Freud was jeered at in his day. I don’t use his famous couch – or share his background in hypnosis or his fascination with antiquities – but in social settings I’m often greeted with a reminiscent scepticism.
I don’t get the chance to go to a lot of cocktail parties. When people in other professions are beginning to gather for wine and hors d’oeuvres, my workday is just gearing up. As a psychoanalyst in private practice, I have to be available to work when other people aren’t working. That means solidly from 5 to 9, rather than 9 to 5, as well as during normal people’s lunch hours, and the other times my patients can snatch from their famously busy New York City schedules.
When I do manage to make it to a soirée, I’m sunk. I’ve been a psychotherapist for 20 years, and a psychoanalyst – more specifically – for the past five. Telling others what I do for a living means being confronted, almost always, with disgust or distrust – embodied in sceptical questions about my work which I wish I were then given time to answer fully.
Don’t you get bored sitting there all day listening to people complain?
What may sound like a complaint to you is likely to hold deeper meanings for me.
When my patient Ruth tells me it’s infuriating that my elevator is still broken, I accept her comment at face value. But, especially as I work on the second floor and Ruth’s in good physical shape, I then ask myself: “What could this statement also mean? Is Ruth telling me she’s been experiencing her daily life/job/family as a climb she’s been doing alone when she had expected some help?”
Then I’d look for messages she might be sending about the two of us. My guess on this one: she’s letting me know she feels like recently she’s been having to do all the work in therapy by herself – to make ‘upward’ progress. (Alternately, she could be implying that she’s exhausted by her attempts to ‘elevate’ her mood. Or that she’s worried I’m not going to manage to ‘fix’ her.)
These are only guesses, gleaned from hints, and I make sure to regard them as such. But let’s say I toss a hunch to her – “Ruth, do you feel like you’ve been having to do all the work around here recently?” – and her reply is, “I hate to say it, or even think it, but I feel like you haven’t been focusing much on me for the last few weeks, Maggie,” I’ll believe I’ve listened between the lines successfully.
My broken elevator is real, but it’s also functioning for Ruth and me as a symbol. (As a symbol, it’s functioning fine.) After we discussed what was going on between us, Ruth apologised for complaining; on the contrary, I told her, I was glad she had. It opened up a conversation that had been too hard to tackle head-on.
How can you possibly remember all those things about all those people?
Do you mix up your friends’ life stories? The names of their siblings or significant others?
I’m working with at most 30 patients at any given time. Our conversations are intense, and I’m seeing each of them at least once a week, some of them three times. While it can be difficult to recall details out of the blue when I’m not in my office, once I’m face-to-face with a patient, everything pours back in.
Patients comment on their therapists’ “amazing” memories. What’s amazing to me is that patients don’t expect us to remember everything about them.
Isn’t it hard to have empathy for people all day? Isn’t it hard to care that much?
Empathy doesn’t imply caring. The word derives from the Greek em-, for ‘in,’ plus pathos, for ‘feeling’. It’s the ability to experience vicariously the thoughts and/or feelings of another person from the inside out, to see the world through that other person’s eyes.
It’s a tool, that’s all. In the wrong hands, it can be used for malevolent purposes, in fact. Empathy is a technique for learning deeply about someone; what you do with what you learn is another matter. Your empathy is likely to help them feel heard, but it only involves caring if you care.
In the case of therapists, we do tend to care – a lot. We do that without depleting ourselves by respecting each patient’s right to run their own life, and respecting, as well, our right to our own downtime.
So are you analysing everything I say right now in your head?
Possibly, as a defence – if I’m feeling really attacked. But I’m trained to hear myself doing things like that and to question myself about my thoughts. Do I really need to safeguard my sense of self against questions at cocktail parties? Isn’t this more of a chance to educate?
Unless you’re really bombarding me, I’m probably just listening. It’s the end of a long day.