What is the Psychoanalyst’s role in different types of therapy?

The other thing that I want to talk a little bit about are the types of therapy; individual therapy, couples’ therapy, and group therapy. In Individual therapy, the patient comes in with a presenting problem; “I’m not feeling well, help me,” and it’s one-on-one.

I work with many couples and one of the things I try to do is help them learn to communicate better. I don’t want to be a referee. There can be so much anger and aggression in the room that I’m asked to be the referee. I work very hard at not doing that.

What I do in couples’ therapy is help people communicate in a positive manner. It’s not always possible. Dr. Spotnitz was a little old fashioned and I trained with him. He had the idea that if you got married and started a family you were a success. I’ve come to realize not every marriage is meant to work. When I first started I wanted to save every marriage that I encountered. It’s not always the right answer.

The difficulty is when there are children involved and they’re getting damaged in the process. You have to weigh is the damage caused keeping this marriage together better or worse than if there is a divorce and/or separation and the effect that may have on children.

The third type of analysis I do is group therapy and that usually involves 5-10 people. You typically meet once a week for an hour to an hour and a half. One of the advantages of group therapy is that there is a social aspect of it that helps people learn to work with more than one person and with people with different backgrounds.

I inherited a group from a psychoanalyst that was retiring several years back, and it felt in this group as if the knowledge resided in the analyst. It is my belief the knowledge resides in the group members. It’s taken awhile for the people in the group to realize that I’m going to manage the conversation and not dominate it, which will let them find the answers.

In individual therapy, my role is to help the patient find the answers that I think reside within the patient. I can guide them, I can help them get there, but my job is not to have them do what I think they should do, it’s to help them figure out what they need to do. ~ Rafael Sharón, NCPsyA, SCPsyA, Psychoanalyst in Princeton NJ