Anna Freud, her Father, and Gay Conversion Therapy

by Anne Ihnen

I came across a post in the Ms. Magazine blog today, about Rebecca Coffey’s 2014 debut novel, Hysterical: Anna Freud’s Story. Based on historical accounts, it tells the story of Anna’s analysis by her father, Sigmund Freud, which included attempts to “cure” her lesbian tendencies.

According to Coffey, the analysis actually happened. At the time, Sigmund was universally acknowledged as the leading expert on sexuality, and he considered lesbianism to be a highway to mental illness that, fortunately, was curable by psychoanalysis.

This sounds like a fascinating and entertaining read – a glimpse into an early attempt to treat homosexuality as a disease (an idea that has been soundly debunked) along with an exploration of the questionable ethics of working on sexual transference with one’s own daughter.

It’s an especially timely read, too, with many US cities and states banning gay conversion therapy and a woman being chosen as the democratic party’s candidate for president.

I am definitely adding this one to my reading list!

“Therapy Wars”: Some thoughts about current psychotherapies

by Judy Koven

In Therapy Wars: the Revenge of Freud (theguardian.com, January 7, 2016), Oliver Burkeman details the shake-up caused by recent research challenging the assumption of the superiority of cognitive behavior therapy (CBT). He cites several examples, including Norwegian research that found that the effects of CBT wore off over time, a large British National Health Service study that found an 18-month course of psychoanalysis more effective than CBT, and a Swedish media report that auditors there revealed expensive investment in a CBT methodology to be ineffective.

For the first time in years, the primacy of this modality is being questioned. Neuroscience discoveries support the idea that the brain processes and integrates information more quickly than we’re consciously aware of; this suggests that not everything can be known and measured quantitatively.

Because CBT is a quantitative approach that treats symptoms, it’s easily measurable. For example, you can keep a journal of your negative thoughts and episodes of physical symptoms of anxiety and measure your progress by looking at changes after you’ve cognitively reframed a thought or applied a behavioral technique. It’s much harder to assess changes such as an increase in one’s internal experience of self-satisfaction or healthy engagement with the world.

It would seem that fewer psychoanalysts, at least here in the western US, still practice in a classic Freudian mode. Analysis has blossomed in many directions, and the emphasis has shifted to other ways of understanding our psyches. The psychodynamic therapists I know focus on the connection between mind and body, “relational” work using the therapy relationship as a framework for exploring our experience of self and other, and the various ways our early life experiences impact our attachment styles. I don’t hear anyone talking about penis envy or such.

We live in a culture that values quick fixes, easy results, and action, and we are more comfortable doing than being. I think CBT speaks to that habit. Exploring and understanding the underpinnings of what makes us tick seems a more lasting approach to how we express our difficulties, but it’s work that can unfold slowly. That being said, I think CBT and related approaches have a real place in the healing modalities. For some people, it’s all they want or can tolerate. And what’s wrong with finding tools to manage or alleviate emotional distress? I just don’t think it’s the panacea that our medical, academic and health insurance systems seem to think it is.

Here’s what psychiatrist Jerome Frank (“Case Study”, Psychotherapy Networker November/December 2015) lists as the essentials for therapeutic success:
• Confiding relationship with a helping person
• Healing setting
• A rationale or mythology that accounts for the client’s symptoms
• Plan that both client and therapist believe can work

These ring true to me and I think argue for no one method being the magic pill. That’s why Women’s Therapy Referral Service emphasizes goodness of fit and congruence of values.

Niche Market Therapy?

A story in the February 7 New York Times Style section highlights the relatively recent phenomenon of therapists gearing their practice to a specialized, and sometimes narrow, demographic, e.g. LGBTQ clients, newly married clients, or those in the tech industry, the last especially prevalent in urban centers such as Silicon Valley and metro Seattle.

The piece concludes, though, with what we in the therapy field have long known, that the crux of successful therapy is the power of the healing relationship between therapist and client.

For College Students, Anxiety Trumps Depression

by Judy Koven

According to an article in the June 2 New York Times, anxiety has overtaken depression as the most common mental health diagnosis of college students. Apparently, “mounting academic pressure at earlier ages, overprotective parents, and compulsive engagement with social media” are among the reasons college students seek counseling for intense and overwhelming anxiety.

This is consistent with our experience at Women’s Therapy Referral Service–in the last several years, more clients seeking therapy, typically women in their 20s-40s, come in with complaints of stress, anxiety, and panic attacks. Depression is now mentioned less often as the primary concern.

Emotions: the feminine advantage

by Martha Reynolds

A recent op-ed piece in the Sunday New York Times caught my attention. Although psychiatrist Julie Holland could say more about the benefits of medication for so many, what she does say is quite convincing. Namely, that having a full range of affect and emotions is vital for a healthy existence, particularly for women who have been subjugated far too long for their emotionality.

One more body part

by Judy Koven

I enjoyed reading a breezy but to-the-point piece in The New York Times Opinion section, 2/15/15,Great! Another Thing to Hate About Ourselves.

Just when we women thought we knew all the things that we could “fix” about our bodies, this essay clues us in to the latest “… body part for women to prune and police.”

For anyone who’s struggled with how she feels about her body, this essay speaks to the nearly constant pressure in our culture to attain unrealistic, even questionable beauty norms, and it does it in a humorous way, reminding us of the ridiculousness of it all.