Author: Naomi

No Motivation? Why Willpower Isn’t Working

No Motivation? Why Willpower Isn’t Working

You sit down to do the thing you have been negotiating with yourself about all day. You open the laptop, you stare at the email, you reread the instructions, you promise yourself you will start in five minutes, and then somehow you do anything except the thing. Later, when the day has slipped away, the explanation arrives with the familiar bluntness: “I have no motivation.”

If you recognize that line, you probably also recognize what follows it: the quiet self-contempt, the attempt to “get serious,” the vow to try harder, and the strange experience of watching your willpower evaporate the moment it matters. People often call this laziness, but laziness is usually a story we tell when we do not yet have a better one, and the problem with that story is that it treats your mind like a single unified engine that should start when you turn the key.

Existential psychoanalysis starts from a different premise, one that is both less flattering and more accurate: we are rarely of one mind, and motivation is often what a person feels when their divided wishes happen to align for a while. When they do not align, “no motivation to do anything” can be the surface description of a deeper conflict, including the kind of conflict that has been running your life for years while you keep calling it a character defect.

Close-up of thick ropes tightly knotted together, combining red and beige strands with a soft sunset in the background, symbolizing tension, complexity, and emotional entanglement

The “I should be able to make myself do it” trap

The willpower narrative is seductively simple because it promises a straightforward cure. If the issue is discipline, then the solution is to apply more pressure, to become stricter, to moralize yourself into movement. That approach sometimes works in the short term, especially when fear is high and the consequences are immediate, but it often produces a bitter loop in the long term because it turns everyday difficulty into an indictment of who you are.

There is also a hidden payoff in this narrative, which is why it sticks: if the problem is that you are defective, then you do not have to ask what you are avoiding, what you are protecting, or what you might lose if you actually change. The language of failure can function as a kind of cover, because it keeps you focused on your performance and away from the meaning of your resistance.

Willpower is not one thing

In M. Guy Thompson’s work on the will, he draws a distinction that is easy to miss and hard to unsee once you notice it: we talk about “will” as if it means conscious control, yet many of the forces that move us, and stop us, do not originate in conscious control at all. If you have been asking “why can’t I motivate myself,” it may help to notice that you might be demanding something from the will that the will was never designed to deliver.

The popular myth: will as conscious control

This is the cultural ideal most of us inherit. You decide. You commit. You execute. You keep your feelings in the background, you override resistance, and you make yourself do what you know is right. In this picture, willpower is a clean tool, and failure is evidence of weakness, immaturity, or some missing virtue.

The problem is not that this model is entirely false. The problem is that it is partial, and we treat it as total. It describes what happens when a person already wants what they are about to do, or when the costs are tolerable, or when the social pressure is strong enough to carry them, but it becomes cruel when applied to situations in which desire and fear are pulling in opposite directions.

The harder truth: desire and resistance can run the show

Thompson’s point, stated bluntly, is that we routinely overestimate conscious control, and we tend to misread the will as a simple command when, in lived experience, it is closer to the shifting, often unconscious, movement of desire. You do not simply pick your desires in the way you pick an item off a menu, and in the most human areas of life you can feel, with unnerving clarity, that your desires choose you.

One way Thompson illustrates this, in his writing on love and loss, is by pointing out something most people know but rarely say out loud: you cannot will yourself to love someone you do not love, and you cannot simply will yourself to stop loving someone you do. That is not a romantic slogan. It is a statement about how limited conscious will is when it collides with the deeper structures of attachment, longing, and fear, and it is part of why self-command so often fails in the very places where you most want it to succeed.

Motivation problems often live in the same territory. You can want to apply for the job and dread the exposure it brings. You can want to write the dissertation and fear the moment it becomes real enough to be judged. You can want to leave a relationship and panic at the loneliness that would follow. You can even want therapy and feel an inexplicable resistance the moment you go to schedule it, as if some part of you understands that being known comes with a cost.

From the outside, this looks like self sabotage psychology. From the inside, it often feels like a stalemate: one part of you insists you should act, another part insists you should not, and the result gets named “no motivation,” even though what you are experiencing is a conflict that has turned into inertia.

The hidden cost of change

Most “motivation” advice assumes the obstacle is fear of failure, as if all you need is confidence and better habits. Sometimes it is that, but often the deeper obstacle is that change threatens to reorganize your life, which means it threatens to reorganize your loyalties, your identity, and your excuses.

People avoid what they want for reasons that make psychological sense once you stop moralizing them. Success makes you visible, which means it makes you accountable, and accountability can feel like danger if you grew up in a world where being seen brought criticism, envy, or intrusion. Growth can disrupt an old role you have played for a family or a partner, the reliable one, the one who stays small, the one who keeps the peace, and the prospect of stepping out of that role can evoke guilt that feels, irrationally but powerfully, like betrayal.

Sometimes the cost is grief. If you finally act, you may have to face the time you lost, the ways you have settled, the ways you have been living as if you had no choice, and for some people that grief is so sharp that procrastination becomes a way to avoid it. Sometimes the cost is responsibility. If you move, you lose the comfort of being able to say “I couldn’t,” and you enter the harsher territory of “I chose,” which is exactly where freedom begins and where self-deception becomes harder to maintain.

If you have been wondering “why do I procrastinate so much,” or noticing the tight link between procrastination and anxiety, this is one reason: anxiety is often the body’s signal that the stakes are higher than the conscious story admits.

Acceptance and change are not enemies

In popular self-help culture, acceptance is treated as the opposite of change, as if accepting yourself means giving up, lowering standards, or resigning yourself to a smaller life. Thompson’s writing takes a different angle, one that can feel counterintuitive until you notice it in your own experience: change that lasts is rarely produced by self-attack, and it is often blocked, not by lack of effort, but by refusal to accept what is actually true about your experience.

In his writing on acceptance in the context of loss, he emphasizes how difficult it is to “move on” when you remain organized around a fantasy that the situation will resolve without requiring you to bear its consequences, and he treats acceptance less as a moral stance and more as the final step in recovery, the point at which the person stops bargaining with reality and begins to live again. The implication for motivation is not that you should resign yourself to avoidance, but that you should stop lying to yourself about why you are stuck, because the lie keeps the conflict frozen in place.

This is also why many people feel that willpower fails precisely when they most want to change. You can use discipline to force a behavior for a while, but you cannot use discipline to dissolve the meanings and fears that make the behavior feel dangerous, and until those meanings are faced, the “no motivation” experience tends to return, often in a new disguise.

The existential turn: avoidance is still a choice

Existential therapy has a way of making people bristle, and sometimes it should, because it insists on taking freedom seriously. The uncomfortable truth is that avoidance is not nothing. Even when it is not fully conscious, it is a way of choosing relief now over the risk of change, and that choice has consequences that accumulate quietly until your life begins to feel smaller than it needs to be.

This is not a blame move. It is a dignity move. If you are not a broken machine, then you are a person making tradeoffs, often under pressure, often out of loyalty to strategies that once protected you, and the task is not to shame those strategies but to understand them well enough that you can decide whether they still deserve to run your life.

Many people discover that their “no motivation” problem is also a meaning problem, because meaning creates exposure, and exposure creates fear, and fear invites withdrawal. When you keep withdrawing, desire starts to feel distant, not because it vanished, but because you have learned to live at a safer distance from the things that would make your life feel real.

Bulletin board with a ‘TO-DO LIST’ sticky note listing tasks like starting a project and going to the gym, connected by a tangled mess of colorful strings to a pink note labeled ‘AVOIDANCE’, symbolizing procrastination and inner conflict

What therapy can do when willpower fails

If you are searching “therapy for procrastination,” you are probably not looking for a cheerleader, and you are probably tired of being told to make a schedule. Depth-oriented work approaches procrastination, avoidance, and self sabotage as expressions of conflict that deserve interpretation, not as a simple skills deficit.

In existential therapy, the conversation often returns to the questions you may have been avoiding because they feel too large or too unsettling: What do you actually want, not what you think you should want? What are you afraid will happen if you go after it? What would you have to give up, and what would you have to take responsibility for, if you stopped living in delay? The work is not about providing easy answers; it is about staying close to your experience long enough that it stops being an enemy and becomes information. If you want to learn more about our approach, see existential therapy

In psychoanalysis, the emphasis includes the unconscious patterns that shape your emotions, relationships, and decisions, including the ways you “act against your own desires” without fully understanding why. This is not about digging for trivia from childhood; it is about seeing how old solutions keep repeating in the present, how your mind organizes itself around safety and loyalty, and how the therapeutic relationship itself becomes a place where these patterns can be felt, named, and worked through rather than reenacted. If you want to learn more about our approach, see psychoanalysis

Both approaches share a commitment that is not especially fashionable: real change tends to happen indirectly, over time, through honesty and relationship, because once you understand what your resistance is protecting, you no longer need to treat yourself like a project that must be forced into submission.

When “no motivation” has become a pattern: If you are tired of blaming yourself and want a deeper explanation of what is happening, you can schedule a first session. If you are trying to figure out costs, coverage, or superbills, you can also learn about insurance and superbills.

How “no motivation” shows up in real life

People rarely walk into therapy saying “I am conflicted about desire, freedom, and responsibility,” even when that is exactly what is happening. What they say is simpler and more painful: they cannot start, they cannot finish, they wait until panic arrives, they overthink until the window closes, they feel a strange competence when doing things for other people and a strange paralysis when doing things for themselves, they know what matters and then avoid it as if meaning itself were dangerous. Sometimes perfectionism is the cover, because if you require certainty before you act, you can postpone the risk of exposure indefinitely; sometimes distraction becomes compulsive, because it offers momentary relief from the fear that rises the moment you approach what you want.

None of this proves a diagnosis. It does suggest that “no motivation” is often a shorthand for an internal arrangement that has been protecting you, and that the arrangement has started to cost more than it gives.

What a first session focuses on

A first session is not a performance review, and it is not a test of whether you are “motivated enough” to deserve help. It is a place to describe what is happening without having to defend yourself, and to begin identifying the structure of the pattern rather than arguing with its moral meaning.

In practical terms, we listen for how you describe your stuckness, what you say you want, what you fear will happen if you move toward it, and what you are currently getting from staying where you are, even if you hate it. We also pay attention to how this pattern shows up in work, in love, and in your relationship to authority, including your own inner authority, because “no motivation” is often not a standalone problem but a style of relating to desire and responsibility.

If you want a clearer sense of our stance and our clinical orientation, you can read more about how we work. If you decide not to continue after the first meeting, your first session is free; if you do decide to continue, we discuss payment and next steps during the session.

Wooden signpost at a forked path with arrows pointing in opposite directions labeled ‘WILLPOWER’ and ‘DESIRE’, overlaid with transparent silhouettes of two human profiles facing each other, representing internal struggle and decision-making.

FAQ

Why do I have no motivation even for things I care about?
Because caring raises the stakes. When something matters, it can expose you to disappointment, judgment, regret, or change in your relationships, and the mind often prefers safety to meaning when it feels cornered. In that situation, what looks like “no motivation” may be your system applying the brakes to avoid a cost you have not fully named.

Is it laziness, or is something actually wrong with me?
“Lazy” is usually an insult, not an explanation. Low motivation can be shaped by burnout, depression, grief, chronic stress, medical issues, and attention-related factors, and it can also be an existential problem, a conflict about freedom, responsibility, and desire. A careful clinical conversation is often the quickest way to sort out what is most true in your case, because different causes require different kinds of help.

Why do I procrastinate more when something matters?
Because meaning creates exposure. When the outcome matters, you are no longer just completing a task, you are making a claim about who you are and what you are willing to risk. Procrastination can be the mind’s attempt to postpone that claim, especially when anxiety is high.

Why do I avoid things I want?
Because wanting is not only desire, it is vulnerability. Wanting puts you in contact with dependency, hope, and the possibility of loss, and for many people those experiences have been historically dangerous. Avoidance is often the compromise between desire and fear, and it becomes habitual when it works too well.

How do I stop self sabotaging relationships?
“Self sabotage” often makes more sense when you treat it as self-protection that has outlived its usefulness. In relationships, people commonly sabotage closeness when closeness threatens their identity, activates guilt, or awakens old expectations about what intimacy costs. Therapy helps you recognize the moment the pattern turns on, understand what it is trying to prevent, and gradually expand your capacity to tolerate closeness without needing to destroy it.

Can therapy help with procrastination and motivation?
Yes, especially when the work goes beyond tools and gets into meaning. Skills can help, but if the pattern is rooted in conflict, then the deeper work is to understand what is being avoided, what is at stake, and what kind of life you are implicitly choosing when you keep delaying. That understanding tends to loosen the internal stalemate, which is where motivation often returns, not as a pep-talk feeling, but as a steadier willingness to bear the costs of change.

Do you offer telehealth, and do you take insurance?
We offer in-person sessions in San Francisco and telehealth. We are in-network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth, and we can also provide superbills for out-of-network reimbursement when applicable. For details, see: https://freeassociationclinic.com/insurance/

How do I get started?
You can schedule a first session here, and we will help you find a good fit. We do not promise outcomes, but we do take the problem seriously, and we treat your experience as meaningful rather than as a personal failure.

Ready to get to the heart of the matter?

If “no motivation” has become a daily argument with yourself, that is often a sign the problem is deeper than discipline. The goal is not to become a harsher manager of your own life; the goal is to understand the conflict that makes you stall, and to develop a more honest relationship with what you want, what you fear, and what you are willing to risk.

When you are ready, you can schedule a first session. If you want to clarify insurance, superbills, or out-of-network reimbursement, you can also learn about insurance and superbills.

Therapy Limits: Why Your Therapist Holds the Frame

Therapy Limits: Why Your Therapist Holds the Frame

You leave a session feeling raw, not in a dramatic way, but in the plain bodily sense that something important has been said and cannot be unsaid, and now you have to walk back into your life carrying it. In the parking lot, or on the sidewalk, or on the ride home, you feel the wish arise for something small that would change the texture of the moment, a brief signal that the connection is still there, that you did not expose yourself into a void.

So you reach for your phone and send a message. It might be a question that feels urgent only because you are shaken, or it might be a modest sentence like “That was hard,” which is really a request to be held in mind. Then nothing happens. The screen stays quiet. Time opens up, and the mind fills it quickly, because that is what the mind does when it meets silence in a relationship that matters.

If this has happened to you, the sting is real. It can feel humiliating, especially if you already carry an old conviction that needing anything is dangerous, or that closeness is always conditional, or that you have to perform to be kept. And it is exactly here, in the place where a simple “no” or “not now” lands as a verdict on your worth, that psychoanalytic therapy becomes either sterile or serious depending on what happens next.

Depth therapy does not treat this pain as an inconvenience to be managed with policy language. It treats it as material. That does not mean the therapist will do what you want, but it does mean your wanting, your anger, your shame, your fear of being dropped, and even your impulse to retaliate by disappearing are not mistakes to correct, they are the living content of the work.

A softly lit therapy room shows a blurred client in the background while a clear hourglass and a sign labeled "BOUNDARIES" sit prominently on a wooden table, emphasizing the theme of time and emotional limits in therapy.

