FAQ | Marianne Goldsmith

Six Questions about Psychoanalysis and this Book

1. Why did you write this book?

The question has a two-part answer. Ellen Pinsky, esteemed reviewer of this book, describes it as a “love letter to the discipline of psychoanalysis.” She is half-right. When I began the analysis, I was not “in love” with psychoanalysis. I began the analysis because it was the only therapy that would help me understand what happened to me in Dr. Coleman’s office; why I left my body when he interpreted the “strange” sensations I had during our first session, after the long summer break.

I remember that I was uncomfortable, tongue-tied, couldn’t think, couldn’t speak, but it didn’t occur to me that the strange sensations I reported having, had to do with our reunion; nor do I remember feeling anything, when he wondered if they did; if the sensations had to do with my being “back” and his being “back.” What happened to me in that moment, is described in the first chapter of this book. It was only much later that I suspected that the dissociation must have had something to do with the loss of my father when I was little, a loss that I did not remember.

So, what sort of memory was it? Clearly, an unconscious memory, a “memory” that I myself, my conscious brain, couldn’t remember, but that my body did. Remarkably, I was living out the title of Bessel van der Kolk’s book, “the body keeps the score,” twenty years before that book was first published, in 2015. In severe trauma, the body “remembers” what the mind does not. All those years of my early childhood, the sudden loss of my father and the Japanese prison camp, resembled a morass, somewhere deep inside of me, deep inside my brain.

When I peered down and tried to find myself in that morass, I couldn’t. I saw nothing, felt nothing. Frustration was the only feeling I could feel. Not to know something about myself that was so important, something that no one else had ever talked to me about, felt unacceptable. Psychoanalysis was the only therapy with a process that has the unique potential of opening a door to the unconscious. So that is where I went.

Part Two of this book is the second of the two-part answer. While creating the journal, I discovered that the analytic process is indeed a “discipline,” and I did indeed, fall “in love” with it. It is a discipline which my analyst respected and adhered to with rigor, conviction and true wisdom, while never forgoing the need for flexibility when the occasion called for it. When I opened Pandora’s box, the cardboard box that held the spiral-bound notebooks with my hand-written notes, my journal, I remembered almost nothing about the analysis. Truthfully, all that I remembered, thirty years later, was that I was angry a lot, and that my analyst was really good about it! In the course of transcribing and decoding my notes, I began to understand the complexity – and the discipline - of the analytic process and to fall in love with it.

2. What is the analytic process and how does it facilitate the analysand’s access to the unconscious?

This is another complicated question without a straightforward answer. There are several, essentially pragmatic, components of the analytic situation. These core components include the recumbent position – not as mandatory or critical as people tend to think – the greater frequency of the sessions and the longer duration of the treatment. The latter two elements are not intrinsic to that process either, but a reflection of the complexity of the issues being addressed and the length of time it may take for the therapy to reach a satisfactory conclusion.

In some patients, the recumbent position tends to foster the regression, as it did in my situation. When carefully managed by the analyst, the analysand’s purposeful attainment of the regressive state will also foster the emergence of unconscious material. This was especially true for me, and very helpful, specifically in bringing to light the unconscious oedipal conflicts of my early childhood, and later on, in my eleventh year, the painful feelings of parental neglect and abandonment.

As an older child, those feelings, too painful to feel, were repressed and denied, yet in the analysis, four decades hence, those very feelings adhered themselves to specific events that to my childhood self had symbolized my unconscious feelings about my parents’ absence and neglect. Those events became the “day’s residue,” the core components of the “deer dream,” the signal dream of my analysis. As the dreaming adult, I still wanted to protect my parents and excuse their neglect, the feelings still too painful to feel. The “deer dream” is presented in full in the second-to-last chapter of Part One.

The more classical “road” to the unconscious is to be found in the analytic process itself. When I entered into the analysis, my basic assumption was that I was expected to say what came to mind without self-censure, and attempt to disregard (or overcome) any internal constraints on my communications. Over time, the difficulty of adhering to that seemingly simple expectation became apparent.

An old-fashioned term, it was once called the “resistance,” a sign that the analysand was “resistant” – i.e., unwilling, but in fact, unable - to experience the pain from which her defenses had tried to protect her. Repression is the most effective defense that enables us to get through life, while simultaneously it prevents us from understanding ourselves, our true (but unwanted) feelings and hence, behavior. This is where the analyst’s job comes in.

A good analyst listens, and says little. While listening, and seemingly doing nothing, she (he) is working very hard. In order to understand her patient, she is paying close attention on multiple levels: not just to the actual words, but to the associative network of thoughts and feelings and their meaning that with deep listening, can be discerned between the words; the emotional content of the words, the body language and gestures that accompany the words, and most important, their communicative intent, value or import.

The latter element – the communicative intent of what the patient is saying - is most important, because it has to do with the transference. At any given moment, the analyst wonders, “who” am I, in the mind of my patient? Her father, mother, brother, lover, friend or foe, or a combination of anyone of these? The analyst is paying close attention to this question as she listens and remembers not only her patient’s feelings, but her own feelings as she listens. Slowly and incrementally, she gathers this wealth of information and integrates it, and at some appropriate moment, will make an interpretation.

At first, these interpretations may be relatively superficial, possibly a way of establishing a connection that will be helpful to the patient and promote trust, but over time, they will travel more deeply into the patient’s sense of herself. Eventually, a “deep” interpretation will convey a portion of the patient’s unconscious material and reveal information of which the patient may or may not wish be aware.

