therapeutic relationship - Free Association Clinic

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

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.

The Personal Relationship in Psychoanalytic Therapy: Thompson on the Demise of the Person

A Reflection on Michael Guy Thompson’s Essays in Existential Psychoanalysis

In psychoanalytic culture, the word personal often arrives with a faint odor of impropriety, as though it names whatever is left over when the real work is finished, or worse, whatever risks contaminating the analytic situation with ordinary human contact. Thompson begins Chapter 10, “The Demise of the Person in the Psychoanalytic Situation,” by naming a fact that is easy to overlook precisely because it is so mundane: person and personal are not standard technical terms in psychoanalytic nomenclature, and when they appear they usually function as offhand labels for what is “non-transferential” and “non-technical,” which is to say, what is easiest to marginalize.

Once the personal is treated as a conceptual remainder, it becomes possible, even virtuous, to define psychoanalysis by what it excludes. Thompson notes that for many analysts, psychoanalysis is distinguished from its more “user-friendly” cousin, psychodynamic psychotherapy, precisely by the absence of personal engagement, as though the analyst’s personhood were a kind of interference to be engineered out of the room. The consequence is not simply a colder atmosphere, but a tighter ontology: contemporary analysts “of virtually all persuasions,” he argues, increasingly reduce the psychoanalytic process to the analysis of transference, resistance, and enactments, and therefore assume that virtually all reactions to the analyst as a person should be treated as transference manifestations, while the analyst’s significant interventions are governed by whichever technical principles their school prescribes.

Thompson’s point is not that personal contact never happens, since every practitioner knows it does, but that entire training cultures have learned to treat such contact as irrelevant, risky, or analytically illegitimate, and therefore something to be avoided or, when unavoidable, promptly converted into an object of interpretation. The personal does not vanish, it is translated, and in that translation the encounter can become strangely airless, technically busy, and existentially empty.

Why “the Person” Can Disappear in Psychoanalysis

If the personal relationship in psychoanalytic therapy is reduced to an obstacle, then “the person” disappears by a kind of conceptual attrition. Thompson is explicit that this tendency cuts across schools that otherwise disagree on almost everything: he includes Kleinian analysts, American ego psychology (often called “classical Freudian” in this context), and many relational analysts among those who “deconstruct the very notion of a person-to-person engagement out of the psychoanalytic process.” What binds these positions together is not a shared theory of mind but a shared reflex, namely the conviction that the analyst’s personhood is best managed by being factored out.

His example is deliberately contemporary and slightly absurd, which is why it lands. He cites a discussion, originating in a Psychoanalytic Psychology article (Maroda, 2007) and later taken up in the New York Times, suggesting that analysts should not treat patients in a home office because it offers “keyholes” into the analyst’s personal life and may “over stimulate and overwhelm” the patient, as though contact with the analyst’s ordinary reality were inherently unsettling or even harmful. Thompson’s parenthetical aside is doing real work here, because it forces the reader to ask what kind of psychoanalytic imagination is operating when knowledge of a therapist’s personal reality is treated as intrinsically traumatic.

What matters is not whether one agrees with the example, but what it reveals about the background assumption: that the patient can only bear the analyst as a screen, and that the analyst’s person, when it appears, is automatically pathogenic. Thompson insists that this attitude is surprisingly recent in the long history of psychoanalytic writing, which is one way of saying that it is not destiny but fashion, and therefore open to critique.

personal relationship in psychoanalytic therapy in a consulting room

When Everything Becomes Transference: The Deconstruction of the Personal

Thompson describes a climate in which the psychoanalytic literature tends to focus so intensely on transference and countertransference, understood as specifically unconscious functions, that analysts are urged to attend above all to projections and their interpretation, while avoiding “interactions of a personal nature” that are implicitly defined as non-interpretive and therefore irrelevant to unconscious process. At first glance this can appear like rigor, an attempt to keep the treatment anchored in what psychoanalysis uniquely knows how to do; yet the rigor contains a peculiar impoverishment, because it quietly assumes that personal contact does not itself belong to the analytic field.

To dramatize the consequence, Thompson returns to a “slave metaphor” and claims that in certain relational formulations both analyst and analysand become “equally enslaved” by their unconsciouses, trapped in an “endless” intersubjective oscillation that tends toward infinite regress. The language is severe because the predicament is severe: once every vestige of the personal relationship has been transformed into transference and countertransference and placed under systematic interpretation, the human encounter no longer functions as a ground from which interpretation emerges, but as a surface upon which technical scrutiny must constantly operate.

From a more traditional angle, he argues, the problem does not disappear, it merely changes costume. If transference is conceived as a rarefied, trance-like regression that places the patient in a one-down position from which they cannot extricate themselves because they are always “in” the transference, then the analysand is implicitly treated as never fully the author of their experience, never fully a proper adult in an I–Thou relationship, but an “effect” of unconscious forces to which only the analyst is privy. One begins to see why some patients, especially thoughtful patients, report that analysis can feel depersonalizing: not because the analyst is unkind, but because the patient’s address is persistently converted into symptom, and the analyst’s response is persistently converted into technique.

Thompson sharpens the critique further by suggesting that transference itself can become a defense, not for the patient, but for the analyst, a way to withdraw from the “realness” of the person in treatment whenever proximity becomes too impacting. In that posture, closeness or informality is not explored as a human event that might matter, but interpreted preemptively as seduction or “transference,” which is another way of saying that the relationship is not allowed to become a relationship except as an object of analysis.

The Unconscious Without a Subject, and the Loss of Agency

It is tempting to say that Thompson is “defending the real relationship,” but the deeper issue is what kind of subject psychoanalysis is willing to recognize. If both parties are framed as governed by unconscious process, and if the only legitimate speech in the room is speech that can be converted into technical categories, then agency becomes difficult to locate without sounding naïve. Thompson’s worry is that psychoanalysis, when it becomes too enamored of its own conceptual apparatus, risks producing an unconscious without a subject, a drama of forces in which no one is answerable and no one can be addressed.

