What is Psychoanalytic and Psychodynamic Psychotherapy? with Dr. Carly Claney
Published on
February 27, 2024

What is Psychoanalytic and Psychodynamic Psychotherapy? with Dr. Carly Claney

Tyson talks with Dr. Carly Claney, founder and CEO of Relational Psych, about psychodynamic psychotherapy, the history of psychoanalysis, the difference between “psychoanalytic” and “psychodynamic,” and the particular benefits of this kind of treatment. They also talk a lot about Freud.
Hosted by 
Tyson Conner

Tyson Conner  00:00

And today my guest on the podcast is Dr. Carly Claney once again. Welcome back.

Carly Claney  00:06

Thank you so much, excited to be here.

Tyson Conner  00:09

Dr. Claney, has her PhD in Clinical Psychology and is licensed as a clinical psychologist in Washington State. She is also the founder, owner, CEO of Relational Psych where she supervises, practices psychotherapy, and just generally makes the world run on time. My boss, Carly's back. Welcome back to the podcast. And today, we are going to be answering the question, 'What is psychoanalytic and psychodynamic psychotherapy?'

Carly Claney  00:39

Yes, we are.

Tyson Conner  00:40

So what are they?

Carly Claney  00:42

Well, to give a little preview, we'll do a little bit of a history lesson. Like a little history theory thing. We'll talk about some key features, and then what it actually looks like in the room. And then hopefully, we'll have enough time to really dive into what the benefits, goals, outcomes, and what it hopefully should do for you.

Tyson Conner  01:03

And to make it very explicit to the listener: we're doing this episode, because at Relational Psych, we do psychodynamic psychotherapy. And we are heavily influenced by psychoanalytic theory. And we'll get into the differences between those two, which are very subtle, later on. But that's the reason we're doing this episode. And so that's what we're going to cover.

Carly Claney  01:26

Yeah, because a lot of what we'll talk about on the podcast and how we think and, like, the foundational elements of a lot of what we do here are based on these things. So let's talk about it so you know where we're coming from. So to get into the history, I will do a little bit of a disclaimer, theory has never been my strong point. So I'm going to give you what I think. And then, if I don't always remember, like, what concept is from which theorist or whatever, hopefully, you can help me, but we're talking about, like, 115-ish years. So it's gonna be...

Tyson Conner  02:01

115-ish years, and 1000s upon 1000s of individual thinkers who have all published and contributed in some way or another, and bunches of others who never even wrote their stuff down who were also important. So yeah, if I remember stuff I'll say it. It's a lot to keep in one head, though. 

Carly Claney  02:17

Yeah. I think a lot about what you actually take in, like what gets diffused, can also be important. 

Tyson Conner  02:25

Sure. A lot of the important bits - it's hard to remember exactly where they came from. Listener, it feels important that we are starting with a little bit of history, because like, my supervisor, Rachel Newcomb likes to say that a lot of theory is biography. And when you're talking about a theory that grew up over the course of 115 years, you're talking about the story of that group of people and the story of that theory. So it makes a lot of sense to me to start with the history.

Carly Claney  02:57

Yeah. And...so we're gonna start with Freud. 

Tyson Conner  03:01

Woo!

Carly Claney  03:02

You know, there's always mixed feelings when you talk about Freud. But it's important, again, thinking about the history of how things evolved. Because he, he really was so influential, obviously, in the start of everything. He was like, early 1900s. So he was born in 1886, and died -- No, he started his practice in '86, and died in '39. Again, a long time ago, and really influential. The central tenant of Freud's theory where he started evolving the psychoanalytic ideas was the concept of the unconscious. And that's where we really start to get into what is so different about a lot of different thinking.

Tyson Conner  03:43

Yeah. Before Freud, people would be neurologists. And Freud was a neurologist - he was a trained medical doctor in Vienna, I think. And he was like the first person to take the sort of standard like medical hospital model, and start thinking about, 'Wait, what's going on in this person's mind? What's not just about what's wrong with their body? What's not just about, like something that we can give a medication for to fix or do surgery to fix. What's happening here?' And what he found was that with some of his patients, if they talked about what was going on for them, their symptoms would go away. And as I understand it, that led him to think that 'Okay, something must be happening on an unconscious/nonconscious level. There's things happening inside of a human mind that we're not thinking about or aware of.' And he was the first person to really take that seriously and dive into it. And like previous philosophers, and poets and and theologians even had written about ideas similar to the unconscious, but Freud was the first one to really sit down and say, like, 'This is a thing that I'm going to be really curious about.' And that's how he got going.

Carly Claney  04:59

And I like how you said that he really validated it, he really was able to then explore how does making unconscious processes conscious change people? Change their well-being really into wellness even. So there's a lot about Freud that we're not going to get into. But one of the really -- just in addition to the conscious and unconscious kind of introduction of that idea, he was also really interested in 'Why do people do what they do?' So he brought in Drive Theory and a lot of different things. And then from Freud even , people who came after him and were trained by him or worked with him, they really began to expand on his ideas, either changing them, adding their own, integrating new ideas... It started to be this really big evolution from there.

Tyson Conner  05:54

Yeah, Freud's big thing was there is a very large, unconscious part of a human mind. And he said that what was unconscious was mostly these drives: desires for certain things and things that motivate us to certain behaviors. And then later the theoreticians? 

Carly Claney  06:14

Theorists?

