help me find myself and figure out my own approach, I think.  I did feel that they genuinely cared.  One of them offered me some free sessions when I was going through a particularly bad time and couldn't afford therapy, which was very kind of her and a very caring thing to do, I thought.  The other would sometimes mention to me something she'd read that she thought I might be interested in or a film she'd watched that she thought I might like, you know those little moments that just make you feel you don't just turn up, talk, and then pay your bill.  I was very lucky with them and very lucky with the board, too! x

[Meh]

That's good news Dr. G.

[Dr. Richard Grossman]

Thanks, Pseudo Mouse!

Richard

[Dr. Richard Grossman]

Hi Tupp,

I’m so glad you found your two “early” therapists.  Obviously, they were both special human beings, and that was so important.  It is worth noting that some techniques can be helpful for some people.  For example, the latest I have read on Cognitive Behavior Therapy is that it is helpful 30% of the time.  But my life and career have always centered on: “How big a difference can I make in another person’s life?”  And after studying and learning all the popular methods, I found that the relationship between the two human beings in the room was by far the most powerful in having a positive, lifelong effect.  Consequently, who the therapist really “is,” i.e., their character, is of critical importance.  Sadly, so few of the people I know who went into the field would have qualified for the profession on the basis of character.  I can only imagine the damage these people have done over the years in the name of mental health with their diplomas proudly hung on the office walls behind them.

Richard