This is why the phrase “author of his or her experience” is so central in his description of what gets lost. To treat the patient as the effect of unconscious forces, and to treat the analyst as the privileged interpreter of those forces, is to generate a relationship that is, in principle, asymmetrical in authority even when it claims to be collaborative, and asymmetrical in personhood even when it claims to be relational. The patient is spoken about, perhaps even empathically, but not necessarily spoken with as a subject whose speech is an address to another subject.

Thompson’s discussion of Greenson helps clarify why this problem persists even when analysts try to reintroduce “the real relationship.” Greenson distinguishes a “real” relationship from transference, yet Thompson notes that such descriptions often emphasize the patient’s experience of the analyst while neglecting the analyst’s relationship with the patient, and because the dyad is not symmetrical, the “correlation between their respective positions is not identical.” What tends to happen, then, is that the patient’s side is described in the language of transference gradations, while the analyst’s side is described in the language of technique, a circumscribed set of behaviors epitomized by interpretive strategies, with countertransference increasingly defined as the totality of the analyst’s experience, including what used to be called “personal” reactions, now subsumed under technical oversight. The personal does not return, it is annexed.

For therapists, this is where Thompson’s critique becomes uncomfortably intimate, because it is not only a theoretical dispute about models, it is a question about what it means to remain a person while occupying a professional role, and whether our theories, however elegant, sometimes function as alibis for avoiding the impact of the other.

psychoanalytic relationship and reflective clinical writing

The Specifically Personal Dimension: Being Oneself Is Not a Technique

A predictable response to the “demise of the person” is to prescribe personhood, to turn genuineness into a technique, self-disclosure into a method, and warmth into a protocol. Thompson is unsparing about this move as well, because it repeats the original problem in a new register. He uses the example of Renik to make the point: even if a clinician insists they are not elevating their personal style into technique, the moment they advocate that manner of working as something all analysts should do, it becomes, by definition, technique, no longer a character trait but an intervention others are instructed to adopt.

Here the argument turns quietly existential, because Thompson is less interested in whether the analyst discloses, converses, or stays silent than in whether the analyst’s way of being is contrived. He writes that the problem with conceptualizing personal engagement as technique is that genuineness requires being true to one’s actual personality traits and behavioral characteristics, and therefore conducting oneself naturally, spontaneously, and “without guile.” In the same passage he names a complaint many patients make, not as a moral accusation but as a phenomenological report: analysts who rigidly conform to classical technique are often experienced as lacking genuineness. Yet the aim of analytic work, he adds, includes increasing the patient’s capacity for genuineness in relation to others and to themselves, which means the analyst cannot plausibly demand from the patient what the analytic situation structurally discourages in the analyst.

This is the paradox that Thompson crystallizes in a line that resists paraphrase: “Being oneself is, by definition, personal.” What follows is equally important for clinicians who want rules, because Thompson refuses them: there cannot be universal standards for how an analyst uses personality in treatment, it cannot be codified, and what counts as personal varies with the analyst, with the patient, with the time of day, with mood, with the phase of work. If this sounds unsatisfying, it is because it denies us the comfort of believing that personhood can be guaranteed by correct technique.

Conversation, Self-Disclosure, and the Question of Genuinenes

If being oneself is not a technique, then the personal relationship in psychoanalytic therapy does not appear as a prescribed behavior so much as it appears as a mode of presence, and Thompson locates its most common manifestation in something deceptively simple: conversation. For the personal relationship to be spontaneous, unpredictable, and authentic, it must be free of contrivance and subterfuge, “a manner of being” that, as he puts it, “comes from the heart.” From there, he notes that spontaneous conversations evolve between analyst and patient, sometimes including self-disclosures but not necessarily, because the point is not disclosure as performance but the recognition that not everything the analyst says should be limited to interpretation, data elicitation, or other technical considerations.

Thompson’s critique becomes especially sharp when he compares how different schools metabolize conversation. Classical analysts, he says, tend to reject it on the grounds that “conversing” has no discernible role in the analytic process, while relational analysts may reduce conversation to a technique, which can be experienced as contrived or manipulative. What is being lost in both cases is not chatter but humanity, because conversation can be restrained by abstinence without being abolished, and its abolition often feels artificial for analysts who are, like Freud and Ferenczi, naturally conversational.

He then gives a clinically recognizable scene that is also, in its own way, philosophical. There are times when patients want to muse about ideas, philosophical, literary, spiritual, and ask their analyst to reciprocate; the analyst may participate without needing to reduce the exchange to transference and analyze it accordingly, and Thompson suspects such extra-analytic exchanges can have a profound impact on both the relationship and the outcome of treatment, even if we cannot determine their effect moment to moment. This is not an argument for informality, but an argument that the medium of psychoanalysis is not interpretation alone, it is speech addressed to another, which is why psychoanalytic relationships cannot finally avoid personal contact, because “conversation is the essence of their professional activities.”

In other words, the personal relationship in psychoanalytic therapy is not a sentimental addition to the method, it is the condition under which the method can remain human.

“entering psychoanalytic therapy and the question of personhood

Character, Virtue, and the Analyst’s Presence

Once the personal is admitted as unavoidable, the question that follows is the one psychoanalytic institutes often prefer not to ask directly: what about the analyst’s character? Thompson insists that the character or person of the analyst is of “critical importance” to how patients experience and benefit from the relationship, and while he acknowledges that this cannot be empirically substantiated, he nonetheless claims, without hedging, that for some analysts the role of character matters more than technique. This is not an anti-technical position, since in the same passage he affirms that technical principles are indispensable, but it is a refusal of the fantasy that technique can substitute for who the analyst is.