Tyson Conner  06:15

Theorists, yeah, that's the word. Later theorists disagreed about what else might be in the unconscious, right? And that's kind of how psychoanalysis has evolved is sort of answering that question. We all agree the unconscious is there. And it's big and it's active. It's a living thing inside of people and between people. But different theorists make sense of it in different ways.

Carly Claney  06:39

Yeah. I think that's a really good point. And after that, then what were those things that people were adding? Some of that included the environment, so rather than just people's -- you might have heard  the debate, nature versus nurture -- the whole "nurture" started to become part of the conversation. People started to move away from Freud's emphasis on sexuality, and bringing in other social or interpersonal issues. And then another, I think, main critique of Freud's work was it was all pathological oriented.

Tyson Conner  07:12

Right? And when pathological is like -- pathology is basically the study of sickness, the study of what goes wrong. So when we talk about something having a pathological focus, we mean that the theory as a whole was focused on what goes wrong, right? And later, theorists would argue that Freud's focus on what goes wrong in a person caused trouble, in that we didn't have a strong enough sense of what could go right in a person. So you saw everyone walking around as these little like broken people. But you didn't have a sense of what like, healthy, well, person looked like.

Carly Claney  07:50

Theories came of what that was: developmental models of what we could focus on to really encourage positive development. And then how do people change? How do people actually grow? And there was more thinking about that. And then I think the other real main thing was the changing of technique. 

Tyson Conner  08:09

Yeah. 

Carly Claney  08:09

Again, you might have seen this very classic psychoanalytic picture of someone laying on the couch, someone sitting behind, not really interacting, being very blank slate. Meaning just like not putting the therapist -- not putting anything into the relationship; which no one really practices like that I think anymore.

Tyson Conner  08:31

No, no. And I've seen people argue that Freud didn't really practice like that, either. That, like, a lot of the stereotype of that way of practicing was more from people who were trying to be the Freud that they read about, and less about how Freud actually showed up with people. But anyway, that's that's kind of a rabbit trail. 

Carly Claney  08:55

Yeah I think it's this false misnomer (however, you say that) this misnomer, that we can be blank with people. But when you're sitting in a room with someone, there's so much conversation that's happening, even if it's been unsaid.

Tyson Conner  09:08

Right, and the idea that a therapist could show up and not in some way participate in what's happening in therapy, that some of their personhood and particularity and specific things about them as a therapist wouldn't be relevant to the work? I think, for a little while, we tried to pretend like that was true. But going all the way back to Freud, even like Freud's first -- Freud had like a -- oh boy, listener. I'll try not to go too deep into this. This is something I can be a nerd about! Freud studied with a lot of different people and you might recognize some of those names. Carl Jung is kind of the big one that people probably know. But others in that group, Ferenczi in particular, were very aware of the therapist's personhood being really relevant to the work that was going on. And those kinds of conversations were happening in the world of people trying to do this kind of work. From the beginning. And, I'm a relationist, so I'm trying to claim the validity of relationship from the beginning. 

Carly Claney  10:14

Yeah. But as you bring up like, that's where a lot of this work started to go. The only other person I'll really like focus on/emphasize right here is Melanie Klein, bringing in Object Relations. Where the focus then really was on those early infant experiences. And how do infants interact/relate to themselves in their world as they're developing? And how influential that is for the rest of the lifespan, really.

Tyson Conner  10:44

Yeah. And Klein was a student of Freud. Freud, later on in his life moved to London, partially to get away from everything happening in the continent in the '30s. And Klein was one of his main students there. And she really brought in a lot of infant observation into how we do theory and how we think about things. And Object Relations as a group is called that because one of the things that they added to our understanding of the unconscious -- if Freud was like, 'What's in the unconscious are these drives these desires, these parts of you that want things' -- the Object Relations, people said, 'You know, there's a lot of different things in the unconscious, and some of them want things, but some of them are ways of thinking about the world,' or like, you know, 'How you imagined someone's going to respond to you.' And they were more complicated than these 'drives.' And so they started calling them 'objects.' So that's where that "object relations," -- and then those objects all interact in that unconscious space. Listener, everything. I mean -some people might disagree with me about this - but when it comes to understanding psychoanalytic theory, and a lot of these words and ideas we're throwing out, a lot of it really is metaphor. It's kind of like, I remember I was watching a YouTube video about a sommolier, who was talking about, like, the tasting notes that the sommelier will share with the with the client, right, who comes into the restaurant. And when they say things, like, "I'm getting notes of licorice and hickory," right? The sommelier said, "I'm not actually tasting licorice, there's no licorice in this." It's a metaphor for what it's like to drink this wine. And in the same way, a lot of psychoanalytic theory is a metaphor for something that's really hard to find language for. So when we talk about internal objects, please don't imagine that we think that there's like a part of you that's invisible with these little physical objects bouncing around like... It's not quite like that. It's more of a metaphor and some imagery and some language that we can use to try to communicate what we think is happening inside of a person on the other side of conscious thought.

Carly Claney  13:04

Yeah. Which, kind of jumping ahead, I think that's even part of the psychotherapeutic work that we do. How do we actually put words to things? Words are symbols, words are our attempt at trying to communicate really complex feelings and experiences and, again, these unconscious things that are happening. So I think that's a really good point. That's all a metaphor, really. 

Tyson Conner  13:31

Yeah. 

Carly Claney  13:31

So I think that's probably enough history. I mean things then went from there.

Tyson Conner  13:37

Yeah. I mean one thing that might be helpful to say is we're talking about Object Relations, because the way that we practice, relational psychoanalysis comes pretty directly from that. And that was the branch that made it over, largely, over to the US. 

