Psychotherapy and The Question of Meaning

What is Psychoanalytic Therapy? – A Personal View, Part 9

All of us, whether we are therapy patients or not, have to resolve the question of what is the meaning we are going to give to each day of our lives, and to the rest of our lives. We have to resolve it even if we do so by trying to evade it and just drift along with what seems the easiest course. From moment to moment life ceaselessly imposes on us choices between alternatives. We must all the time make decisions, which means we must all the time decide which values and priorities will govern us, from moment to moment, from day to day, from year to year. The way we make those decisions determines how we end up shaping our lives and whether we feel content with ourselves or not, whether we feel we have achieved the best self that we can, under the circumstances we must work with, or whether we do not.

The psychiatrist Viktor Frankl, who wrote the famous meditation on his experience in the German concentration camps, Man’s Search for Meaning, emphasised possibly more starkly than anyone else the importance of recognising this in psychotherapy. Frankl writes:

Nietzsche’s words, “He who has a why to live for can bear with almost any how“, could be the guiding motto for all psychotherapeutic and psychohygienic efforts regarding prisoners. … It did not really matter what we expected from life but what life expected from us. … Life ultimately means taking the responsibility to find the right answer to its problems and to fulfil the tasks which it constantly sets for each individual. Man’s Search for Meaning, 1959, pp.76-77. Emphasis in original

It is of course not just to the case of psychotherapy with prisoners but with everyone that this applies.

Frankl himself coined the term “logotherapy” for his approach to therapy. Fortunately this is one term that has not passed into general use.

In the decades after World War II there was a great flowering of terms within the general field of psychotherapy and there arose names such as humanistic therapy, object relations therapy, existential therapy, gestalt therapy, and others.

These reflect the cultural upheavals that occurred in the wake of the dictatorships of the 1930s and the war that followed. There was at that time a hunger for new perspectives in most cultural spheres and a sense that the assumptions that had dominated the years leading to the years of tragedy needed to be questioned. This was seen in psychoanalysis and psychotherapy also.

Some of these schools are still around at least in name and you will find slightly different therapeutic emphases in each. Ultimately however they are all variations on the theme of Freud’s original psychodynamic therapy, with an added emphasis on meaning, purposefulness, life goals, and so forth.

In the contemporary field of psychotherapy then, psychoanalysis, psychoanalytic therapy, psychodynamic therapy, existential therapy, humanistic therapy, and a few others, are all now terms between which it is, in practice, impossible to make distinctions that will be found to be consistently reliable.

Finding a therapist who uses one of these titles for his work will not give you any clear indication, before you meet and talk with him, how his approach may or may not differ from a therapist who is using any one of the others. The only meaningful test is to talk with the therapist and see whether you feel he understands where you are coming from and has a good grasp of what you have experienced in life.

Saturday: Psychoanalytic Therapy and Cognitive Behavioural Therapy (CBT)

Author: Marcus Bowman PhD

I am a psychoanalytic therapist working in Cork.

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