When we approach dreams, we are entering what Freud called a “foreign country” the unconscious, the repository for our unacceptable impulses. Jung expanded the idea of the unconscious and described it as “that cosmic night which was psyche long before there was any ego-consciousness and which will remain psyche no matter how far our ego-consciousness may extend.” Bosnak simply called it the (1) “uncontrollable unconscious.” The world is always coming to us. Our psychic membranes distance us from experience. Through dreaming we become vulnerable to what comes to us and goes unnoticed.
If dreams are messages from the inner-beyond, and possess an intelligence beyond our intelligence to grasp, how do we optimally approach dreams? Dream tending is a way of working with dreams developed by Stephen Aizenstat. It is a non-interpretive approach that creates an imaginal space, a theater for the dream to enter the waking world.
Two principles are foundational to dream tending: how the dream images are regarded, and the disposition of the dream tender. Aizenstat says, (2)“Dream images are not representations of our personal nature only, but are also informed by the subjective inner natures of the things and creatures in the world.” They exist “in the wild place of dream time, and have their own intelligence.” According to James Hillman, (3)“dreaming is a source of imaginal information from a psyche that is not merely mine, attached to my brain and within my skull,” but connected to the anima mundi, an intrinsic connection between all living things on the planet.
Dream images have a dual existence, a semi-autonomous presence that exist beyond the parameters of the individual mind. To the extent that we simply interpret a dream, we limit ourselves to the parameters of our interpretive system. The dream image is like a boat moored to a dock. The image reveals more of itself, individuates, when it is unmoored and allowed to drift. Hillman states, “Dreams call from the imagination to the imagination and can be answered only by the imagination.”
Dream tending is more a way of being than a technique. It prioritizes the importance of the dream tender’s personal dream practice. The term was chosen to emphasize a relationship to the dream characterized by curiosity and caring. The dream tender is not an authority but a guide. Dream tending is quintessentially improvisation, a playing with images, an attunement to affect, an overarching curiosity, and vigilance to the ever-present machinations of the interpretive ego. The dream tender is encouraged to meet the dream with patience and the curiosity of a tourist in a foreign country; to attend to the dream with “soft eyes,” and deep listening that empties the mind of pre-conceptions.
Dream tending builds on the work of Hillman. His theorizing about dreams led to a radical approach to working with dreams. (3) “We must reverse our usual procedure of translating the dream into ego-language and instead translate the ego into dream-language. Dream images ask us to hear, see, feel, and think differently. “This means doing a dream-work on the ego, making a metaphor of it, seeing through its reality.” Within this framework, interpretation prematurely fixes a meaning to the dreams often to relieve anxiety in the encounter with the “uncontrollable unconscious.”
Dream tending utilizes the techniques of free association, amplification, and animation. Free Association was developed by Freud to tap the unconscious. It is a radical, subversive method of giving voice to the unconscious by encouraging the individual to say whatever comes to mind. This method links dream images to deeper meanings found in the personal unconscious. Amplification is a technique developed by Jung to expand the dream image, connecting it to the collective unconscious. Amplification links dream images to archetypal themes found in myths, movies, and literature that have universal meanings relevant to humankind.
Animation is the heart and soul of dream tending. It views the dream image as a living image that needs to be animated rather than interpreted. Tending a the dream utilizes expressive and enactive techniques to bring the dream image into the present, to make it alive, so that it can be observed and interacted with, so that the images can individuate, and reveal their multidimensional meanings.
Animation involves an intuitive scanning of the affective currents in the dream. When a resonant image is identified, the dreamer is asked to name it, describe its significance, and imagine that image in the room. Who is visiting and What is happening now are two basic orienting questions, alternatives to asking, what does this mean. “Who …” invites the shadows of the dream image into active dialogue. “What is happening here” focuses on the present experience of the dreamer in relationship to the dream image. Through the interaction between dreamer and dream image, the image takes on new meanings, and the dreamer begins to experience the image differently.
Dream tending example. An individual in a dream tending workshop presented the following dream to me: “There are six qualities intense and deep forming a rectangle, with someone standing with each one. I am standing with Death. There is a sense that all these qualities are about to be infused into David from the television show Six Feet Under. He is standing across from me. I understand that this is whole-making. That this is making David whole”.