I think that Dr. Coleman’s interpretation of my reunion with my father when I was little, went too “deep,” and in a sense, it was re-traumatizing, because he was penetrating a loss that was not the consequence of repression and conflict, but of dissociation, a very different defense, that is primarily used in traumatic situations. Nevertheless, his interpretation was the result of long and deep listening, and he had no other tool to reach me. For that, I will always be grateful.

Until I reviewed my journal and wrote my book, I had not remembered a single one of Dr. Notman’s interpretations. Strange indeed, and I’m not sure that I can explain it exactly. Decades have gone by. An analysis works with unconscious material, and once that material is understood, the new knowledge gained is integrated into thoughts and feelings that become part of the self. Internalized, they are no longer a part of the unconscious. I suspect that this is the reason that a successful analysis can last a lifetime, as it has in my case.

In the quest for clarification, hers and mine, Dr. Notman’s interventions were mostly in the form of questions; her comments tended to be short, pithy and to the point, and I always took careful note of them. The longer, more complicated interpretations I would remember and copy down in my notebook when I came home, word for word. I would think about them and slowly, surreptitiously, like waves that momentarily mar the surface of the ocean, the waves would be absorbed and disappear, as if forgotten, and my understanding of her message become part of me.

3. What is transference?

Transference is a psychological phenomenon where an individual unconsciously experiences and redirects feelings, desires, or expectations originally associated with one person—often a significant figure from the past, such as a parent—onto another person in the present. A basic misperception, for the most part unconscious, the enactment of the transference can result in feelings and behavior that are often a significant source of psychological distress in relationships.

An exploration of transference lies at the heart of psychoanalysis. Its ultimate aim is to uncover and bring unconscious thoughts and feelings to consciousness, with the expectation that fresh insight and self-understanding will alleviate the psychic suffering entailed by our relationships with significant others and ourselves. The management and interpretation of transference in all of its complexity, with its unconscious manifestations in multiple, different situations and contexts, is the psychoanalyst’s primary tool, and the use of interpretation, a finely honed art.

In psychotherapy, transference is an important dynamic as well, but the goal of bringing unconscious thoughts to consciousness, and the exploration of the transference to that end, is not one of them. But when recognized and skillfully managed by the therapist, transference may uncover emotional patterns often hidden from a client’s conscious awareness, and their awareness can transform therapy sessions into useful opportunities for self-discovery and change.

4. How does psychoanalysis differ from other forms of psychotherapy?

For individuals seeking deep, long-term change and insight into unconscious processes, rather than solely alleviating surface symptoms, psychoanalysis remains a recognized and valuable form of psychotherapy. By exploring early life experiences, repressed memories, and unresolved conflicts, it seeks to resolve the underlying issues that drive current behaviors and emotions. The mechanisms for lasting change are as follows:

a. They help individuals gain insight into their unconscious motivations and defense mechanisms. This new self-awareness can lead to lasting changes in how people think, feel, and relate to others, making them less likely to relapse after therapy ends.

b. The process of “working through” involves repeatedly examining and understanding problematic patterns over time. This allows new and healthier ways of coping and relating to become deeply ingrained. This unique factor is crucial in terms of creating persistent behavioral change, as compared with shorter term therapies.

c. Lastly, the therapeutic relationship provides a safe space for patients to experience and process in the present, emotions that may have been avoided or suppressed in the past. This which can lead to profound emotional healing and growth.

5. Why is psychoanalysis an invaluable resource that should be preserved?

Our world is full of people who have been traumatized in early childhood by sudden parental loss – in wars, in climate change disasters and the rise of gun violence. Parental loss or abandonment leaves a deep psychic wound that follows a person throughout life. Despite its marginalization, psychoanalysis remains a viable form of psychotherapy for individuals dealing with complex or chronic mental health issues. Psychoanalytic concepts - such as the unconscious, transference, and defense mechanisms - remain foundational in many contemporary therapies and continue to inform psychiatric thinking.

6. How does the integration of psychoanalytic concepts with neuroscience promote clinical progress and research?

a. Neuroscience has begun to bridge the gap between subjective psychological experience and objective brain processes, enhancing clinical practice, stimulating innovative research, and fostering a more comprehensive science of the mind, while respecting the complexity and richness of both psychological and neurobiological perspectives.

b. Psychoanalysis offers rich conceptual models for understanding complex mental phenomena—such as dreams, emotions, and attachment—that can direct neuroscientific research toward new hypotheses and experimental designs. Conversely, modern neuroscience has begun to provide concrete explanations for the unconscious processes first described in psychoanalytic theory, explanations that focus on how the brain encodes, stores, and processes information outside of conscious awareness, and how these processes influence behavior, emotion, and cognition.

c. Understanding the neurobiological underpinnings of psychoanalytic mechanisms (e.g., transference, repression) may lead to more targeted and effective interventions for psychiatric disorders and advance clinical practice. Furthermore, neuroimaging and other neuroscientific tools can help assess changes in brain function associated with psychoanalytic therapy, providing objective markers of treatment progress.

d. Neuroscience can help address complex psychological phenomena and elucidate how deep, long-term personality changes are instantiated in brain networks, especially in areas related to emotion, memory, and self-regulation.

e. Integrating developmental neuroscience and psychoanalysis enhances understanding of how early experiences shape brain development and other lifelong psychological patterns.