The frame is not a set of rules, it is the condition that makes the work possible

Psychoanalysis has a name for the structure that holds the work together: the frame. The frame is the stable set of conditions that make the encounter recognizable as treatment and not as something else. It includes the time and regularity of sessions, what happens when time runs out, the financial arrangement, what kinds of contact exist outside the hour, what the room is for, and what kinds of roles the therapist will not assume, even if a part of you longs for them. The point is not to make the relationship less human; the point is to make it human in a very particular way, one that can tolerate truth without collapsing into rescue, seduction, or retaliation.

This can be hard to appreciate from the inside, because when you are suffering you do not want a “structure,” you want relief, and the therapist’s refusal to provide relief in the form you have asked for can feel like a lack of care. But the frame is not designed to make you smaller. In its best form, it does the opposite: it gives your experience enough consistency that it can unfold, be remembered, be returned to, and be thought about, rather than being endlessly
improvised in the heat of the moment.

If you want the deeper orientation for this kind of work, you can read about our approach to psychoanalysis and depth therapy. (Free Association Clinic)

Freud’s “abstinence” is not moralism, and Thompson is blunt about what it is for

Freud’s technical term “abstinence” has been badly misunderstood, sometimes even by therapists who invoke it. It is not a demand that the therapist be distant for its own sake, and it certainly is not a virtue-signaling posture of clinical purity. In Freud’s technique, abstinence is a way of protecting the treatment from becoming a substitute life, because the moment the analyst starts gratifying the patient’s demands in order to ease tension quickly, the treatment begins to drift toward a disguised form of dependency that feels soothing while it quietly blocks change.

Michael Guy Thompson, in The Ethic of Honesty, takes this idea seriously and strips it of sanctimony. His point, following Freud, is simple enough to be uncomfortable: the therapist must not become the thing that temporarily resolves the patient’s longing, because then the longing disappears from speech and returns as a pattern. A therapist who constantly reassures you, bends the frame to make you feel special, or becomes a stand-in attachment figure on demand may be experienced as kind, but the kindness can function as a substitute satisfaction, and substitute satisfactions have a way of stealing the very energy that would have driven the work forward.

What drives the work is not comfort. It is the persistence of a question. When you can bear the ache of a question long enough to speak it, you begin to learn what you actually want and what you are afraid will happen if you want it openly, and then you can begin to recognize the strategies you use to get closeness while pretending you do not need it.

This is why abstinence, when practiced with thoughtfulness, is not “withholding,” it is an insistence that your desire not be anesthetized before it can be understood.

Why won’t my therapist text back?

If you are looking for an answer that makes the hurt vanish, you will be disappointed, because no explanation erases the fact that you reached out and met silence, and that silence landed on a tender place. But there is still a useful psychoanalytic answer, and it begins by taking the wish seriously rather than pathologizing it.

Texting is immediate, casual, and intimate, which is precisely why it so easily becomes a vehicle for the kind of contact that bypasses thought. When a therapist responds in the moment, the nervous system settles, and there is relief, but relief can become a way of not knowing what is happening inside you. The “hard session” becomes something you survived with help rather than something you can return to with language, which means that what you were trying to avoid, the feeling of exposure, the fear of being too much, the terror of being dropped, gets postponed rather than metabolized.

The frame does not insist that you never reach out. It insists that reaching out not become the main way you regulate the relationship. When between-session contact becomes the place where the relationship is repeatedly repaired, soothed, or intensified, the therapy hour can quietly lose its function, because the intensity has leaked into the phone. A consistent limit here is not a punishment; it is a way of keeping the emotional meaning where it can be explored, in the room, with time.

That said, a limit is only clinically useful when it can be spoken about. If the therapist’s non-response is treated as untouchable, if you are expected to swallow your reaction in private, then the frame has become an excuse for emotional evasion, and that is not psychoanalysis, that is a kind of professional hiding. In a serious treatment, you should be able to say, plainly, that you felt rejected, and the therapist should be willing to stay with what that brings up, including anger.

A partially open therapy room door displays a “SESSION IN PROGRESS” sign while a person holds a phone with a message saying “That was hard,” hinting at emotional processing following a difficult session.

Why won’t my therapist hug me, or share more, or be “more like a friend”?

When people ask these questions, they are rarely asking about etiquette. They are asking whether the relationship is real. They are asking whether the therapist sees them as a person and not as a case. They are asking whether love, or something close to love, is possible without the relationship turning into something messy and unsafe.

The psychoanalytic answer is not that hugs are bad or that personal sharing is forbidden. The answer is that these gestures can easily become enactments, meaning actions that express unconscious wishes in a way that bypasses reflection. A hug can be comfort, but it can also be a way of erasing anger, or sealing a moment that should stay open, or turning a complex feeling into a sentimental resolution. Friendship can feel like the proof that the connection mattered, but friendship also carries mutual needs and social expectations that change what can be said, and therapy depends on a kind of asymmetry that protects the patient from having to take care of the therapist.

The frame is what makes it possible for you to experience intense feelings toward the therapist, including longing, dependence, idealization, envy, hatred, and grief, without those feelings being exploited or acted out. It is what keeps the therapist from being recruited into the role of rescuer, judge, romantic partner, or parent, roles that may feel familiar and therefore compelling, but that tend to reproduce the very problems that brought you into therapy.

This is where Freud’s abstinence and Thompson’s insistence on honesty meet. The therapist does not hold the frame because you do not deserve closeness; the therapist holds the frame because the work is to find out what closeness means to you, what you demand from it, what you fear it will cost, and how you have learned to secure it, often at the price of your freedom.

The existential edge: relief can be a way of staying in an old script

In existential psychotherapy, there is a recurring question that does not let you off the hook: what are you doing with your life, and what are you avoiding by doing it that way? When therapy becomes primarily about immediate soothing, it can quietly reinforce an old position in which you remain a child in relation to an imagined authority, always waiting for reassurance, always scanning for signs of abandonment, always bargaining for safety.

A stable frame brings the issue into focus because it frustrates certain maneuvers. When the therapist does not immediately soothe you, you are confronted with your own strategies for dealing with frustration and uncertainty. Do you collapse and decide you are worthless? Do you become furious and attack? Do you try to please your way back into favor? Do you withdraw, cancel, and punish? Do you pretend you never needed anything?

None of this is a character flaw to be corrected. It is the living architecture of your relational life showing itself in real time. And when it shows itself in the therapy relationship, it can be met with thought rather than reenacted blindly.

When a held frame becomes punitive, and how to tell the difference

It would be naive, and frankly dishonest, to pretend that every clinician who invokes the frame is using it well. A rigid frame can become punitive when it is used to dominate rather than to contain, when it is enforced with contempt, when it becomes an excuse to avoid emotional responsibility, or when it is applied without regard for the person in front of the therapist.

Thompson is explicit that abstinence requires tact. It is not a blunt instrument. There are people for whom too much distance does not create space for thought, it creates collapse; there are contexts in which a carefully considered responsiveness is not “gratification” but a necessary condition for safety. The frame is not a religion. It is a clinical measure, and measures can be misused.

A practical way to evaluate this, without gaslighting yourself, is to notice whether the limit is stable and speakable. Stable means you are not being drawn into a confusing pattern of exceptions and reversals that feel manipulative. Speakable means that you can bring your reaction into the work without being shamed, dismissed, or met with defensive moralizing. If the therapist can tolerate your anger and stay curious about it, the frame is likely serving the treatment. If the therapist cannot tolerate your anger and retreats behind policy language, the frame may be serving the therapist’s comfort at your expense.

One more point needs to be said plainly: the frame is not a crisis plan. Ethical treatment includes clarity about what to do when you are at risk, and clear referral to appropriate emergency resources. If you feel unsafe and there is no plan, that is not “depth work,” it is negligence.

Bring it into the room, because that is where it can become change

Most people try to manage these feelings alone, which usually means they either swallow them and turn them into shame, or they act them out by sending a scorching message, quitting abruptly, or disappearing in a way that feels like self-protection but often repeats an old pattern of leaving before you can be left.

A different move is more exposed and more powerful: you tell the truth in the session about what happened in you. You do not have to perform sophistication.
You can say, in ordinary language, “When I reached out and didn’t hear back, I felt rejected, and then I started telling myself you don’t care.” You can add the part that embarrasses you, because that part is usually the core, “I wanted you to reassure me so I wouldn’t fall apart.” You can admit the aggression, “I got angry and I wanted to punish you by canceling,” and you can admit the fear underneath it, “I’m scared you’ll be angry at me for being angry.”

This is not about persuading the therapist to change the frame, although sometimes the frame does get revised as the treatment develops and as two people learn what is workable. It is about bringing desire into speech rather than turning it into maneuver. Freud’s technical ideal was not obedience; it was that the unconscious could become speakable. Thompson’s ethical emphasis is that honesty, including the messy kinds of honesty, is the condition of real encounter.

A countryside path bathed in morning light is blocked by a wooden gate secured with a heavy chain and padlock, symbolizing restricted access or firm boundaries.

How Free Association Clinic works with the frame

At Free Association Clinic, our work is grounded in existential psychotherapy and psychoanalysis, which means we take seriously the human questions people try to outrun: meaning, freedom, responsibility, love, anger, and the unconscious ways we repeat what hurts. The clinic’s approach is not built around quick fixes or generic coping scripts, and it is also not built around a cold posture that hides behind professionalism. The aim is a relationship sturdy enough to hold truth, and a method disciplined enough to keep that relationship from turning into something that feels good while staying false.

If you want a clearer sense of our stance, you can read how we work, or explore existential therapy at FAC and psychoanalysis and depth therapy. (Free Association Clinic)

If you are considering starting, you can request an appointment. The contact form is designed for scheduling and questions, and the clinic explicitly asks you not to share medically sensitive information there, which is worth respecting. (Free Association Clinic)

Practical details: location, insurance, and the first meeting

Free Association Clinic offers in-person sessions in San Francisco and telehealth. (Free Association Clinic)

The clinic is in network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth, and can also provide superbills for out-of-network reimbursement. If you want the clean logistics without guessing, start with learn about insurance and superbills. ((Free Association Clinic)

On the clinic’s service pages, the consultation is described this way: your first session is free if you choose not to continue, and if you do continue you discuss payment during the meeting. (Free Association Clinic)

A final word: the frame is not the absence of care, it is a form of care that can be used

If you came into therapy hoping to finally be met, it makes sense that you would also hope, sometimes desperately, that the therapist would be more available, more personal, more like family, more like a friend. Psychoanalysis does not treat that hope as childish. It treats it as a serious expression of how you have had to live. But it also refuses to mistake immediate gratification for cure.

A held frame can feel sharp because it forces the question into the open, and the question is almost always something like: what do I need from the other, and what do I believe it would mean about me if I needed it?

If you are in a treatment where that question can be spoken, explored, and survived, then the limit you hate today may become the place you finally understand yourself tomorrow. And if you are in a treatment where that question cannot be spoken, where the frame is used to silence rather than to contain, then you have learned something important too, and you are allowed to take it seriously.

If you want to begin work of this kind, you can schedule a first session or request an appointment. (Free Association Clinic)

Transference in Therapy: Why Feelings Get So Intense

Transference in Therapy: Why Feelings Get So Intense

At some point, therapy stops feeling like “an hour I talk about my week” and starts feeling like a relationship you carry around with you. You replay a sentence your therapist said, you wonder what they meant, you notice yourself wanting to impress them or win them over, and then you feel ridiculous for even thinking that way because you are paying for this and you know it is professional. Or it goes the other direction: you leave a session quietly furious, convinced you were dismissed, exposed, or misunderstood, and on the way home you start bargaining with yourself about canceling next week so you never have to feel that particular kind of sting again.

If you are searching phrases like “transference in therapy,” “why do I feel attached to my therapist,” “why am I angry at my therapist,” or “is it normal to have feelings for your therapist,” you are usually trying to answer a very specific fear: “Do these feelings mean something is wrong with me, or wrong with my therapist, or wrong with the therapy?”

There is a more useful way to put it, and it is the one depth therapy is built around: the feelings are real, and their reality is precisely why they can be studied rather than obeyed.

A translucent overlay of two silhouettes facing each other symbolizes introspective dialogue in a therapy setting.

What transference in therapy actually means

Transference in therapy is what happens when your familiar way of attaching, expecting, defending, pleading, testing, and withdrawing shows up in the therapy relationship with unusual clarity. You are not inventing feelings out of thin air, and you are not merely “projecting” a past relationship onto a blank screen; you are encountering another person inside a very particular situation, and the situation amplifies patterns that are easier to hide in ordinary life.

In everyday relationships, we soothe ourselves with contact, distraction, flirtation, reassurance, performance, caretaking, silence, withdrawal, or conflict, and most of it happens quickly enough that we do not notice the structure underneath. In depth therapy, time slows down, attention is sustained, the relationship is bounded, and your usual solutions do not work as cleanly, which is exactly why the underlying longing starts to speak in a louder voice.

This is why transference tends to feel “too intense,” even when nothing dramatic is happening. The intensity is the material.

Freud’s blunt observation: the hardest part is not interpretation, it is managing the relationship

Freud’s paper on transference-love is famous for one simple reason: it refuses to treat romantic or erotic feelings as an embarrassing exception, and it refuses the tempting “solutions” that make everyone feel better in the short term and destroy the therapy in the long term.

He describes a situation many people quietly fear and many therapists quietly expect: a patient becomes intensely, unmistakably “in love” with the therapist. From the outside, it looks like a straightforward dilemma with only two respectable outcomes: either the therapy stops, or the relationship becomes “real.” Freud’s point is that psychoanalysis creates a third path that is harder, less cinematic, and far more productive, because it asks both people to tolerate the experience without turning it into a moral drama or a consummation.

Two parts of Freud’s thinking matter for patients reading this.

First, he treats transference-love as something that can be genuine in feeling while still being shaped by repetition, because the state of being in love is never purely new; it is always a fresh edition of older patterns, older “prototypes,” older ways we learned to want and to fear. In other words, “Does transference mean my feelings aren’t real?” is the wrong question. The better question is: “What kind of love is this, what is it trying to do for me, and what does it cost me in the rest of my life?”

Second, he argues that intense love in therapy can become a form of resistance, not because the feeling is fake, but because it is so powerful that it can conveniently replace the work. In his clinical description, love can suddenly become the only topic, the only demand, the only reality, and that shift can pull attention away from what the therapy is beginning to uncover. That is why he insists on a disciplined stance: the therapist does not gratify the love, but also does not shame it, crush it, or preach it away. The feelings are allowed to come into the open, to be spoken, and to be traced back to their deeper sources, precisely so that they do not have to be acted out as a repetition.

This is a hard idea to accept when you are in the middle of it, because the wish inside transference-love is often simple and human: “Please be the one who finally says yes.”

Depth therapy does not answer that wish with a yes or a no. It answers it with an invitation to tell the truth about it, and then to find out what it is doing there.

Thompson’s existential-psychoanalytic turn: transference is ordinary love and expectation, concentrated

Michael Guy Thompson’s way of framing transference is patient-friendly without being simplistic, because he starts with an observation that most people recognize immediately once it is said plainly: we do not enter relationships empty-handed. We enter with expectations, and with a certain quota of unmet need, and with a particular style of loving that was learned under specific conditions.