When she first told me the dream, I was struck by the abstractness of the dream. It seemed full of a dark, impenetrable emptiness. I asked about the other qualities in the dream. She said she couldn’t remember any of the other qualities. I felt like I was moving around in a dark room clueless to any openings. I asked for her associations to the tv show. She described watching Six Feet Under, when it first aired and she was involved in a significant relationship. The show is about a family of undertakers who live in a large craftsman house in Pasadena that serves as funeral parlor and their dwelling. Recently she started watching it again that coincided with beginning a new relationship.
She strongly identified with the character of David who she described as sensitive. She expressed a strong identification with David and I asked her to imagine him in the room. She did this easily. Her ability to use active imagination made my dream tending much easier. After a while, she said, he was different than in the show. He had an edge of aggression. He conveyed the feeling that he could take care of himself. She talked about how difficult it was for her to integrate aggression in her life. She said, “It was like a rock that my ship kept breaking on.” She described feeling very stuck and sad. I asked her to imagine telling David about her struggle with aggression. She was silent for a very long time. I was impatient and I asked what she was noticing. She said with a sharp edge to her voice “I am getting to it, but it’s taking time.” I backed off, struck by the authority of her tone. She imagined a discussion where he conveys to her not with words but a “sense image” that aggression is part of nature. She then noticed that he was changing and taking on the personality of Walt Whitman. At a funeral in the show, a section of Walt Whitman’s Leaves of Grass was read.
The session was close to ending. She had been moved by the way she had experienced aggression. I asked her, if she could imagine taking this new sense of aggression beyond our dream tending. She felt pretty confident that she could apply this in different aspects of her life, especially her new relationship. As we discussed the session, we both were amused by her edge of aggression that had been directed toward me.
There was far more to this dream than my initial reaction feared and what was captured in the dream tending session. Death and Walt Whitman were not touched on, nor the implication for how she might bring this more assertive sense of herself into her new relationship.
The dream was not interpreted. An imaginal space was created that encouraged the dreamer to interact with the dream image of David. Animation of the image brought into the present an emotional engagement with aggression that represented a stuck point in her life. Interacting with the image of an edgy David facilitated a new positive, experience of aggression that was not destructive. She embodied this feeling in her interaction with me when she told me not to rush her. Had we only talked about her conflict, there would have been less of a transformative experience.
The surprising aspect of the work occurred when the image of David transformed into Walt Whitman. It lent credence to the notion of the “living image” that has an evolving life to be realized imaginatively. When you sit with an image and observe it rather than interpret it, you enter a transitional zone, in between what is known and what could be known. The potential space is a source for creative thinking for recognizing what Bollas has described as the (4) “unthought known.” The challenge of dream work is to be able to inhabit that transitional space and tolerate the not knowing that is the field upon which dreams live.
An epilogue. She later emailed the section of Leaves of Grass, “Song of Myself” lines 115-122 that was read in 6 feet under and some of her reflections.
What do you think has become of the young and old men?
And what do you think has become of the women and children?
They are alive and well somewhere,
The smallest sprout shows there is really no death,
And if ever there was it led forward life, and does not wait at the end to arrest it,
And ceas’d the moment life appear’d.
All goes onward and outward, nothing collapses,
And to die is different from what anyone supposed…and luckier.
As we worked the dream, this is the nature of death that I experienced in the “quality” of Death that I stood with in the dream, and ties into how I experienced the David figure as “Whitmanian”– understanding the cycles of nature, which include both bounty and destruction. In that way, I experienced aggression as natural as the destructive forces of nature that kill and break things down so that they can become food for the next life cycle. “All goes onward and outward, nothing collapses,” including aggression. I think those of us with a fear of aggression do fear that it will collapse things. The David figure being made whole through infusion of these dark, intense qualities was profoundly reassuring. There was a solidness about him, even a kingliness– the quiet assurance and power of someone who is standing firmly in their whole character, nothing split off, nothing rejected. He was replete with himself, resplendent in his completeness. (I am reminded here of the Christian verse in which Jesus says, “Be perfect, as I am perfect”– and how I learned that in the Greek, it is better translated as “Be complete, as I am complete.”).
