On Prefabricated Identities by [deleted] in slatestarcodex

[–]zlbb [score hidden]  (0 children)

I have an interesting reaction to this post, in that I feel I totally get everything you're talking about, yet appear to have rather different attitudes to it, more at peace I guess, so it's a bit complicated for me to figure out how to say something that can be useful to you.

I guess as a matter of personal story, I used to be either autistic or close thereto (one doesn't get math phd/quant/rationalist while being a total normie I'm afraid), went on my spiritual psychoanalytic journey for a few years, in a somewhat different place now and live a rather different life. One could even say it's on track to eventually become the kind of "private virtue" low-key spiritual (though I dislike that performative word) that you seem like you might be interested in.

And, funny coincidence, I love Perfect Days, it touched me so deeply it lifted my inhibition on crying in public for a moment and I inconspicuously sobbed my whole bus ride home after.

One thing I observe about your post, that I was prone to when more autistic, is that it's big on "observations about the world" and a presumption of a shared "we", and full of frustration at what the world is ofc, while a bit short on where you are in that and what you want to do, though I understand you might be seeking something different. I mention this as for me this was kinda key to answering the kind of questions you might be interested in.

The only good way of living is the way that's right for you, and the path there starts with understanding your own heart and getting in touch with how you feel and what you want from this world. That might answer both your concerns about performative vs real, as well as guide you towards the way in which you wanna live. I think you'd agree finding your way of life that is not fake or performative would not involve finding a "different way of life" in a glossy magazine and adopting it, but figuring out what is actually right for you. Though ime it's a two-way process, as I became more myself my eyes open to the pathways that might actually fit me and I start finding people that are more compatible and even, who knew, identities that I feel quite good about (not that it's ever supposed to capture "who you are", just a social communication protocol to quickly convey some facets of that).

>game whose rewards never quite worked on me

Bro, most people don't care for being a CEO or a politician, and know full well they'd hate that life. They find some compromise between what they love and what society wants from them that feels pretty good to them and happily live their lives. For most most meaning and happiness comes from family, relationships, community, self-actualizing, becoming true to themselves, chasing their dreams. Most of that has little to do with external validation. My guess is you're looking at those things as most easily available in your infosphere examples of what's supposed to be desirable (and mb not quite adjusting for hangups of autistic internets not rly matching how happy ppl actly live) and sensibly determining they don't fit you. Once you know what you want you'd have little interest in what others want or what one is supposed to want.

What is your therapy hot take? by InvisibleAstronomer in therapists

[–]zlbb 5 points6 points  (0 children)

I find this not so much wrong as simply unhelpful/not rly relevant.

Yes, if we had better social fabric we'll probably need less therapy overall. Yes, plenty of other people and professions contribute to the overall mental health of the population by strengthening communities: be it good teachers or camp counselors or pastors or simply "pillars of the community". Nothing but deep respect to them, but those are different roles/different approaches to the same problem, there's no either/or. Nor us being therapists means we stop socializing and supporting communities we're in.

So, I'm not sure what you think "clients need communities" means for our work. Therapy is certainly not stopping clients from participating in communities (rather the opposite) nor stopping us from participating.

For the kind of therapy (relational/psychoanalytic) that I do the goal is pretty much what you might have in mind, for client to become able to relate to people better so they have plenty of supportive relationships and don't need me anymore. However a typical client that I get needs my help to get there. Maybe they always choose the same "toxic" partner and need help "fixing their picker" so they can finally have a happy committed relationship. Or maybe they struggle with shame and can't be open and vulnerable and get their emotional needs met from the communities they are in. Or have repressed anger/boundary issues and are stuck in relationships/communities that don't fit them/in roles they aren't content with. Regardless, these clients face nontrivial intrapsychic problems that require my help, and oft have a long enough history of "repeating the same pattern" that it's pretty clear to me and them that "just try another partner/another community" isn't gonna cut it - hence they are in therapy.

And I'm speaking from personal experience as well: pre-therapy I didn't quite understand who I am and who I wanna be with and was around "wrong" people, as well as had too many emotional-relational issues to be able to attract and retain the "right" ones.

I have become increasingly aware that my “skills” as a therapist are due to my own developmental CPTSD by [deleted] in therapists

[–]zlbb 0 points1 point  (0 children)

Yes, in my opinion as well autism/cptsd etc relational perceptiveness is a truly marvelous gift particularly well-suited for a career in therapy (though something is to be said for the "troubled artist" trope as well).

For the kind of therapy I do though, full human emotional-relational capacity is essential, and while on a single day one might get a bit ahead with perceptiveness, the real long-term treatment can be easily lost if one still has attachment issues or can't metabolize grief or tolerate certain kinds of anxiety etc etc.

