What we’ve said about Psychoanalysis

“saying it's not relevant is like saying money's not relevant because you have a credit card. So much of our modern thinking is developed from it. And the ideas are just like baked into a lot of our theories today”

“Talk therapy as we conceptualize it in the West since pretty much 1905 maybe didn't really exist properly before psychoanalysis. Psychoanalysis is the original talk therapy and all others kind of come out from that in some way or another”

“Where you see it the most baked in is our psychotherapy concepts. So time-limited modalities are really drawing on the earlier insights. You know, CBT itself grows from an analytically trained therapist”

“if we anchor to the DSM there, we can still see the psychoanalytic roots. You know, we see Freud's melancholia influences is a huge part of the melancholic subtype of depression. A lot of the ideas are rooted, are in the diagnoses”

“I always say that the things that Freud got right, everyone just thinks are psychology. And the things that he was off the mark on where people misunderstand, that's what people say are Freud”

“It's relevant to know that the unconscious probably exists. There's a large part of your brain's workings and your psychological workings that you cannot immediately or easily call into your conscious mind to think about and to manipulate with your executive functioning”

“It gives a rich way to formulate patients. From the last podcast, the help-rejecting patient example shows the value of thinking psychologically instead of just, you know, the patient has depression, I'm going to follow the medication algorithm”

“as the, quote, neurotic conditions went to biological treatments and CBT, then the purview of psychoanalysis and psychoanalytic treatments, I think has become more and more the personality disorders”

“all the legwork is done on levels zero through three and that the interpretation is just a small skip it's not this gigantic jump”

“Psychoanalytic psychotherapy and psychodynamic therapy use those ideas in treatment. So some use psychoanalytic psychotherapy to mean higher frequency technique driven work, like meeting two to three times per week. And psychodynamic often means using those principles about the past shaping the present in a more flexible format”

“Anna Freud advances defense theory within that frame. Then comes object relations with Klein and Kernberg being the big people. And that focuses a lot on internal representations of self and others and how that shapes our unconscious life”

“the emphasis there is two subjectivities meeting and the implications of that and treatment. And a lot of my favorite mentors in New York City are more relationally trained”

“if you skip the later developments that are easier to translate into today's language, it's easy to dismiss the whole field as kind of just pseudoscience and just nonsense. And that's a big mistake”

“If you take certain things in, let's say, the DSM at face value without understanding the history behind it, you're practicing almost cargo cult psychiatry”

“most of the time maybe 80 to 90 of the time the terminology is needlessly abstract uh to capture you know the information that is trying to be communicated”

“if you have a reader or a thinker grapple with something difficult they may emerge you know, at the end of it with more than they would have had if you made it very, very concrete and plain and non-abstract”

“Freud always wrote hypotheses and then his followers would then say, this is what's happening, you know? And then they overstate things. I think they attribute too much meaning to repetition, like saying it's a desire for mastery”

“Freud didn't work with patients with primary psychotic illness. Most of his theories were based on patients with hysteria. His formulations and understanding of psychosis were based on a totally different subset of patients”

“you can't do good treatment without giving some degree of normal psychoeducation, and at least advice in the form of not direct advice, like, I think you should do this specific thing, but in suggestion. It's interesting that you did this one thing. Did you ever consider doing this other thing”

“it's basically impossible for any two year four year seven year nine year uh program to really cover everything in a meaningful fashion you know and anyone that claims to say that i think is making some kind of an error”

“The loss in terms of, you know, where the question comes from, is it still relevant today, is that many clinicians aren't as able to think psychologically as they were before”