Carly Claney  13:49

Yeah, good point. 

Tyson Conner  13:50

And, yes, things kept evolving. There's a bunch of different branches. We'll have other people on this podcast in the future. Clearly, I get excited about this stuff. But like those - Freud and Klein are kind of important to make sense of and to have a sense of, to understand kind of where we're coming from when we talk about psychoanalytic practice. 

Carly Claney  14:13

Yeah. And when you say that I should actually mention, I think, a lot of what I'm influenced by as well is Bowlby: attachment theory, ego and self psychology, you mentioned Jung earlier. So again, that's diffused into my way of thinking. So maybe I'm gonna start talking, you're like, that's about Klein. And I don't know. 

Tyson Conner  14:34

Yeah. And I'll even throw a little bit of Lacan in there, too, who was a French guy who said, "I never made anything new. I was just repeating what Freud said." Like in our conversation about language being a symbol, right? That's very much Lacan's whole thing. This world of psychoanalysis, listener, we can talk about these different branches, and they each kind of have stereotypes and if someone identifies with one branch more than another, then there might be some nuances. And I think part of what we're trying to communicate is that at the end of the day, psychoanalysis is both a very large world with a lot of different ways of thinking. And a pretty small world where there's a lot of cross pollination. Most people who practice this way have been exposed to ideas from all kinds of traditions. And we kind of all bring them together in how we practice.

Carly Claney  15:23

Yeah, I think that's a really good way to understand this difference between the psychoanalytic and psychodynamic terminology. I think of them both -- I'll start with psychoanalytic, I think of it both as like the most broad and also the most specific term. 

Tyson Conner  15:38

Help me there. What? 

Carly Claney  15:42

This is my opinion. 

Tyson Conner  15:43

Sure, sure. Sure. Yeah. 

Carly Claney  15:44

Broad in the sense that of what we're just saying, psychoanalytic is inclusive of all this history, all of the theories and influences from Freud. So I think anything within this tradition could really be considered psychoanalytic, but when we're talking about psychoanalysis, that is a very specific. So psychoanalysis is done by psychoanalysts: analysts who have been psychoanalytically trained in, usually an institute. I think always? Maybe?

Tyson Conner  16:15

I think so. 

Carly Claney  16:16

There's some gatekeeping there? 

Tyson Conner  16:18

 So to clarify, for the listeners, psychoanalysis is also the name of a specific form of treatment, which is different from psychotherapy. And if you practice psychoanalysis, there is no governing body that's gonna, like, take away your license or anything. But generally speaking, if someone claims to be a psychoanalyst then they have probably had a very specific kind of training at a psychoanalytic institute. That was after graduating, people, you know, they get their master's degree or their doctoral degrees, and THEN they do another four years of psychoanalytic training. And it's pretty intensive. And it's pretty similar to how Freud first started practicing. It's evolved a little bit, but a lot of it - it's very intense. It's very intense.

Carly Claney  17:06

Yeah. So I think that's where I get a little bit, "Okay, what are we talking about here?" Because, at Relational Psych, we don't have any analysts on staff. So we think psychoanalytically, we practice from a psychoanalytic lens. But honestly, I feel a little bit more comfortable sometimes saying that what we're doing is psychodynamic. Because it doesn't confuse that idea of what we're doing is psychoanalysis. And I think the other thing that psychodynamic brings into it is flexibility. There's integration of other personality theories. It is more flexible, too, on frequency and length  Againt psychoanalytic work tends to be really long term, usually multiple times a week, like three to four to five, whatever. Whereas psychodynamic, I think it's just got that flexible lens to it.

Tyson Conner  17:57

Yeah. And listener, if you're not aware, this is a current controversy in psychoanalysis - what's psychoanalytic versus psychodynamic. If you pay attention to the words themselves, generally, psychoanalysis is about analyzing a psyche, making sense of a mind, you come in multiple times a week, you talk about your dreams, you talk about your unconscious, you're getting deep in there. A psychodynamic approach, is aware of unconscious dynamics and makes use of them, but is usually a little bit less focused on like 'the analysis of it all,' explaining it all, getting deep in there. The dynamic approach accepts that, yeah, there's stuff that's moving and changing unconsciously, that I'm just not going to have time to settle on. And maybe we'll talk about it sort of from a distance, and understand that, like, we'd have to meet four times a week for six months before we could really unpack and make sense of what's happening.

Carly Claney  18:55

Yeah, I think that's helpful to think about, because a lot of this also has to do with what does the patient want? What does the client want? And I think, I don't know if I could claim that psychodynamic is more popular, but I think it is more digestible for most Americans, I'll say. And so I think it is more common to be practicing psychodynamically, even if you are thinking psychoanalytically.

Tyson Conner  19:19

Yes, and yeah, I agree. And like there there's nobody who's doing short term psychoanalysis. But like, short term, psychodynamic psychotherapy is something that people like practice and train in all the time. So yeah, psychodynamic is a lot more flexible.

Carly Claney  19:36

Yeah. So all that to say, we are going to use the words interchangeably.

Tyson Conner  19:45

If you are confused about that, don't worry. It doesn't really matter.

Carly Claney  19:48

That's more for the psychoanalytic police in our mind.

Tyson Conner  19:51

Yes, yes. And whichever ones might be listening.

