May I Have a Hug?

A question that comes up a lot in discussions of therapy is that of touch — when, if at all, is it appropriate for a therapist to touch a patient? As you might imagine, this is a complex subject.

Setting aside for the moment entirely justified concerns about issues of sexual misconduct in therapy, let’s look at the common desire of patients for a hug or a pat on the back or some other reassuring gesture from the therapist. There is much more involved in such transactions than first meets the eye.

Back in the 70’s and early 80’s when I was much newer in practice, it was common for therapists to hug patients, an outgrowth, I suppose, of the whole encounter group movement and the idea that hugging and touching, because it felt “natural” was a good thing. But cooler heads looked more deeply at the issue and their thoughts on the issue led me to become more thoughtful about hugging and touch.

A hug is a feeling that is acted out, regardless of whether it is initiated by patient or therapist. The same is true of a pat on the back or grasping the hand. And emotion acted out becomes less available for understanding. The purpose of therapy is in part to make what is unconscious conscious — a task that of course is never completed — and that means forgoing certain automatic, “natural” behaviors and gestures in order to understand the feelings and beliefs which underlie them.

At the end of a difficult session, the patient indicates she would like a hug and the therapist complies. What does this mean? Is the patient asking “Do you love me?” or saying “please take care of me”? We have no idea because the feelings did not become words, they became action. And what does the hug from the therapist mean — “sorry you are hurting” ? Something else? Who knows? 

So a strict frame around touch puts physical contact between therapist and patient out of bounds, except perhaps for a handshake, more commonly a part of process in Europe than in the US, I believe. Certainly this has the effect of drastically reducing the likelihood of improper physical contact if the dictum is adhered to.  Beyond that, it reinforces the emphasis on putting feelings into words. So the patient asks for a hug and the therapist says, “I think it would be a good idea to talk about what you are feeling when you ask me that” as a means to underline the basic task of therapy and to support the acceptance of all thoughts and feelings expressed in words. In my experience these requests almost always come  at the very end of a session or even at the door when there isn’t time to look at and process what is happening. The therapist is now in bind – whether to just give the hug knowing that the meaning is passing by unexamined or to decline knowing this may well feel like a rejection to the patient. There is a thin line to walk here between supporting the “real” relationship and adhering to the frame of the therapy. Yeah, I know, this is starting to feel convoluted and it can be, especially to less experienced therapists.

It can be a difficult task to work through those feelings of being denied much desired contact with the therapist. It is important for the therapist to be able to bear the fact that the boundaries of therapy can and do create discomfort and can and do interfere with otherwise normal and natural behaviors because to do otherwise is to leave unanalyzed significant feelings and desires and to open the door to the possibility of escalating demands and possible problematic behavior.

There are times when even well thought out rules should be set aside. We therapists must not let ordinary human concerns and feelings always yield to frame and what we believe are rules. Therapy is after all a relationship. I think of the day a patient told me she had been diagnosed with a fatal illness. We spent many sessions afterwards talking about her feelings but in that first moment, I did place my hand on hers as I expressed my sorrow about her difficult and painful news. In the strictest terms, I violated that rule. I was aware that it would be important to talk about that moment and we did. The key was that I was conscious of that necessity and was prepared to and welcomed talking about it.

See, it is not as simple as it seems. At the very least it seems to me to be good practice to talk about the issue of hugs and touch at the outset of therapy so that there is time and room to talk about it and explore feelings.

On the Way to Becoming

A while ago quite by accident I happened to see a photo of a woman I saw in therapy many years ago. I recognized the name — the face, like mine, has aged and I probably would not have recognized her had I seen her on the street.

And that set  in motion in my mind’s eye a kaleidoscope of  remembered patients now long gone from my life; of patients I saw years ago; kids from the therapeutic nursery program I oversaw more 40 years ago. What ever happened to those kids? The child who was electively mute? The one with feet scalded by an angry mother?  The man who struggled with a serious physical illness? The women who were my Handless Maidens? Among many others.

Because that’s the thing about being a therapist. Patients pass through our lives. And unlike friends, who, even when contact is lost, we can locate again and find out how they are doing, patients, when they leave, may or may not ever contact us again. That’s part of the deal, one of the things we have to accept from the beginning. These people who become an intimate part of our lives, sometimes for years, may very well, when they leave, leave us behind except in memory. And when the desire to know how they are arises in us, we have to be satisfied with not knowing. 