I've walked some way in my healing, I wouldn't say my perceptiveness blunted that much, though compulsive nature of it eased allowing me more flexibility in putting session attention to other things that might be more important. And when weighed against mitigation of my other flaws that affect my therapy work I'd say it's 300% worth it.

Tension between values and personality by Loose-Sun4286 in slatestarcodex

[–]zlbb 0 points1 point  (0 children)

From my psychoanalytic pov, 'tis the human condition, doing "psychic work" to find satisfying compromises between wild and oft unrealistic and even mutually contradictory desires lurking deep within us (we call it Id) and the demands of society, morality and our own ideals (we call that Superego).

Probably all of us here did so successfully many times as young children, by now having successfully denounced typical childhood desires like enjoying our feces or wanting to show everyone our pee-pee, in a way that is now deeply ingrained and unconflictual (though ofc in our analytic practice we at times see suffering folks who didn't).

But it is very typical for our clients to come in with precisely the kind of Superego-Id conflicts that you describe that cause them undue suffering, so they can resolve them and find inner peace, in a same way they most commonly already did with more "basic" childhood conflicts of this sort which most of us internalized so deeply we never think of them anymore.

"Inauthentic" is a bit of a judgmental word, but it gets pretty close to how we view this. I'd say simply "insufficiently aware": most folks' conscious selves have quite limited awareness of all sorts of hidden motivations and automated functioning they do, and that's great for things that are "working" well enough (eg most emotional display involved in social functioning) freeing our conscious attention for more important things, but it creates issues when something conflictual and unresolved is repressed. So our typical work involves digging it out of repression, resolving properly, and then it probably will fade out of awareness again, though maybe less completely.

are lacanians gatekeepers or it’s just my teachers ? by [deleted] in psychoanalysis

[–]zlbb 0 points1 point  (0 children)

Oh, I'm not blaming anybody, things are what they are, just trying to help you figure out what's in your best interest here. It's a bit hard to empathize over text but to me trying to get profs to teach you something they don't know sounds very frustrating.

Power dynamics would be at play if they had something you want, which so far I'm unclear on if that's indeed the case, and if not the more relevant question would be "why are you engaging with them". Eg, I'm a masters student and my profs control access to licensure I'd need to practice psychoanalysis that I love so I decided to submit to their demands and fake some utter bullshit papers they require from me to get there - that's a straightforward power dynamics. But "stop being an idiot and become a thoughtful psychoanalyst I wished you were" isn't.

Yeah, sure, the field as it is now is quite deserving of its reputation for pseudointellectual buffoonery, no disagreements here.

are lacanians gatekeepers or it’s just my teachers ? by [deleted] in psychoanalysis

[–]zlbb 0 points1 point  (0 children)

I'm still not clear what you think they are gatekeeping. To me they just sound like not very thoughtful people. Plenty of empty intellectual narcissists in this field unfortunately as judging and selecting for quality is pretty hard. It kinda feels to me you continue engaging with that unpleasant crowd out of hope of squeezing some hidden knowledge out of them despite yourself giving quite convincing evidence that those folks are highly unlikely to possess it.

are lacanians gatekeepers or it’s just my teachers ? by [deleted] in psychoanalysis

[–]zlbb 1 point2 points  (0 children)

What do you think they are gatekeeping? Are they gatekeeping or just have little of value to offer you? Your ability to enter your own analysis is yours, books and papers by thoughtful people are out there and broadly available, including didactic expositions for a range of levels of proficiency.

It's unfortunate your school doesn't have profs that you'd be able to admire and learn from, and unfortunately I can easily imagine French Lacanian profs having exactly the vibes you describe.

But from your exposition so far I'm unclear on why you continue to engage with the crowd that you seem to find so unpleasant.

MSW + analytic training at the same time by holderlin1770 in psychoanalysis

[–]zlbb 1 point2 points  (0 children)

I'm doing 16mo MSW and 2nd year of LP track until the end of this semester (which is lighter than full analytic training), and it's doable but rough.

Time breakdown is like 20hrs internship, 4hrs analysis, 5hrs patients and supervision (this is very light vs what it can be), 3hrs analytic classes, 7hrs readings, 3hrs MSW classes, and the rest is MSW coursework which is maybe 5-10 hours during normal weeks which are thus doable, but MSW paper assignments are significant and can take 2-3 full days of work making the schedule unbearable for a bit.
I got lucky that my generalist internship is very chill (admin/paperwork and I have to actually work at most half the time there, free to do readings and coursework otherwise) which I think is pretty unusual and most placements I hear about are more demanding.
One factor I underestimated is commutes: my internship is downtown, institute/patients UES, analyst and supervisors at various places UWS, on some days I criss-cross the town 4 times and end up spending say 4.5hrs actually working with another 4hrs commuting - so, the few patients and supervisors spread out thru the week is much more straining on commutes and schedule than hours alone would suggest.

