Alright folks, as promised, I give you my 10 questions about psychoanalysis with one of my mentors, psychiatrist Charles Turk, who connected me to the training analysts of GIFRIC in Quebec City around 8 years ago, as well as to their extraordinary program for the treatment of young adults with psychosis. The center is named after its street address, Le 388, and I first visited it five years ago with Dr. Turk. I will talk more about that another time as the psychoanalytic treatment of psychosis was a shared interest of ours. For now, let’s look at what Charles has to say about what drew him to psychoanalysis and how he uses it in his practice.

1. Why Psychoanalysis? What drew you to psychoanalysis?

Decades ago as a medical intern, I felt a certain dissatisfaction when physically ill patients recovered, but continued to suffer from emotional distress. To address this level of disorder I was drawn to psychiatry. My residency in psychiatry was equivalent to an immersion in psychoanalysis – as the supervisory staff was predominantly made up of psychoanalysts. My training thus occurred before psychiatry “re-discovered the brain.” Subsequent clinical experience both on the couch and behind it awakened and sustained my interest in psychoanalysis.

2. How would you describe the difference between psychoanalysis and psychotherapy?

Briefly put, psychotherapy is reparative of failing symptoms, while psychoanalysis aims at resolution of those symptoms by means of exploring their sources.

3. What is it about psychoanalysis that you find most helpful in treating patients?

It establishes a space where an individual can speak freely of matters never addressed to anybody before – and do so without incursions by the analyst, however well-intended.

4. In your opinion, who can benefit from psychoanalysis?

In our field there is a generally held notion that strict criteria exist that must be used to determine who is suitable for psychoanalysis. This is so because the method is deemed potentially dangerous to “vulnerable individuals”. Over time through supervisory experience and further training, I have come to an alternative view. One cannot predict who might benefit from psychoanalysis without attempting the venture, and so I implicitly offer engagement in psychoanalytic work by establishing a setting for it, in a way that allows the person to reject it as it may be more demanding than can be endured. In this way the so-called “dangers” may be avoided.

5. How do you explain psychoanalysis and what you do to your patients?

I do not give formal instructions – but convey what is expected by offering a space and encouraging the person to fill it in whatever way is found to be useful in his/her particular circumstance. S/he is implicitly invited to “free associate” and is free to reject the invitation.

6. How would you advise a person, who is seeking professional help, to decide on wanting psychoanalysis versus other forms of therapy?

That that person should reflect on what disturbs his/her present life circumstance and decide whether to seek symptomatic relief or a more extensive examination of his/her subjective position.

7. How does what you do as a psychoanalyst differ from what other mental health professionals do in therapy?

I do not offer advice because the psychoanalytic perspective seeks to assist the person to find the key s/he already possesses that can unlock the door of a self-constructed prison. I tend to avoid using medication while keeping in mind that it can sometimes be an important ingredient of the frame.

8. Tell us about your own personal experience with psychoanalysis.

As an analysand, the space the couch offered me was an indispensable means that enable me to resolve a longstanding sense of alienation, terror, a stubborn compulsion and depressive mood – all of which I’ve exchanged for that “ordinary human unhappiness” Freud promised to his patients. My experience as analyst follows.

9. What else would you like to say to our readers about your psychoanalytic work?

I have worked with several patients, who had run into impasses in previous treatments and who over a long period of time improved as indicated by creating a place for themselves in the social scene. These include three schizophrenic patients, and three suffering from a borderline disorder. This latter group suffered from disabling effects of childhood trauma. That said, three failed attempts with disturbed patients, who initially seemed amenable to and wanted a “talking cure,” moves me to not promise more than can be delivered.

Additionally, I volunteer in a community mental health center founded on psychoanalytic principles. The staff’s clinical work is reviewed in a case conference and seminar where we can view the relative roles of the “talking cure” and of medication in their course.

10. In your opinion, who can benefit from psychoanalysis?

We know that there are some people who are so wedded to symptoms or dysfunctional actions that they are unwilling to risk losing them or giving them up. If they come to our consulting rooms they deserve to be extended an offer of psychoanalysis because there is ever a chance that the human subject hidden within may be able to make use of what we offer. Beyond this anyone wanting to re-consider negative situations s/he repeatedly finds him/herself in or to relieve suffering or symptoms that negatively impact his/her life could potentially benefit from psychoanalysis.

 

Charles Turk, MD is a practicing psychiatrist who obtained psychoanalytic training at the Center for Psychoanalytic Study in Chicago.  He pursued his interest in treating psychotic and other severely ill individuals as medical director of a partial hospitalization program in a community mental health center, in suburban Chicago, for which he received an Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1992.

He has continued his psychoanalytic studies at the Ecole Freudienne du Quebec (EFQ), and is a founding member of the Chicago Circle Association, an affiliate of the EFQ  He is a member of GIFRIC  (Interdiscipinary Freudian Group for Research and Clinical Intervention), the parent organization of the EFQ. In 2004 he received a Local Educator award from the International Federation for Psychoanalytic Education.

If you would like to contact Dr. Turk directly, you can email him at [email protected]