When my daughter was born, we chose for the announcement a phrase I had read somewhere — A child is someone who passes through our lives on the way to becoming an adult. And maybe a variant of that is apropos for therapy and therapists — a patient is someone who passes through our lives on the way to becoming.

As the twig is bent…

bent branch
bent branch

“Psychoanalysis cannot be considered a method of education if by education we mean the topiary art of clipping a tree into a beautiful artificial shape. But those who have a higher conception of education will prize most the method of cultivating a tree so that it fulfils to perfection its own natural conditions of growth.”Jung CW, vol. 4, para. 442

People come to therapy expecting cure or healing from their problems. I don’t think of therapy as healing in the usual sense. To heal means to make whole or healthy, to recover or restore and comes from the root kailo meaning whole or uninjured. In order to think of what I do as healing, I would need to see the people I work with, and indeed myself, as broken, ill and I don’t, not in the sense of illness. Barbara Stevens Sullivan has a wonderful way of putting this:

“In some sense, a person is her wounds. A sapling, planted beside a supportive stake that the gardener neglects to remove, will grow around the stake. The stake’s presence will injure the growing tree; the tree will adapt by distorting its “natural” shape to accommodate the stake. But the mature tree will be the shape it has taken; it cannot be “cured” of the injury, the injury is an intrinsic aspect of its nature.” (The Mystery of Analytical Work, p. 175)

I do believe that all humans are wounded, varying in degree and type of wound, but we are all wounded. My first professor in abnormal psychology put it this way — from the moment of conception we are bombarded by influences of all kinds, both noxious and helpful and as adults we are who we are at least in part due to the effects of these influences. Some of us will be more scarred than others, but none of us will be unmarked by the experiences of our lives. So wounded per se is the normal state, not a state of ill-health. 

Now, the extent to which our wounds make our lives complicated and/or difficult is where therapy enters in. Problems in living are what bring most people that I have seen into therapy — the desire to experience life in a different way is the motivator. There is no procedure or pill or technique I can apply that will close the wound. Whether or not healing is the appropriate description for becoming conscious of something that is an integral part of us, an unerasable part of our history, is something I balk at a bit. I can become more conscious of the ways I have internalized people and issues in my life. Becoming more conscious of them increases the array of possible responses I have available to me, so I can choose differently and thus find myself not in the old familiar ruts but in very different relationship to myself and those around me. That is what I believe therapy does for people and indeed is what I have experienced in my own therapy. I cannot be what I might have been had I not had the mother I had or the experiences in life I have had — I am indelibly marked by them. But I can be freer in how I live my life and perceive my possibilities through the process of examining my thoughts, behaviors, history, dreams, reactions. That is what talk therapy as I know and do it is about.

This past Saturday I had lunch with someone who was one of my first friends in Maine. We met when both of us were in our late 20s. We and our respective husbands were very close for close to 10 years. Then life intruded and the chaos of divorce, first hers then mine, and we drifted apart. She who knew me when I was 27 and seeing me now would not notice too very many things different about me except that my hair is grey and I am wearing glasses rather than contacts — all external manifestations of age and the life I have lived. I look at her and I see her grey hair and a few wrinkles. Superficially we are both quite the same.

Yet having known her very well, I can feel she is different — softer, sadder, more open. I imagine she noticed that I am calmer, less prone to sarcasm, more contemplative, warmer, maybe more confident. I still delight in words and have a dry sense of humor. Still I am a bit shy, though a bit less reserved. But on the whole, like her, I feel softer and more open.

The changes I have experienced in my life as the result of a long and successful analysis are interior, and though they shape what others see, are most likely unknown to others. Those inner changes were hard won. The forces against them from my early life were fierce and did not go down without a ferocious fight. Through those hours of talk with my analyst, I began to be able to see the destructive bits and then to be able to not act on them, to let them go by, like bubbles rising in champagne. I still have moments of feeling like I used to feel, but I see it, I feel it when it happens and I now have the freedom to make choices that do not feed those moments and so they do not grow into hours or days as once they did.

I see therapy  as opening the door to new possibilities. I cannot undo my history, make myself as if my childhood or any part of my life had been ideal, but I can become more conscious of the ways that history and my interpretations of it have operated in my life and in that way allow me to choose from a wider array of possible behaviors as I go forward. I think we are all wounded to greater and lesser degrees. The wounds do not disappear, though they do become less dominant in our lives. But healing, in the sense that we usually think of it, seems to me to not be operative in the dealing with these wounds. 

