An unexpected conversation about psychodynamic therapy
It was a day off, and dusk was already settling in — that early darkness that comes in late autumn. We were waiting for friends to come over for tea. They were just returning from a walk — from the damp, fog-filled evening into a warm kitchen. The conversation moved around ordinary, everyday matters, and its content wasn’t really the point.
For immigrants, what often matters most is presence — the feeling of someone similar nearby, someone in a comparable situation. It offers a quiet sense of relief: a chance to relax, to warm up both emotionally and physically, and to feel that, in the end, things somehow get resolved and move in the right direction.
Our friends brought along a woman they knew. When she learned that I am an analyst, she asked a question that made me pause. It wasn’t a new question. I hear it often. And I often respond to it.
Describing those who remain in analysis
Once again, I found myself thinking about how — in a relaxed evening conversation — one might describe, briefly and precisely, the shared qualities of people who come to an analyst in private practice and remain in analysis for a long time.
What makes them capable of choosing this approach in particular — and, more broadly, of relating to their lives through its lens? What traits shape their sense that, beyond symptom relief, there is also value — or even a certain luxury — in immersing themselves in the depth of their own psychic experience?
The limits of a simple answer
A short answer did not come easily. And I cannot treat this question mechanically or offer a ready-made response for several reasons.
The main one is this: although these qualities can be described in general terms, they are often present only implicitly. In a sense, analysis brings into view qualities that already exist in a person — latently — or are just beginning to take shape. They may not be immediately visible to the person themselves, to others, or even to the analyst. But when they do emerge, they are precisely what helps a person remain in analysis.
In this way, these qualities appear both as a reason someone is able to choose and stay in analysis, and as a result of the analytic process itself.
This sometimes leads to the question of whether analysis shapes people — whether it, in a way, “forms” those who remain in it. The answer may depend on perspective. What is certain is that analysis offers a particular way of seeing — an optic. Whether that optic feels helpful or not is something each person can decide for themselves, for example by reflecting on how they relate to the qualities that develop through analytic work.
Another reason I resist a stock answer is more personal: responding mechanically would feel dishonest toward the person asking — and overly simplifying, even subtly devaluing, toward myself.
Qualities that often grow within the analytic process
Very few people come into analysis already possessing all of the capacities described below. More often, only some of them are clearly present. Others emerge or gradually take shape over the course of psychodynamic therapy.
• A high degree of motivation and persistence is common among those who choose analysis. Many have been living with their difficulties for years. What often draws them is a wish for fuller relationships with others and, equally, for greater acceptance of themselves. Most have prior experience with sustained effort in pursuit of meaningful goals.
• Some capacity for honest self-observation and self-exploration is present — “honest” in the sense of not turning away when encountering aspects of oneself that are not especially appealing. Importantly, this capacity is not always available at the beginning of analysis; quite often, it forms within the analytic process itself.
• The ability to sustain long-term relationships — with partners, friends, family members, or colleagues — is usually present in some form. These relationships may be tense or conflictual, yet they exist. There is material to work with, as well as motivation for developing more satisfying and healthier ways of relating.
• A certain tolerance for frustration gradually becomes evident. As conflicts inevitably arise in analysis, it becomes possible, over time, to speak about them openly with the analyst and to deepen self-understanding. Continuing the work despite difficulty is part of the process. This requires time and is closely linked to the gradual development of trust — in oneself, in the analyst, in others, and in the world.
Inner resources that sustain and deepen analytic work
Recognition often develops that one participates in the creation of one’s own difficulties. Problems come to be understood as expressions of inner conflicts, and there is a growing willingness to explore these conflicts more deeply in order to relate differently to recurring challenges.
• Alongside goals for the future and a wish to improve everyday life, a connection to early childhood is usually retained. Even when early experience does not explain everything, it is acknowledged as having had a significant influence on both strengths and difficulties.
• Dreams are not dismissed. The ability to recall them and to recognize dreams as one of the windows into the unconscious often becomes part of the analytic work.
• An understanding takes shape that feelings outside awareness can influence behavior, and that change becomes possible through emotional — not merely intellectual — engagement with these feelings.
• Those who come to and remain in psychodynamic therapy can be described as “sufficiently stable.” Some capacity to cope with frustration and conflict is present, even if it is not recognized at the outset. Over time, these internal resources often unfold and strengthen within the course of therapy.
• Even amid the difficulties that lead someone to an analyst, a range of strengths is usually present.
On nuance and the idea of the “ideal client”
There is one more important nuance. This list can easily be read as a portrait of the “ideal client.” What I am describing, however, is closer to what gradually becomes visible in those who remain in analysis.
Often, these capacities appear forgotten, inaccessible, or unrecognized — including in people facing severe life circumstances, addictions, disturbances of attachment, psychosomatic symptoms, or borderline organization. Where someone may initially feel, “I am not like this, so this is not for me,” a different reality may slowly emerge: an inner strength that later becomes what sustains them in the analytic process. The conversation over tea stretched on — we did not part until after midnight. Perhaps it is inevitable that the question of who analysis, or psychodynamic therapy, is suited for does not lend itself to a truly brief answer.