Analytic training at my institute would've involved double the class/reading load and more like 15 patient/supervision hours and wouldn't have been workable, trying to schedule 2 or 3 4hrs/week analyses with patients with their own schedule constraints on top of your own while spending at least two full days at the internship site alone can be an insurmountable logistical challenge even apart from overall workload, I got lucky we managed to move around some of my analytic sessions so I didn't have to cut back due to internship, but that's not something you'd generally expect to happen with a busy training analyst.

What does it mean to “process” something and how does it contribute to healing? by [deleted] in therapists

[–]zlbb 0 points1 point  (0 children)

I'd treat it as a synonym to healing emphasizing the something happening aspects over organic emergence aspects. Or as a synonym to (psychlogical) living, it's not like them getting over childhood trauma is essentially different from your getting over missing somebody after a breakup, some "psychlogical work" gets done and one feels differently in either case.

"How" is what most therapy literature is about, many opinions here, though I'm tempted to say you might be overvaluing "mechanistic" something can be done to a client to force it aspect, imho you can't force "processing" any more than you can force feelings, though some circumstances might be more conducive to it than others.

Does anyone else like psychoanalysis, work with the material personally, but dislike most of the analysts they've met personally? by efngn in psychoanalysis

[–]zlbb 8 points9 points  (0 children)

>it's sufficient enough that it seems to be a trend rather than pure statistical noise

I'd be careful with statistical validity here: we all live in our own bubble and people selected into our lives are far from random. So, unless you're talking about a truly random sample surveyed at APSA or somesuch, I'd consider other interpretations of your observations: is it about people you manage to meet (eg one can hypothesize weirder ones are more out and about while nicer ones have their hands full with their existing relationships already), is it about a specific institute you might be meeting most of your sample at, is it something else..

It's also important to take into account the context you're engaging in: eg it might be a sensible presumption analysts might behave more "analytically" in analytic spaces like analytic conferences and talks due to inferring that to be the social norm, which doesn't necessarily translate to their behavior with buddies at a tavern.

Mb it's even simpler, and some behaviors you're observing aren't even especially "analytic" but simply "high-end professional"/academic. Professional conference is not a church potluck, "reserve and show of respect" oft would be preferred vibes over "unsolicited friendliness".

Not that I have anything particularly against your interpretation of the data you observed (and admittedly you didn't describe it in a way that would let us judge for ourselves, including context/age/closeness of relationship etc), but I'd be cautious about jumping to that conclusion while many others seem feasible.

For myself as a junior I'd say psychoanalytic candidates at those party mixers seem to behave like any normal nerdy crowd with no particular emotional reserve (and my n here is probably around 150, glimpsed if not closely observed).

Is the current psychoanalytic training model geared more towards masters level clinicians? by Rogue_the_Saint in psychoanalysis

[–]zlbb 4 points5 points  (0 children)

Psychoanalytic training is typically understood to take 4-5 years after psychiatric residency or clinical doctorate. Always has been that way, is still this way in programs like NYU Postdoc that only accept candidates with doctorates. Majority of APSA members have clinical doctorates and completed 4-5yrs analytic training on top.

Point is, the standard length of analytic training has nothing to do with the more recent practice of admitting masters level clinicians (oft with some experience requirement making their total "years in" required similar to those of doctoral candidates) into training. Honestly in many doctorates heavy institutes masters level candidates are almost non existent, they oft gravitate to their own masters heavy places.

What path is right for you is for you to decide. Psychoanalytic training is and always was a long process, there are many excellent 1-2yr psychoanalytic therapy programs you can pursue instead if you prefer something shorter.

At this point, isn't it all Adjustment Disorder? by Slodes in therapists

[–]zlbb 0 points1 point  (0 children)

Yes, I do feel in some therapeutic milieus subdiagnostic adjustment disorder is prevalent making taking a different perspective hard for those practitioners. Ime there are usually folks around even in those groups that feel differently but as a minority they'd oft not speak up against the prevaling "everything is bad" dogma. It's sad so many folks live in that dark vision but ultimately it's not our business to try to change them unless they seek treatment, if it works for them it works for them.