Secrets

Frost

Frost

The image above is of ice crystals on my window on a very cold winter day. They obscure the view outside, just as the secrets we carry obscure a truly clear view of us.

Probably my favorite volume of Jung’s Collected Works is V 16, The Practice of Psychotherapy — which isn’t surprising, I suppose. It is one of the first that I read all the way through. In his discussion of catharsis as a part of psychotherapy, Jung talks about the pernicious effect of secrets in our lives and says that they prolong our isolation from others.

Secrets, like an affair or a gambling problem or some misdeed or money problems — the kind of thing we lie awake and worry about, worry about others discovering — are often a big part of what brings people into therapy and what patients find most difficult to talk about. Shame and fear of judgment fill the room. The carefully cultivated image of respectability or responsibility or moral superiority will surely shatter into a thousand pieces the moment anyone, even the trusted therapist, finds out what is concealed beneath the facade. Each patient with such a secret imagines herself to be alone in the world, unlike and apart from all the rest of humanity, unable to imagine that the therapist has heard similar tales many times before. 

When we carry secrets like this, they become barriers between us and everyone in our lives, cutting us off from real intimacy. Anything which threatens to reveal what we seek so to hide becomes a source of anxiety and must be avoided. Maintaining the facade, the persona which covers the shame of the secret becomes paramount. In Japan I am told there is a saying that first the man takes a drink, then the drink takes a drink then the drink takes the man. The same is true of secrets as the secret comes to own the life of the person carrying it.

Psychotherapy, like the confessional, offers a unique opportunity to break the secret and its hold on the life of the carrier. First comes the mustering of courage to say it, to tell the therapist what has been held in shame, to brave the condemnation and the rejection, the fear of which maintains the grip of the secret. And once spoken, then the work of discerning the meaning of the secret and opening to the shadow. 

I hear from people about things they are afraid to discuss with their therapists, secrets they carry and feel shame about. I know how hard it is to open up the dark corners of our lives and let another see in. It feels like a huge risk. But what is the point of being in therapy if, at some point, the secret is not told? If it remains untold and unexplored, the therapy in a very real sense is a lie because it never gets to the truth of the patients life and feelings. So we say to patients that they should say whatever comes to mind and mean to include the secrets as well.

Here are some of Jung’s thoughts, all taken from Vol. 16, pp.55-60:

Anything concealed is a secret. The possession of secrets acts like a psychic poison that alienates their possessor from the community.

All personal secrets … have the effect of sin or guilt, whether or not they are, from the standpoint of popular morality, wrongful secrets.

…if this rediscovery of my wholeness remains private, it will only restore the earlier conditions from which the neurosis, i.e. the split off complex,  sprang.

All of us are somehow divided by our secrets but instead of  seeking to cross the gulf on the firm bridge of confession, we choose the treacherous makeshift of opinion and illusion.

It is by no means easy to let go of our secrets, whether we feel,  that do so would be rude or because we fear being judged or rejected or abandoned. It is hard work and takes time. But it is important to keep at it.

Saying whatever comes to mind is a goal and one it takes work to reach. An important part of that work is exploring the difficulty we have in getting there.

May I Ask You a Question?

Leo, one of my cats, has no problem with questions of any kind. But in therapy personal disclosure is a common issue in  therapy as patients wonder if it is intrusive to ask the therapist personal questions and  therapists wonder how much to disclose. I have never found this to be an especially difficult issue. Taking a page from an early supervisor, I tell patients early in our work that they should feel free to ask any questions that they like of me. I tell them I will answer any that I feel comfortable with *and* that I think it  is also important that we consider what the question is about for them. What is happening, what are they feeling that gives rise to this question today? Very rarely has anyone asked anything that felt intrusive or that I felt I couldn’t or shouldn’t answer. 

But this issue touches into boundaries and the frame of therapy and needs to be handled thoughtfully rather than automatically.

Years ago, when I was trying to sort out just what was the nature of my relationship with my analyst and wishing that I could know that we would or could be friends when our work was over, he told me that he considered the analytic relationship to be very personal, as personal as any. That puzzled me because I knew the boundaries — we wouldn’t have dinner together or any of the kinds of things that friends do. Yet the relationship was very close. Therapeutic relationships occupy their own niche — neither friendship nor distantly professional, but a space which is both intimate and follows its own etiquette. And because it is different, an intimate relationship yet not mutually disclosing, it can be difficult to understand the boundaries.