1. Bosnak, R. (2007). Embodiment: Creative imagination in medicine, art, and travel. London: Routledge.
2. Aizenstat, S. (2011). Dream tending: Awakening to the healing power of dreams (Pbk. ed.). New Orleans, La.: Spring Journal.
3. Hillman, J. (1979). The dream and the underworld. New York: Harper & Row.
4. Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unthought known. New York: Columbia University Press.
Image created by Garland Cannon used under Creative Commons license.
“The ecology of forgotten dreams is the Infinite.”
We spend on average one third of our lives sleeping, and about 25% of this time in REM sleep, dreaming. Between 5 and 10% of our dreams are remembered. When remembered, they are often recalled in fragments and quickly forgotten. Or, if not forgotten, they are neglected. When forgotten, a random stimulus can trigger recall, suggesting that dreams, though forgotten, are mysteriously preserved.
It is puzzling why so few dreams are remembered, given the centrality of dreaming to sleep. Neuroscience can partially explain the mechanics of forgetting, and highlight some of the benefits of dreaming, but not its psychological or cultural significance. The eminent dream researcher Allan Rechtschaffen noted, “we have learned a great deal about the biology of dreaming without really knowing what dreaming is the biology of.” The hippocampus, which monitors activity of the cortex and is involved with memory consolidation, is less responsive to inputs from the cortex during sleep, allowing dreams to slip away on awakening.
REM deprivation studies suggest that REM dreaming is important for emotional regulation during the day. If there is a benefit to dreaming that does not necessitate recall, what is the significance of forgetting and or neglecting our dreams? Is there an unrecognized loss to the individual and the culture? Should we be concerned that we are not even aware that we are missing something of importance, that there is no discernable symptom to signal this loss? Is this unawareness itself symptomatic?
The presence of dreaming creates an epistemological puzzle. On a nightly basis sleep introduces us to an other-worldliness that we are intimately connected to, that we have mysteriously created, and yet seem estranged from. The presence of dreaming co-exists with waking consciousness creating an unsteady relationship between two psychological states: conscious and unconscious functioning.
James Hillman in his book, Dreams and the Underworld, asks, ”What does the psyche want that it doesn’t know to ask?” The psychological significance of dreaming and dream forgetting and neglect reflect the dynamic and contentious relationship between our conscious and unconscious modes of functioning. Individual and collective dream neglect reflects a waking consciousness that doesn’t recognize the vital relationship between what occurs at night and the psychological events of the day, nor the immense, potential benefit from tending to our dreams. The ego’s eyes are blinded to the night. This phenomenon of neglect represents a profound alienation from the unconscious. Untended, it is left to wildly roam unrecognized through the day. Our waking world drifts unknowingly on the currents of the unconscious.
The cost of this neglect is subtle yet profound, though admittedly speculative. There is no diagnostic entity called “dream neglect syndrome.” Individuals don’t come to therapists complaining they can’t remember their dreams. How might we understand this phenomenon? In Dreaming Culture: Meanings, Models and Power in Us American Dreams, Jeannette Marie Mageo points out that Tahitian culture doesn’t have a specific word for sadness. She goes on to describe the experience of a Tahitian man who is disturbed when his wife and child leave for another island. Because he has no category for this feeling, he concludes he is ill.
This example calls into question how we see and understand our world. The sociologist Ernest Goffman defines frames of reference as “cognitive structures that guide the perception and representation of reality.” To this definition I would add the dimension of unconscious thinking. When we don’t have a conceptual frame that is attuned to the unconscious, psychological meaning is unmoored from reality that assumes an illusory objective status.
The unconscious seamlessly influences our conscious experience through the process of projection. We project our inner feelings onto people, places and things. Christopher Bollas in his book Being a Character asserts that the unconscious infuses our subjectivity creating a dream-like veil over the waking world. We live in a play or perhaps a dream co-created by the unconscious and the world. The unconscious is distributed into the space and objects of our world that we mistakenly view as the objective world. The unconscious not only influences how we view the world, but also our behavior. Freud’s oft quoted statement, “What is not remembered is acted out,” suggests that that much of our behavior is unwittingly driven by unconscious factors.
