On Free Association
Free association means the patient speaks freely of whatever is on their mind, trying not to edit or hold back. While the concept is easy, it is usually very difficult to reduce inhibition, and, of course, it is impossible to free associate without consciously or unconsciously editing somewhat. The good news is as long as you are willing to try, there is no right or wrong in free association. If you don’t know what to say, great news; that’s something to talk about! My job is to show up without judgement or my own agenda and propose questions that may serve to identify potential patterns, emotions, motivations, values, and ways of relating to myself and others that might have previously been unconscious, or poorly understood. My observations are made with complete humility; I may be very wrong; in fact much of the time I don’t get it quite right; humans are complex, and only you can get to accurately know the inner you. The goal of free association and my emersion in it with you, is to bring different possibilities to life, so you can understand what might be happening outside your awareness. The goal is to say unsayable things within a safe and compassionate container.
What Should I Expect?
Therapy starts wherever you are at. The goals are determined by you, for you. Generally, a first session starts with these basic questions: What brings you to therapy? Why now? What are your personal expectations? What questions or concerns do you have for me?
From there, we frequently look at strengths, motivations and your perception of self. At this point. a natural progression toward patterns of behavior, feeling, or thought generally pop up. We will work to explore and understand these patterns and eventually begin to identify what holds you back from taking self-knowledge into action.
For folks struggling with personality disorders, the beginning of psychotherapy can be particularly fraught. Intense feelings of anxiety, disgust, rage, or confusion can be overwhelming. While the feelings may feel all consuming, or unsavory they aren’t something to push down, or fix. They are essential for us to tolerate and explore. You will have space to feel and express whatever might be present for you in a given moment. We will spend extra attention on how you are experiencing me, the relationship, and yourself in real time.
I make frequent reference to the concept of content and process. Content is what brings you to therapy. It is the history, relationships, struggles, symptoms, concerns, and events that you are hoping to discuss. Process refers to exploring the interactions and communications that take place between a therapist and patient amidst that content. Process allows us to examine how you respond and relate to another person (me) first hand. Since most content occurs outside of the therapy room, process allows us to notice and tend to how dynamics develop and live in the therapy space. The therapy relationship itself is vitally important to acknowledge, explore, reference and reflect on throughout your treatment. If this sounds scary, it can be! I takes a lot of courage and I will be right there with you managing my vulnerability as well.