Carly Claney  19:56

Yeah, so we've kind of talked about this, but just to reiterate the key feature is of what this type of work is. It's a strong focus, in my opinion, on discovering what we don't yet know about our thoughts, our emotions, our relationships, and our experience of our of our world and of ourselves. There's that point, again, about making what is so far unconscious conscious. There is... I think we're all focused in kind of this key feature that I really liked to highlight. In, again, my opinion, there's a lot of room in this approach to focus less on symptom management, and surface level change. And instead focus on really long term change, changing at the root of who we are. So really, by understanding all of these unconscious processes, we're actually able to increase our agency and live a life that we want to live. There's a lot of room for flourishing.

Tyson Conner  20:53

Yeah, I think that's probably the key distinction between a psychodynamic approach to psychotherapy, and a more behavioral approach. And those are kind of like the two big ones. There are others listener, but those are kind of the two main pillars, at least around here in Seattle. Is that a behavioral approach is interested in changing how you are in the world, changing how you behave, changing how you do things, changing how you think, maybe, reducing your symptoms, reducing distress, things like that. A psychodynamic approach is more interested in like changing who you are in the world. Not how but who. There was a - there's another podcast called Between Us -a psychotherapy podcast, which we'll talk about later. But in it, there's a theme that he comes back to - he's a psychotherapist around Seattle, who also practices psychodynamically - he talks about characterlogical change, characterlogical change meaning change of your character: change on a personality level. Like, it's not about making sure you stop doing that thing. It's about making sure that you can become the person you want to be in the world.

Carly Claney  22:10

Yeah. Yeah it seems so rich. I mean, it is so rich, it's so deep. And it really makes me think about how sometimes when we get started with someone, we say, 'it might get worse before it gets better.' I'm not anxious - I don't like it when my clients feel worse. But sometimes it's so needed to really dive into and go into the worst-ness of it, so that you can really understand it, and really, actually move through it rather than just trying to change it. Again, on that surface level of just, 'okay, I stopped doing that behavior,' or 'I stopped feeling anxious, because I avoided...' Whatever is going on in there. 

Tyson Conner  22:50

Yeah. A lot of times those things that we do to avoid feeling scary feelings that are causing us trouble. When we stop doing them, we start feeling those scary feelings again. And then we got to figure out what to do with that. And yeah, sometimes it gets worse before it gets better.

Carly Claney  23:09

Yeah, so I mean, we're talking a little bit about what it is. But I think it's also helpful to think about what it looks like. 

Tyson Conner  23:15

Sure, yeah. 

Carly Claney  23:16

So it is a process and you referenced a little bit about the behavioral approaches, those tend to be manualized, meaning there is a specific manual that has been created for the treatment that is then followed for the treatment. Literally a book -- that can be flexible, but it's usually a book. And this is not that. It is a lot more... sometimes non-directive, there's not a specific way you should always do every part of it. And it's talking, usually what's called free associating when talking about whatever comes to mind, to be able to even see what it is that there is to work on. 

Tyson Conner  24:00

Yeah. 

Carly Claney  24:02

There's also a strong value in understanding that there's nothing off the table. So you can literally talk about anything and we want you to. We want you to talk about money, and sex, and your relationship with your therapist and big emotions and things that you've never said before, and things that you've never thought before and everything is encouraged. Yes!

Tyson Conner  24:22

And things that you've said 100 times before and things that you've said in therapy 100 times before. This goes back to Freud, what he called The Ethic of Honesty, right? And his idea with all this stuff, and the reason why we free associate and say nothing's off the table, is that the idea is that whatever is coming to your mind does so for a reason. And if we're curious about the non-conscious reasons that you might be talking about things, then we can pay attention to what might be happening on that deeper level. And also, I'm very aware as a therapist that like we ask people to be very vulnerable with us. Right? If it takes some time for you to say the thing that's on your mind, that's okay. Like it can take years before you're ready to say that thought that you had in session one. That's all right, all of the things preventing you from feeling safe enough to talk about that thing are also what we're interested in. It's all about the process.

Carly Claney  24:51

Yeah. And we don't want to just arrive at that moment when you can say that thing. Like, we don't want to arrive five years in the future, six months or whatever. We really are curious about each step of it. And I think there is value in going through all of those different layers in the relationship and in your relationship with yourself. Like there's such -- it's so good to do all of those things.

Tyson Conner  25:50

Yeah. And with this idea of 'it all being part of the process' is that one of the advantages of what they call the 'relational turn' in psychoanalysis, is that, like, if you have conflict with your therapist, if you feel judged by your therapist, if you feel aggressive towards your therapist, talking about that, and working through it together, can be really helpful and really healing and really transformative. And that's always been true, but the the relational movement is about acknowledging that that's always been true. And then being really thoughtful about like, 'Okay, if this is what does it like... If we're going to have conflicts, if we're going to have ruptures, how do we as therapists actually engage with that in a way that's helpful and meaningful?' Our goal is not to make you feel bad, but you're probably going to feel bad with us. So what do we do when that happens? 

