By Lindsay Nejmeh, LMHC

Six years ago, I wrote a blog entry as a first-year candidate in the Licensure Qualifying Program at the Manhattan Institute for Psychoanalysis. Beginning training lit me up in the most wonderful way and I felt honored to share my early analytic thoughts with our esteemed community. 

As training began, I enjoyed my share of resistance. Climbing onto the couch, I floated on a brown leather cloud three times a week. My feet kicked the sofa’s bottom cushion whenever I wanted to scream. Psychoanalysis was often dreadful. My worldview was shifting and this was both compelling and slightly terrifying, as I felt myself coming apart. With the support of my analyst, my colleagues in the same boat, sage supervisors, wise instructors, and beloved read and re-read articles, I chugged along. Slowly, I could see segments of my inner turmoil shedding away like peeled layers of an onion. However, not without the discomfort of raw, newly exposed skin. 

The star of my 2019 blog post was my recently deceased grandmother Audrey—Aud for short. She was comforting, glamorous, and often cantankerous. I will forever picture her curvy frame and religiously box-dyed hair, grinding away in the kitchen. She was a pillar of stability during an unpredictable early life. Aud always tried to fix it. Standing over the stove with her fork stabbing at fried meatballs called “polpette,” pronounced pa-pet-TAH. (Disclaimer for purists: This is Italian American slang and not representative of native Italian speakers. Alright?) As we often plucked and ate them straight out of the pan, these savory and tender globes were the tangible reassurance that everything was going to be okay. We were eating, and eating very well. We were lucky and there was nothing more to think about, to feel, or to say. 

As training moved forward, I saw how clinging to old habits interfered in my work with patients. Sitting tearfully in sessions, one patient was confused and hurt but kept going back for more, repeating the same pattern, and I wanted to soothe. I wanted to show how much I cared and how they didn’t have to feel this pain anymore. I found myself implying, “There’s a bright future! It doesn’t have to be this way!” This early training kind of “help” seems so obviously saccharine to me now that I believe it’s why I lost some people, and I don’t blame them. I recognize on some level that it was a collusion and we both wanted to look away from what was really happening, avoiding what needed to be said. For a long time, psychoanalysis didn’t make sense to me, and I admit I struggled. Staying diligent, continuing to brave the couch three times a week, and developing patience, I eventually approached a clearing. I started to make the space I needed to push past the entropy, and to see forward. The blue calm of insight emerged only after I stopped fighting it. Bless her—Aud used food to distract, to soothe, to ignore. I had to own how I had unwittingly collapsed the analytic field in soothing tones.

Today, I am well aware my job is not to fix. We look together, trying to keep our eyes open even when it’s hard. I try to stay curious, mindful, and patient even when things feel dark. To keep us on the move, Sullivan grills us, “What are the details here?” Even when I hear the mounting frustration in my patient’s voice: more inquiry. The Interpersonal tradition calls for self regulation, rather than self-soothing. We may move slowly but we will open the door once we arrive. It’s a journey, and one that I wish weren’t quite so frustrating, but I wholeheartedly believe it helps us to always keep moving forward. 

Now, as a more experienced analytic therapist, I am not seeking perfection. It’s tempting to “coast in the countertransference,” as Irwin Hirsch puts it, not naming what is really happening. “What’s going on around here?” Levenson urges us to want to know. Finding just the right balance is tough, with each unique patient. In my opinion, it is important to provide that precious holding from time to time. I see a patient suddenly shift just as we turn the corner into a difficult memory. His body is trembling, expelling short breaths, and struggling to speak. This is when I hold. I let him know we are together and it is safe to explore. I tell him I know it’s hard but it is important to make sense of the past. I believe that this security is necessary before taking the plunge. 

I am grateful for the flavors that held me together early on, and I am grateful to Aud. Today, I don’t need as much to eat, and there’s a lot more to me than an appetite for fried polpette. I look forward to being with my patients as they find out what else is inside of them, too.

References:

Hirsch, I. (2008) Coasting in the Countertransference: Conflicts of self interest between analyst and patient. Analytic Press.

Sullivan, H. (1954) The Psychiatric Interview. The Detailed Inquiry: The Theoretical Setting. W.W. Norton.

Levenson, E. (1989) Whatever Happened to the Cat?—Interpersonal Perspectives on the Self. Contemp. Psychoanal., 25:537-553

 

Lindsay Nejmeh, LMHC is Co-Director of the Licensure Qualifying Program at the Manhattan Institute for Psychoanalysis, and Co-Editor of this blog, Analysis Now. Lindsay’s private practice, Lindtherapy Mental Health Counseling, PLLC, is located in lower Manhattan. 

 

If you enjoyed this post, we recommend:

Psychoanalytic Training with a Side of Pasta by Lindsay Nejmeh, LMHC

The Evolution of the Interpersonal Tradition: Dr. Irwin Hirsch Interviewed by Lorraine Caputo, LCSW