11

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Group Psychoanalysis

 

Diane’s experience in psychoanalysis made this consolidation of individual, conjoint and group modalities all the more attractive to us. I’ll digress here to describe the psychoanalytic model of emotional healing as I’ve come to understand it.

The analyst (usually an M.D. psychiatrist) “treats” the patient in an interpersonally sanitized, clinical environment. Lying on a couch, the patient free-associates (says whatever comes to mind) with a minimum of direction from the analyst. The idea is for the patient, over time, to get in touch with his innermost fantasies and preoccupations.

The analyst, by contrast, remains scrupulously impersonal in these sessions. Seated behind the patient like an invisible alter ego, he offers sporadic interpretive comments the substance and timing of which are what make the process a therapeutic one. But like any good clinician, the analyst must monitor the patient’s process from a personal and relational remove.

There’s good reason for this professional detachment. The symptomatology of the patient’s “illness” is his history of unsatisfactory interactions with family, friends, employers, etc. However well handled the analyst’s own issues and relationships might be, were he to allow his emotional field to intersect the patient’s, he would become part of the very subject matter he was trying to help sort out. To prevent this, the analyst avoids all contact with the patient outside their formal sessions. He likewise cordons himself off from the patient’s family and friends in order to maintain both complete confidentiality and undivided loyalty to the patient.

The analytic hour thus amounts to an interactive time-out, a freeze-framing of emotionally charged events for review and interpretation with the analyst before pushing the relational resume-play button. To that end, both participants are sequestered from their respective personal contexts for a most private, but relationally sterile tete a tete.

Now I didn’t know any of the above in the days of Diane’s first psychoanalytic experience. However, all the signals my wife was sending suggested that her treatment was not going well. Over a period of months, she had become increasingly depressed to the point that she was now talking, albeit abstractly, about suicide. When this got me concerned enough to begin hiding away my razor blades, I took it upon myself to phone her analyst.

Dr. Heinrich spoke to me in terms even a psychologically illiterate young lawyer like me would comprehend. “Sir, you and I do not have a contract. My contract is with your wife. I cannot discuss this matter with you. So please do not interfere any further in my work with Diane.”

Even with my current understanding of the importance of confidentiality in the psychotherapeutic relationship, this response to my legitimate if unsolicited concern still strikes me as doctrinaire and overzealous. In all events, my reaction at the time was to give Diane an ultimatum: “You can have your ‘work’ with that man or your marriage with me. If the good doctor interprets my call under these circumstances as an interference with his contractual expectations, one of us has got to go.”

Thus forced to choose one authority figure over the other, Diane chose me. The implications of this will be addressed in a later chapter, but the above may shed further light on the appeal that Tanya and Sherman’s approach had for both of us. For in their community, there was no turf war between the individual and relational processes. The relationship was seen as the very portal to the psychodynamics of the individual. Whatever issues needed to be addressed, it was within the relationship that they would inevitably present. We could then work backwards, from the patent marital conflicts to the more latent individual ones.

Tanya and Sherman were thus taking a systems approach, examining the individual issues in their larger, relational context. But unlike even a systems-oriented therapist or marriage counselor, they had on-the-spot access to the relationship and its constituents. If a conflict erupted at midnight, we would all roll out of bed and lend our collective insight to its resolution. And stay with the process, not for 45 minutes, but until the energy at play had been identified (and hopefully, shifted).

Needless to say, this created quite a different culture than the one we had all grown up with. In normal life, husbands and wives attempt to conduct their conflicts in private. So long as the marital behavior remains within bounds, the relationship muddles through its ups and downs, maintaining discretion while on public display. An unfinished argument on Saturday afternoon may thus give way to convivial chitchat as the dinner guests arrive. Unless and until the pair can no longer keep the lid on, they will endure this marital Jekyll and Hyde routine, relating to each other one way when they’re alone and quite another (like a set of dress clothes) for public consumption.

In the community, we came to disparage the latter as “performance behavior.” Our goal was to walk our domestic talk – to live up to the authenticity we espoused, not just at home but in our social and even economic contexts.