Psychotherapy Teaching Sample: On the practitioner’s internal listening
Date : October, 2025
These “Psychotherapy Teaching Samples” are designed for psychotherapy students who are beginning their clinical practice. That is, trainees who are not attempting to do psychoanalysis as such, but who seek to do competent psychotherapy that might later eventuate into the workplay of psychoanalysis. In this context, much is missing about the inner reactions of the practitioner and their significance…material that is essential to the conduct of psychoanalysis as such. The strong distinction between psychotherapy and psychoanalysis — that is made again and again in the “Rediscovering Psychoanalysis” literature — must be kept in mind when studying these “Samples.”
Psychoanalytic listening is neither a practice of merely ‘observing and inferring’ in the manner of an objectivistic scientist examining a specimen or case, nor is it a practice in which anything and everything that occurs within the mind of the practitioner should be welcomed licentiously as necessarily having significance for the treatment. Thus, in terms of the way in which the practitioner listens to her/his internal thoughts, feelings, and fantasies, while in a session with a patient, there is a crucial balance between bracketing-off one’s own material and being receptive to one’s own reactions as being responsive — often on an unconscious level — to what the patient is expressing.
Achieving such a balance is why a full course — or courses — of personal psychoanalytic treatment is essential if one is to become a psychoanalytic practitioner, and additionally it is a reason why both trainees and senior practitioners should engage in frequent consultation with trusted and competent colleagues.
Here is an example from my own experience, early in my training.
Ivan was a professor of law, older than me by more than a decade. During a session in the middle phase of psychoanalytic treatment, he had spent almost thirty minutes telling me about several events in which he felt disrespected, ignored, or even abrogated. The committee running his soccer club had not responded to a letter he had sent them requesting a change in procedure that he considered moderately serious. A friend had more or less snubbed him in relation to a coffee date. At a faculty meeting, the Head of his Department had not only failed to consider, but had treated dismissively, an important point he had been trying to raise.
These stories were told with increasing emotion of irritation, frustration and anger. At the point in which he seemed most angry, an image came into my mind of Lewis Carroll’s Mock Turtle as depicted in John Tenniel’s illustration, which shows the Turtle weeping.
[It subsequently occurred to me that this image might make me into Alice, who sits listening to the Turtle, occasionally challenging him with questions. It also might make me the Gryphon, who also listens (and who seems to be—like me—of Cockney origin); as a personality the Gryphon tends to be rather dismissive, although he and the Turtle later become friends, somewhat by default.]
In any event, as the image came into my consciousness, I was struck by the Mock Turtle’s tearful sadness. And I spontaneously — by which I mean without any notable conscious deliberation or forethought — said to my patient:
“And yet, Ivan, beneath your irritation, there is sadness.”
By most criteria in the literature on psychoanalytic technique, my comment was misplaced, mistimed, or simply wrong — at least in the sense that it suggested little or no empathy for the Professor’s escalating emotions of irritation, frustration and anger. It is noteworthy that Ivan responded to my comment with a sort of “uh-huh” and continued with additional stories about irritations in his everyday life.
In psychoanalysis — as perhaps contrasted with psychotherapy — the practitioner is little concerned with whether the patient agrees, disagrees, or seems to ignore an intervention one has just articulated. The usefulness of the intervention — interpretation, if your will — pivots on whether it opens up, or closes down, the patient’s free-associative freedom (and does so without scoring off the patient’s suggestibility). But in what timeframe should the opening or closing of the patient’s discourse be assessed?
In the next day or so following the session, I thought about why I had had this experience, and also in what sense — or to what extent — it might have been less than optimal for be to have blurted out (for that is more or less what it was) my conjecture about the patient’s underlying sorrow.
It subsequently occurred to me that the reason the Turtle is so sad is that he anticipates being made into soup. His life, his memories of being in “school” with the “porpoise” of being taught by a “tortoise,” and his tender feelings … all will be irrelevant, expunged, as he is annihilated and ingested.
In subsequent sessions, my patient did indeed move into seemingly different thematic material. He began to speak, quite movingly, of his mother’s lack of interest in him, her preoccupation with his elder brother, and his awareness that, because she had been managing this brother, who was little more than a year older than he, she had declined to breast‑feed him. These were poignant recollections, accompanied by the beginnings of deep grief.
As a sidenote of self-criticism: I also later recalled how, right at the beginning of my professional career, while in New Orleans, I had gone to an unfancy but excellent restaurant by the docks, called Les Bons Temps — “Good Times” — and I had enjoyed a delicious bowl of turtle soup (this was before it became a protected species). A year later, I was at a very highbrow psychoanalytic conference, in the same city. A group of very senior and very distinguished colleagues, knowing that I had been in New Orleans relatively recently, asked if I knew a really good down‑to‑earth restaurant. I gave them my recommendation. It seems that that night they walked the streets for a long time, trying to find the restaurant that I had praised so highly, which had in fact closed down. However, after asking for directions, they did arrive at a new establishment, also called Les Bons Temps, which had recently opened in the vicinity — a lavish topless bar, with which they were less than impressed, believing that their very junior colleague must have sent them there as a prank. Sometimes, one should be cautious when making recommendations to one’s seniors!