Shirah Vollmer MD

The Musings of Dr. Vollmer

Psychotherapy As A Chess Game

Posted by Dr. Vollmer on October 2, 2013

“Anyone who hopes to learn the noble game of chess from books will soon discover that only the openings and end-games admit of an exhaustive systematic presentation and that the infinite variety of moves which develop after the opening defy any such description. this gap in instruction can only be filled by a diligent study of games fought out by masters. The rules which can be laid down for the practice of psycho-analytic treatment are subject to similar limitations.” S. Freud, “On Beginning The Treatment” SE (Standard Edition) 1913.

Psychotherapy, psychoanalysis, cannot be taught, so says Dr. Freud, the founder of psychoanalysis. A century later, this quote rings true. The paradox of teaching psychoanalytic technique, knowing that technique cannot be taught, is one of the many ironies in the field. How do students come to learn something that cannot be explained? Freud said it was like chess, where one has to play over and over again, in order to understand the complexities of the game, but I think it is more like art school, where there is an art salon to talk about impressions, ideas and free associations to the material. This parallel process to psychotherapy is the value of psycho-therapeutic, or psychoanalytic education. In other words, the classroom is the petri dish which allows for things to grow, with the reminder that as ideas come to mind during class, so ideas also come to mind during psychotherapy. Sure, I have talking points. I am going to discuss transference, the fundamental rule, the dose, tact and timing of an interpretation, but mostly I am going to spearhead a discussion about how to be a therapist: how to allow the patient to feel free enough to say things that may cause psychological pain and distress. The operative word is “allow” as the patient decides when and how she discloses her ideas, but the environment gives her the freedom to do that. The patient has the resistance to feeling their inner pain, and as such, the environment, the consultation room needs to gently diminish those resistance so that a patient can experience the world without  her self-imposed constraints.

“I am really happy,” Leah, age thirty, tells me as she cries and grabs more tissues. “You do not look happy,” I say, pointing out this disparity. “Maybe you want to be happy,” suggesting that she is speaking in wishes, as opposed to representing her internal experience. “I guess I am just not ready to go there,” Leah says,,  implying that she understands that she has pain, but she would rather stick with her position that she is happy. “Being ready is important,” I say, agreeing that timing is critical to psychotherapy. Leah leaves expressing gratitude, unsure about whether to make another appointment. How do you teach this process? Each exchange is a new experience. Knowing that it is not teachable, is how we will begin.

6 Responses to “Psychotherapy As A Chess Game”

  1. Ashana M said

    You have some very strange ideas about art school.

  2. Shelly said

    Sometimes the patient and therapist relationship isn’t always a happy one. Sometimes the patient doesn’t trust the therapist. Sometimes the therapist draws out the worst from the patient and the patient doesn’t want to reveal things to the therapist. Sometimes the patient is assigned to the therapist by the courts or other authorities and the patient is there under duress. For these reasons and others, the free flow of information is prevented. Until trust and rapport is built, the exchange of information cannot be given.

    • Ashana M said

      And sometimes being happy makes you sad.

      • Sad for all the times when you were not happy?

        • Ashana M said

          That could be the case for Leah. But I was really thinking about joyous occasions when people cry. Generally, feelings are often complex and mixed, and sometimes we cry not because we’re sad, but because the mixture is so intense or confusing. Crying seems to be an all-purpose response to overload, rather than a specific expression of sadness. Some people cry when they’re angry, others cry when they’re very happy, some cry with relief.

    • Yes! The time to develop trust is critical to the relationship, and, as you know, my concern is that with “brief” therapeutic interventions, this trust cannot be built, and hence the utility of the therapy is severely limited.

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