The therapist is not the subject of the therapy and that is one reason that there may be some reluctance to answer personal questions. Not because there is something to be hidden but because focusing on the therapist’s life means turning away from that of the patient, thus it can be a resistance, this wanting to ask questions. Or the desire may rise from ordinary curiosity. This is why it is useful to consider what underlies the desire to know. It is important to remember that the therapeutic relationship is not like any other and that one of the goals of depth therapy is to make the unconscious conscious.

“The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help (the client) acquire steadfastness and patience in the face of suffering. ”
-C.G. Jung

Do you have to want to change?

Remember this joke?

Q. How many psychiatrists does it take to change a light bulb?

A. None—the light bulb will change when it’s ready.

Well it is actually appropriate in talking about therapy.

How much does a person have to want to change in order to change at all? Basically nothing is going to happen as a result of therapy if the person doesn’t want to change. And it is a lot more complicated than it seems. Change is inherently destabilizing and uncomfortable, even when it seems highly desired. So there is a big difference between feeling you want to change and actually doing the changing.

I read somewhere that a famous guru when asked how to stop smoking said, “That’s easy. Don’t smoke the next cigarette.” All the work of therapy lies in that space between the question and the action. 

The pattern of beliefs and feelings we have about ourselves, built up over a lifetime often with roots in our earliest relationships and never really challenged by us create the prison we live in. We don’t realize is that this prison has only three walls and no bars keeping us in. We don’t realize this because we stand in the corner looking at the walls in front of us and believe that there is no way out. Therapy is, at least in part, the process of turning around and discovering that we can walk out of our prison. That process is not easy and it can take a very long time, but stripped to bare essentials, that is what we do in therapy.

So you decide one day to go to a therapist to see what she can do to help you. In therapy, no matter how much you may believe you are controlling your responses and behavior, over time your habitual ways of thinking and acting about yourself and your world show up. These are the stories you tell yourself about yourself; they make up your prison. As the therapist questions your habitual responses and views and challenges your ideas about yourself and the world, ever so gradually, you start to change — daring to be more open, to question what you have believed, to try new ways of behaving. It is slow and subtle. The therapist has to be both patient, caring and willing to challenge you, the patient, even make you uncomfortable or upset. And be able to not take personally the feelings you have toward her or him.   Gradually the story you tell yourself about yourself changes, not in kind but in degrees. The things that used to be self-defining recede a bit to allow other self-perceptions and beliefs to come to the fore. The more deeply ingrained the patterns, the longer it takes to change them.  

The therapist doesn’t DO anything. We listen, we offer observations in the form of interpretations, we may confront but we have no magic to make change happen. It is entirely possible to spend months or even years in therapy without changing at all. The hard work of making the change — or, to return to our famous guru’s recommendation, not smoking the next cigarette — is up to the patient. So why see a therapist? Because it is very difficult to see yourself clearly. Just as a camera cannot photograph itself except in reflection, the kinds of changes that are the heart of therapy need someone to serve as a mirror, as someone who can see and hear you without having an agenda about or for you, someone who can be caring and brutal. I can’t think of anyone I know who has done that without help, including myself.

Got questions about therapy? Leave a comment or email me using the form on the right, and I will do my best to answer. Please keep questions general rather than about your therapy or therapist.

How I Came to be a Jungian and What That Means for You

Two Chairs
Two Chairs

 I entered private practice in the early 80s after my children were born. At first, I did a lot of school consultation and consultation to day care centers and to Head Start. But after my own children came along, I decided I no longer wanted to work with young children. 

In my mid-30’s I started to wonder what I really wanted to do when I grew up. I considered going to law school. Or becoming a nurse and then a nurse midwife. Or going to medical school. Or getting a degree in public policy. In the end I came back to my beginning — I knew I wanted to do psychotherapy with adults.

Graduate school and my first job had given me the bare minimum training to be able to sit in a room across from another person and listen. Which I started doing. And I began to read again about therapy. I would find a book that spoke to me and when I finished it, I would look at the bibliography and start reading those books. I read Freud and Jung and neo-Freudians and post-Jungians. My father had always told me I could learn anything I needed to know from books, and though he wasn’t right, that notion stood me in good stead as I read and read and read. I came to the material without prejudices so I read widely — everything from ego psychology to archetypal psychology. It was all fascinating to me. Of course some of what I read resonated more than others and I found myself drawn particularly to two areas — object relations and that branch of post-Jungian psychology that developed in England and influenced by object relations. I fell in love with Winnicott, Guntrip,  Balint and Samuels, Redfearn, Stevens Sullivan. I plowed my way through several volumes of Langs’ seminars.

