I’m going to use the same quote I used in the article What It’s Like to Be an Analysand.
“Life lived in fantasying is life not lived. For Winnicott, the return both to living and to dreaming and playing is what the analysis is all about. He holds that experience which has never been experienced is the task of treatment. In psychoanalysis, this is a real analyst who survives the patient’s attacks without retaliating. The clarification of the patient’s inner world is not an end in itself. It must ultimately lead back to reality, to syntactic experience in the psychoanalytic situation. (Kwawer, J.S, 1981, pp. 285).”
In my practice in mental health I’ve worked as an outreach clinician, going to the homes of clients so they can receive mental health services, in an office under insurance companies as a therapist and in my practice in psychoanalysis. Between being an outreach clinician and being a therapist in a clinical office, I preferred outreach because there was something more genuine about the interactions in their homes. You were in their environment, things were happening live, for better or worse. For me, working in a clinical office, I feel minimal engagement, but the weight of paperwork and the insurance companies looking down on you is most present. It didn’t work for me, I’m not a manager, not me, my degree, specialty, or life.
Being an analyst brings in experiences, you’re with the analysand, wherever they are at and wherever they bring you. As an analyst, you start with the words that symbolize some facts and many fantasies. You’re there to gain understanding about the analysand and gain understanding on how you are reacting to the analysand which perpetuates more understanding about them, and yourself, so you can cooperatively progress with them. That’s one of the cycles that happens in the office with the couch.
Some analysands walk you through many years of dreams and fantasies, some stick us with what feels like concrete reality. It doesn’t matter. I walk, crawl, run, suffer, love and dive with them. We have no treatment plan that some higher up in an office who doesn’t understand mental health is forcing us to abide by. I work for and with the analysand.
The part that is difficult, yet what makes psychoanalysis powerful, is that the analyst and analysand have experiences together in the office. You can give me every experience you want through your words, through the feelings, manifest & latent messages. Through sharing dreams, thoughts, desire, all of it. By being late, by being early, by being on time, by reacting or not reacting to what I say. There are a lot of good times, and a lot of times the analyst is asked to survive by the analysand. Some analyst call this the negative transference. It’s when the analysand can’t fucking stand the analyst and fights with them in their own way of fighting. Verbal assault, dead quietness, no showing, not paying, in any way. I sit with the realities and the feelings, staying curious and understanding until it’s the right time to make an intervention to promote growth from that stage as to bring that growth into daily life. And it’s not just me giving some grand interpretation about why you’re doing this or that and how it connects with your mother. That’s great, but not the final point, not what leads to health. That point can be made if needed, but it’s to make a genuine contact with you so what is said, the linguistics and the feelings, co-designs constructive change internally and externally through our relationship. So what wasn’t experienced enough, or not at all, can be experienced enough to create change in your life.
I think I could say all of this in this phrase. “Regardless of what you do, I’ll give all the fucks in the world about you and we’ll keep going on for the better, together.”