From this angle, transference is not a weird therapy-only distortion; it is an intensified version of a basic human condition. If your need for love and recognition has not been satisfied by reality, you will approach new relationships with anticipations that are not fully conscious, not fully chosen, and not fully rational. You will also bring the strategies you used to survive disappointment: self-silencing, pleasing, testing, contempt, withdrawal, seduction, defiance, emotional numbness, intellectualization, or the insistence on being “the easy one” who needs nothing.

Therapy intensifies this not by accident but by design. Thompson emphasizes that, in ordinary relationships, our entreaties for love are typically met, rejected, negotiated, or ignored quickly, and the relationship moves on; in depth therapy, the entreaty is neither simply complied with nor simply refused. Instead, it is invited into language. It becomes something you and your therapist can look at together, without turning it into a performance, a punishment, or a bargain.

If you want a single sentence that captures the difference, it is this: in depth therapy, the goal is not to get rid of transference, it is to make it speakable so you can stop living it blindly.

That is the “ethic of honesty” applied to attachment. You do not win by having the perfect insight, and you do not fail by having messy feelings; you do the work by telling the truth about what is happening between you and another person, and then staying in the room long enough to understand what that truth has been protecting.

A blurred hand extends gently toward a seated woman, evoking connection, vulnerability, and therapeutic trust.

So what do you do when the feelings are strong?

The most practical move is also the one people avoid, because it feels exposing: you bring the feeling into the therapy itself.

If you feel attached, say you feel attached, and then stay with what you think will happen if you admit it. If you feel ashamed, say you feel ashamed, and then stay with what you fear your therapist will see in you. If you are angry, say you are angry, and then stay with the fantasy of retaliation or abandonment that anger often carries. If you have a crush on your therapist, you do not need to dramatize it or minimize it; you can name it and then study the wish inside it, which is usually some mix of longing, recognition, safety, and the hope that you will finally be chosen without having to twist yourself into someone else.

When this goes well, something subtle changes: you stop treating therapy as a place where you must manage your image, and it becomes a place where your relational pattern can actually be encountered. That encounter is not comfortable, but comfort was never the real aim. The aim is freedom, which in this context means you get more choice about whether you repeat your old bargain or step into a different way of relating.

There is also a distinction worth making, because it keeps people from acting impulsively: speaking is not acting out. Telling your therapist you feel drawn to them is not the same thing as trying to turn therapy into a friendship or romance, and a competent therapist will not confuse those two. In fact, the boundary is what makes the speaking possible, because it protects you from the usual outcomes of longing, namely humiliation, rejection, conquest, or collapse.

When it is not “just transference”

A serious therapy relationship can handle powerful feelings without using theory to dodge responsibility, and that is where the line is.

If you feel consistently dismissed, manipulated, pressured, sexualized, or pulled into secrecy, you do not need a clever interpretation. You need a direct conversation about what is happening and whether the frame is safe, and you need to trust what you observe. Transference does not excuse unethical behavior, and ethical clinicians do not hide behind jargon when something has gone wrong.

At the same time, discomfort by itself is not a red flag. Often the moment you want to quit is the moment the work is becoming honest, which is exactly why the urge to leave can feel so righteous. If the relationship is basically respectful and boundaried, it is usually worth slowing down and talking about the wish to disappear before you act on it.

A wooden desk holds paper cutouts of two seated figures, a photo, candle, and notebook, representing the therapeutic process.

How we work with transference at Free Association Clinic

Free Association Clinic offers existential psychotherapy and psychoanalysis, which means we take the relationship seriously without turning it into a sentimental story or a quick fix. We are interested in getting to the heart of the matter, and that includes the moments when therapy starts to matter enough that you feel exposed by it.

If transference is present, our stance is to treat it as meaningful, speakable, and workable. The point is not to eliminate attachment, anger, longing, or shame. The point is to understand what they reveal about how you love, what you expect, what you fear, and what you do when you want something you cannot safely ask for.

You can read more about our clinical orientation in our pages on psychoanalysis and depth therapy and our approach to existential therapy, and you can get a feel for our broader stance in how we work.

If you want to begin, you can request an appointment here.

Practical logistics, insurance, and getting started

We offer in-person sessions in San Francisco and telehealth for clients located in California. We are currently in-network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth, and we also provide superbills for out-of-network reimbursement. Details are here: /insurance/.

If you reach out through our contact form, keep it simple and do not include medically sensitive details online; we will take care of the specifics once we connect. You can request an appointment here. If you choose not to continue after the first session, that first meeting is free.

Common questions people ask about transference in therapy

Does transference mean I am “not really” in love?

It can mean that the feeling is carrying more history than you can see from the inside, but it does not mean the feeling is fake. Freud’s own position is more nuanced than many internet summaries: the love can be genuine as a human experience, and it can still be shaped by repetition, intensified by the therapy situation, and recruited as a defense against the work. What matters clinically is whether the feeling becomes something you can speak and understand, or something you must enact.

Is it normal to have a crush on your therapist?

It is common enough that Freud wrote about it more than a century ago because he considered it one of the central technical challenges of treatment, not an anomaly. The better question is whether your therapist can respond ethically, meaning they neither exploit the feeling nor humiliate you for having it, and whether the two of you can use it to understand what kind of recognition, safety, or rescue you are seeking.

Why am I angry at my therapist?

Anger often shows up when you feel unseen, when you fear you have been misunderstood, or when you are about to need something you do not want to admit you need. In depth work, anger is rarely “just anger”; it is also a map of expectation, a protest against disappointment, and sometimes a test: “Will you still be here if I stop performing?”

Should I tell my therapist I have feelings for them?

If the therapy is worth doing, then yes, because secrecy is usually where the pattern grows strongest. You do not have to confess in a dramatic way. You can simply name what is happening and see whether it can be thought about together. A therapist who cannot tolerate that conversation is not in a good position to do depth work with you.

How do I know whether to stay or leave?

If the frame is ethical and the relationship is basically respectful, it is often worth speaking about the impulse to leave before you act on it, because the wish to flee is frequently part of the transference pattern itself. If boundaries are being violated, if you are being pressured into secrecy or a dual relationship, or if you feel consistently manipulated or demeaned, leaving may be the appropriate move.

How do I start at FAC?

Use our contact form to request an appointment. Request an appointment.

Ready to begin?
Schedule a first session.
In-person in San Francisco, telehealth across California.
In-network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth. Superbills available.
Your first session is free if you choose not to continue.

Process Group Therapy in San Francisco: How Groups Create Relational Insight

Process Group Therapy in San Francisco: How Groups Create Relational Insight

A Reflection on Process Group Work at Free Association Clinic

If you are searching for process group therapy in San Francisco, you may already know something important: many of the problems that bring us to therapy are not only “inside” us. They show up between us, in the subtle push and pull of closeness, distance, belonging, conflict, and repair.

A process group offers a simple, demanding invitation: bring your real experience into the presence of others, and let relationship become the material of therapy.

A softly lit therapy room features a circle of empty chairs around a coffee table, evoking openness and shared conversation.

Process Group Therapy in San Francisco: Why the Group Matters

Most of us learn how to be with people long before we learn how to talk about it. We adapt. We protect ourselves. We discover what gets approval and what gets punished. Over time, these adaptations can become so familiar that they feel like personality, or like fate.

Process group therapy gives you a place to study this “how” of relating, not as a theory, but as a lived experience. The group becomes a social world in miniature, one where your patterns have room to appear, and where new possibilities can be tried without pretending you are someone else.

In many ways, group work is not about becoming a better performer in relationships. It is about becoming more present in them.

What “Process” Means in Group Therapy

The word “process” can sound technical, but in a therapy group it is surprisingly ordinary. It means paying attention to what is happening right now: in the room, between people, inside you as you speak, and inside you as you listen.

A process group does not primarily revolve around a lesson plan. Instead, it revolves around the living moment.

Not a class, not advice, not a performancey

A healthy process group is not a seminar where the most articulate person wins. It is not a place where you are expected to impress anyone with insight, or to provide the perfect encouragement at the perfect time.

It is also not a place where “fixing” each other becomes the main activity. Advice sometimes appears, but it is not the point. The point is something more difficult and more human: learning how you actually impact others, and how others actually impact you.

The group as a living relationship

In a process group, the relationships matter. People notice things. People react. People misunderstand, and then sometimes they repair. Over time, the group becomes a container sturdy enough to hold honesty that might feel risky elsewhere.

This is where group work begins to differ from many of our everyday conversations. In daily life, we often move away from tension quickly. We change the subject. We reassure. We smooth things over. In group therapy, the invitation is often to slow down and stay with what is happening long enough for something real to emerge.

The Group as a Microcosm of Your World

One reason process groups can be powerful is that the patterns you bring into relationships do not remain abstract. They show up.

If you tend to disappear, you may notice how quickly you hold back, even when something matters to you.

If you tend to manage the emotional climate, you may feel how exhausting it is to keep everyone comfortable.

If you expect rejection, you may feel the impulse to reject first, or to never need anything.

This is not a moral evaluation. It is an opportunity to see yourself more clearly.

Repetition, avoidance, and the relational present

Many people come to group therapy with a sense of repetition: “I always end up in the same kind of relationship,” or “I don’t know why I keep doing this.”

In a process group, repetition becomes visible in real time, which means it becomes workable. The goal is not to shame the pattern. The goal is to make it speak.

Often, what looks like a “bad habit” is also a kind of loyalty to survival. Group therapy can help you honor why the pattern formed, while also making room for something new.

Feedback that lands, and feedback that misses

Group feedback can be transformative, and it can also be confusing. Sometimes what someone says about you lands with immediate truth. Sometimes it does not.

Both matter.

Process group therapy is not a popularity contest, and it is not a voting system for who you “are.” It is a practice of encountering the fact that multiple perspectives exist, and that your inner experience and others’ experience of you may not match.

Holding that tension, without collapsing into defensiveness or people-pleasing, is part of the work.

A cozy therapy corner displays an open journal, pens, and a candle on a wooden table, suggesting warmth and introspection.

What You Actually Do in a Process Group

For people unfamiliar with group psychotherapy, the biggest question is often practical: what do you do in there?

The short answer is: you speak, you listen, and you learn to stay close to experience.

Speaking in the first person

In process group therapy, it helps to speak in the first person whenever possible.

“I felt exposed when the conversation moved on.”

“I noticed I wanted to interrupt.”

“I’m afraid I’m taking up too much space.”

These are not theatrical confessions. They are ways of making the inner world available for relationship, instead of keeping it private and unchanged.

Learning to stay with experience

Many of us have learned to leave experience quickly. We intellectualize. We explain. We tell the story from above the story.

There is a place for reflection, of course. But process group therapy often invites a deeper move: to stay close to what is happening, long enough to feel it and understand it from within.

This is one of the quiet disciplines of group work: noticing when you are tempted to flee, and practicing a different kind of presence.

Repair, accountability, and freedom

Groups inevitably include rupture. Someone misses your point. Someone says something clumsy. Someone feels left out. Someone feels criticized.

This is not a failure of group therapy. It is one of its most important materials.

When repair becomes possible, when people can say, “I misunderstood you,” or “I think I reacted from my own history,” or “Can we try that conversation again,” the group begins to offer something rare: a lived experience of accountability without humiliation.

From an existential perspective, this is also where freedom becomes practical. Freedom is not only an inner idea. It shows up as the capacity to respond differently, right here, with real people.

Who Might Benefit From Process Group Therapy

Process groups can be a good fit for many people, but not for every situation. A thoughtful consultation helps clarify that.

Still, certain themes often suggest that group work may be especially meaningful.

When isolation becomes the default

Many people suffer in isolation even when they are surrounded by others. They have learned to keep their deeper feelings private, either because it felt safer that way or because no one seemed able to receive them.

A process group offers an alternative to isolation that is not superficial socializing. It offers contact with depth.

When relationships keep repeating the same story

If you notice recurring relationship patterns, in romance, work, friendship, or family life, group therapy can become a living laboratory for those patterns.

It is one thing to understand your history. It is another thing to discover how your present ways of relating keep recreating the same outcomes, and then to practice something different.

An abstract graphic of overlapping warm-toned speech bubbles symbolizes layered dialogue and communication.

What Process Group Therapy Is Not

It may help to name a few misconceptions.

Process group therapy is not a place where everyone must disclose everything. You choose your pace.

It is not a place where conflict is encouraged for its own sake. But conflict is not automatically avoided.

It is not a “support group” in the casual sense, though support often emerges.

It is not a shortcut. Group therapy can be profound, and it often asks for patience.

If you are also considering individual therapy, group work can complement it. Many people benefit from having both an individual space and a relational space, especially when relationship itself is part of the struggle. (Learn more about our individual therapy and our psychoanalytic therapy approaches.)

Beginning Group at Free Association Clinic

At Free Association Clinic, our process group therapy is designed to support honest exploration in a relational setting, in a way that is grounded, respectful, and clinically serious.

If you are curious but uncertain, that uncertainty is often part of the doorway. Group therapy can feel unfamiliar at first, especially if you have learned to manage yourself carefully around others. Over time, the group can become a place where you do not have to perform your way into belonging.

Conclusion

Process group therapy is, in a sense, therapy in the presence of the world. It is where the questions of relationship, authenticity, conflict, and connection become immediate rather than abstract. For many people, that immediacy is exactly what makes group work transformative.

If you are exploring process group therapy in San Francisco, we invite you to learn more about our Process Group offering, or to contact Free Association Clinic to schedule a consultation and talk through fit.

James Norwood, PsyD
Associate Director, New School for Existential Psychoanalysis (https://www.freeassociation.us)
Clinical Director, The Free Association Clinic for Existential Psychotherapy and Psychoanalysis (https://www.freeassociationclinic.com)
Founder/CEO, inpersontherapy.com (https://inpersontherapy.com)

References

Yalom, I. D., & Leszcz, M. (2005). The Theory and Practice of Group Psychotherapy (5th ed.). Basic Books.
Foulkes, S. H. (1984). Therapeutic Group Analysis. Karnac Books.
Bion, W. R. (1961). Experiences in Groups. Tavistock Publications.
MacKenzie, K. R. (1990). Introduction to Time-Limited Group Psychotherapy. American Psychiatric Press.

Why Your Therapist Sometimes Doesn’t Give Advice

Why Your Therapist Sometimes Doesn’t Give Advice

If you’ve found yourself typing “why won’t my therapist give advice” into a search bar, you’re probably not looking for a philosophy lecture. You’re looking for traction. You’re in a situation where the stakes feel real, where the cost of getting it wrong feels high, and where you want someone to simply tell you what you cannot yet tell yourself, whether you should leave, stay, confront, wait, apologize, walk away, stop, start, risk, or protect what you have left.
And then, in the middle of that urgency, you meet a particular kind of response: not a verdict, not a plan, but a question, or a pause, or a shift toward what you are feeling rather than what you “should” do.

That can be infuriating. It can also feel strangely personal, as if the therapist is withholding out of coldness, indifference, or some private need to stay above the mess. In ordinary life, care often arrives packaged as advice, and when we are anxious or exhausted we can experience advice as the most basic form of kindness, because it temporarily releases us from uncertainty.