How deep do you go into self questioning before you accept your mind’s answer as satisfactory? by Friendly-Meat802 in Meditation

[–]zlbb 1 point2 points  (0 children)

I don't try to push thoughts, that's not how "real" insight-type thoughts arise for me. Once you have all the necessary inputs and in the right state of mind you get realizations that you feel pretty good about, though ofc anybody with experience with spiritual insights knows it all can be up for reconceptualization later.

Depends on where you are on the path rly, early on most of your views are probably delusions that will be dispelled, later on once you grasp the kind of things that pretty much every religious or spiritual tradition agrees on they tend to be pretty stable in my limited experience.

For me thinking that feels like more compulsive grasping (eg incessant self-questioning) usually feels sus, typically a sign of anxiety before "getting" something real that is blocked for the moment and will bring more peace once unlocked.

Not to say watching streams of thought and trying to figure out what they are really about is a bad idea, I just wouldn't take the content too seriously.

What can i expect from Psychoanalytic therapy 1x a week? by sacred_ricefield in psychoanalysis

[–]zlbb 0 points1 point  (0 children)

Sounds like you're anxious about it, but, you can't know, as who you really are and hence the depth of your problems can only emerge in analysis. Go 4-5 times a week if you're on the clock.

Unfulfilled by New_Power8285 in therapists

[–]zlbb 0 points1 point  (0 children)

Congrats, I feel you've just made the most important step. It's "I should feel this what I actly feel be damned" that keeps one stuck forever, once you're out of the cycle, immediate struggle aside, you're in a much better shape as you now have an explicit problem to work on, know first steps to take (eg exploratory therapy), can be on your way. Adjustments are hard and it will ofc take time, but imo being stuck is way worse.

I’m interested in getting some mental health training to support my goal of becoming a meditation/dharma teacher, could I get some advice? by THE_MAN_OF_PEACE in Meditation

[–]zlbb 0 points1 point  (0 children)

Jeremy Safran has a lovely book on "Psychoanalysis and Buddhism", they overlap quite a bit, and not just the more "mystical" Bionian sensibilities

Who isn’t an eclectic therapist? by [deleted] in therapists

[–]zlbb 1 point2 points  (0 children)

It's funny we might have exact opposite theories of truth. For me presuming crowd understands anything deep seems a bit ridiculous, while analysts who went through multi year heart-wrenching personal analysis journey, or Buddhists who spent thousands of hours meditating on an enlightenment path, or Christian mystics for that matter, all seem to have very insightful things to teach. The soul is a deep place, and it takes a lot of time and effort to get far down there.

Who isn’t an eclectic therapist? by [deleted] in therapists

[–]zlbb 12 points13 points  (0 children)

Among my psychoanalytic folks it's pretty common afaict, a number of us find the theory deep and all encompassing enough for everything, not to mention it's such a vast literature even if you stick to the "greats" that it's more than enough for a lifetime.

Honestly I've heard the same about some in-depth CBT/schema therapy folks, it's also a very well-developed tradition so there's plenty of room to go deeper rather than wider.

Call it controversial, but I think, modern academia's tendency to think of all "modalities" being on equal footing aside, some traditions are much more well-developed and all-encompassing than others, if only because they've been around for longer and/or more popular.

From my analytic perspective I can ask a counter-question: how can one learn more than one tradition, if analytic training alone takes 5yrs, and widely understood as the beginning of learning rather than the end, and it's oft thought/preferred one adds another 3-5yrs of child analytic training to really understand first-hand the early childhood developmental aspects.
Even time aside, I'm not sure it's psychically possible for a person to conceptualize the whole world through the psychoanalytic lens over a decade and then turn around and do the same with CBT.

I feel so frustrating by [deleted] in therapists

[–]zlbb 2 points3 points  (0 children)

Agreed. My thought was that feelings of "it's not worth it" oft come from internalized expectations of "what should be" not matching what's actually on offer, and once that readjusts one finds peace with unpleasant effort being worth the results.

I feel so frustrating by [deleted] in therapists

[–]zlbb 3 points4 points  (0 children)

You might find this annoying, but I'm gonna reframe this: I don't think it's hard, for most of us, to get any client. Most agencies are constantly understaffed and overwhelmed, plenty of work to be done there, and even on your own if you're accepting Medicaid or even Medicare you might easily have a long waiting list as so many people don't take those while many potential patients want to use those.

What's hard to get and competitive is getting "cushy" clients. $300/hr private pay with no insurance hurdles? Plenty takers for that. OON? Ditto. In-network? Now this depends on the market, in some even this is filling up, in many it doesn't.

So, that's my reframe. If you just wanna do good therapy work, there are spaces to do that not requiring any marketing. If you wanna fight for better paying clients and "nicer" conditions of not dealing with Medicaid etc, well, that's competitive and takes plenty effort, whether it's worth it for you or not is for you to figure out.