He also observes that psychoanalysis has historically pathologized the notion of character, treating it primarily as embedded structures that compromise gratification or adaptation, and he notes that Freud used the term in two distinct ways: occasionally as virtue, more often as psychopathology. In contemporary analytic language, virtue tends to appear only in offhand, non-technical speech, even though in ordinary moral life we still speak of strong character as integrity, courage, honesty, and the like. Thompson’s provocation is that psychoanalysis has no coherent way to speak about these qualities without either moralizing or reducing them to structure, and yet the patient experiences them immediately, long before any interpretation “works.”

This returns us to training, where Thompson makes a claim that is modest in tone but radical in implication. Because character is hard to measure and depends on subjective judgment, institutes have tended to omit it from admissions considerations in the effort to make processes more democratic, and ironically this has allowed the relationship between character and technique to recede into the background. Even if personal virtue cannot be taught, he argues, it can and should be included in curricula, not as an ideal to impose, but as an object of awareness, a way of seeing how frustrations, preferences, limits, and attitudes shape what we call theory and what we call technique.

His conclusion is neither romantic nor permissive. He argues that the capacity to acknowledge a personal relationship with one’s patients, and to engage it freely in a manner that complements the needs of each treatment situation, lends genuineness and authenticity to the relationship, and that this has profound implications not only for how analysis is experienced but even for how technical principles are applied, adding that most analysts know this intuitively even when they do not articulate it.

Conclusion

Thompson’s Chapter 10 can be read as a critique of psychoanalysis at the moment it begins to confuse rigor with evacuation, as though the safest way to practice were to make the analyst disappear behind technique. Yet his argument is not a plea for a new orthodoxy of warmth, nor a demand that analysts disclose more, converse more, or sound more “human” in some standardized way, because the moment one tries to standardize personhood, one has already turned it back into technique. What he insists on, instead, is the simple and difficult claim that psychoanalysis is conducted by persons, not by methods, and that the personal relationship in psychoanalytic therapy is not what happens when the analysis fails, but what makes it possible for analysis to be addressed to someone rather than performed upon them.

At Free Association Clinic, our work in psychoanalytic therapy and existential therapy takes seriously the depth of unconscious life while refusing to lose the person in the process. Clinicians interested in a more existentially grounded approach can explore our training program and psychoanalytic training, and prospective patients can contact Free Association Clinic to inquire about treatment.

Source

Thompson, M. G. (2024). Essays in Existential Psychoanalysis: On the Primacy of Authenticity. Routledge.

Psychoanalysis as an Ethic of Experience: The Sceptic Dimension to Psychoanalysis

Reflections on Michael Guy Thompson’s “The Sceptic Dimension to Psychoanalysis,” in Essays in Existential Psychoanalysis

Many people enter therapy with a hope so quiet it can be mistaken for common sense: that somewhere behind the confusion there is a final account, a settled explanation, a true story that will not change tomorrow, and that the right clinician, armed with the right theory, will be able to pronounce it. Therapists, too, can be tempted by their own version of this hope, which appears as a hunger for the correct technique, the clean formulation, the conceptual mastery that would protect them from being surprised by what a patient says and from being shaken by what the encounter evokes in them.

In Chapter 7 of Essays in Existential Psychoanalysis, Michael Guy Thompson disrupts this mutual fantasy without ridiculing it, and he does so by shifting the ground beneath the clinical conversation. Psychoanalysis, he argues, is best understood as an ethic of experience, not as a technology for manufacturing certainty, and the stance that makes analysis possible is, in a deep sense, sceptical, not in the modern sense of reflexive disbelief, but in the older sense of disciplined inquiry that refuses premature closure (Thompson, 2024).

This sceptic dimension matters in the analytic situation because psychological suffering is often organized around a particular kind of desperation, the desperation to stop experience from moving, to arrest it in a diagnosis, a moral verdict, a story of causality, or a metaphysical explanation that promises relief by promising control. Thompson’s wager is that psychoanalysis does not truly meet this desperation by satisfying it, because satisfaction would simply reinstall the very defence that suffering depends upon; it meets it by creating the conditions under which experience can be endured, thought, and eventually spoken more honestly.

Why Thompson begins with ethics, not technique

Thompson begins his chapter with a claim that can sound oddly anachronistic in a clinical culture that prefers methods, protocols, and outcome measures: psychoanalysis is an ethic, a “moral art” concerned with how one lives, how one bears oneself in the midst of conflict, disappointment, and desire (Thompson, 2024, pp. 117–118). In this framing, ethics is not synonymous with morality. Morality, he notes, pertains to distinctions between right and wrong, good and bad, while ethics, in the Greek sense, concerns the pursuit of a form of happiness whose mark is equanimity, a freedom from mental anguish that does not depend upon eradicating life’s difficulties (Thompson, 2024, pp. 117–118).

Once psychoanalysis is understood this way, the usual clinical questions begin to change their meaning. Symptoms are no longer treated as isolated malfunctions to be corrected by explanation, as though explanation were always the same thing as truth. Symptoms become intelligible as compromises within a life, as strategies of endurance that have become costly, and the analytic task becomes inseparable from an inquiry into the patient’s ethos, the customs of a life, the characteristic ways of thinking and avoiding and relating that both protect and imprison (Thompson, 2024, pp. 117–118).

This is also why Thompson can insist, without romance and without cynicism, that psychoanalysis revolves around work that “succeeds or fails,” because the question is not whether the clinician has produced a brilliant interpretation, but whether the encounter has fostered a transformation in the patient’s relation to experience itself, including the parts of experience that cannot be mastered, cured, or made to disappear (Thompson, 2024).

working through in existential psychoanalysis as a gradual process over time

Scepticism in psychoanalysis as inquiry, not cynicism

In contemporary speech, “skepticism” often implies dismissal, a posture that prides itself on not being taken in, and that treats belief as stupidity. Thompson’s usage is almost the opposite. The sceptic stance he retrieves is not a performance of superiority, but a discipline of open-ended inquiry, an insistence that experience is not to be replaced by a conclusion simply because a conclusion is soothing (Thompson, 2024).

