Dear Therapist:

One of the panelists recently mentioned that “the source of the problem needs to be uncovered and healed” in order to really feel safe and secure. I’ve been wondering for a while how this is actually done in therapy. I’m married in my twenties with some kids and have been struggling with general anxiety. I’ve been seeing a therapist for a couple of months now and she’s really helped me a lot on the “uncovering” aspect through looking at my childhood. I now know that it’s not a surprise that I have insecurities as an adult. But how do I get to the healing aspect? She says that talking over and over about those childhood experiences eventually ends up healing the subconscious. I don’t see how that works. Are there specific tools or steps to get there? What do therapists typically do to "heal" the subconscious?

Response:

The decision as to whether “the source of the problem needs to be uncovered” can depend on many factors including desired length of the therapeutic relationship, short-term and long-term goals, and type, severity, frequency & progression of symptoms.  A therapist who uses various therapeutic modalities can help clients to determine whether they have a need or desire to focus on the root of an issue.

Once a decision is reached to indeed work on the underlying childhood emotions and insecurities, there are different ways of going about this.  Although later neo-Freudians changed and added to Sigmund Freud’s concept, “pure” Freudian psychoanalysis basically focuses on a cathartic (healing) experience through which a person can theoretically be helped and "cured." 

The unconscious mind is extremely powerful; it has an effect on our every waking (and sleeping) moment.  It constantly affects how we feel and how we react emotionally.  Since our unconscious minds were largely formed in childhood, the signals that it sends to us are based on childhood beliefs, feelings and insecurities.  Many of us go through life largely unaware of these signals, simply incorporating them into our conscious thoughts.  However, it is when we have strong emotions that seem inexplicable to the logical, conscious mind that we often begin wondering what may be occurring under the surface.

Many therapists use psychoanalytic techniques to help clients to better understand early sources of their symptoms, essentially making their unconscious impulses conscious.  For many people, reliving problematic childhood experiences (more than simply talking about them), leads to the healing to which you referred.  Other people require the therapist to be more involved in interpretation and the understanding of mental associations.  However, if after a number of sessions you are experiencing no progress (or stagnation) in this area, you should begin asking whether the psychoanalysis is being done properly, whether the therapist should consider incorporating other techniques into the therapy to enhance the results of the psychoanalytic process (like cognitive techniques to help incorporate now-conscious impulses into your normal though process) or generally whether psychoanalysis is right for you.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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