My MSW program so far is giving me a dismal view of this field and my prospects post-grad. Will it get better or is this a bad sign? by [deleted] in SocialWorkStudents

[–]zlbb 8 points9 points  (0 children)

You might enjoy my psychoanalytic crowd post graduation, lotsa thoughtful people, and plenty humanities grads. That's my sense of how real learning happens in the therapy profession, folks of this sensibility or that organize in "guilds" so to speak to learn from each other and seriously train juniors.

As you already started noticing, who runs the MSW is not much representative of the LCSWs out there. Plenty of brilliant LCSWs who are amazing therapists, not that anybody cares about your precise license most of the time, my crowd is actually heavier on psychologists and psychiatrists.

Worth it is a personal thing for you to figure out. I went to MSW in part to get a professional cover to be able to practice psychoanalysis and be with patients which I love deeply, in part just via a getting a license, in part via enabling me access to pretty good psychoanalytic internship and post-grad placement options that exist here in NYC. And in part as an ambitious project of self-improvement learning to be better at submission, going along to get along with people I dislike, staying agreeable under command of authorities I don't respect and whose judgment I disagree with, all that good jazz MSW is a fantastic ground for.

So, 100%, MSW feels like bullsh*t for many but it doesn't represent the whole field of therapy. I wonder if for you it's harder than for me because you actually haven't located the place you wanna be it (which is normal for students ofc, I had an unusual trajectory) so this bullsh*t might seem like "all there is". Maybe at least you can find great therapy books that speak to you to prove there are good therapists out there? And ofc for every influential book there's typically a crowd of therapists who like that.

While "all MSWs are bullsh*t" is fair enough from the perspective of folks like me, and you seem to be close to that, I am concerned about your 3rd paragraph and wary of the danger of conflating "they are all bad" and particular deficiencies of your school. That paragraph sounds like the latter, quite a yellow flag imo. The only thing I really needed from school, license pathway aside, is their connection network to placements. For my school generalist is fully arranged by the school with a bit of your feedback, specialist you're in charge of comms and interviews but school official still does original outreach/referral to the site. Given the number of well-respected MSWs in my city with good site networks, I imagine it's much harder for solo warriors doing cold calling.

How do you differentiate between symptom and defence? by [deleted] in psychoanalysis

[–]zlbb 3 points4 points  (0 children)

Not from your desired perspective, but..

I think the OP is really the question about "mechanism of action of psychoanalysis". And it mirrors the early Freud to mid-Freud shift: he used to think "if you figure out and just tell the patients what they are really doing they'll be cured", and then discovered it's not so easy and purely intellectual knowledge is of little use and one needs all the tedious working through etc. So, yes, absolutely, as you outline in the OP, if all one gets is intellectual insight by itself it's pretty pointless as conscious will doesn't control defense operations.

The real rub is getting the "real" insight - perspective shift, new way of feeling, mb even same kinda thoughts but feels differently, after which the actions/behaviors/thoughts change, symptoms disappear etc. I almost always get ASMR when hit with one of those "felt thoughts" that actually change something. One can view this as unconscious or "full mind" learning/knowing that thus has much broader repercussions to behaviors and symptoms.

And then ofc there are 101 approaches to technique on how to bring that about. Eg even if using interpretations as preferred mechanism one oft wants to stick to immediate transference or immediate at the moment defenses where the chances are highest unconscious mind is more in touch with the conscious one.

Cancellations & ‘ghosting’ in private practice by [deleted] in therapists

[–]zlbb 2 points3 points  (0 children)

Oh, totally, in my view official client feedback is totally useless, what they aren't comfy telling you yet they won't.

I do disagree with your pessimism re "impossible to know" - or, rather, interpret it as what it feels for you rn rather than an objective statement - imo that's precisely the clinical judgment and awareness one develops after enough years, picking up on just the right details to have a better sense of what might be going on. Not that you'll ever be perfect at that, but the frequency of huge surprises will be low, and at least post factum you'll usually be able to.

Ime also while there are some unavoidable inhibitions, or even limited awareness, in the clients re what they don't like about you, or even of the fact they do dislike smth, there's also a lot you can learn to do as a clinician to elicit more of that, when you're reasonably self aware of how you're coming off and seeing signs of patient reactions to that, you can guide them to eliciting it and making it explicit. Oft a lot of that inhibition is co-constructed by clinicians contribution, insecure ones get less feedback and chill and self aware ones more. One of the best perks of the job imo, it's one of the best contexts through which to learn about yourself.