He marks an important historical distinction that is also clinically clarifying. There were sceptics he calls the Academics, preoccupied with epistemological refutation, devoted to proving that certainty is impossible, and thus capable of producing an impressive, sterile negativity that ends in a cul de sac; and there were the Pyrrhonian sceptics, whom he calls the Therapists, who rejected epistemological questions “in principle” and devoted themselves to developing an ethic, a therapeutic method, oriented toward happiness understood as ataraxia, equanimity, freedom from psychic conflict (Thompson, 2024, p. 121; Annas & Barnes, 1994). Where academic knowledge privileges abstraction, these sceptic “therapists” emphasized the here-and-now of immediate experience, and in that emphasis Thompson hears an ancestor of analytic work, not because psychoanalysis repeats antiquity, but because it inherits a practical problem that never disappears: how to live when certainty cannot do the work we demand of it (Thompson, 2024, p. 121; Groarke, 1990).

Burnyeat’s famous question, “Can the sceptic live his scepticism?”, is not merely an academic puzzle from the history of philosophy, because it describes, in another register, the clinical problem of whether one can inhabit a stance of suspended certainty without collapsing into paralysis, despair, or fanaticism (Burnyeat, 1997). Psychoanalysis, at its best, does not answer that question with an argument. It answers by staging a relationship in which the refusal of premature certainty becomes tolerable, and in which the costs of certainty can become visible.

Epoché in therapy, the suspension of judgment as a clinical attitude

The centre of Thompson’s chapter is epoché, the suspension of judgment. The term can easily be misunderstood as a recommendation to become vague, or to “hold space” by refusing thought, or to adopt indifference in the name of neutrality. Thompson means something more exacting and more demanding. Epoché is the capacity to attend to experience as it unfolds, “from one unpredictable moment to the next,” while bracketing the reflex to explain, justify, moralize, or reduce what is happening to an already familiar schema (Thompson, 2024, pp. 121–122).

This suspension is not passive. It requires abandoning theoretical, conceptual, or causal considerations as a first move, not because such considerations are always false, but because they are too often seized as an escape from the shock of experience. It is, in Thompson’s language, an “emptied” mind, a negative capability, a willingness to be with the not-yet-known without forcing it to become knowable on command (Thompson, 2024, p. 122).

Patients tend to recognize, often with ambivalence, why this matters. The rush to certainty, whether it takes the form of self-diagnosis, moral condemnation, or a fixed narrative about one’s history, can function as a way of not having to feel what is being felt, and of not having to admit what is being avoided. The analytic encounter becomes ethically distinctive when it refuses to collaborate with this rush, not by withholding interest, but by insisting that experience be allowed to appear before it is disciplined into a conclusion.

For therapists, epoché is equally unsettling because it deprives the clinician of the fantasy that competence is equivalent to immediate knowing. In this sense, epoché is not simply a technique, it is a posture of humility, a constraint placed on the clinician’s wish to be right, and a safeguard against using theory as a shield. Wachterhauser’s collection on phenomenology and scepticism can be read as a reminder that this problem is perennial: how to keep inquiry open without dissolving into incoherence, and how to hold openness without turning it into dogma (Wachterhauser, 1996).

Neutrality as a sensibility, not a rule, and why that distinction matters

Thompson’s argument becomes clinically concrete when he turns to analytic technique and insists that what is usually taught as “neutrality” is better understood as a cultivated sensibility, an ethos, rather than a rigid method (Thompson, 2024). He is explicit that scepticism and neutrality are not rules to be obeyed mechanically, and that the language of rule-following can itself become antithetical to the analytic attitude, because rules invite a defensive performance rather than a receptive attention (Thompson, 2024).

When Thompson traces neutrality back to Freud, he emphasizes that Freud’s recommendation is not a performance of detachment for its own sake, but an attempt to protect the work from the analyst’s presuppositions. The stance entails making no assumptions, abandoning pretensions to knowledge, letting the patient’s experience determine the course of the work with minimal interference, and cultivating an “evenly-suspended” attention that does not seize selectively upon what confirms the analyst’s expectations (Freud, 1912/1958; Thompson, 2024).

Freud’s language is unambiguous about the discipline involved:

“Thus we are warned against introducing our own expectations into the material. We must allow ourselves to be taken by surprise and always meet the patient with an open mind, free from any presuppositions.”
(Freud, 1912/1958)

If neutrality is misunderstood as coldness, it is often because both patient and therapist feel, in different ways, the anxiety that openness evokes, and they seek protection by turning the encounter into something predictable. Yet neutrality, understood sceptically, is not the refusal of relationship. It is the refusal to coerce the other into one’s own conceptual comfort. It is an ethical gesture toward the patient’s experience, including the aspects of experience that are inconvenient to the clinician’s preferred theory.

psychoanalytic working through resistance in the therapy room “free association and resistance in existential psychoanalysis

Montaigne, Freud, and the ethic implicit in free association

Thompson’s chapter becomes historically vivid when he suggests that the sceptic attitude “insinuated itself” into Freud’s conception of technique, even as Freud sought to secure psychoanalysis within a scientific idiom, and he locates this sceptic inheritance especially in free association and the sensibility of neutrality (Thompson, 2024, p. 128). He is careful about the limits of historical certainty, yet he notes that Freud became acquainted with Montaigne “around the time” Freud’s technique took what Thompson calls “a more sceptical turn,” roughly between 1912 and 1915, and he reads Montaigne’s counsel as an anticipatory version of the analytic attitude (Thompson, 2024, pp. 128–129).

