Theoretical Orientation


Like all therapists, my clinical approach is based on a cohesive set of therapeutic principles, called a “theoretical orientation”. It provides the basic framework through which I view your emotional issues and establishes the practical guidelines for our work together. My particular theoretical orientation is derived from the world of contemporary psychoanalysis and is a combination of two specific schools of thought: Intersubjective Systems Theory and Relational Psychoanalysis. Let me explain what that means.

Most people, when they think of psychoanalysis, immediately picture Freud, along with his most famous ideas, some of which still have great validity. In particular, I, like all psychoanalysts, accept Freud’s basic notions that your history influences the way you are in the present and that your unconscious emotional activity impacts what you consciously think, feel, say, and do. However, my approach differs from Freud’s in two important ways: it is (1) emotional and (2) relational. Let me begin with emotions.

Rather than seeing your mind as composed of set structures such as the “superego” or the “id,” I see it shaped along emotional lines. Emotional activity, which can be conscious or unconscious, includes longings, beliefs, expectations, hopes, fears, dreams, and attachments to important others. Perhaps most importantly, your emotions form the matrix of principles by which you organize your experience of the world around you. They are the rules by which you relate to yourself and others. Some of these principles prove to be helpful over the course of your life. Others create big problems. Let me give you an example.

Imagine that you have as an emotional principle that idea that you are “defective” in some fundamental and unchangeable way. Further, you believe that your defectiveness renders you unlovable and unfit for human company. (Note: this is an extremely common emotional organizing principle.) Implied by these central tenets will be the conviction that if people could see your defectiveness, they would, of course, reject you. As a result, you will organize your life in such a way as to prevent the “shameful truth” from emerging. You may hide behind a façade of happiness, friendliness, or intelligence. You may become a workaholic or driven in some other way, attempting to overcome imperfections with great achievements. Similarly, you might adopt a perfectionist approach to life, one in which you try to mask your defects by looking, acting, or performing flawlessly. None of these approaches works, of course, and your life becomes a living Hell.

The second way my approach differs from Freud’s is that I believe that all emotional organizing principles arose and are continually maintained in the context of relationships with important people in your life. In the beginning, it was your mother and father or other primary caregivers. Soon thereafter, it included siblings, peers, and eventually the wider world around you. As such, your emotional principles and the problems they create are not “things” that are “all in your head.” They are the fundamental ways you try to co-exist with the people around you and still get what you need emotionally: love, safety, warmth, and a sense of connection.

As such, I don’t see you the way Freud did (and as Cognitive-Behavioral therapists do,) as a “sick” patient in need of cure by the “correcting” of your “distorted view of reality”. Instead, I believe firmly that your way of being makes sense, especially in the context of your history, but that it is probably less flexible and adaptive than is needed in the context of the complex, grown-up world in which you now live. My goal, therefore, is to give you the freedom to change those aspects of your approach to life that are not working anymore. How do I help you to do that?

Here is where your emotions come in; but not just feelings, it is your feelings about feelings that are the key. Here’s why. Based on our childhoods, we all have feelings about our various emotional states. You may feel guilty about your anger because it hurts others, ashamed of your sadness, because you think it makes you feel weak, or anxious about your fear, because you believe others will think less of you if they could see how afraid you are in a given situation. And change requires you to tolerate many feelings that you may have negative feelings about.

All change, for instance, comes with a certain amount of disorientation and anxiety, and the longer something has been in place, the more disorientation there is. Emotional change also tends to bump up against long-established rules and prohibitions – should, oughts, have-to’s, musts and must nots – that have long ago become automatic default settings for you. As you change, you may experience yourself as falling short of these ideals, and you may feel guilt or shame about doing so. Perhaps most of all, since you may not be fully in touch with all of your feelings, your emotional world may be a place of great confusion, mystery, and anxiety for you.

What I do is help you tolerate all of the feelings that go along with personal growth and change. Little by little, you can come to fully inhabit your emotional world, experiencing, tolerating and integrating the full range of your emotions. By doing so, you can come to embrace yourself as a unique and profoundly human being, one deserving of, and capable of receiving, the acceptance and love of the world around you. At that point, you can live the kind of life you have always hoped to live. That is because if you are not afraid of feeling, then you will not be afraid of life.

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