But existential and psychoanalytic therapy often works from a more skeptical view of help, one that is wary of the quiet kind of control that can hide inside “helping,” and wary too of the idea that psychological change is primarily produced by instruction. Free Association Clinic’s public language makes this orientation plain: the aim is not simply symptom management, but getting to the heart of the matter, in a way that helps you uncover meaning and reclaim what has become elusive in your life. (Free Association Clinic)

So the question is not simply whether your therapist gives advice. The deeper question is what the therapy is trying to protect when it does not, and what it risks when it does, because neutrality is not a gimmick and not a ban on human response. It is a mindset, and like any mindset it can be practiced well or poorly.

A woman gestures with uncertainty while talking to a therapist, with large question marks subtly layered over the background to suggest emotional confusion.

When you want an answer and you get a question

Most people come to therapy at least partly because the mind can become a closed room under pressure. You circle the same argument, you rehearse the same conversation in your head, you reach for the same solution that has failed before, and the repetition itself starts to feel like proof that you are stuck. When you finally bring that stuckness into the room, it is natural to want the therapist to act like an exit sign.

But a good question can do something advice cannot. It can return you to the part of the problem that is genuinely yours, which is not the part where you want the discomfort removed, but the part where you are divided, where you want two incompatible things, where you are trying to preserve love without risking loss, or preserve safety without feeling dead, or preserve self-respect without being alone.

In that sense, the therapist’s restraint is not meant to be passive. It is meant to keep your life in your hands.

If you want the broader frame FAC uses for this kind of work, start here: our approach to existential therapy

Neutrality is not the same as silence

In everyday language, neutrality can sound like a therapist who stays quiet, or a therapist who refuses to react. In classical psychoanalysis, though, neutrality points to something more demanding: an effort to engage without turning the session into an evaluation, without deciding too quickly what is important and what is trivial, what is respectable and what is shameful, what should be emphasized and what should be dismissed.

Freud’s phrase “evenly suspended attention” is useful here because it names a discipline of listening that is not ruled by the therapist’s preferences, impatience, or moral instincts. When neutrality is practiced well, it creates a particular condition in the room: you can say the thing you were bracing for judgment about, and instead of being corrected or steered into a preferred narrative, you are met with a serious kind of attention that makes truth more speakable.

That matters because people rarely hide their truth only out of secrecy. More often they hide because they expect evaluation, or they have learned that being fully honest will cost them love, status, belonging, or dignity. Neutrality is one way the therapist tries to reduce that cost, not by pretending everything is fine, but by refusing to moralize your inner life.

This is also why neutrality cannot be reduced to a rule like “the therapist never gives advice.” Neutrality is not an algorithm. It is a stance that asks a more difficult question, again and again: what is my talking, or my restraint, in service of right now, and is it serving the patient’s freedom, or is it serving my need to be effective, admired, reassuring, or in control.

Neutrality also should not be confused with indifference. A therapist can be engaged, warm, and emotionally present while still refusing to turn the session into a performance for approval, or a lecture on how to live. FAC’s own framing leans toward this kind of human seriousness: someone you can trust, who can stay with the pain of the human condition without turning you into a project. (Free Association Clinic)

Why a therapist may hold back from advice

There are practical reasons a therapist may be cautious about advice, and they have less to do with being mysterious and more to do with what advice can do to the relationship and to your agency.

Advice can be relieving, but it can also be misleading, because it often treats the surface dilemma as the real dilemma. You can ask, “Should I break up?” and receive a plausible answer, while the deeper problem remains untouched: why you choose the people you choose, what you are repeating, what you cannot bear to want, what you cannot tolerate losing, what you call love when it is really fear, what you call independence when it is really withdrawal. Advice may solve the moment while leaving the pattern intact.

Advice can also invite a subtle displacement of responsibility. If you do what the therapist says and it goes badly, the therapy can quietly become a court case. If you do not do what the therapist says, the therapy can quietly become a struggle over authority. Either way, the work gets pulled away from your desire and toward the therapist’s position.

This is where Thompson’s critique of “therapeutic ambition” matters. Therapeutic ambition is not the desire to be helpful. It is the therapist’s belief that they know what is good or bad for you in a way that licenses them to shape you accordingly, which turns help into a form of authorship. The danger is not advice itself. The danger is advice that carries the therapist’s private certainty about who you should be.

Neutrality is one way of refusing that certainty.

A calm and softly lit therapy room scene shows a pen resting on a closed journal, next to a box of tissues and a glass of water on a wooden table.

When advice is offered, it should not replace your responsibility

It is worth saying plainly: sometimes therapists do give advice. Sometimes safety is involved. Sometimes resources are needed. Sometimes a practical obstacle is blocking the work. Sometimes couples therapy or crisis-oriented work requires more structure and more direct intervention than individual depth therapy.
The issue is not whether advice ever appears. The issue is what kind of thing advice is treated as.

In existential and psychoanalytic therapy, advice is not usually seen as the catalyst for change, because lasting change rarely comes from being told what to do. It comes from coming into contact with what you actually want, what you actually fear, what you keep sacrificing, what you keep repeating, and what you keep calling “circumstances” when it is also your own participation in your life.

So when advice is offered in a depth-oriented relationship, it should feel less like instruction and more like a natural expression of helpfulness within a relationship that still refuses to bypass the central task: discovering your own desire and taking responsibility for your choices. In other words, help is allowed, but it is offered in a way that keeps the burden of authorship where it belongs, with you.

If that sounds demanding, it is, and it is also respectful. It assumes you are not a child in need of direction. It assumes you are a person trying to regain contact with yourself.

How this connects to neutrality and “non-judgment”

Many people hear “non-judgmental” and imagine a therapist who approves of everything, or who refuses to have a point of view. Neutrality is not approval. It is not permissiveness. It is an effort to keep the therapist’s evaluative reflex from becoming the governing force in the room, so that the patient’s truth can become clearer rather than immediately organized around what will earn praise or avoid disapproval.

That is why neutrality is bigger than advice. A therapist can give advice and still remain neutral in the relevant sense, if the advice is not carrying moral verdicts and not attempting to form the patient in the therapist’s image. A therapist can also refuse advice and still violate neutrality, if the refusal is used as a power move, or as a way of avoiding real engagement.

The question, again, is not “Did my therapist tell me what to do?” The question is “Is my therapist helping me face my life as mine, without condemnation and without takeover?”

A notepad labeled “Advice” with action steps sits beside another labeled “Thoughts” with introspective questions, symbolizing the contrast between external guidance and inner reflection

A practical check: when neutrality is working, it feels like thinking is possible again

When neutrality is working, many people notice something simple but profound: they start thinking again, in a way that is not just rumination. They become more honest about their motives. They catch themselves repeating patterns earlier. They feel less compelled to perform for approval, including the therapist’s approval. They begin to tolerate uncertainty long enough to find the real problem, rather than prematurely solving a substitute problem.

When neutrality is not working, the room goes dead, or you feel chronically shamed, or you feel emotionally stranded in a way that never becomes meaningful. In those cases, the right move is not to silently endure. The right move is often to say it plainly, in the room, and see what happens.

If you are looking for therapy that takes meaning, honesty, and responsibility seriously, Free Association Clinic offers existential psychotherapy and psychoanalysis, with in-person sessions in San Francisco and telehealth options described across service pages.

Schedule a first session: https://freeassociationclinic.com/contact-us/
Learn about insurance and superbills: https://freeassociationclinic.com/insurance/

How Free Association Clinic approaches this stance

FAC describes its work as existential psychotherapy and psychoanalysis, oriented toward uncovering meaning behind struggles and restoring what can feel lost in life, including passion, love, and joy.

In practice, that means the therapist is not primarily trying to direct your life from the outside; they are trying to stay close enough to your experience, and steady enough in their attention, that you can begin to see what you are doing, what you are avoiding, what you are protecting, and what you are asking of other people without realizing it.

If you want the clinic’s overview pages, use:

how we work / introduction: https://freeassociationclinic.com/introduction/
existential therapy: https://freeassociationclinic.com/existential-therapy/
psychoanalysis therapy: https://freeassociationclinic.com/psychoanalysis-therapy/
our staff: https://freeassociationclinic.com/about-us/

Practical details and insurance

FAC’s insurance page states the clinic is in-network with: Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth, and also offers superbills for out-of-network reimbursement.

Details: https://freeassociationclinic.com/insurance/

Common questions

Should my therapist ever give advice?
Sometimes, yes, especially for safety, crisis steps, or practical barriers that need to be addressed. The bigger distinction is whether advice is being used to replace your responsibility, or whether it is offered as a human form of help inside a relationship that still returns authorship to you.

Does neutrality mean my therapist has no feelings?
No. Neutrality is not emotional emptiness. It is the effort not to use the therapist’s feelings to steer your life, punish you, rescue you, or recruit you into their values. Therapy can be very human, and it should still feel like someone is with you.

Why is my therapist so quiet?
Sometimes quiet is a way of making room for your experience rather than filling the space with the therapist’s preferences. But quiet should not become a weapon, and neutrality should not require you to endure emotional absence. If the quiet feels abandoning, say so.

How do I know if therapy is working if I am not getting answers?
In depth work, progress often shows up as increased honesty, sharper awareness of your patterns, and a stronger capacity to tolerate uncertainty without collapsing into avoidance or impulsive action. Over time, you find yourself living the same life in a different way, with more self-knowledge and less self-deception.

What if I want a more directive approach?
That is legitimate. Some people want skills-first or structured treatment, and sometimes that is exactly what is needed. Fit matters. A mismatch can feel like failure when it is really a mismatch of method.

Ready to start?

If you are ready to begin, you can request an appointment here

People Pleasing and Losing Yourself

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People Pleasing and Losing Yourself

You agree to something you do not want, and what makes it painful is that you can hear yourself consenting as it happens. You say yes with a tone that sounds sincere, because part of you is sincere: you want the other person to stay pleased, you want the relationship to stay stable, and you want the moment to pass without consequence.

Then you are alone and the consequence arrives anyway, not as drama, but as something duller and more corrosive: irritation, dread, a low-grade anger with nowhere obvious to go, followed by the familiar question that is not really a question at all. Why did I do that again?

If you recognize this pattern, you have probably been told to set better boundaries. Sometimes that advice is accurate, but it often feels thin because it is aimed at the surface of the problem; it treats people pleasing as a skill deficit when, for many people, it is closer to a way of existing with other people, a posture toward life that can look like kindness from the outside and feel like self-erasure from the inside.

A woman sits solemnly on a bed holding a white mask, surrounded by crumpled tissues, symbolizing emotional vulnerability and hidden identity.

The private aftermath is the truth of the pattern

People pleasing is usually not the presence of generosity. It is the presence of a bargain.

The bargain is rarely stated out loud, which is part of why it keeps operating. It tends to sound like this: if you are disappointed in me, I am not safe; if you are angry, I have done something wrong; if you withdraw approval, I might lose you; if I ask for what I want, I will be exposed in a way I cannot tolerate. When that bargain is running, the yes is not really about your desire, and it is not even about your values; it is about managing the other person’s reaction so you can keep your footing.

Resentment follows for a simple reason. You are spending your life stabilizing the emotional weather around you, and even when you succeed, you succeed at the cost of disappearing. The anger is not a character flaw; it is often the part of you that still knows you traded yourself away for peace.

When kindness becomes self-loss

There is a version of people pleasing that is simply social intelligence, the ordinary tact of living among others. But the kind that leaves you resentful and unreal tends to have a different texture: it feels compulsory, and it keeps widening until it is no longer confined to a few situations. You begin to notice that you adapt before you think, that you apologize for taking up time or space, that you do not know what you want until you are finally alone, that you can sense what everyone else needs while your own desire feels quiet, distant, or embarrassing.

This is the moment many people say, “I don’t know who I am.” It can sound melodramatic until you take it seriously, at which point it becomes a precise description of what has happened: your life has become organized around being acceptable, and acceptability is not the same as being real.

When kindness becomes self-loss

There is a version of people pleasing that is simply social intelligence, the ordinary tact of living among others. But the kind that leaves you resentful and unreal tends to have a different texture: it feels compulsory, and it keeps widening until it is no longer confined to a few situations. You begin to notice that you adapt before you think, that you apologize for taking up time or space, that you do not know what you want until you are finally alone, that you can sense what everyone else needs while your own desire feels quiet, distant, or embarrassing.

This is the moment many people say, “I don’t know who I am.” It can sound melodramatic until you take it seriously, at which point it becomes a precise description of what has happened: your life has become organized around being acceptable, and acceptability is not the same as being real.

Authenticity is not a trait, and it is not a hidden object

From an existential psychoanalytic view, authenticity is not a stable personality feature that you either possess or lack, and it is not a pure “true self” waiting underneath your social roles like a buried treasure. Authenticity is a way of existing, which means it is something you appropriate in the middle of real life, and it is something you can lose again and again, especially when you begin living by public opinion, by others’ expectations, and by the quiet tyranny of what you imagine you are supposed to be.

This matters clinically because it changes what you are trying to do. If you keep waiting to discover a ready-made identity, you may never do the harder work of taking up your own life in the presence of other people, where the risks are real and the consequences are not imaginary.

People pleasing is one of the most efficient ways to avoid that work, because if you become what others want, you never have to find out what you want; you can remain socially successful while privately absent.

A woman appears cheerful as she speaks to her reflection in a shattered mirror, which shows a somber expression, illustrating a divide between outward expression and inner truth.

Winnicott’s false self, or the self that keeps the relationship safe

Winnicott gives language that many people recognize immediately once they hear it, because it names the lived experience rather than offering advice. He described a false self that develops when a person learns, often early, that spontaneity is risky, that certain feelings are not welcome, and that the safest way to stay connected is to present what the other person can tolerate.

This false self is not simply “fake.” At its best, it is protective and socially useful; it helps you navigate a world that requires adaptation. In the best of cases, it can be a means by which a more intimate relationship is reached. The trouble begins when the false self becomes your primary way of being, when it stops serving you and starts running you, because then your life becomes a performance built around maintaining connection and avoiding rupture. However, the connection it affords is a catch 22, the relationship might be stable, but it is based on a lack of intimacy. You may look functional and agreeable while feeling internally strained, resentful, empty, or strangely unreal, as if you are living through a socially acceptable version of yourself while something more alive stays hidden, not because it is mystical, but because it has learned it is safer not to appear.

People pleasing often fits this picture with uncomfortable accuracy. It is compliance in the service of attachment, and it is frequently fueled by the fear that if you stop being good, you will stop being loved.

The paradox of being liked

People pleasing is often praised, and that praise can become part of the trap. If everyone experiences you as easy, reasonable, helpful, thoughtful, then the role hardens into identity, and identity becomes a kind of prison because you start defending the image you have created. You become allergic to disappointing people, not only because you fear their anger, but because their disappointment threatens the self you have built to survive.

The paradox is that the more you specialize in being liked, the harder it is to feel known, and the harder it is to feel real. Being liked can function like an invisibility cloak: you avoid conflict, and by avoiding conflict you avoid the moments that require you to take a stand, to state a preference, to risk being misunderstood, to tolerate someone’s frustration, and to remain present anyway.