Let me illustrate the interplay between the unconscious and behavior. I have been seeing a man in psychotherapy for several years. He is in his 30’s and had been experiencing major depression and panic attacks that significantly impacted his life. After several months of therapy, he recalled memories of being sexually abused by a neighbor as a child. This realization was both painful and illuminating, helping him to have a better understanding of what appeared to him as inexplicable, intense emotional reactions. One day he came into session stating that he felt “super blah.” He had talked to his sister the night before and disclosed to her that he had been sexually abused as a child. This was the first time he had told a family member about the abuse. Throughout the day and into the night he described having a powerful desire to hide. His girl friend had gone to sleep. He described going into the bedroom and lying on the floor by the bed in a state of terror. As we tried to understand this behavior, I suggested that his conversation with his sister triggered a post-traumatic stress response. He recalled the following memory: after he was abused he would go to his bedroom and hide under the bed. He recognized that he was re-experiencing the terror that he felt as a child. His feelings of “super blah” diminished as we talked through the experience.
The relationship between waking and dreaming realities is variable and complicated. Dreams span the continuum from bizarre and incomprehensible to the strikingly clear. I had the following dream before attending a workshop on social dreaming.
I am walking with my wife, talking about writing an essay on social dreaming. She is making suggestions that I don’t agree with. And she is becoming dismissive of me. I blow air gently in the direction of her third eye.
There are many ways to look at this dream. For the purpose of this essay let’s assume that my wife is both my wife and the ideas that I am married to. In other words she is both my wife and a symbol representing a part of me. As I write this, I am conscious of the many trivial arguments we have had that seem embodied by the dream. What ideas am I married to? To what extent am I dismissive of other people’s ideas and resistant to hearing what they have to say? To the extent that I don’t recognize the conflation of internal and external reality, I am more likely to have conflicts with people in the world. To the extent that I am aware that other people might represent parts of myself, there will be less emotional activation more understanding of the multiple layers that characterize interpersonal interactions.
Gordon Lawrence, who developed the technique of social dreaming, believes that dreams reflect social as well as personal meanings. They hold a collective, cultural meaning, a social unconscious comprised of dissociated social, political, and cultural experiences. He states, “Provided we can remember our dreams, we can have confidence that we are in touch with our unconscious, and if we can associate to them, and use amplification, we are on speaking terms with our unconscious. If that is made possible, we can minimize the possibility of being caught up in psychotic-like social processes, because we can speak with our own psychosis.”
To be “on speaking terms with our unconscious” helps us to be attentive to projective mechanisms that distort our interpersonal perceptions, and create confusion between our internal world and external reality. The failure to recognize this effect leads to “psychotic-like social processes” that are manifested in marital conflict, as well as the violence and cruelty that pervades our world. The hated “Other” whether wife, husband, Muslim, Christian or Jew is often a dissociated part of our self-hate-filled psyche.
What does it mean “to be on speaking terms with our unconscious?” Hillman views dream work as an attempt to “speak with our own psychosis.” He states, “We must reverse our usual procedure of translating the dream into ego-language and instead translate the ego into dream-language.” The value of a dream is to help the ego experience the unconscious—all that is messy, terrifying, and repugnant: all that is Other to self. He states, “The dream-work cooks life events into psychic substance by means of imaginative modes… The dream is an initiation that moves the ego into the world of the imaginal.” The imaginal is a quality of thinking “on speaking terms with the unconscious” that makes waking experience psychologically meaningful through this “cooking process.”
Paul Lippman, in his book Nocturnes: On Listening to Dreams suggests that the unconscious and the conscious mind require each other for survival. The mind evolves on the basis of acquiring knowledge by making use of unconscious, undigested, unformulated experience. Dreams are the material upon which psychological experience is constructed and a form of thinking that operates on the level of the imaginal.
One far-reaching consequence of dream neglect is the failure to develop the imaginal Ego, the source of creative thinking and the quality of mind that evolves. Dreaming helps us think new thoughts, to realize thoughts that we are unable to think until we dream them. Lawrence writes, “cognition and consciousness arise out of thinking, which will have its basis in dreaming.” He states, “The ecology of forgotten dreams is the infinite” and the infinite is “a mental space that contains all that has ever been thought and is capable of being thought.”