Montaigne’s formulation is worth quoting because it clarifies the ethical seriousness behind what can otherwise sound like a mere method:

“It is an act of love to undertake to wound and offend in order to benefit.”
(Montaigne, 1925, Vol. 4, p. 307)

In a therapeutic culture that often confuses kindness with reassurance, Montaigne’s sentence can feel severe, and it should, because it names a difficulty that patients know intimately: honesty hurts, not because truth is inherently cruel, but because our attachments to belief, to self-image, to fantasy, and to the protection those provide are passionate, tenacious, and often desperate. Thompson pushes the point further by suggesting that the intensity with which we defend our “sacred assumptions” is not merely an intellectual habit, but a root of psychopathology, because such defences organize avoidance and distort relationship (Thompson, 2024, p. 129).

When this is brought into the analytic room, free association ceases to look like a clever technique and begins to appear as an ethical demand placed on speech. It asks the patient to risk saying what is inconvenient, shameful, contradictory, or seemingly senseless, while the analyst risks not knowing in advance where the speech will go or what it will demand from them in return. In that reciprocity, the fundamental question is not whether the right interpretation will be delivered, but whether experience will be allowed to speak without being prematurely silenced by certainty.

When theory becomes an escape from experience

Thompson is not anti-theoretical, and the chapter does not lapse into the familiar anti-intellectual gesture that pretends experience is self-interpreting. His scepticism is aimed elsewhere. It is aimed at the way theory can become a refuge, a way of avoiding the encounter with what is actually happening between two people by replacing it with the comfort of conceptual recognition. The sceptics, he reminds us, rejected rote learning and emphasized immediate experience, and Thompson reads this as a clinical warning: the mastery of theory does not by itself produce the capacity to listen, because listening is not the passive reception of content but an exposure to what is unpredictable, disturbing, and morally consequential (Thompson, 2024, p. 121).

For therapists, this warning cuts against a common training fantasy: that competence is achieved by accumulating knowledge until one is immune to uncertainty. In reality, the analyst’s wish to know can become as defensive as the patient’s wish to know, and the analytic situation becomes distorted when theory is used to stop inquiry rather than to deepen it. At that point, schools of thought can function as shelters from experience, offering certainty as an identity, and certainty as an identity is always tempted by dogmatism.

For patients, the same point is often lived from the inside as a feeling of being reduced. When the clinician rushes to diagnosis or explanation, the patient may feel temporarily understood, but they may also feel quietly erased, as though their living experience has been translated into a concept that is easier for the clinician to handle than the person themselves. Thompson’s sceptic ethic would regard that translation as a danger, because it replaces the person with a theory of the person.

Equanimity, suffering, and the limits of cure

Thompson closes his chapter by returning to the ethical horizon that began it. If psychoanalysis is oriented toward equanimity, then its aim is not the eradication of suffering but a changed relation to suffering, a stance that can remain “unbothered” by suffering in the sense of accepting it as a condition of life rather than as evidence that life is an error (Thompson, 2024, p. 139). He writes, with a directness that is existential rather than consoling, that the truly happy individual is one who can cope with life’s problems without avoiding them, who can “endure the anguish of living without cursing it” (Thompson, 2024, p. 139).

This is where the sceptic lineage becomes something more than historical color. Sextus Empiricus, the physician of scepticism, suggests that if one can remove the intensity of one’s beliefs, one can endure “moderate suffering” (Sextus Empiricus, 1949). This is not a promise of cure, and it is not a minimization of pain. It is a description of how belief, especially dogmatic belief about what must be true, can amplify anguish by turning suffering into a verdict on existence itself.

Freud’s remark about transforming “hysterical misery into common unhappiness” is often repeated as a sign of pessimism, but it can also be heard as a sober ethical claim about the limits of psychotherapy, and about the possibility that a less defended life may suffer more honestly and therefore with less self-imposed cruelty (Freud & Breuer, 1893–1895/1955). Thompson’s sceptic ethic does not celebrate suffering, but it refuses the fantasy that suffering can be abolished without remainder, and it treats the desire for abolition as one more place where the human being tries to escape experience rather than to live it.

Conclusion

Thompson’s “sceptic dimension” is not a call to doubt everything, and it is not an invitation to cultivate vagueness; it is a disciplined refusal to replace experience with certainty, especially when certainty functions as a defence against the discomfort of living and the vulnerability of relationship.

Psychoanalysis, on this view, is ethical not because it preaches morality, but because it concerns the manner by which a person conducts themselves in the face of conflict and disappointment, and because it asks both patient and therapist to endure what is revealed when judgment is suspended long enough for experience to speak (Thompson, 2024).

At Free Association Clinic, this sensibility informs our understanding of psychoanalytic therapy and existential therapy as forms of depth work that take experience seriously and resist the urge to substitute slogans for inquiry. For clinicians, our training program in existential psychoanalysis is oriented toward precisely this capacity, the capacity to listen without coercing, to think without retreating into dogma, and to remain receptive in the face of uncertainty. If you want to explore this work as a client or clinician, you can contact us.

References

Thompson, M. G. (2024). Essays in Existential Psychoanalysis. Routledge.
Annas, J., & Barnes, J. (1994). Sextus Empiricus: Outlines of Scepticism. Cambridge University Press.
Burnyeat, M. (1997). Can the sceptic live his scepticism? In M. Burnyeat & M. Frede (Eds.), The Original Sceptics: A Controversy. Hackett Publishing.
Freud, S. (1912/1958). Recommendations to Physicians Practising Psychoanalysis. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 12). Hogarth Press.
Freud, S., & Breuer, J. (1893-1895/1955). Studies on Hysteria. In Standard Edition (Vol. 2). Hogarth Press.
Groarke, L. (1990). Greek Scepticism: Anti-Realist Trends in Ancient Thought. McGill-Queen’s University Press.
Montaigne, M. (1925). The Essays of Montaigne (G. B. Ives, Trans.). Harvard University Press.
Sextus Empiricus. (1949). Adversus Mathematicus (R. G. Bury, Trans.). Loeb Classical Library, Heinemann.
Wachterhauser, B. (1996). Phenomenology and Scepticism: Essays in Honor of James M. Edie. Northwestern University Press.