Why advice fails, and what therapy changes

Most people pleasers already know the advice. They can recite it, sometimes with impressive sophistication. Yet when they attempt to follow it, something inside them reacts as if a boundary is not a sentence but a threat. That reaction is the point. It tells you that the pattern is not maintained by ignorance, but by fear, and fear does not yield to checklists.

Psychoanalytic and existential therapy take seriously that people pleasing often began as adaptation. It may have been how you kept connection, reduced threat, stayed in good standing, or found a place for yourself in a family or culture where approval felt conditional. Even when your current life is safer, the old bargain can remain in force, and the false self can keep doing its job long after it stops protecting you.

Therapy matters here because the problem is relational, and therefore the work has to become relational too. The impulse to be the “good patient,” to make the therapist comfortable, to hide anger, to soften your language, to say what you think is expected, to stay agreeable at the very moment you are not agreeable, is not a distraction from the treatment; it is often the treatment, because it allows the false self to become visible as it is happening, and it allows you to experiment with a different way of being in a relationship where the stakes are real but the goal is not approval.

In existential work, authenticity is not comfort; it is exposure. It is the willingness to let your desire, your anger, your limits, your grief, and your ambivalence be part of the relationship, not because you want conflict, but because a life without that truth is not a life you can actually inhabit.

Learn more about existential therapy: https://freeassociationclinic.com/existential-therapy/
Learn more about psychoanalytic therapy: https://freeassociationclinic.com/psychoanalysis-therapy/

A woman sits in silence at a table while faded, overlapping figures around her appear engaged in conversation, representing isolation amidst social noise.

Starting at Free Association Clinic

If your yes is keeping the peace while your private life fills with resentment, you do not need a more optimized personality. You need a different relationship to fear, guilt, and responsibility, and you need a place where the part of you that has been managing everyone else can stop performing long enough for something more genuine to appear.

Free Association Clinic offers in-person sessions in San Francisco and telehealth across California.

Request an appointment: https://freeassociationclinic.com/contact-us/
How we work / our staff: https://freeassociationclinic.com/about-us/

Insurance and practical logistics

The clinic is in-network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth. If your plan is not listed, out-of-network reimbursement may still apply, and the clinic can provide a superbill.

Learn about insurance and superbills: https://freeassociationclinic.com/insurance/

Consultation: your first session is free if you choose not to continue. If you decide to move forward, payment is discussed during the meeting.

FAQ

Is people pleasing the same as being kind?
No. Kindness can include honesty and limits, and it can tolerate another person’s disappointment. People pleasing is often organized around safety and approval, which is why it can feel like care on the outside while feeling like disappearance on the inside.

Why do I feel resentful after I people please?
Because the relationship stayed calm, but it stayed calm by costing you something. Resentment is often the aftertaste of self-erasure, especially when you agreed out of fear rather than desire.

Why do I feel guilty when I set a boundary?
Because guilt can be the emotional price of breaking an old rule, even when the rule is destroying your life slowly. Guilt does not always mean you harmed someone; sometimes it means you stopped conforming.

Is people pleasing a trauma response?
Sometimes. Sometimes it is a learned adaptation to conditional approval, volatile relationships, or environments where being low-maintenance was the safest role. The label matters less than understanding what your people pleasing protects and what it costs.

What if I don’t even know what I want?
That is common, and it often makes sense. If the false self has been steering for years, desire can go quiet. Therapy can help you recover it without forcing quick answers, and without treating your life like a self-improvement project.

Schedule a first session: https://freeassociationclinic.com/contact-us/

Repetition Compulsion: Why You Keep Repeating the Same Patterns Even With Insight

Repetition Compulsion: Why You Keep Repeating the Same Patterns Even With Insight

You can tell the whole story.

You know where it started. You can name the theme. You can predict what you’re about to do next.

And then you do it anyway.

Same relationship, different face. Same shutdown when conflict becomes real. Same overwork until you feel hollow. Same promise that this time will be different, followed by the same quiet collapse.

There is a specific kind of misery in this: your mind has caught up, but your life has not.

Psychoanalysis does not treat this as a simple failure of awareness. Freud’s name for the phenomenon is repetition, and later, repetition compulsion. The point is direct. When something cannot be fully remembered, spoken, or borne as experience, it returns as something you do. Not as a story about the past, but as a pattern that keeps happening now.

A couple in therapy shows emotional strain while a therapist observes, surrounded by repeated, fading images of internal anguish.

Repetition compulsion, when the past returns as the present

Freud noticed that people often do not merely describe what troubles them. They re-create it. The past returns as a choice, a relationship, a reflex in conflict, a predictable collapse, a way of handling need, shame, anger, desire, or dependence.

That return can be humiliating, especially when you can see it coming. It can also be confusing, because it often looks like you are choosing against yourself.

One way to name what is happening is this: repetition compulsion is the person’s tendency to prefer the familiar, even when the familiar hurts, because the familiar is organized. It has rules. It has a role for you. It offers a known price rather than an unknown risk. It feels like home, even if it is painful.

If that sounds too abstract, bring it down to one question. What is the pattern buying you, and what is it helping you avoid?

Insight can become a form of protection

Many people who repeat patterns are not ignorant. They are perceptive. They can track their history. They can offer a sophisticated explanation. They can even say, with eerie accuracy, what they will do next.

Insight matters, but it does not automatically change how you live.

Sometimes insight becomes a shield. If you can explain your pattern, you can keep it at the level of concept, where it cannot touch you. You can turn experience into narration, and narration into control.

This is one reason therapy can become oddly performative in contemporary culture. People arrive with a well-built theory of themselves. They may even be correct. Yet the pattern remains.

Existential therapy does not oppose insight. It simply asks more of it. If insight does not reach your actual life, then it has not yet become truth in the sense that matters.

Learn more about existential therapy: https://freeassociationclinic.com/existential-therapy/

Working through, the slow conversion of understanding into lived conviction

Freud did not only name repetition. He also named what is required to loosen it.

Working through is not a single realization and not a clever technique. It is the clinical and ethical labor of staying with what resists change, repeatedly, until the repetition becomes speakable and therefore negotiable.

This is where psychoanalytic therapy can feel repetitive. That repetition is not an accident. It is the material. You do not simply talk about the pattern. You encounter it as it appears in the way you relate, including the way you relate to the therapist.

Michael Guy Thompson’s writing places the emphasis where it belongs: on the primacy of lived experience and on the fundamental rule as a pledge toward honesty. Not honesty as confession, and not honesty as self-display, but honesty as the refusal to keep curating your inner life for safety, approval, or control.

Working through begins when the pattern is no longer treated as an object you describe and becomes something you can experience, bear, and respond to differently.

Learn more about psychoanalytic therapy: https://freeassociationclinic.com/psychoanalysis-therapy/

A man and woman face away from each other in a tense therapy scene, with ghostly echoes of the man holding his head in distress.

Freedom and evasion, why repetition can feel like fate

It is tempting to describe repetition as something that merely happens to you. That story is comforting, but it is often incomplete.

Existential thought complicates the picture, and makes it more honest. In a way, we do choose our suffering, often outside awareness. Not because we consciously want pain, but because we participate in an arrangement whose costs we already know. The familiar costs can feel safer than the unfamiliar risks.

This is where Sartre’s point matters. Freedom is not a prize at the end of therapy. Freedom is already the condition. The question is what you do with it, and how you evade it.

A repeating pattern often functions as an alibi. It allows the sentence, “This is just how I am,” or “This is what always happens,” which is less terrifying than admitting, “This is what I keep choosing, and I do not yet want to face the alternatives.”

Working through is the process by which that evasion becomes visible, and therefore less automatic.

What changes when repetition becomes an encounter

Therapy becomes useful when repetition moves from something you regret to something you can meet.

Often the first change is not behavioral. It is clarity about cost. The pattern stops being a story you tell well and becomes something you can feel in its consequences, in intimacy, in aliveness, in time, in honesty.

A second change is how anxiety is understood. Anxiety is often treated as a warning that you are doing something wrong. Existential work treats it more soberly. Sometimes anxiety is what rises when you stop relying on an old arrangement and speak about what’s important.

A third change is that the repetition becomes relational and speakable. Psychoanalytic therapy treats the encounter as central. The relationship is not incidental. It is where the unspoken can emerge, and where old dynamics can be recognized instead of acted out.

This is the lived meaning of working through. Insight becomes real when it is no longer merely said, and begins to change what you can bear, what you can admit, and what you can choose.

A calm, concentric spiral made of smooth stones arranged on a sandy surface, evoking order and contemplation.

Starting at Free Association Clinic

Free Association Clinic offers in-person sessions in San Francisco and telehealth across California.

Request an appointment: https://freeassociationclinic.com/contact-us/

Insurance and practical logistics

The clinic is in-network with Aetna, Blue Shield of California, Blue Cross Blue Shield, Optum / UnitedHealthcare, and Cigna / Evernorth. If your plan is not listed, out-of-network reimbursement may still apply, and the clinic can provide a superbill.

Insurance details: https://freeassociationclinic.com/insurance/

Consultation: Your first session is free if you choose not to continue. If you decide to move forward, payment is discussed during the meeting.

Common questions

If I already understand my pattern, why am I still stuck?
Insight can describe a pattern. Repetition compulsion is the pattern in motion. Working through is how the motion becomes thinkable, speakable, and changeable.

Does it mean therapy is failing if it feels repetitive?
Not necessarily. Repetition is often the doorway. When therapy feels repetitive, it may be contacting the actual material rather than refining the story about it.

What does working through look like in a session?
Often it looks like staying with the moment you usually escape, the moment you convert into explanation, or the moment you try to control. It looks like naming what is happening now, including what is happening between you and the therapist.

How long does it take to stop repeating patterns?
There is no honest universal timeline. Patterns built over years rarely dissolve on command. Psychoanalytic work aims for durable change rather than quick relief.

Safety note

This article is for general education and is not medical or mental health advice. If you or someone you care about is in immediate danger or crisis, call local emergency services or 988 in the United States.

References

Sigmund Freud, Remembering, Repeating and Working-Through (1914)
Sigmund Freud, Beyond the Pleasure Principle (1920)
Michael Guy Thompson, The Fundamental Rule of Psychoanalysis (1998)
Michael Guy Thompson, The Enigma of Honesty: The Fundamental Rule of Psychoanalysis (2001)
Michael Guy Thompson, The Ethic of Honesty: The Fundamental Rule of Psychoanalysis (2004)
Jean-Paul Sartre, Being and Nothingness (1943)

Psychoanalytic Neutrality in Therapy: Thompson on the Rule of Neutrality

Deception and Trauma in Existential Psychoanalysis: Laing and Freud on Mystification

Neutrality, as psychoanalysis uses the word, is not the absence of care, it is a way of refusing to take over someone else’s experience while still remaining fully present to it.

The trouble begins with the word itself. In everyday speech, “neutral” suggests detachment, evasiveness, even a kind of moral cowardice, as though the clinician were trying to avoid the risks of relationship by hiding behind a technical ideal. Thompson’s point, in his essay on the rule of neutrality, is that this misunderstanding is not a minor semantic problem but a distortion of technique itself, because it subtly encourages two equally familiar caricatures, the analyst who withdraws in the name of neutrality, and the analyst who manages the hour through interpretation, persuasion, or “helpful” direction, while telling himself this too is neutrality.

If you are a patient, the first caricature can feel like being treated as an object of study or, worse, like being left alone with your suffering while someone watches from behind glass. If you are a clinician, the second caricature can look like competence, since it offers the quick relief of taking charge, the relief of being the one who knows what is going on, what it means, and where it should go. Thompson insists that both can be defenses, and that the discipline of psychoanalytic neutrality in therapy exists precisely because the analytic situation reliably pressures the therapist to become either absent or controlling.

psychoanalytic neutrality in therapy in a calm office setting

Why neutrality is so often mistaken for emotional absence

One reason neutrality gets moralized is that it sounds like a moral posture. “Do not take sides” can sound like a refusal to commit, and a refusal to commit can sound like a refusal to care. Yet within the psychoanalytic tradition, neutrality is not primarily a statement about what the analyst feels, nor a rule about how the analyst should appear, but an attempt to describe a mental attitude that protects inquiry, an attitude that must withstand the patient’s provocations, the analyst’s anxiety, and the many subtle invitations to make the work easier by making it smaller.

Thompson notes, in effect, that neutrality is a technical term whose meaning is precarious outside the analytic lexicon, and that it has been repeatedly reduced to an image, the analyst as blank, cold, and withholding. The reduction is tempting because it is simple, and it permits one to confuse a style of interpersonal distance with a discipline of listening. But neutrality, as Thompson reads Freud, is closer to a cultivated openness, one that refuses premature certainty, refuses the seductions of therapeutic ambition, and refuses the gratification that comes from being the decisive author of the patient’s story.

Neutrality as a discipline of attention, not a personality style

Thompson’s most important correction is that neutrality belongs to the analyst’s manner of attending, and this places it immediately in the vicinity of Freud’s technical recommendation of “evenly suspended attention,” a stance that refuses to select too early what matters and what does not. In Freud’s view, the very act of selection is already a theory, already a bias, already a way of deciding in advance what is meaningful, and therefore a way of foreclosing what the material might disclose later.

This is one reason neutrality cannot be reduced to a performance of impassivity. One can be impassive and still be deeply biased, because bias does not require visible emotion, it only requires an interpretive hunger, an impatience with ambiguity, an inability to tolerate the patient’s experience showing itself in its own sequence rather than in the order the therapist would prefer.

Thompson connects this to a phenomenological sensibility that he names directly, the suspension of judgment, epoché, not as an academic ornament but as a clinical requirement: a disciplined bracketing of what one is certain one knows, so that what is present, but not yet articulate, has a chance to come forward. Here neutrality starts to look less like “not caring” and more like a form of restraint that makes room for experience, including the experience that embarrasses our theories and threatens our self-image as helpful professionals.

Three inherited definitions, and how they quietly moralize the technique

Thompson’s chapter becomes especially useful when he refuses to attack caricatures and instead takes seriously three influential definitions of analytic neutrality meaning, showing how each can be clinically sound in one respect and clinically misleading in another.

Roy Schafer’s formulation places emphasis on evenhandedness: no saints and sinners, no favorites, no advocacy for one side of a domestic conflict, and no easy conscription of the patient into the analyst’s personal values. There is real wisdom here, particularly for patients who arrive already looking for an ally, a witness, a judge, or a rescuer. At the same time, Thompson’s worry is that the definition can harden into an axiomatic ideal, a purity standard, as though neutrality were measurable by how consistently it is maintained, rather than by whether it serves the situation that is actually unfolding. When neutrality becomes an abstract criterion of “real analysis,” the analyst can begin to act as though the hour were a series of permissible and impermissible “incidents,” rather than a living relationship in which judgment, discretion, and timing are indispensable.

