Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for October, 2020

Free Association

Posted by Dr. Vollmer on October 5, 2020

PsychoAnnalsMonday, October 5th, 2020
6:00 to 7:30 PM pacific
discussing Henry Lothane’s “Free Association as the Foundation of the Psychoanalytic Method and Psychoanalysis as a Historical Science”with Shirah Vollmer, M.D., Clinical Professor of Psychiatry

Aiming to spark a new conversation on psychodynamic ideas and their relevance to psychiatry today. 
All are welcome!
Image: Miró’s Femme et Oiseau dans la Nuit, 1947

Tonight…is a zoom journal club…and I am very excited to be the discussant.

I will begin with this quote from Charles McNulty in the LA Times on 10/3/20…

“Narrative is humanity’s defense against the randomness of existence. We tell ourselves stories not to sink into chaos. Would-be authors of our time on Earth, we impose order onto our lives by drawing connections between events, underscoring thematic trends, fleshing out character psychology and shoehorning our years into plots with beginnings, middles and ends.”

How we form the narrative of our lives has a lot to do with our mental health and our mental well being.

To improve mental well-being free association helps us to understand how we verbally construct our lives and in so doing it helps us to see the pivotal points of our lives. Free association is used to help understand dreams, day-dreams, hallucination, delusions and enactments.

Associating means to link a thought or a feeling with another. This involves memory, both conscious and unconscious, as well as imagination and emotion. In other words words are the essential tool of mental treatment. Freud said “the magic of words can remove the symptoms of illness.”

Free association recreates a “drama” meaning there is character, conflict and crisis. Freud said that as we encourage patients to free associate, we learn that they are “unfree” in that the associations are determined by unconscious material.

The therapist simultaneously free associates or as Freud said “While I am listening to the patient, I too, give myself over the current of my unconscious thoughts.”

Freud famously directed patients to “say whatever goes through your mind. Act as though…you were a traveler sitting next to a window in a railway carriage and describing to someone inside the carriage the changing view which you see outside. “

Dr. Lothane states “The analytic listener visualizes the images evoked in him by the patient’s words, not unlike a reader of a novel visualizes in his thoughts the scenes described by the novelist…The analytic listener relives them vicariously.”

Words are nodal points of numerous ideas such that they represent condensation and disguise of underlying processes. Symptoms therefore are determined by how words are representing distress or as Breuer and Freud stated in 1895 words are “nodal points at which two or more threads meet and thereafter proceed as one…such that a symptom is determined in several ways is overdetermined.”

Free association is the beginning of a long-term search for the history of a lifetime. Starting from the initial fragments, a person’s biography unfolds in countless free associative and cognitive communications and “yielding a picture of the patient’s forgotten years.”

In summary, an analyst and patient are a team, working together to heal the patient’s suffering by re-examine the history of their live with free associations. And there is no end to telling stories about one’s life. As Dr. Lothane says “there is no end to history and interpretations of history.”

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