Authenticity in Psychoanalytic Therapy: The Vicissitudes of Being Real

A reflection on Michael Guy Thompson’s “Vicissitudes of Authenticity in the Psychoanalytic Situation,” in Essays in Existential Psychoanalysis: On the Primacy of Authenticity (Thompson, 2024).

Introduction, why authenticity matters in psychoanalytic therapy

“Two chairs in a therapy room representing authenticity in psychoanalytic therapy

Authenticity in psychoanalytic therapy is rarely announced as the explicit aim of treatment, partly because the word itself has been worn thin by culture, and partly because psychoanalysis has historically preferred to speak in a technical idiom, as if what matters most can be safeguarded by speaking in concepts that keep the moral imagination at bay. Yet Thompson proposes that the analytic relationship, when taken seriously, is better characterized as a quest for authenticity than as the mere cultivation of insight, adaptation, or symptom relief, and he makes that proposal precisely because the consulting room is one of the few places where a person can discover, in a lived way, what it costs to tell the truth about themselves without converting that truth into a performance (Thompson, 2024).

This is not a romantic claim about “being yourself,” as though the self were a stable possession waiting behind the curtain, nor is it a recruitment slogan for therapy; it is closer to an existential claim about what it means to bear reality when one can no longer hide behind the small dishonesties that make life feel manageable. If psychoanalysis has an ethical gravity, it may be found less in the therapist’s values, and more in the peculiar demand that the situation makes on both people, namely that they meet one another under conditions where evasion becomes increasingly difficult to sustain.

Introduction, why authenticity matters in psychoanalytic therapy

Patients rarely arrive saying, “I want authenticity,” and when they do, it is often because they have already tried to purchase that feeling through other means, through reinvention, through disclosure without consequence, through the curated honesty of social media, through the moral certainty of an identity that never needs to be questioned. More often, what arrives is distress, the fog of anxiety or the bluntness of depression, an unnameable dissatisfaction in love, or the weary sense of living at a distance from one’s own life, and yet, if one listens without rushing to interpret, a quieter wish can be heard beneath the presenting problem: the wish to become less divided, less strategic, less coerced by fear into living a life that does not feel like one’s own.

For therapists, that same wish appears in a different register, not as a “goal” to be delivered, but as the atmosphere that slowly develops when a patient senses that the hour is not organized around being managed, corrected, or recruited into optimism. In that atmosphere, what begins to matter is whether speech can become more than reporting, whether the patient can risk saying what is true enough to disturb their familiar self-understanding, and whether the therapist can tolerate the consequences of that disturbance without turning the work into reassurance or technique-as-theater.

Why psychoanalysis rarely names authenticity directly

Thompson’s first move is deceptively simple: he points out that authenticity is not a conventional technical term in psychoanalysis, even though what he means by authenticity has “pervaded psychoanalysis from its inception,” and he treats that mismatch as more than a historical curiosity (Thompson, 2024). When something is central yet unnamed, the unnamed thing tends to reappear in distorted forms, sometimes as ideology, sometimes as sentimentality, sometimes as the brittle insistence that one’s technique is “neutral” while one’s practice is quietly organized around fear.

Philosophy, culture, and the discomfort of ambiguity

The word authenticity enters the psychoanalytic bloodstream through existential philosophy, and Thompson notes that this alone creates resistance, since many analysts are temperamentally and institutionally averse to philosophical reading, even when the clinical situation forces philosophical questions upon them (Thompson, 2024). He also locates a cultural divide: European sensibilities have more readily treated suffering as a source of strength and character, whereas American sensibilities are more inclined to treat suffering primarily as trauma and psychopathology, and authenticity sits uneasily at precisely that interface because it refuses to promise comfort as the criterion of truth (Thompson, 2024).

What makes the term especially difficult, however, is not simply its philosophical pedigree but its ambiguity, since authenticity cannot be stabilized as a measurable outcome without being falsified by that very stabilization. Thompson suggests that the pragmatic, market-oriented description of psychoanalysis as increasing “work and love” becomes, in this context, a kind of defensive simplification, because it allows the field to speak in terms that sound sellable while avoiding the darker and more demanding question of what a person is willing to face about their own existence (Thompson, 2024).

Authenticity is not a moral checklist

One of Thompson’s most clarifying claims is that authenticity has “no specific moral agenda,” and that the absence of an inherent moral program is precisely what many clinicians find disturbing (Thompson, 2024). In a culture that alternates between moral exhibitionism and moral cynicism, it is tempting to make authenticity mean “doing the right thing,” or “saying the honest thing,” or “being transparent,” but psychoanalysis becomes unrecognizable when it is reduced to character education, and existential thought becomes kitsch when it is reduced to a lifestyle. Even Charles Taylor’s influential effort to rehabilitate authenticity within a moral frame, whatever its virtues, illustrates the ease with which authenticity is pulled toward moral discourse and away from the clinical texture of the hour (Taylor, 1991).

In the analytic situation, authenticity is less a set of correct statements than a stance toward one’s own evasions, a willingness to see how one uses speech to hide, seduce, attack, or manage, and a willingness to notice how the other person is being recruited into that same familiar drama. It is not, therefore, a doctrine of disclosure, since disclosure can be used defensively, and it is not a doctrine of emotional intensity, since intensity can be theatrical; rather, it concerns the slow collapse of contrivance, which is why it is so often accompanied by shame, fear, and the temptation to flee into theory.

What Thompson means by authenticity in the analytic situation

Thompson restricts authenticity, for the purposes of his argument, to a few elementary attributes that are clinically useful because they resist the sentimental uses of the word: authenticity tends to involve the road less traveled, it tends to be more arduous and therefore potentially more rewarding than the easier path, and it is genuine in a way that resists generalization because it is context-specific and characterized by an absence of subterfuge or contrivance (Thompson, 2024). That final attribute matters clinically because it immediately places authenticity inside relationship rather than inside private conviction, and it implicitly aligns authenticity with psychoanalytic efforts to name what is “real” or “honest” in what he calls the extra-transference dimension of the treatment relationship (Thompson, 2024).