A second definition, from Moore and Fine’s Psychoanalytic Terms and Concepts, emphasizes countertransference and value restraint, framing neutrality as the avoidance of unwarranted interference, the refusal to impose personal values, and the effort to let the patient’s needs and capacities guide the work. The formulation also tries to avoid extremes, neither detachment nor overinvolvement, and it describes the analyst’s stance as one of helpful, benign understanding. Thompson’s objection is not to restraint itself, but to the fantasy that benign understanding is simply an “emotional attitude” one can calibrate, as if countertransference could be managed by turning down the volume on one’s feelings. Understanding, on his reading, is not merely a mood but a capacity that can oppose mood, especially when anxiety drives the analyst to act. He also insists, crucially, that treatment goals are always imposed in some sense, even if minimally and tacitly, because treatment without any goal would be purposeless. Neutrality therefore cannot mean the absence of aim; it must mean something like restraint in the way aim is pursued.

The third definition, from Laplanche and Pontalis, makes explicit the breadth of neutrality: neutrality toward religious, ethical, and social values, meaning no directing treatment toward an ideal and no counseling; neutrality toward transference, captured in the maxim “Do not play the patient’s game”; and neutrality toward the patient’s discourse itself. Laplanche and Pontalis then point to Freud’s 1912 recommendations as the clearest statement of what neutrality is meant to be, especially where Freud castigates therapeutic ambition in therapy and educative ambition, and likens the analyst to the surgeon whose single aim is to perform the operation as skillfully as possible. Thompson treats this as a pivot, noting the irony that Freud’s most extensive discussion of the stance later called neutrality occurs before Freud actually introduced the term, since the term appears later, in 1915.
What links these definitions, in Thompson’s hands, is the recurrent danger of mistaking neutrality for an external posture rather than an internal discipline, and of converting a technical principle into a moral identity. Once that happens, neutrality is no longer something the analyst does with his mind, moment by moment, but something he imagines he is, a “neutral” person, which can quickly become a justification for emotional absence, interpretive domination, or both.

Freud’s two injunctions, the surgeon and sympathetic understanding

This is the point at which the familiar accusation, “neutral means cold,” begins to look less like a patient’s misunderstanding and more like a consequence of analysts repeating Freud’s metaphors without hearing Freud’s argument.

Freud’s surgeon analogy is often recited as an endorsement of coldness, yet Freud introduces it to criticize the analyst’s temptation to turn treatment into something else: an educative project, a moral project, a scientific project, a project of proving one’s cleverness. The surgeon metaphor is not primarily about the analyst’s affect but about the analyst’s aim, which is why Freud places it in the context of condemning therapeutic ambition and its cousin, the wish to “set tasks” for the patient. When the analyst’s aim becomes the display of expertise, neutrality collapses, not because the analyst becomes warm, but because the analyst becomes intrusive.

At the same time, Freud is explicit elsewhere, in On Beginning the Treatment, that the therapist’s stance should be one of sympathetic understanding, and that the therapist must not enter the scene as a moralist or become an advocate for one side of a conflict. The apparent contradiction only persists if sympathy is confused with taking sides, or if neutrality is confused with withholding. Freud’s point, as Thompson reads him, is that sympathetic understanding is precisely what allows the analyst to refrain from moralizing, refrain from recruiting, and refrain from replacing inquiry with judgment, so that the patient can speak more fully into the space the analyst is holding.

The deeper issue, then, is not whether the analyst is warm or cool, but whether the analyst can remain open, patient, and ethically restrained while being fully engaged, and whether the analyst can tolerate the anxiety of not resolving the patient’s conflict by adjudicating it.

Neutrality vs abstinence, a clinical dialectic rather than a slogan

Thompson is also careful not to let neutrality be romanticized as pure openness, because openness has consequences, particularly in the transference. If neutrality is rooted in openness, patients will often experience this openness as a kind of love, and in the logic of transference it can feel personal, as though the analyst’s openness were meant for them alone. This is one reason Freud insisted that the treatment must be carried out in abstinence, that the patient’s need and longing should be allowed to persist so that it can become a force impelling work and change, and so that the analyst does not appease those forces through surrogates.

Thompson’s point is that neutrality vs abstinence is not a matter of choosing one slogan over another, but of recognizing that the two rules correct each other. Abstinence moderates how much openness is prudent in a given moment, guarding against seduction and against the quiet transformations of the analyst into lover, rescuer, or benefactor. Neutrality, in turn, guards abstinence from turning into a rigid withholding that inhibits candor, since a stance that is too afraid of encouraging fantasy can easily become a stance that discourages disclosure.

The important sentence in Thompson’s account is almost disappointingly plain: neutrality was never meant to be employed universally. It must be applied with discretion, depending on the forces at play, and discretion, unlike slogans, requires judgment.

rule of neutrality in psychoanalysis symbolized by balance

When neutrality becomes a caricature, permissiveness and interpretive compulsion

If neutrality is treated as universal, the analyst is tempted toward the fantasy of neutrality “full bore,” and Thompson is blunt that such a stance is impossible. Were it feasible, he argues, the analyst’s role would be compromised and reduced to a permissive patron, while the analysis itself would lose tension because patients would inevitably interpret the analyst’s inactivity as agreement. A caricature of neutrality thus becomes a covert form of collusion, not because it takes sides overtly, but because it refuses to take responsibility for the meanings and impacts of its own silence.

But Thompson also targets the opposite caricature, one that is especially common among talented clinicians, namely the interpretive compulsion.
Interpretations, by their nature, undermine cherished assumptions, and thus they often breach neutrality, not because interpretation is forbidden, but because it easily becomes a way of directing the patient, controlling the narrative, or relieving the therapist’s anxiety by producing quick explanatory mastery. Thompson suggests that this dilemma pushed figures like Winnicott and Lacan toward using fewer interpretations, sometimes toward dispensing with them more or less entirely, in order to widen the range of neutrality they could sustain, though he also notes that Freud warned against the opposite error, the abandonment of common sense, and explicitly advocated alternating a neutral frame of mind with an ordinary one, “swinging over according to need” from one mental attitude to the other.

The point is not to idolize silence or idolize interpretation, but to see how both can serve as defenses, and how neutrality, properly understood, is the attempt to keep one’s defenses from becoming the patient’s fate.

What patients experience, what therapists must bear

For patients, the lived experience of psychoanalytic neutrality in therapy is rarely neat. It can feel relieving when one recognizes that the analyst is not trying to recruit one into a worldview, not trying to win an argument about one’s life, and not trying to adjudicate one’s conflicts by declaring one side correct and the other pathological. It can also feel frustrating, since neutrality refuses the fantasy that someone else will finally solve the problem on one’s behalf, and the refusal is not punitive but structural, because psychoanalysis is built on the recognition that freedom and responsibility cannot be outsourced without cost.

Thompson also insists that neutrality should not inhibit friendliness, because neutrality is not a ban on human presence; it is a disciplined restraint in the use of power, a way of bracketing the analyst’s eagerness, morality, and ambition so that the patient’s experience has room to become articulate. When neutrality turns inhuman, it is no longer neutrality but defensiveness masquerading as technique.

For clinicians, especially clinicians in training, the most difficult implication is that neutrality is not something one “applies” once one memorizes a definition. It is a discipline of mind that requires patience, an ability to withstand pressures to do something, to demonstrate signs of success, to reassure oneself by acting. Thompson’s formulation becomes almost paradoxical here: doing nothing can be the principal means of effecting change, not because passivity is virtuous, but because premature action often serves the analyst’s anxiety more than the patient’s inquiry. The measure of analytic efficacy, on his view, is not how much neutrality is used, but whether the analyst knows when it is prudent to remain neutral and when it is necessary to take a position.

In that sense, neutrality is not the renunciation of responsibility but a particular form of responsibility, the responsibility not to steal the patient’s experience by interpreting it too quickly, moralizing it too readily, or rescuing the patient from the burdens that belong to existence itself.

analytic neutrality meaning openness and suspension of judgment.

Conclusion

Thompson’s reading of the rule of neutrality in psychoanalysis clarifies why neutrality has been so easily distorted, and why the distortions matter: neutrality is not a posture of coldness, it is a discipline of openness; it is not the refusal to care, it is the refusal to take over; it is not the absence of aim, but the restraint of aim, especially when therapeutic ambition threatens to turn treatment into persuasion, indoctrination, or performance.

Neutrality, in Thompson’s hands, is best understood as a cultivated capacity to suspend judgment without suspending contact, to listen without selecting too soon, to resist taking sides in therapy without refusing moral seriousness, and to balance openness with abstinence so that the analytic situation neither collapses into seduction nor hardens into inhumanity.

At Free Association Clinic, our work in psychoanalytic therapy and existential therapy is grounded in this tension, and our training program treats it not as a slogan but as an ethic of attention. If you wish to explore whether this approach fits what you are looking for, you can contact Free Association Clinic

James Norwood, PsyD
Associate Director, New School for Existential Psychoanalysis (https://www.freeassociation.us)
Clinical Director, The Free Association Clinic for Existential Psychotherapy and Psychoanalysis (https://www.freeassociationclinic.com)
Founder/CEO, inpersontherapy.com (https://inpersontherapy.com)

References

Freud, S. (1912/1958). Recommendations to Physicians Practising Psycho-Analysis. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 12, J. Strachey, Ed. and Trans.). Hogarth Press.
Freud, S. (1913/1958). On Beginning the Treatment. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 12, J. Strachey, Ed. and Trans.). Hogarth Press.
Laplanche, J., and Pontalis, J.-B. (1973). The Language of Psychoanalysis (D. Nicholson-Smith, Trans.). Hogarth Press.
Moore, B., and Fine, B. (1990). Psychoanalytic Terms and Concepts. American Psychoanalytic Association, Yale University Press.
Schafer, R. (1983). The Analytic Attitude. Basic Books.
Thompson, M. G. (1994). The Truth About Freud’s Technique: The Encounter With the Real. New York University Press.
Thompson, M. G. (2024). Essays in Existential Psychoanalysis: On the Primacy of Authenticity. Routledge.

Free Association in Psychoanalytic Training: Beyond the Institute Model

Free Association in Psychoanalytic Training: Beyond the Institute Model

Reflection on Chapter 12 of Michael Guy Thompson’s Essays in Existential Psychoanalysis: On the Primacy of Authenticity

There is a settled faith that shadows most professional training, even when no one says it outright: if you accumulate the right knowledge, and if the institution that guards the knowledge certifies you, then you become the kind of person who can practice it. Study hard, learn the method, pass the examinations, demonstrate competence, and you will have earned your authority.

In Chapter 12 of Essays in Existential Psychoanalysis, Michael Guy Thompson does not merely dispute this faith, he exposes the kind of human relationship it quietly presupposes, and he asks whether that relationship can possibly yield an analyst. His provocation is not that scholarship is worthless, nor that institutes should be burned down, but that psychoanalytic education cannot be reduced to academic education without losing the very sensibility it claims to transmit. When free association is treated as the founding condition of analysis, Thompson suggests, it becomes difficult to regard it as a technique alone; it begins to look like an ethic of formation, a model of how one learns to listen without coercion (Thompson, 2024, pp. 243–246).

This is not only a question for clinicians, even if it begins there. Patients rarely ask where an analyst trained, but they do encounter, immediately and unmistakably, what the training has made possible in the analyst’s presence: whether the room is a place where speech can unfold, or a place where speech is quietly pressured to conform.

Free Association in Psychoanalytic Training: Why the Question Matters

Technique or formation: what is actually being taught?

The title of Thompson’s chapter presents itself as a technical query, almost bureaucratic in tone, as though the question were simply where to file free association in the educational syllabus. Yet the force of the chapter comes from the fact that Thompson does not accept the premise that analysis is first a body of content to be mastered and only later a relational practice to be performed. Psychoanalysis, in his telling, concerns the conditions under which one human being can meet another without turning the other into an object to be managed. If that is what psychoanalysis is for, then education cannot be a matter of training candidates to reproduce an approved discourse; it has to be a formation of character and sensibility, the slow acquisition of an ability to bear what is uncertain, unflattering, and ethically demanding (Thompson, 2024, pp. 243–244).

So the question “What is being taught?” becomes sharper than it first appears. Are institutes teaching a procedure, a method that can be applied from the outside, or are they cultivating an inward capacity, a kind of disciplined openness, without which method becomes a form of evasion? Thompson’s wager is that free association, properly understood, does not sit comfortably inside the academic model precisely because it is not a content-area. It is a way of being with experience, and it is therefore a way of being with another person.

Notebook representing free association in psychoanalytic training

Thompson’s Critique of the Academic Model

Why book-knowledge cannot substitute for lived authority?

Thompson’s opening declaration is deliberately unsoftened: “The academic model of education is ill-suited to train and educate people to become psychoanalysts” (Thompson, 2024, p. 243). The sentence is blunt enough to provoke defensiveness, and Thompson anticipates that response by insisting he is not speaking as someone unfamiliar with academia. His point is not that universities should have no place in psychoanalytic education, but that academic formation, by its structure, tends to treat knowledge as something possessed, verified, and then licensed.

The most striking feature of his critique is how quickly he locates the psychoanalytic task in the moral texture of ordinary life. He writes that psychoanalysts are “concerned with the way human beings treat each other,” and that they help others come into their own by treating them with “respect, compassion, and honesty” (Thompson, 2024, p. 243). This is not a sentimental aside, it is the ground of his argument, because once psychoanalysis is framed as a matter of how persons treat persons, the fantasy that authority can be granted by institutional proof begins to look naïve in the pejorative sense, a wish for certainty where uncertainty is constitutive.

Academic training, at least in its prevailing form, is built upon a tautology: you learn by reading what others claim to know, and you prove learning by repeating, with increasing sophistication, what has already been said, until the institution determines you may finally practice. Thompson names this directly, noting how psychology programs presume that students can learn to be therapists by studying books and then being evaluated on how well the material has been absorbed before they are permitted to treat (Thompson, 2024, p. 243). The problem, for him, is not the reading. The problem is that the reading is too easily mistaken for the capacity to stand in the analytic situation without substituting knowledge for contact.

Training as confrontation with one’s own suffering

Thompson deepens the critique by moving from epistemology to experience. If analysis is not primarily the application of knowledge, then what grants authority? He gives an answer that is both simple and difficult to tolerate, because it does not flatter any institutional procedure: “We learn about human misery from our own suffering, and we learn to relieve it by coming to terms with the suffering that we have experienced and continue to experience every day of our lives” (Thompson, 2024, p. 244).

This sentence is the hinge of the chapter. It shifts training from an external sequence of requirements to an inward confrontation, and it does so without romanticizing suffering, because the point is not that pain automatically ennobles, but that unworked suffering easily becomes coercion. An analyst who has not begun to come to terms with his or her own misery will be tempted, in the consulting room, to manage the patient’s misery as a way of managing his own, which is to say, to impose an agenda under the guise of care.

Thompson therefore defines psychoanalytic training as the practical task of getting in touch with the roots of one’s suffering and devoting oneself to alleviating it from a psychoanalytic perspective, so that one can eventually accompany another without pretending to stand above the human condition one is addressing (Thompson, 2024, p. 244). In this light, “authority” is not granted by the institution, it is earned in the slow work of being educated by experience, which includes, unavoidably, the experience of one’s own limitation.