Reading is fine and important. But no amount of reading can make anyone a better therapist. So I also sought both clinical supervision and personal analysis. I wanted supervision from therapists I knew to be better than me, more skilled, better trained, more experienced. And as Jungian analysts began to settle in Maine in the 80’s, I was able to find them. Between 1985 and 1998 I worked with three different Jungian analysts in supervision — one was quite classical, another embraced Langs’ therapeutic frame, and the third gave me the blend of psychoanalytic approaches and Jung that appealed to me.

Supervision is an important part of becoming a therapist. But personal therapy is even more important in my view. I had been in therapy in college and again in my mid-thirties. But what I wanted now was Jungian analysis. In 1986, a week before I turned 40, I started analysis with one of the first analysts to move to Maine, I worked with her for 3 years. I then started seeing another analyst, a man I ended up working with for 24 years. 

But why Jung, you ask? It is the focus on meaning that really works for me with Jung. Symptoms have meaning which for me is a liberating way to understand life and behavior. Far more useful for me than something rooted in pathology and a notion of illness.

Jungians frustrate me sometimes. Sometimes it becomes too airy and I used to get annoyed at how little in the Jungian literature there was on technique.  But the other side frustrates me too — with too much on technique and rules. Finding my own balance point in between has been a big part of my growth and development as a therapist.

I long ago lost count of how many books I have read on analysis and depth psychology in the last 40 years. And I continue to read, recently Barbara Stevens Sullivan’s The Mystery of Analytical Work: Weavings from Jung and Bion,  not an easy read but well worth the effort.

One of my supervisors told me we practice what we believe. So I came to be a developmental Jungian (that’s what Andrew Samuels calls that branch of post-Jungian practice that combines Jung and object relations) because it is what I believe, because it makes sense to me in some deep and fundamental way. If you could see me work, you would not likely see much difference between how I am in session with a patient and how Paul Weston of In Treatment  is or how most modern psychodynamically oriented therapists are. The difference lies more in how we view what we see, a difference not as great as some think, than it is in what we do. So, I practice what I believe.

Here are a few of the books that I read along the way that I have returned to more than once:

Barbara Stevens Sullivan: Psychotherapy Grounded in the Feminine Principle

Aldo Carotenuto: The Difficult Art

Andrew Samuels: Jung and the Post Jungians

Michael Balint: The Basic Fault

Harry Guntrip: Schizoid Phenomena, Object Relations and the Self

 

Now to what any of this means to you. If you decide to work with me, it helps for you to know that I am not an overnight sensation, that I have spent many years learning about and reflecting on what I do as a therapist and that I have also done my  own work in my personal therapy. The specifics of my theoretical orientation may be of interest to you but as we  sit with one another, they are not really important for you  all.

Knowing that I come from a depth orientation matters because we will not be focused so much on solutions but rather on meaning– what does it mean in the context of your life that this issue persists for you? or what is this dream trying to tell you about yourself and your life. 

As Sheldon Kopp put it, “The continuing struggle [in psychotherapy] was once described in the following metaphor by a patient who had successfully completed a long course of psychotherapy: ‘I came to therapy hoping to receive butter for the bread of life. Instead, at the end, I emerged with a pail of sour milk, a churn, and instructions on how to use them.’ “

 

When we go into the woods

Into the woods

Starting therapy is a lot like going into the woods in fairy tales. We go together into territory that is both like and very different from ordinary daily life. But sometimes people are casually dismissive of therapy,  that it is just good listening and if friends could learn good listening skills, then therapy wouldn’t be necessary. Certainly listening empathically can and does provide catharsis and catharsis is an element of therapy. But it is only an element, not the whole thing.