Carly Claney  26:51

Yes. How can we be with you in it? And I think that goes the same for ruptures as well as terminations. Ending? I think it's so common to just peace out. And like, if you need to, that's fine. And yet, if you're able to do that piece of work, the termination process, it can be the most valuable process of the entire piece of work. So yeah, there's so much richness in that relationship,

Tyson Conner  27:17

Research about storytelling, and how people process stories has shown that the way that a story ends, will color and impact someone's experience of the entire story. I think most people have probably seen a movie with like a slightly rushed or strange ending, right? Like something happened there. And then it kind of sours you on the whole thing. Alternatively, I'm sure we've all like read books, or watched movies or seen plays that had like incredible endings, that just wraps it all up and makes it feel like oh, so good. And then our opinion of the whole thing changes, right? Endings are important. And I think that this approach to therapy, part of why it's so powerful, is because everything we do we do on purpose, including ending, we try to end on purpose. And I've had experiences with clients where the ending - the termination phase as they call it in the articles - has been the some of the best work that we got done was because we knew we were coming to an end. And that was important.

Carly Claney  28:19

Yeah. Yeah, I think it's, it's incredible work.

Tyson Conner  28:23

So how does it help? What does do? Pitch it to me, Carly! Now I understand it, why is it any good?

Carly Claney  28:33

Well, I'm gonna borrow from another author who wrote this down so that I had a list. Nancy McWilliams is an incredible writer. And she's very accessible, at least for clinicians, like, I'm sure she could be accessible for anybody. But she writes for therapists. And I'm taking this from her book, Psychoanalytic Case Formulation. 

Tyson Conner  28:58

Check the show notes, listener.

Carly Claney  29:00

She literally had a list of like goals. I think they were in chapters or something. And I want to walk through them if we have the time. So the first one is symptom relief. And I really love that she has this first because I feel like she's pushing back on me when I'm like, "It's not all about symptom relief." And she's like, "Yes, yes, it is. In part." We want you to feel better.

Tyson Conner  29:22

Yeah. And I feel like that's something that can be tricky in the world of psychoanalysis to talk about, but like, people come in, usually, because they want symptom relief. Every now and then you get someone who comes in who's like, "I just want to understand myself better," right? But most people come to therapy because they feel bad about something. They want to feel better. And like, I mean Freud get started as a doctor, people came to him saying, "I broke" and Freud said "I fix" right? Like, we've evolved a little since then. But that's still at the core about what we're here for. On some level. Even if it does get worse first.

Carly Claney  29:57

Yeah. And I think that's the only caveat. It's like, to really engage with this kind of work, I think that can't be the only thing you want. If that's the main focus, I think there's plenty of other therapies that really do that really well. And it might not last forever, but it will help you in the time of need. And that is totally fine.

Tyson Conner  30:16

Yes, we are not exclusive to psychoanalysis as the only good therapy. Like there are other great therapies that do -- some of them do symptom reduction way better than psychoanalysis does -- and we think that psychoanalysis does an awful lot of other good things that we really like. Like?

Carly Claney  30:40

Increased insight. So I mean, this shouldn't be a surprise, insight about yourself, insight about your world, insight about your in intrapsychic: so how you experience yourself. 'Intra' being within yourself. Interpersonal dynamics: between you and others. Insight about what the hell happened in your childhood? Why do you get mad when this thing happens? Like just insight across the board.

Tyson Conner  31:09

Yeah, just deeper understanding of yourself. And I want to -- now might be a good time to dial down on some words. You used intra psychic, right? And, like, listener, you might be noticing this word "psych" keeps coming up, right? Where does that come from? What's that about? Well, I think, did Freud choose the language of psychology? Or was that around the first? 

Carly Claney  31:30

I have no idea.

Tyson Conner  31:30

I don't know. He chose the word psychoanalysis. And maybe psychology as an independent thing had been around before then? I don't know. I know I've heard people chalk it up to him. But people also tend to say, "Yeah, Freud did stuff," even though there was a bunch of stuff happening around him. And he just picked up on current trends. Anyway, point being, that word psyche is from Latin - or Greek? It's from Greek, and it means soul. It means spirit. And I say that, not to like, freak you out and be like, 'yeah, it's a cult,' because it's not. But because, I think, what a lot of Greek philosophers were talking about when they talked about "spirit," right? Because the Greeks had this whole three part person idea of the like, the appetite, the reason, and then the spirit. That's Aristotle, I think. When they talked about spirit, what they meant was, the part of a person, that's them, right? They were talking about personality, they were talking about values, they were talking about all of this unconscious stuff that Freud was interested in. And so when we talk about intrapsychic, we're talking about the stuff inside of your spirit, and like the depth of your being. It's kind of out of fashion, but for a while, people talked about psychological work as soul care, right, as a society, we become less and less religious over time. So these like, ways of speaking that make overt references to spirituality have fallen out of favor, and like, that's, that's all around probably a good thing. We're more pluralistic as a result. And I do think that there's some nuances to those ideas, that can really inform - someone who's interested in psychoanalysis is someone who is interested in that 'spirit' of you; we don't call it a spirit, we don't necessarily all think that, that part of you goes to heaven or hell or whatever. But that it is something that is hard to put a finger on, that is definitely a big part of you. And that is important, and that we care about. And so when you hear us using words like psychoanalysis, we mean, the analysis and examination of that part of a person. When we talk about intrapsychic, we mean the bits inside of that part of you. I feel like that's important to keep in mind.

Carly Claney  33:56

Yeah. And that makes me think to you, it's not on her list, which I'm actually interested by, but maybe it's included in another point. But the existential ideas - I think that's maybe more of a contemporary idea, a lot of what you just spoke to, but I think it's also like, we exist, to whatever extent you understand that to mean, and there's a lot of these existential ideas of wrestling with that idea of your existence. And I think that's a level of insight that you can gain about yourself in the world.

Tyson Conner  34:28

Making sense of what's happened to you and making sense of the fact that you even exist.