Free Association as a Model for Psychoanalytic Education

Self-disclosure, openness, and the refusal of an agenda

Thompson is attentive to the way free association becomes a cliché precisely because it is so familiar. One of the benefits, he says, of attempting to define it is discovering that it resists final definition; it is recognizable, yet elusive, and any concise account tends to falsify it (Thompson, 2024, p. 245). This matters because what cannot be finalized cannot be owned, and what cannot be owned cannot be administered with the same confidence as a curriculum.

In the chapter, Thompson treats free association as inseparable from self-disclosure and openness, not in the confessional sense of saying everything for its own sake, but in the existential sense of speaking from where one actually is, rather than from where one believes one should be. Its most distinctive feature, as he emphasizes, is the absence of an externally imposed agenda: there is no plan the patient is expected to follow, no sanctioned trajectory that would reassure both patient and analyst that the “right” material is being produced (Thompson, 2024, p. 245).

If this is what free association is, then one can see why Thompson is drawn to it as an educational model. An education modeled on free association would not be organized around predetermined outcomes, because predetermined outcomes are precisely the temptation that free association resists. Instead, education would have to cultivate a capacity to remain with what is unexpected and unfinished, and to allow understanding to arise as something earned in relation, not delivered as doctrine.

The cultivation of naiveté

At the center of Thompson’s argument is a line that should not be rushed past, partly because it is easy to sentimentalize and partly because it threatens every credentialist fantasy: “The key to analytic education isn’t the acquisition of knowledge but the cultivation of naïveté” (Thompson, 2024, p. 246).

Naiveté here does not mean ignorance. Thompson defines it as an “open state of mind,” an attitude that is antithetical to skepticism in its cynical form, but aligned with the phenomenological demand that one meet what appears without immediately explaining it away (Thompson, 2024, p. 246). The analyst’s knowledge, however extensive, can become a defense, a way of neutralizing the patient’s otherness by translating it too quickly into categories. In that sense, knowledge can function as a way of not listening, because it tempts the analyst to hear only what fits.

Thompson’s claim is that analytic candidates must be educated into a disciplined openness that is capable of letting experience teach, including the experience that contradicts one’s favorite theories. In my reading, this is not a rejection of theory but an insistence that theory remain answerable to the lived encounter, which is always more singular than the conceptual net we throw over it. A training that loses this capacity may produce therapists who can speak fluently about analysis while quietly fearing the very thing analysis requires: not knowing.

When Institutes Become a “Tight Ship”

Compulsion, obsessionality, and the longing for certainty

Thompson’s critique sharpens when he turns from education in principle to institutes in practice. In his account, many institutes embody a structure that is opposed to the spirit of free association, because the institutional imperative is to control, standardize, and legitimate. He describes the “tight ship” atmosphere, the “air of military precision,” the rigidly defined roles and rules, and he notes the irony that a discipline devoted to ambiguity should so readily construct training environments that defend against ambiguity (Thompson, 2024, p. 247).

He reads this rigidity not merely as a sociological quirk but as a psychological and ethical problem, because it tends to recruit and reward an obsessional sensibility, and that sensibility can be mistaken for seriousness. Thompson observes that analytic candidates are often driven, dedicated, and studious, and that these virtues can slide into humorlessness, ambition, and a defensive posture of control when the institutional environment invites it (Thompson, 2024, p. 247). One can pass such training by becoming increasingly adept at appearing certain, and one can become increasingly frightened of what cannot be made certain.

It is here that Thompson invokes Hans Loewald, who warns that what we call reality can itself become defensive. Loewald writes that reality can take on the quality of “a hostile-defensive integration, akin to the obsessional mechanism” (Loewald, 1980, p. 30, as quoted in Thompson, 2024, p. 247). The implication is unsettling: institutions that claim to teach analysis may end up reproducing, at the collective level, the very psychic defenses that analysis exists to illuminate at the individual level.

Thompson’s point is not that all institutes are uniformly corrupt, nor that discipline and standards have no place. It is that the longing for certainty, when it becomes the organizing principle of education, is not neutral; it shapes the analyst’s temperament, and it shapes the room the analyst later builds with patients. A training that rewards control will not easily cultivate the capacity to bear the patient’s uncontrolled speech.

A Salon Instead of an Institute

Seminar circle symbolizing mentorship-based psychoanalytic education

Equality, conversation, and psychoanalysis as philosophy

Thompson does not end with critique, and his alternative is not a utopian fantasy, but an experiment grounded in a particular historical moment. In 1988, invited by students who wanted training but were dissatisfied with conventional institutes, he and colleagues formed a psychoanalytic salon in San Francisco. They called it Free Association, a name he treats as a double entendre: it aimed to help students learn the free association method, and it understood itself as an association of equals devoted to the free dissemination of ideas (Thompson, 2024, p. 248).

What matters here is the ethos. The group included psychoanalysts, philosophers, historians, and others with backgrounds in phenomenology or psychoanalysis, and Thompson describes them as viewing psychoanalysis as philosophical in the Socratic sense, meaning that psychoanalysis belongs to a tradition in which ethics is conceived as a therapy for suffering, not merely a set of professional rules (Thompson, 2024, p. 248). This is a profound reframing: psychoanalysis is not simply a clinical technology housed in an institution, it is a practice of inquiry into the human condition, and education should resemble inquiry rather than indoctrination.

No curriculum, and the courage to meet the unexpected

The salon model becomes concrete in Thompson’s refusal of curriculum. He states, with an almost mischievous clarity, that their curriculum did not resemble conventional curricula because they did not have one (Thompson, 2024, p. 248). The point was not to be anti-structure for its own sake, but to avoid the subtle coercion of predetermined outcomes, the way a fixed sequence of requirements can quietly teach candidates that the goal of learning is compliance.

Instead, Thompson describes an atmosphere meant to invite students to grapple with what is unexpected, unexplained, and ambiguous, by approximating, as much as possible, the experience of a psychoanalytic session (Thompson, 2024, pp. 248–249). This is where free association becomes educational: education becomes a milieu in which one is asked to tolerate not knowing, and to let thought arise from encounter rather than from the safety of advance conclusions.

Mentorship, Apprenticeship, and the Here-and-Now of Seminars

Provocation over indoctrination

Thompson’s educational model leans toward apprenticeship, not because apprenticeship is simpler, but because it keeps education tethered to the lived authority of persons rather than the impersonal authority of an institution. He describes seminars organized around the instructor’s predilections and current professional concerns, and he portrays the value of such seminars as lying in their capacity to provoke, to generate controversy, and to inspire independent study, rather than to transmit a sanctioned orthodoxy (Thompson, 2024, p. 250).

There is a quiet ethical claim here. Indoctrination offers the comfort of belonging and the relief of borrowed certainty, but it risks producing analysts who cannot think, or worse, who can only think within the approved dialect of their school. Provocation, by contrast, can feel destabilizing, even threatening, but it is closer to what analysis requires, because analysis is not the repetition of doctrine, it is the encounter with what resists doctrine.

History as a living dimension

One of the most intellectually serious dimensions of Thompson’s salon model is his insistence that psychoanalysis be situated in an historical context broad enough to include its prehistory. He describes seminars devoted to phenomenological method, intentionality, intersubjectivity, and self-disclosure, and he traces free association to antecedents in meditation, Christian mysticism, and Montaigne, while linking neutrality to ancient skeptical traditions and abstinence to German Romanticism (Thompson, 2024, p. 250).

This is not antiquarianism. It is an attempt to keep psychoanalysis from collapsing into the cult of the new guru or the latest institutional fashion. History, for Thompson, is not a museum of dead ideas; it is a living dimension that keeps education from becoming captive to a narrow present. When the analyst learns to hear psychoanalysis as part of a longer conversation about suffering and truth, the analyst may become less tempted to treat technique as a proprietary invention that must be defended, and more able to treat it as an ongoing ethical task.

Standards, Authority, and the Ambiguity of “Completion”

Self-selection and the limits of evaluation

The predictable objection to Thompson’s model is the one he himself anticipates: without curriculum, without standardized evaluation, what becomes of standards? Thompson’s reply is not to deny the need for seriousness, but to refuse the fantasy that seriousness can be guaranteed by procedure. He describes the Free Association model as self-selecting in a strong sense: anyone may join seminars, students choose supervisors, and even the practical terms of work, such as whether the patient sits or lies down and how frequently sessions occur, are left to the discretion of the analyst and patient rather than being dictated by institutional templates (Thompson, 2024, p. 250).

He acknowledges that this absence of official criteria can seem alarming, and he turns the alarm back upon the objector by naming what everyone in training already knows but rarely says: standards are often arbitrary, the evaluation process is never neutral, and the question of “completion” is inherently ambiguous, in much the same way that termination in analysis is ambiguous (Thompson, 2024, p. 250). In other words, the demand for certainty in training repeats the demand for certainty in life, and analysis exists partly to expose the impossibility of satisfying that demand without distortion.

The deeper question is what kind of authority we are seeking. If authority means institutional sanction, then Thompson’s model will always look suspect. If authority means the capacity to remain ethically present in the analytic situation, to tolerate uncertainty without collapsing into control, then standards may need to be reconceived as matters of character and judgment that cannot be fully captured by checklists.

Creating Psychoanalysis Anew

Institutions, succession, and why renewal matters

Toward the end of the chapter, Thompson places his argument inside a recurring historical pattern. Freud, Sullivan, and Laing founded their schools by gathering students around themselves, and after their deaths institutes were created in their names, which then grew into institutions (Thompson, 2024, p. 254). Thompson does not treat this as a scandal so much as an almost inevitable drift, the way living traditions harden when they are preserved rather than enacted.

His most radical claim follows from that diagnosis: it may be that the only way to preserve the psychoanalytic instrument is to periodically create it anew, forming new institutes and dismantling old ones, so that successive generations can discover its “uncanny uniqueness” for themselves rather than inheriting it as doctrine (Thompson, 2024, p. 254). Free Association, in his telling, tried to enact this principle by refusing succession, hierarchy, and the competitive promise of spoils, and by aiming to train a group and then disband when the work of that moment was complete (Thompson, 2024, p. 254).

Thompson’s closing caution is sober and recognizably true to clinical life. Psychoanalysis is isolating, alienation is not merely an intellectual theme but an occupational reality, and loneliness can tempt the analyst to compromise what he most values, not out of malice but out of an all-too-human wish to belong (Thompson, 2024, p. 254). Education, then, is not only a matter of learning the instrument. It is also a matter of remaining vigilant about the ways one’s own needs can infiltrate one’s professional life and bend it toward corruption.

Therapy room emphasizing listening and the free association method

Conclusion

What this approach protects in the consulting room

Thompson’s Chapter 12 is, on its surface, about psychoanalytic training, but its true subject is the ethical architecture of the consulting room. If free association is treated as a technical rule, it becomes procedural, and procedure always risks becoming a defense. If free association is treated as an educational model, it becomes formative, shaping the analyst’s capacity to remain open, to resist coercion, and to bear ambiguity without prematurely converting it into certainty (Thompson, 2024, pp. 245–250).

For patients, what is at stake is not a debate about institutes, but the quality of presence they encounter when they speak. A room governed by the analyst’s need to know, to classify, to control, can feel subtly violent even when it is polite. A room governed by an educated naiveté can feel, paradoxically, more serious, because it does not flee from what is difficult by hiding behind explanations.

Connecting Thompson’s chapter to FAC’s clinical orientation

At Free Association Clinic, our work in psychoanalytic therapy and existential therapy is grounded in this deeper ethic of listening, where technique is always answerable to encounter. For clinicians drawn to this orientation, you can learn more about our training program, or contact us to begin a conversation.

James Norwood, PsyD
Associate Director, New School for Existential Psychoanalysis (https://www.freeassociation.us)
Clinical Director, The Free Association Clinic for Existential Psychotherapy and Psychoanalysis (https://www.freeassociationclinic.com)
Founder/CEO, inpersontherapy.com (https://inpersontherapy.com)

References

Kirsner, D. (2000). Unfree Associations: Inside Psychoanalytic Institutes. London: Process Press.
Loewald, H. (1980). Papers on Psycho-Analysis. New Haven and London: Yale University Press.
Thompson, M. G. (1994). The Truth About Freud’s Technique: The Encounter With the Real. New York: New York University Press.
Thompson, M. G. (2024). Essays in Existential Psychoanalysis: On the Primacy of Authenticity. Abingdon and New York: Routledge.
Thompson, M. G., &Thompson, S. (1998). Interview with Dr. Otto Allen Will, Jr. Contemporary Psychoanalysis, 34(2).

Deception and Trauma in Existential Psychoanalysis: Laing and Freud on Mystification

Deception and Trauma in Existential Psychoanalysis: Laing and Freud on Mystification

An essay in reading Michael Guy Thompson’s Essays in Existential Psychoanalysis (Chapter 11)

Deception and trauma in existential psychoanalysis are not treated as mere clinical “content” to decode, nor as the private property of an isolated mind. In Michael Guy Thompson’s Chapter 11, they become the ethical problem that quietly governs everything else: the question of what happens to a person’s relation to reality when reality is repeatedly bent, denied, or strategically withheld, and what it demands of a therapist who claims to practice psychoanalysis in the name of truth. Thompson’s wager is that R.D. Laing’s work, so often positioned as psychoanalysis’ rebellious counterpoint, becomes most intelligible when we notice how thoroughly Freud inhabits it, even where Freud is barely named.

This is not only a theoretical matter, and it is not a dispute to be settled by choosing a camp. For therapists, Thompson’s chapter presses on the uncomfortable point that technique is never merely technique, because every technique presupposes an ethic, and the ethic can be betrayed in the very procedures meant to protect it. For patients, it gives language to an injury that often resists language: the peculiar devastation of being made to doubt one’s experience, and of discovering, often too late, that one’s world had been organized around what was concealed. Thompson’s claim is that the trauma at issue here is not simply what “happened,” but what happened to the possibility of believing what happens.

The gulf Laing refused to accept

Thompson begins where existential psychoanalysis often begins, not with a doctrine but with a stance. He portrays the most telling feature of Laing’s clinical technique as a radical effort to eliminate the gulf that customarily hardens between therapists and their patients, so that the patient can feel, in the therapist’s presence, not the impersonal authority of a procedure but “another human being like themselves,” someone who shares the ordinary weight of living and the ordinary capacity for pain. The point is deceptively simple, and it becomes demanding precisely because it deprives the therapist of a familiar refuge: the refuge of role, the refuge of expertise performed as distance, the refuge of a professional posture that can quietly turn the other into an object. In Laing’s hands, the clinical encounter becomes an exposure, because the therapist’s relation to truth cannot be kept outside the room as a private virtue while technique proceeds inside the room as a neutral instrument.

Thompson does not sentimentalize this stance as “niceness,” and he does not treat it as a rejection of analytic discipline. He treats it as a more austere demand: that the therapist’s humanity is not an ornament of the work but one of its conditions, and that the ethical imperative is not an afterthought added to interpretation but the ground on which interpretation can be trusted. The deeper problem, in other words, is not whether a therapist can interpret cleverly, but whether the relationship being formed can bear truth without collapsing into coercion, and whether the therapist can bear the temptation to manage reality, even in the name of improvement.

