Clinical “Gems” in Psychoanalytic Psychotherapy

 Psychoanalytic Psychotherapy “gems”

In my opinion there are about eleven such “gems” in psychoanalytic psychotherapy.  Use of these interventions in various types of psychotherapy may improve clinical outcomes beyond insight. Although these curative interventions have often been associated with treatment of psychological trauma, object loss, and inner conflict, they may also be useful in the treatment of other clinical conditions: depression, anxiety, eating disorders, and self-medicative addictions.  Along with skilled mindfulness training and practice with a mindfully-experienced therapist, psychoanalytic gems may be helpful to clients suffering from limbic-dominated habit actions, urges and related brain plasticity realities; again, skilled applications of informed mindfulness and yoga, along with the “gems,” may improve the BIG FIVE common co-occurring clinical conditions: trauma, addictions, depression, anxiety, and eating disorders. The clinical value of the gems rests in the reality that they may be used in both long-term traditional psychoanalytic psychotherapy AND in short-term interventions within cognitive-behavioral therapy, acceptance and commitment therapy, mindfulness-based cognitive therapy, and mindfulness-based stress reduction. In this first of a series of posts on this topic I will simply list the eleven so-called gems.

In my clinical experience with various forms of psychotherapy and clinical supervision over the past 30 years I have found the following psychoanalytic gems to be very helpful for many of my clients – almost all of whom suffered from complex co-occurring disorders.  What is of more importance is the fact that I never considered myself to be a psychoanalytically-oriented psychotherapist; that approach simply required too long a treatment period to be effective, and it seriously challenged the level of specific cognitive-mental capacities of many of my clients.  I was skilled in various evidence-based therapies, to which I added these “gems.” I did require additional clinical supervision in this advanced integrative therapy process.

Here is my list.

1. Cultivating the psychoanalytic clinical alliance – the therapeutic relationship
2. Strategic and limited ab-reaction experiences
3. Conscious and unconscious linking of childhood wishes into the present relationship
4. Object and self-object internalization and their presentations in therapy
5. Re-synthesis of “repressed” failed object relations
6. Frames of clinical reliability and honest concerns in clinical interactions
7. Balanced perceptions of self in reality with self and with others – the true and false selves
8. Corrective emotional experience regarding distorted object representations
9. Cognitive-behavioral applications of formulated insights – moving the insights into actions
10. Strategic and limited therapeutic regressions and re-enactments
11. Uses of conscious projective identification processes (perhaps the most important skills of all)

In the series of posts to follow, I will elaborate the what, how and what-ifs of these “gems.”

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont

Author of Mindful Happiness  

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