Carly Claney  34:33

In this particular world. 

Tyson Conner  34:34

And in this way, and with this story and this body. 

Carly Claney  34:39

Yeah, the embodiment piece too. Moving to number three: agency. So we talked about this a little bit before, but a greater sense of agency in your world. So I think this really comes by when you're able to have a greater sense of consciousness about the way that you go about living. You can interrupt the past and really just stop unwanted, repeating past cycles, you can create a better future for yourself potentially. Or at the very least, we'll talk about this a little bit later, but have a capacity - increase your capacity for how you're going to go about living.

Tyson Conner  35:20

Yeah, yeah, I like to use this example when I'm talking to new clients about the idea of the unconscious. And what happens when we think about things more consciously, like breathing right? Most of the time breathing is unconscious, we don't think about it, we do it. And now that I've mentioned it, you, listener, are probably conscious of your breathing. Which on the one hand, is annoying, because now you're thinking about breathing in and out. And on the other hand, being conscious of your breathing means, if you wanted to sing very loudly, you could do so; you could take a deep breath in and sing very loudly, because you took control of a usually unconscious process. A lot of the unconscious things that people do, can get a lot more complicated than breathing. But if you find yourself in certain situations, constantly responding in certain ways without thinking about it, developing insight, and developing agency means understanding, "Oh, I'm going to have an impulse to respond in this way. And I'm going to not do it." Like if you are learning how to swim, and you dive underwater, and your first impulse is to scream and lose all the air in your lungs, right? Choosing instead to hold it in so that you can make use of that oxygen, right? That's the analogy. And it gets complicated later on.

Carly Claney  36:44

Yeah, and I've actually heard you say this before. So I'll quote you back to you. You brought up the idea of control. And I think it's a really important thing to differentiate control from agency, I think you said something like, and correct me if I'm wrong, we don't ever have control over our environment or our life. No one has control. But we can have agency over how we interact with it and how we respond.

Tyson Conner  37:09

We can choose how to respond, right? I can choose to get up when my alarm goes off, and get dressed and go to work in the morning. I can't control whether or not my bus breaks down on the way into work. That's the limit of control. But I have the agency to say "I'm going to work."

Carly Claney  37:25

And that will flex for people for all different reasons. Some people don't have that sense of agency of getting up when their alarm goes off. That's just the variations of people.

Tyson Conner  37:38

If I'm severely depressed, the alarm going off might just be a reminder that it's another day, and I might not have the ability to choose to get out of bed because my depression has just weighed that heavily on me. 

Carly Claney  37:51

Then the next in her list - again, these are goals of what to hope for from psychoanalytic therapy - is identity. And I think we've kind of talked about this already before. But I when I think about identity, I think about 'Who are you? What are the different pieces that make you up?' Sometimes that's values, sometimes that's an integration of your identity factors, whether that's demographic or cultural, or your sexuality or your faith? Or where did you grow up? Like those kinds of things. What else would you want to say about identity?

Tyson Conner  38:32

Gosh, honestly, I just want to tell people like watch this space, because we're going to be having an episode coming out soon, hopefully, with a local psychoanalyst Brian Pendergast, who's written an entire book on this idea on what he calls Multiplicity of Self. So like, we're gonna dive into that in that interview. Because yeah, having access to all those different parts of yourself, and acceptance of all those different parts of yourself, is like - some people call it integration. Right? Dan Siegel talks about it in terms of integration there. I'm referencing Dan Siegel again, for those of you keeping track at home. But there's just a lot of good stuff that comes from having access and understanding and acceptance of all those different parts of a person. 

Carly Claney  39:25

You're kind of alluding to this, but I'll jump down to the idea of ego strength and self cohesion. So do you want to define ego for us? 

Tyson Conner  39:33

Sure! Yeah. So in pop culture, ego is usually meant to mean narcissism. If someone has a big ego, they're really narcissistic. If someone's feeding their ego then they're trying to feel important or powerful or grandiose or something. In psychoanalysis, ego is a sense of cohesive self. Interestingly, going back to Freud, Freud came up with the categories of id ego and super ego And that those categories, those labels were a decision that translators made later. He didn't use Latin, he used his native German, he called the id the 'it' the 'thing,' he called the super ego, the 'above me,' 'the thing in control of me,' 'the thing with authority over me.' And the ego was just the 'I,' the "ich" the 'self.' So in psychoanalysis, when we talk about ego, we're referring to that bit of a person that knows who it is. That's self aware.

Carly Claney  40:27

Yeah, yeah. So when we're talking about ego strength, it's like that increased awareness of being a self, creating that self cohesion amongst the self. And also honoring that there's multiple ways of being, you can be a sad self, and then a happy self, and then a whatever else self, like there's there's variability and how we can show up and be.

Tyson Conner  40:58

Yeah, the ego is also the parts of us that can act, that is most conscious, that can make decisions. In a classical Freudian sense, and I think in a lot of modern understandings, too,

Carly Claney  41:09

Yeah. And that kind of goes hand in hand with increased self esteem. So I think when you know yourself, you can have more capacity to like yourself. Sometimes it also brings on really intense self hatred, and shame and things that tend to actually also be worked through in therapy. But I think when you really get to understand the why you are the way you are, and oftentimes, then grieve through some things that aren't the way you wish that they could be - or that they were -then there's more room to actually be with yourself and enjoy that. 

Tyson Conner  41:48

Yeah, absolutely. 