When I enter a session with a patient I endeavor to do so without memory or desire — which is to say that any day as I meet with my  patient, I put away thoughts about this blog, about my husband’s latest project, about other patients, and about our last session with each other  and I prepare to meet her in the moment and without an agenda. I wait for her to begin and allow her to set the agenda for our time together. I follow the thread of her concerns and as I do so, bits and pieces of the other times we have met come to mind. I hear more of her themes and as we go along I am relating them to themes I have heard from others and what I know about such themes. I am aware of issues in her life that have led to her personality being structured as it is — this is a clinical piece where I touch into my database of experience with people who have similar histories and who have had the constellation of issues in their lives that she has has and what I know from more theoretical material as well.  I challenge a bit here, ask a question there, offer a suggestion, share a personal experience. I watch as we do our dance of of speaking and listening and I see when an interpretive arrow hits the mark and when it misses.

I am patient with hearing the same story told many times over the course of our work together and I listen for the subtle ways it changes as we explore the nooks and crannies of her life, how she begins to see herself in her life a bit differently and sees others a bit differently as well. The story in its basic outline remains the same but it changes as well in nuance and color and emphasis.

I bring to my work over 40 years of training and experience, many years of my own personal therapy, 10 or more years of supervision by masters in the field, and 70+ years of my life experience. I do not ask nor in any way expect my patients to reciprocate with me and listen to me and my issues. I have no agenda for what they should do. No subject is off-limits, including the full range of feelings they have about me.

What I do is well beyond empathic listening, though that is part of what I do. And while I agree that anyone benefits from being able to talk about feelings with an empathic listener, I do not think that listening alone is sufficient for dealing with a wide range of the things people bring into therapy. For some, it is about a corrective emotional experience, for others a chance to look at their lives with a person who is not entangled in that life and can be neutral, for still others it is where deep psychic wounds can be opened  so that they may heal. It is also a place where we can pay attention to dreams and symbols and archetypes and fantasies and discern the pattern of meaning in a life.

It is hard work. It is sacred work, I believe. 

Better to be bad than weak

Some years ago I read Harry Guntrip’s Schizoid Phenomena, Object Relations, and the Self. I often think of something he wrote in that book, that many of us would rather be bad than weak. Now that seems paradoxical at first but think about it — it is often more satisfying to believe that we, in our “badness” ,create the behavior in others that bothers us, because that way, if we become good, then they will change too.

If my mother treated me badly because I was bad; if my lover is abusive because I am not good then all I have to do is change, become good and then I will have the mother I wanted, the lover who will cherish me.

But if I have no control over my mother’s behavior or my lover’s abuse, then I have to live with knowing that I cannot change them, that I have to deal with who they are as they are.

To accept that I cannot determine the behavior of others means I must be more aware of my own choices and what drives them. I have to surrender my illusions about my power to control others.

Slow Magic

“Exchanging words is the essence of psychotherapy.” Nor Hall

I met with someone new the other day. When I meet with a new patient, I always have a slight anxiety before this new person arrives — anxiety and also anticipation Will we “click”? What new doors will open through this person and our work — because this process changes both of us, though not to the same degree. So there is that tingle of the new and unknown as I answer the door. And then, once in my office, whether in person or on the screen via Skype or FaceTime, we sit down and I ask, as I always do, “What brings you here today?” and we begin.

It is a curious process, therapy is. I have no visible tools. No questionnaires. No workbooks. No pills or potions. I bring with me 40+ years of sitting and listening in the same way plus my own life experience and a lot of reading. The journey is never the same with any two people. Which is why I never get tired of it, never weary of starting again with “What brings you here today”.

When psychotherapy works, it is not magic. For me, the experience of seeing therapy work is like a miracle. I go about my business, and I know how to attend to my work. I observe. I listen. I take in. I accept the person as he or she chooses to present in my office, with as little or as much as they disclose. I attempt to the best of my ability to bracket my own issues and unfinished business, my own insecurities, trusting myself to the moment and the occasion of our meeting.

Then, I describe what I am observing and experiencing in the presence of this unique person who has come for help. It is to me a signal of transcendence that that simple process can change things.

Freud wrote,

“Nothing takes place between them except that they talk to each other. The analyst makes use of no instruments— not even for examining the patient—nor does he prescribe any medicines. If it is at all possible, he even leaves the patient in his environment and in his usual mode of life during the treatment…The analyst agrees upon a fixed regular hour with the patient, gets him to talk, listens to him, talks to him in his turn and gets him to listen… It is as though he were thinking: ‘Nothing more than that?… ‘So it is a kind of magic,’ he comments: ‘you talk,and blow away his ailments.’ Quite true. It would be magic if it worked rather quicker. An essential attribute of a magician is speed—one might say suddenness—of success. But analytic treatments take months and even years: magic that is so slow loses its miraculous character.”