A contemplative male therapist sits in a chair, hand on his forehead, surrounded by ghostly, cracked images of a screaming woman, a solemn child, and an older man—symbolizing emotional burden, intergenerational trauma, and the lingering presence of the past

Freud’s “Truth and Trauma” and the expansion of reality

If Laing’s technique begins with the abolition of the gulf, Thompson’s argument begins with a different abolition, the abolition of an easy story about Laing’s relation to psychoanalysis. Thompson insists that Freud’s influence on Laing was “pervasive,” though generally omitted, and he goes further, suggesting that Laing saw himself, quietly and without fanfare, as Freud’s intellectual heir, with a style of allusion that makes the inheritance hard to see unless one knows how to listen for it. What matters is not biographical gossip about influence but the alignment of a central preoccupation: deception and its relation to trauma.

Thompson’s route through Freud is precise, because it follows the transformation of Freud’s own theory of trauma. Freud begins, under Charcot’s influence, with a relatively direct idea, that hysterical symptoms follow from traumatic seductions, from sexual experiences imposed on the child, a theory whose apparent concreteness has a certain moral clarity. Yet the theory collapses under contradictory evidence, and Freud’s collapse becomes, for Thompson, one of psychoanalysis’ decisive expansions: if some patients trace symptoms to traumas that did not occur as events, then fantasies have force, and “psychical reality” must be taken into account alongside practical reality. That phrase is not an escape from truth but a widening of truth’s domain, because it names the way the psyche can be organized around scenes that have the status of reality for the person, regardless of historical verification, and because it locates trauma not only in external violation but in the psyche’s own struggle to bear what it anticipates, what it dreads, and what it cannot admit it already knows.

Thompson reads Freud’s later conception as a subtle account of how deception and conflict co-constitute each other. The child, vulnerable to disappointment, can repress what is too painful, replacing an objectionable reality with an inviting fantasy, and thereby “not experiencing” the disappointment in the ordinary sense while still suffering its effects; later, anxiety forms around the fear of discovering what one must not know, which is to say, around the dread of re-encountering something that, in reality, has already happened. Trauma becomes inseparable from concealment, and the psyche’s defenses become, in their own way, deceptions that purchase bearability at the cost of truth. It is in this terrain, where reality is not denied merely because a person is irrational but because reality is unbearable, that Freud’s theory can be extended without being reduced to moral judgment.

What matters clinically, and existentially, is that the question of truth is no longer reducible to whether something “really happened,” as if the psyche were a courtroom. The question becomes: what has the status of reality for this person, what has been split off in order to survive, and what kind of relationship is required for what has been disavowed to become bearable without humiliation or coercion. Freud’s move toward psychical reality, in this sense, is already an ethical move, because it refuses the contempt implicit in dismissing the person’s experience as mere fabrication, and it binds the analyst to a more difficult fidelity, fidelity to the reality that is lived, even when it is not easily verified.

From psychical reality to social phenomenology

This is the point at which Thompson’s chapter takes its most consequential turn, because he argues that Laing takes Freud’s conception of psychic trauma and applies it to delusional confusion, but does so “in a more dialectical framework,” and this dialectical shift changes the moral topology of the clinical scene. Freud had emphasized fantasy as a way the psyche avoids objectionable realities, and even when Freud attends to interpersonal deceptions, the conceptual center remains intrapsychic conflict. Laing, by contrast, asks what happens when deception is not primarily what I do to myself, but what is done to me, repeatedly, by others, and done in a way that aims not merely at my compliance but at the manipulation of my experience, and therefore my reality.

Thompson names this shift with Laing’s term “social phenomenology,” defined as an “internal critique” of how others affect, and sometimes play havoc with, my experience. The emphasis is decisive: the psyche is not simply a private theater, because the stage itself is partly built by others, and the lines one is forced to speak are sometimes the lines of another person’s denial. Laing’s dialectical dimension, as Thompson describes it, is the tormenting structure of interpersonal reality: what I think you think about me, and what you in fact think but conceal, and the way this concealment invades my capacity to know what is happening, and to trust that what is happening is nameable. When this dialectic becomes chronic, the problem is no longer only repression or wish-fulfillment; the problem becomes confusion as an existential injury.

Thompson’s formulation is stark and, if taken seriously, unsettling. Laing concluded that schizophrenia can be understood as the consequence of deceptions employed on someone who assumes he is being told the truth, and who depends on what the other tells him to be true. The language is careful. It does not romanticize psychosis. It does not reduce it to an abstract “break” from reality. It suggests that what is shattered is the person’s footing in reality, and that the shattering can be precipitated by relational conditions in which truth becomes unstable, where the person is repeatedly forced into the impossible task of sustaining a reality that is denied by those on whom he depends.

This is also where Thompson’s contrast between Freud and Laing becomes clinically useful, because it clarifies two different models of trauma that do not exclude each other but interact. Freud often conceived trauma in terms of frustration that thwarts anticipated pleasure, a model that makes sense for neurosis and for the ordinary compromises of life. Laing envisioned a different form of trauma that could account for psychotic anxiety and withdrawal: states of confusion that follow when one’s reality has been savaged, not through self-deception alone, but through being duped or deceived by another, and the loss of reality becomes more poignant precisely because it compounds frustration with disorientation. In contemporary idiom, one might reach for “gaslighting,” but Laing’s point is more radical than a popular term can hold, because it concerns the conditions under which a person is forced to betray his own perception in order to remain attached, and the way attachment can become the vehicle of unreality.

To say this is not to collapse all psychosis into family dynamics, nor to transform existential psychoanalysis into a single-cause polemic. Thompson explicitly resists simplistic causality. What he insists on, instead, is that reality is not merely a given, it is something that is sustained, confirmed, or subverted between people, and that the clinical task cannot be faithful to experience if it treats relational deception as incidental.

A distressed woman holds her head in anguish while a faded silhouette of a couple whispering looms behind her, split by visible cracks—conveying themes of psychological distress, secrecy, relational conflict, and emotional fragmentation

Mystification in therapy, a vocabulary for interpersonal deception

Thompson’s reading of Laing’s oeuvre sharpens the point further by showing that deception between persons is not a marginal theme in Laing, it is a sustained preoccupation across his most prolific decade. Thompson notes, with some irony, that The Divided Self is the only major work of Laing’s in which interpersonal deception does not play a major role, since it is oriented toward the existential experience of going mad rather than toward the social context that later becomes central. The shift is visible in Self and Others, where Laing turns toward the effect human beings have on one another in the etiology of severe psychological disturbance, and it is here that Thompson locates an important philosophical inflection: Laing’s engagement with Heidegger’s “On the Essence of Truth” and with the pre-Socratic term aletheia, truth as what emerges from concealment. Laing does not simply borrow Heidegger’s notion of truth, he twists it toward the interpersonal, emphasizing the interdependency between candor and secrecy, and thereby locating truth not as a detached property of propositions but as something that appears and recedes within conversation, within the fragile drama of what is disclosed and what is withheld.

This is where mystification becomes more than a provocative term, and becomes instead a conceptual instrument. Thompson underscores that Laing coined a vocabulary, terms such as collusion, mystification, injunction, untenable positions, and did so in order to name how ordinary interactions can distort truth so effectively that they affect each other’s reality, and therefore sanity. Thompson’s claim is not merely that Freud cared about deception and Laing cared about deception, but that Freud lacked this interpersonal vocabulary even where the problem was present, and that Laing supplies what psychoanalysis, in Thompson’s view, too often evaded: the possibility that pathology is not only a private compromise with desire, but also a response to a world in which reality is negotiated through power, denial, and coercive “care.”

Thompson’s account of Laing and Esterson’s family studies makes the clinical stakes concrete without collapsing them into accusation. In Sanity, Madness and the Family, Laing and Esterson demonstrate families in which massive forms of trickery and mystification are employed against the identified patient, sometimes with chilling casualness, and Thompson recounts the case of “Maya,” where parents deny to their daughter what they have openly admitted when she is absent, a denial that functions not simply as lying but as a systematic twisting of the child’s hold on reality. Thompson is careful to note the controversy that follows, and he observes that Laing did not claim that such incidents conclusively “cause” schizophrenia, only that they were ubiquitous in the families studied, leaving readers to draw their own conclusions. He also insists that mystification is not unique to “pathological” families, because it is inherent in the hypocrisy of everyday life, and the difference is often one of degree, persistence, and consequence.

Laing’s later work extends the analysis to other relational fields, including couples. Thompson’s discussion of Interpersonal Perception is striking because it presents the book as “radical even now,” precisely insofar as it exposes how duplicity and deception can be woven into love relationships through confused communication patterns that resemble, in magnified form, what occurs in families of schizophrenics. Laing’s “politics of experience” then names the wider terrain: how others confirm or disavow my experience, how they determine what my experience is permitted to be, and how severe disturbance is not only an internal defect but can be the consequence of human deviousness, sometimes unwitting, sometimes masked as altruism. Thompson’s point, again, is not that the world is nothing but cruelty, but that truth is always vulnerable to being politicized, and that psychic life cannot be understood without acknowledging this vulnerability.

If “mystification in therapy” is to mean anything, then, it cannot mean only that patients lie, resist, or distort. It must also name the more uncomfortable possibility that therapy itself can become a site of mystification when the therapist uses interpretation to override experience, or uses technique as a way of winning, or treats the patient’s reality as raw material to be managed. Thompson’s Laing is not simply warning against bad clinicians, he is exposing a structural temptation within the therapeutic situation: the temptation to convert an encounter into an operation, and thereby to reproduce, under the banner of help, the very distortions that have injured the person’s relation to reality.

Truthfulness in psychoanalysis, not as virtue, but as condition

Thompson’s chapter culminates where it began, with ethics, though the ethics here is not an external code but the condition under which psychoanalysis remains psychoanalysis. He argues that if we hope to resolve the dilemma of living amid disappointment and betrayal, the first step is not to explain the person away but to have one’s experience of the past confirmed rather than dismissed as “pathology.” The clinical rationale is existential, because the wound is often compounded by the denial that the wound exists, and the denial becomes a second trauma, a forced estrangement from one’s own perception.

From this vantage, the ethic of truthfulness in psychoanalysis is not a moral ornament, and it is not reducible to the therapist’s sincerity. It is the scaffolding of the analytic relationship, and it binds the therapist as much as the patient. Thompson notes that therapists, in their zeal to effect change, can resort to questionable tactics and transform therapy into a contest where the clever protagonist “wins,” a perversion of the work that is especially insidious because it can masquerade as clinical effectiveness. Laing’s technique, Thompson suggests, can be reduced to a single preoccupying concern, how honestly therapists are behaving with their patients, and how honest they are capable of being, a concern he links explicitly to Freud’s “fundamental rule,” the pledge exacted from the patient to be candid about what comes to mind.

Thompson then refuses the easy fantasy that the fundamental rule is simply a compliance instruction. Freud discovered that patients are loathe to disclose, because disclosure threatens their secrets and what those secrets might reveal about themselves. Laing adds a different emphasis, that many patients have learned, through experience, that it is wrong to think or feel as they do, so that concealment is not merely defensive but historically instructed, and the person may have “forgotten” what they think and lost the sense of who they are. In that context, truthfulness is not an order one can give. It is a relationship one can slowly make possible, if and only if the therapist’s neutrality is not coldness but a form of acceptance, and if the encounter is grounded in mutual respect rather than coercion.

Thompson ends the chapter with Freud’s blunt warning, the line that is easy to quote and harder to live: “psychoanalytic treatment is founded on truthfulness,” and it is dangerous to depart from that foundation. The point is not sanctimony. It is that psychoanalysis, when it is faithful to itself, cannot proceed by lies and pretenses without betraying its own authority, because the authority at stake is not social status but the credibility of the relationship in which truth can be spoken.

For existential psychoanalysis, this returns us to the first problem, the fragility of reality. If psychotics are not only anxious but confused, then the imperative is to understand the nature of their confusion and to avoid doing or saying anything that increases it, which means that deception, whether in the family, in the culture, or in the consulting room, cannot be treated as peripheral. Thompson recounts Laing’s insistence that victims of duplicity can be devastated when truth is discovered after long concealment, because they can feel as though their reality has been taken from their grasp, leaving them lost between the world they thought was real and the world that is suddenly thrust upon them. In that light, therapy is not the imposition of a “correct” story but the slow repair of a person’s relation to reality, which is also the slow repair of a person’s capacity to trust experience without surrendering it to someone else’s authority.

A man in a suit stares at his reflection in a shattered mirror, his expression tense and searching. The broken glass distorts his face, suggesting inner conflict, identity fragmentation, and the painful journey of self-confrontation. Books behind him, including Freud’s Interpretation of Dreams, hint at psychoanalytic themes

Conclusion

Chapter 11 is not merely a comparison of Laing and Freud, and it is not a rehabilitation of Laing through Freudian credentials. It is a meditation on deception as an existential force, on trauma as what happens when reality becomes unstable, and on truthfulness in psychoanalysis as the ethical core without which technique becomes, at best, empty, and at worst, an instrument of mystification. Thompson’s contribution is to show that Laing’s work does not stand outside psychoanalysis as an ethical protest, but stands inside it as a demand for fidelity to experience, and as a warning about what happens when care becomes a vehicle for disconfirmation.

At Free Association Clinic, this question remains central to our understanding of depth psychotherapy, whether the struggle presents as anxiety, depression, relational deadlock, or the more diffuse suffering of not having one’s experience believed. If you want to learn more about our psychoanalytic therapy and existential therapy services, or about how these questions appear in the work of couples therapy, you can also contact us when you are ready for a conversation.

James Norwood, PsyD
Associate Director, New School for Existential Psychoanalysis (https://www.freeassociation.us)
Clinical Director, The Free Association Clinic for Existential Psychotherapy and Psychoanalysis (https://www.freeassociationclinic.com)
Founder/CEO, inpersontherapy.com (https://inpersontherapy.com)

References

Thompson, M. G. (2024). Essays in Existential Psychoanalysis: On the Primacy of Authenticity. Routledge.
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Freud, S. (1915/1958). Observations on Transference-Love: Further Recommendations on the Technique of Psycho-Analysis III (J. Strachey, Ed. & Trans.). Hogarth Press.
Freud, S. (1924/1961). The Loss of Reality in Neurosis and Psychosis (J. Strachey, Ed. & Trans.). Hogarth Press.
Heidegger, M. (1977). On the Essence of Truth. In Basic Writings (D. F. Krell, Ed.). Harper & Row.
Laing, R. D. (1960). The Divided Self. Pantheon Books.
Laing, R. D. (1969). Self and Others (2nd rev. ed.). Tavistock Publications.
Laing, R. D., Phillipson, H., & Lee, A. R. (1966). Interpersonal Perception: A Theory and a Method of Research. Tavistock Publications.
Laing, R. D., & Esterson, A. (1964/1971). Sanity, Madness, and the Family: Families of Schizophrenics (2nd ed.). Basic Books.
Laing, R. D. (1967). The Politics of Experience and the Bird of Paradise. Penguin.