Carly Claney  41:51

And again, that goes hand in hand with recognizing and handling feelings. So having an increased capacity to feel, having -- I think of it oftentimes is like an increased range. That if we're so afraid of feeling the bad feelings, sometimes we just kind of stay in this really small range of 'kind of happy.' But then once you start to kind of expand and have greater tolerance and capacity for that flexibility of emotional responding, then you can feel rage, and you can feel despair. And you can feel peace and joy and giddiness and excitement, all the things.

Tyson Conner  42:25

In the research around this stuff, they don't use the language of feelings or emotion, they use the language of an 'affect,' right? That's the word that the neuroscientists use, and that we use a lot too. Because it's not just like, 'I feel happy.' It's also like, 'I feel happy and light in my chest, and my voice raises in its pitch' like it's the whole body. Right? That's part of why we use that word. And there's also technical reasons why. But point being, in a lot of other forms of doing therapy, they talk about the goal of 'affect tolerance,' right? The idea is that affect, strong affect, strong feeling is a lot, it's a whole body experience. And sometimes it's overwhelming. And you'll see this a lot with little kids, right? If you get a little kid who's too excited about something, they get too, like, stoked, they might start to cry, and then they'll feel embarrassed, and they'll feel confused. And then that, like excitement turns into just a meltdown, right? The affect was too much, they could not tolerate it. And so one of the goals is to be able to hold yourself together, to not fall apart when you have big affect, regardless of what it's about. Regardless of if it's happy or sad, or scary or anxious or whatever else.

Carly Claney  42:29

Yeah. And that's where I like the idea of of increased capacity because it doesn't mean that the feeling necessarily has to get smaller, but we grow around it, we can get a bigger container to hold all of that feeling.

Tyson Conner  44:00

Yeah, yeah.

Carly Claney  44:03

Last few, so there's pleasure and serenity, which I don't want to like jump over but I feel like we've kind of like spoken to that enough.

Tyson Conner  44:10

Yeah, it connects to that that existential stuff. Like an integrated sense of self to, again borrow Dan Siegel's kind of categories, is more at peace. 

Carly Claney  44:22

Yep. And I think that goes hand in hand a little bit with love, work, and mature dependency. I'm sure she unpacks that a lot more in the book. I don't have the notes about it. But I think that really speaks to like how you can improve your relationships. And what I believe, I mean, I literally think that therapy can change the world. So the work that you do or that I do, I'm talking to you, client, you listener, the work that you do in therapy, like it's the most important investment that you could ever make for yourself, but also for the people around you. It can have an incredible impact on your relationships. For you, again, but also like for the systems that you're engaging with. To be well and to have more of that interrelatedness and increased love. So I think it can be pretty great.

Tyson Conner  45:14

Yeah. And I think if I can unpack a little bit the categories of love, work, and mature dependency slightly, because I could imagine how some of those words might make a listener go 'what?' So by love, we mean attachment, we mean not just romantic love, although that's part of it. But even Freud said - Gosh, going back to Freud - love is the cure, right? That's something that was felt from the beginning that like, something about this process is important about how human beings care for and about and to one another. And to increase capacity for love and have access to love is one of the goals of this treatment. Similarly, by work, this feels especially relevant given like the current political moment, but work means meaningful activity. Right? Freud said that work was a necessary thing for a person to be well in the world. And what we mean by that isn't, 'you need to go out and make a job that makes a certain salary.' What we mean is, you need to put your efforts into something and those efforts need to feel like they matter. And if they matter to you, that's what's important. Right? There are lots of people whose work is caring for children, or whose work is volunteer work that they do or creating art. School kids are a great example. A lot of school kids don't care at all about their homework, but they still do a lot of work. And a lot of times it's art or learning how to skateboard or like playing an instrument.

Carly Claney  46:48

Or even just developing. 

Tyson Conner  46:53

Yeah, actually. Building healthy relationships, right? Work, separate from the economic realities, is about finding meaningful activities that matter to you, that you're invested in and care about. And mature dependence is an important word, another fancy way of saying that might be 'healthy interdependence.' Right? As opposed to codependence. People hear the word dependence? And they might think, "What do you mean by that? I'm independent." That's what we value as a western society is independence. And one of the things that we accept as relational psychoanalytic thinkers is that like, "No." No one is an island or an asteroid or a moon floating out in space, with no connection to any other person. Right? Like, we do need one another. The question is, how can we live with that? And also make sure that our needs are healthy and mature, communicated clearly and well? And met clearly and healthily? That's what mature dependence means. It's not about saying like, 'yes, you need to rely on your therapist.' You know, Winnicott who we didn't talk about today, once said, psychoanalysis is no way of life. Eventually, we want our clients to forget us and move on. And he meant something there specifically, he said, please don't forget about me, I want to be remembered. But we don't want people to become dependent on us. But we want people to have healthy dependencies in their life.

Carly Claney  48:31

Yeah. I will explore that more. I agree with that. And yet, there's a way that I think in order to get there, sometimes the need is to be dependent. So I also want to caution us against, like if you're having that sense of like, 'I do need my therapy, or I do need my therapist.' I think that sense of that draw toward it isn't what we're talking about in this like, landing spot. And I think that can look different too.

Tyson Conner  48:59

Yeah, I agree. And that ties to something we didn't really go into too much in this episode - that psychoanalysis is a developmental theory. So a lot of times, we are trying to help people go through developmental processes. And that might mean that you are very dependent for a little while. And that's okay. And by being dependent for a little while, you learn how to be independent. Right? And just hearing that, listener, I hope you can understand why we often think about and talk about experiences of infancy, because so much development happens then, because people are dependent physically, not just emotionally. 