Unconventional, difficult, and strangely rewarding

To call authenticity “unconventional” is not to romanticize rebellion, but to notice that the patient’s deepest evasions are rarely idiosyncratic; they are usually culturally reinforced, often rewarded, and sometimes identical with what the patient thinks of as their character. The analytic demand, then, is not a demand for novelty but for a different kind of fidelity, fidelity to what is actually happening, including the parts that the patient has learned to speak around, and including the ways the patient tries to make the therapist into a collaborator in their avoidance.

This is why authenticity is arduous. When a patient begins to abandon familiar defenses, what they lose first is not misery but protection, and what replaces protection is not immediate freedom but exposure, and exposure is experienced as danger long before it is experienced as liberation. The analytic situation makes room for that danger without rushing to annul it, and in that sense it becomes one of the few relational spaces where a person can discover that they are capable of bearing what they previously treated as unbearable.

A winding path symbolizing the difficult but rewarding path of authenticity in therapy

Context-specific truthfulness, not a “one size fits all” stance

Because authenticity is context-specific, it cannot be codified as a stable therapeutic posture, and this has implications for technique: if the therapist tries to apply authenticity as a rule, the therapist will inevitably become inauthentic, because the “application” will be driven by the therapist’s need to be a certain kind of clinician rather than by responsiveness to what is actually happening between two people. Thompson is explicit that analysts may emphasize some dimensions of authenticity and neglect others, and he notes that Freud, Winnicott, Bion, and Lacan had markedly different clinical styles while still exemplifying something essential about authenticity, which should caution us against confusing authenticity with any single school’s technical identity (Thompson, 2024).

The practical implication is not eclecticism for its own sake, but humility: the question becomes less “What would an authentic analyst do?” and more “What is being demanded of us, here, if we are not to lapse into contrivance?” That question is not answered once, because the analytic situation does not stop changing, and neither do the ways the patient tries to manage closeness, fear, desire, and disappointment.

Authenticity and suffering, what analysis does (and does not) promise

If authenticity is made into a therapeutic slogan, it will be used to smuggle in rescue fantasies, and Thompson’s argument is partly an argument against rescue, not because he is indifferent to suffering, but because rescue fantasies are themselves among the most tenacious forms of inauthenticity. Psychoanalysis does not promise happiness, and when it pretends to, it becomes indistinguishable from those cultural forces that deny the inevitability of disappointment by selling solutions.

Freud’s “common unhappiness” and the end of rescue fantasies

Thompson recalls Freud’s austere line about the aim of analysis, “to transform hysterical misery into common unhappiness,” and he reads it not as cynicism but as a demand for honesty about the human condition, including the reality that the end of neurosis is not the end of suffering (Breuer & Freud, 1893–1895/1955; Thompson, 2024). The phrase becomes clinically useful when it is heard not as a lowering of expectations but as a refusal to lie, because what many patients experience as despair is often the dawning recognition that no other person, no perfect love, and no correct interpretation will exempt them from the burdens of being a finite human being.

Thompson presses this further with a Lacanian theme that he treats as existentially significant: the fantasy that someone will appear and solve one’s problems, like a parent who arrives just in time, is not relinquished by reasoning or coercion, but through the day-to-day experience of bearing disappointment while simultaneously trying to understand one’s resistance to it (Thompson, 2024). The rescue fantasy is not a childish error to be scolded; it is a form of hope that has become fused with dependency, and letting it go feels, at first, like letting go of life itself, which is why it requires a setting where disappointment is not humiliating but metabolizable.

Winnicott and Bion, becoming a “sufferer,” and why fear belongs

Thompson’s use of Winnicott is similarly stark. He cites Winnicott’s claim that “If we are successful [as analysts] we enable our patients to abandon invulnerability and become a sufferer,” and he treats this as a description of what authenticity demands, namely the renunciation of invulnerability as a way of living (Winnicott, 1989; Thompson, 2024). The language is jarring only if one assumes that the goal of treatment is to eliminate suffering; if one assumes instead that the goal is to make suffering bearable without distortion, then becoming a sufferer sounds less like a defeat and more like a recovery of basic human capacity, the capacity to feel what is real without collapsing or retaliating.

Bion’s contribution, as Thompson presents it, is even less consoling: Bion suggests that analyst and patient should both be experiencing fear, and that if they are not, they have no business being there, a formulation that treats fear not as a symptom to be neutralized but as a sign of proximity to what matters (Bion, 1974; Thompson, 2024). This is not an endorsement of intimidation, and it is not a claim that therapy should be frightening, but it is an insistence that authentic work approaches what the patient has organized their life to avoid, and avoidance, when it begins to fail, is experienced as danger.

Technique in service of authenticity

In Thompson’s frame, technique is not discarded, but it is stripped of its defensive uses. Technique exists to protect the analytic situation from the seductions of comfort, control, and mutual collusion, and when technique is understood in that way, its ethical dimension becomes clearer: it is not primarily about being correct, it is about refusing the forms of dishonesty that both patient and analyst will tend to prefer.

Free association as an honesty practice

Thompson’s earlier work on honesty makes explicit something that is often treated as a historical artifact: the fundamental rule of psychoanalysis is, at its core, a pledge, a contract in which the patient agrees to be candid, to say what comes to mind and to try not to lie about it, even though Freud discovered that this is precisely what patients are loath to do because they fear what their secrets reveal about themselves (Thompson, 2004). When this is taken seriously, free association is not a quaint ritual; it is the difficult practice of speaking beyond the edited self, and the therapist’s task becomes not to reward eloquence but to keep faith with the premise that what is most important is what the patient least wants to say.

