Contemporary Psychoanalytic Ideas

In the final post on my series on the useful theories of psychoanalysis I end with some current thinking and practice which has evolved since attachment theory. In essence there has been a movement from classical psychoanalysis towards a more relational and neurobiological way of working.

prominent psychologists of recent times

Working at a similar time to Bowlby, Daniel Stern published his findings in The Interpersonal World of the Infant (1985) which gathered his research of studying babies on a moment-to-moment basis. His resulting theories echoed Bowlby, proving the importance of the relationship between baby and care giver and how it impacts the development of the baby. This is mirrored in therapeutic practice with an increased understanding of the importance of the relationship between the patient and therapist.

From the 1990s there were several prominent psychologists and researchers who heavily influenced and developed psychoanalytic thought and practice: Peter Fonagy, Philip Bromberg and Allan Schore all helped integrate neuroscience, attachment theory and psychoanalytic ideas. One of the useful ideas they proved is affect regulation which is the importance of being able to manage our emotions. This has become a recognised concept in everyday conversation and is a very helpful idea to work with in treatment. If we are overwhelmed with our emotions, then we can’t think straight. This means we can’t make decisions wisely and depending how seriously the issue is we may not be able to function well in day-to-day life.

Affect regulation work

Affect regulation work is often linked to trauma. There has been a huge body of work related to people who have been affected by trauma. Babette Rothschild, Daniel Siegel and Bessel Van der Kolk amongst many have studied trauma and helpfully linked it to neuroscience. I find Daniel Siegel’s hand model of the brain most helpful in describing how the brain gets overwhelmed with emotions when we are stressed or traumatised. Our aim is to become aware of what is going on when we are triggered emotionally and then to pause, if only for a few breaths, so that we can gather ourselves internally and steady our heightened feelings.

Somatic work

Somatic work, ie working with our bodies, is another development of psychotherapy that I find helpful. I find that some patients are unable to explain how they feel. So, gradually I encourage them to tune in to their bodies and see how they feel when events happen. For example, where in your body do you feel butterflies when you are nervous? What happens in your body when you are beginning to get angry? Once we work out our physical reactions, we can begin to relate them to triggers and to our feelings.

My work as a psychotherapist

I describe myself as a relational psychotherapist because I also work with the relationship between myself and the patient in the room when it’s appropriate. I resonate with two current American psychoanalysts: Karen Maroda and Nancy McWilliams who also work relationally. I find this super helpful because what happens in the room between the client and I often mirrors what is happening in other relationships the patient is experiencing. As we uncover patterns and behaviours in the therapeutic relationship we can work on the same aspects and improve communication with other people in their life.

I feel thankful for the many people ahead of me in the world of psychoanalysis who offer insights and theories that I find useful in my day-to-day work. I still feel privileged and excited about my work with patients and supervisees and have a long lineage of passionate and dedicated women and men to thank for creating and developing the art and craft of psychotherapy – as it is today and as it will continue to develop in the future.