Carly Claney  49:37

Yeah. And I also think that that kind of ties back to like that idea of this being more of a focus on wellbeing and development and all that. Because you could be in therapy for a very long time because you're kind of moving through so many different things. And thinking of it not as -again, this particular type of therapy, psychoanalytic work - it's not bad if you're still in it. it's not a failing that you're not 'graduated' yet, which I get tired of hearing that mentality from other therapists who don't think in this particular way. That they're - in a good way - they're wanting to kick their clients out. That's the feeling I get sometimes. And I just don't feel that because I think there's so many pieces of the work to do if the client is wanting to do it, and if the relationship can handle it. So I think that it's part of wellness and even preventative care at that point.

Tyson Conner  50:30

Yeah, I agree. And that's part of the complexity of this work. Is that like, the longer timescale is deeply valuable, I think, and doesn't really fit with the way that a lot of other ways of thinking about this kind of psychotherapy. So conflicts with the broader culture.

Carly Claney  50:53

So one thing that you can do as like our little experiment that we add in, sometimes at the end, I would encourage people, listeners to explore - everything we just talked about - how if you were to invest in your own therapy in this way, if you were to seek those kinds of goals that we just talked about, if you could honestly even dream that those things could be for you - which I think is even a risk to even allow yourself to consider having agency over your life or dreaming about a future for yourself, sometimes that can be really hard -- Well, I guess that's the point. Do that. Dream about a future. Dream about a life that you actually like yourself, that you have healthy relationships, that your capacity for emotions, is that you actually understand - when you feel something you kind of understand where it's located inside of you - and also, if you could imagine how that kind of investment that you could do in yourself, could do these ripple effects in your life. Not that that's the main purpose, I think it is a self oriented focus, usually, but how could it impact your relationship or if you're a parent, or if you are even a child and you're the only person who's done therapy in your family? How is that going to have these ripple effects in your family and your friendships, in your work relationships? Again, not to be cheesy, but how could you change the world by investing in yourself in this way?

Tyson Conner  52:27

Yeah, and if I'll add an addendum to that, listener, if you're in therapy, and you do this imaginative experiment, bring it to your therapist, because especially if they're psychoanalytic, or psychodynamic, you've just described your treatment goals. That's it right there, because when we talk about therapy changing the world - at the very least, it will change yours. And if you can imagine an image of what that world looks like? Oh, man, if you're my client, take this as homework. I don't assign homework. This is good. Great, thanks for coming on. I think this is delightful. This is good times. And you'll be back.

Carly Claney  53:11

I'll be excited to come back. Thank you.

Tyson Conner  53:16

Special thanks to Dr. Carly Claney. Dr. Claney can be found at Relational Psych. We have a number of options for further learning for you today, listener, if you're interested in learning more about psychodynamic psychotherapy or psychoanalytic theory. Here's some good places to start: if you're interested in the more accessible, applied psychoanalysis kind of ideas, the TV show In Treatment on HBO is about a psychoanalytic psychotherapist in his practice. It's highly dramatized, not super realistic, like a lot of TV therapy, but it is pretty psychodynamic. The second thing is a podcast called Shrink the Box by Something Else Productions. It's a show where a TV presenter and analytically informed psychotherapist, psychoanalyze characters from popular television. They've done episodes on Walter White, or Tony Soprano. And you can kind of see how a psychodynamic therapist might try to think about and make sense of how a person behaves and lives their life. Another podcast we have is Between Us, a psychotherapy podcast by local Seattle therapist John Totten, where he interviews therapists, psychoanalysts and talks about the work of doing therapy and all sorts of topics within that. For books, we've got Freud and Beyond by Steven Mitchell, which is a really great introductory text to psychoanalysis. It covers the history, theoretical development... it's a really good introductory text and a common textbook for people who are interested in getting started with this sort of thing. And finally, Psychoanalytic Case Formulation by Nancy McWilliams - that's the book that Carly referenced earlier and pulled that list of the goals of psychodynamic psychotherapy from -- McWilliams writes a lot of lovely books and they're all really accessible to read and very well cited and just, she's an incredible writer. So, if you are interested in these sorts of things, you've got a lot of options there. Links in the show notes.  The Relational Psych Podcast is a production of Relational Psych, a mental health clinic providing depth oriented psychotherapy and psychological testing in person in Seattle and virtually throughout Washington state. If you are interested in psychotherapy or psychological testing for yourself or a family member, links to our contact information are in the show notes. If you're a psychotherapist and would like to be a guest on the show or a listener with a suggestion for someone you'd like us to interview, you can contact me at podcast@Relational Psych.group. The Relational Psych podcast is hosted and produced by me, Tyson Conner, Carly Claney is our executive producer with technical support by Sam Claney and Ally Raye. Our music is by Ben Lewis. We love you buddy. Great, that's it. 

Carly Claney  56:26

Did it record?

Tyson Conner  56:28

Yes. It recorded the whole time.

Carly Claney  56:30

(Sigh of relief)

Further Learning

In Treatment on HBO Max

Shrink the Box by Something Else Productions

Between Us: A Psychotherapy Podcast by John Totten & Mason Neely

Freud and Beyond by Stephen Mitchell

Psychoanalytic Case Formulation by Nancy McWilliams