In that sense, free association and honesty in therapy are not reducible to confession, because confession often seeks absolution; free association seeks exposure, not exposure to the therapist’s judgment, but exposure to oneself, which is why it so often produces ambivalence and resistance. Thompson emphasizes that the analytic encounter is inherently conversational, even when classical technique tries to deny this, and that conversation, when it is not merely gratifying but intelligently restrained, becomes a humanizing tool that can deepen free association rather than dilute it (Thompson, 2024).

FNeutrality, “evenly suspended attention,” and “erasing memory and desire”

Neutrality becomes corrupt when it is mistaken for emotional absence, because emotional absence is not neutral, it is a stance, and often a stance organized around the analyst’s fear of being affected. Thompson’s account of neutrality, both in The Ethic of Honesty and in his reading of Freud, emphasizes something closer to “not knowing,” a disciplined openness that empties the mind of preconception so that the patient’s experience can appear as it is, rather than as the analyst needs it to be (Thompson, 2004). Freud’s phrase “evenly suspended attention” and Bion’s phrase “erasing memory and desire” point in the same direction, not toward blankness, but toward the courage required to listen without forcing the hour into the analyst’s preferred narrative (Freud, 1915/1958; Bion, 1967; Thompson, 2024).

Thompson treats this as a feature of authenticity because it demands that the analyst relinquish the small dishonesties of certainty and mastery. If neutrality is real, it is felt by the patient not as coldness but as the unsettling experience of not being managed, which can provoke rage and longing precisely because it interrupts the patient’s habitual strategies of control.

Notebook and pen symbolizing free association and honesty in psychoanalytic therapy

Abstinence and the courage to disappoint

Abstinence, in Thompson’s rendering, is not a synonym for cruelty, and the confusion between abstinence and aloofness has done immense damage to the public understanding of psychoanalysis. He quotes Freud’s admonition that the analyst should treat transference love “like no other emotional relationship,” while also never returning it, rejecting it, or demanding it, which is a formulation that places abstinence in the service of protecting the analytic space from seduction and retaliation rather than in the service of moral superiority (Freud, 1915/1958; Thompson, 2004).

In Thompson’s chapter on authenticity, this theme converges with Lacan’s stark insistence that the analyst abandon the wish to be helpful when help is asked, give up the fantasy of miracles, and even relinquish the hope of ending treatment with gratitude. Thompson’s summary is brutal and clarifying: “The goal of analysis is to disappoint,” and disappointment is painful, often unappreciated at the time, and yet potentially liberating because it undermines the patient’s investment in rescue fantasies (Thompson, 2024; Schneiderman, 1983). If abstinence is practiced with intelligence rather than sadism, it becomes one way of protecting the patient from the therapist’s wish to be needed, which is one of the most common sources of inauthenticity in clinical work.

Transference and countertransference, and the real relationship

If there is a point in Thompson’s chapter that should unsettle therapists, it is his insistence that the concept of transference can itself become a defense, not for the patient but for the analyst, a way of refusing the impact of proximity by translating whatever is human into something that can be interpreted away.

When “transference” becomes a defense against proximity

Thompson argues that post-Freudian technique, particularly the versions that advertise themselves as “classical,” often redefines the analytic relationship by eliminating the personal or real relationship and expanding technique to cover what Freud treated as personal engagement, a shift that robs the relationship of genuineness in ways patients can feel and often complain about (Thompson, 2024). He is blunt: transference can become “a vehicle of defense against the realness of the person of the patient,” especially when it is convenient for the analyst to remove themselves from the impact of closeness (Thompson, 2024).

This is not an argument against transference interpretation. It is an argument against hiding behind transference interpretation. When every sign of warmth is interpreted as seduction, when every moment of closeness is treated as regression, and when the therapist’s own fear of intimacy is masked as technique, the analytic situation becomes a theater of avoidance that calls itself depth.

The personal relationship, credibility, and the ordinary negotiations of treatment

Thompson does not romanticize the personal relationship, and he is clear that it cannot be codified, since it varies with analysts, with patients, with stages of treatment, and with the moods and limits of both people (Thompson, 2024). Yet he insists that analysts inevitably talk to patients about ordinary matters, whether the analysis is working, whether the couch should be used, disagreements about frequency, absences, fees, and the simple question of what is being asked of each person, and these matters are resolved not by theory but by credibility, by the patient’s sense that the analyst is speaking without guile (Thompson, 2024).

He also makes a claim that many clinicians privately know but publicly avoid: the patient’s love for the analyst, not merely as projection but as something real that emerges through sustained proximity, is often the very condition that makes the trials of analysis endurable, and the field’s reluctance to speak of love is itself a symptom of its discomfort with authenticity in the therapeutic relationship (Thompson, 2024). To acknowledge this is not to abolish boundaries, it is to refuse the lie that the work occurs without human impact.

Conclusion, authenticity requires courage from both people

Thompson’s conclusion is not a celebration of authenticity as an ideal, but an insistence that change is necessarily painful and requires sacrifice, and therefore cannot be demanded from the patient by an analyst who insists on remaining safe behind detachment. If the patient must bear disappointment, fear, and the loss of protective fantasies, then the analyst must also bear sacrifice, not as martyrdom but as participation, since authenticity cannot be “applied” as technique from the comfort of evacuation, but must be suffered repeatedly as an act of courage throughout the treatment (Thompson, 2024).

In that sense, authenticity in psychoanalytic therapy names something like an ethic without moralism: a commitment to a relationship that is continually tempted toward contrivance, and yet capable, under the pressure of the work, of becoming more honest, more real, and therefore more alive.

James Norwood, PsyD
Associate Director, New School for Existential Psychoanalysis
Clinical Director, The Free Association Clinic for Existential Psychotherapy and Psychoanalysis
Founder/CEO, In Person Therapy

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