From Counseling to Psychoanalytic Psychotherapy: A Life Time of Caring for Others ( Part III )

Pastoral Psychoanalytic Psychotherapy Training (1991-93) was mainly a faith based psychoanalytic psychotherapy training experience. It was a dual track program that provided me with both a Certification in Pastoral Counseling and a License in Professional Counseling. The faith base was assumed to be there so the concentration was on the science-, evolutionary biology, psychoanalytic therapy theory and practice, and other scientific approaches to treatment. Religious faith or spirituality in the pastoral psychotherapy world is very broadly defined from traditional Christian, to Liberal Theology, to Unitarian views, to World Religions, to Higher Power as one defines it etc. So my then Unitarian and Christian Humanism beliefs fit right in. Because of my interests and experience in psychoanalytic psychotherapy I was able to "major" so to speak in that type of practice. Like other traditional psychotherapy training programs this training was tripartite. It consisted of: 1. Didactic coursework 2. Supervision and 3. Personal Therapy. I had already done personal analytic therapy so I just dove into the coursework and supervision. My supervisor just happened to be an interpersonalist psychoanaytically oriented pastoral psychotherapist (that is a mouth full.) I was still a pastor at the time so my "clients" were my parishoners and people in the community who were interested in therapy. My supervisor picked up with me where I was at that time, when I was beginning to read in the psychoanalytic psychotherapy practice field. That year, 1992, a book was published entitled, Psychotherapy: The Analytic Approach, by Morton Aronson and Melvin Scharfman--both classically trained Modern Freudian psychoanalysts. But the book was not about how to do psychoanalysis, but how to do psychoanalytic psychotherapy. The major difference between the two is that psychoanalysis takes place on a couch five times a week for an average of five years, and is only done by psychoanalysts (which to become one requires much more training than I was receiving.) Psychoanalytic psychotherapy, on the other hand, takes place sitting in a chair across from the therapist, once or twice a week, for three years (on average.) In the broader world of all mental health professions this is often called psychodynamic therapy, exploratory therapy, or insight oriented therapy. It is based in psychoanalytic principles but the technique is different and the depth of insight is less--because it is not as intense as psychoanalysis, due to less time spent in treatment and fewer sessions per week, etc. In reading this book and going over it in supervision and applying it to my work with my patients, I came to learn that within psychoanalytic psychotherapy there are two types: insight and supportive. Insight therapy is more similar to psychoanalysis and the goal is depth personality change. Supportive therapy is more about making some personality changes over time, but also learning to understand the nature of your personality problems and learn to better manage them in your life. Which type of therapy I would do with a particular client would depend on many factors, but the main two would be how interested the client was in insight therapy, and how capable they were to do it. No psychotherapy experience is easy but insight therapy requires a great deal of time, effort and hard work that at times can be anxiety producing as well as anxiety relieving. What I also learned was that supportive therapy was a description of everything I did as a and a teenager and college student in the Church. It encompassed ministering to others, offering care and support, acceptance and empathy-- and even encouragement and guidance. Supportive therapy also included everything I had learned and practiced in seminary in Rogerian therapy---empathy, congruence, and unconditional positive regard. And even some of what I had learned from the interpersonalist psychoanalysts in seminary training and pastoral psychotherapy training could all be included in supportive therapy. At the same time I had had insight oriented psychoanalytic psychotherapy myself from two different analysts. So that was the new path I was on and that is what I wanted to learn how to do. This text I was studying started me down that path. There were chapters in the book by Sander Abend, Jacob Arlow, Harold Blum, Martin Blum, Barbara Deutsch, and Richard Kessler--all classically trained psychoanalysts teaching me how to do analytically oriented, insight oriented, or exploratory psychotherapy. I will talk more in my next post about what this type of therapy is and how I have done it for the last 30 years.