A departing dream…. I walk into a family room of a friend or client and lay on a very large bed-couch. I believe the wife is there and maybe an older child. The husband walks in. I say something like this is better than being walked around on a leash. He is a Psychologist. He walks toward me and takes my belt and wraps it around my neck and says in a forceful but not threatening way, “I will show you what it is like to be led around on a leash.” We walk outside. I am trying to explain that I was speaking metaphorically and if you make it real it loses its meaning. I am barefoot. As I am being led, I feel unsteady like I could fall. We walk passed a rectangular, plastic, (maybe light pink) contraption. As we pass it shoots out 4 or 5 radiant, rainbow colored funnels of water that momentarily freeze in the air. I am trying to release the belt so that I can take a picture of this, but can’t do it quickly enough.
Image created by Jeronimo Sanz, used under Creative Commons license.
Imagine the following… You are standing on the shore of consciousness. There is a bridge that extends from morning to the end of cosmic night and from consciousness to the bottomless depths of unconsciousness. You begin the trek on this bridge, this royal road. You notice Freud and Jung, as well as others. There are few road signs. Those that can be detected are misleading. You inevitably reach a mysterious gap, as if the bridge suddenly ended and you are left only to imagine….
Dreams shroud the waking world, dazzling and disturbing it with mystery, perplexity, novelty, anxiety, terror, hope, and possibility. Anthony Blake, an English intellectual, has described dreams “as something unbidden that come out of darkness with an intelligence beyond our waking intelligence to grasp.” The mystery of the dream is suggestive of an otherworldly interface between the sleeping and waking self and the world, an indeterminate interface that holds unrealized potential.
Dreams have been part of our history as a species. Before the word was the dream. Within certain early cultures, dreams occupied a central role in the society. In indigenous cultures dreams were told to shamans and were used to guide important decisions as well as critical to healing. In Greece and Egypt dream temples were constructed as centers of religion and healing. Kilton Stewart, anthropologist and psychotherapist, in the 1930’s studied the Senoi, a Malayan aborigine tribe, whose happiness and well-being were linked to their morning custom of family dream-telling where members of the family would tell and discuss their dreams.
Western, industrial culture had its brief but significant encounter with the dream. One can say that Psychoanalysis was born from the dream. Freud’s seminal work that launched psychoanalysis in 1900, The Interpretation of Dreams was based on his interpretation of his dreams. It not only articulated a framework for understanding dreams, but also contained his earliest theories of mental functioning. Psychological culture as we know it emerged from this unconscious portal.
Dreams have also been the source of scientific discovery, creative work, and healing in our culture. Deirdre Barrett, Ph.D. in her book The Committee of Sleep: How Artists, Scientists, and Athletes Use Dreams for Creative Problem-Solving– and How You Can Too documents this history with many examples. Kekule, the German chemist discovered the ring structure of Benzene in a dream. He dreamt of atoms dancing around that linked together to form snakes. One of the snakes reached around and took its tale in its mouth. When Kekule awakened he realize that benzene was a ring formation. Mary Shelley’s idea for her novel Frankenstein, The Modern Prometheus came from a dream.
This enduring mental phenomenon that had been integral to many indigenous cultures as well as to the growth of our contemporary psychological consciousness, now exists on the margins of our technologically dominated culture. Even psychoanalysis has abandoned the dream. According to Paul Lippman, a contemporary psychoanalyst, “psychoanalysis was not up to the dream’s openness, puzzling variety, creativity, and zaniness… That is, psychoanalysis shied away from a genuine encounter with dreams, instead shaping dreams to fit its version of the unconscious.”
He attributes this phenomenon to theoretical, economic and cultural factors. Theoretical changes, Ego Psychology’s interest in mental structure, attachment theory’s interest in developmental patterns of attachment, have shifted attention away from the unconscious. Economic factors have led to a decrease in the frequency of weekly visits and an increasing focus on coping. Beyond this, he feels that the technological world lures us away from inner experience as we outsource all too willingly many of our psychological functions to gadgets and their apps.
The presence of dreaming creates an intrinsic epistemological puzzle and personal challenge. “The dream is always enlarging the space of the possible. Through the dream we are brought into tension between the finite (that which we know) and the infinite (that which is beyond our ken.)” G.W. Lawrence, Experiences in Social Dreaming. On a nightly basis sleep introduces us to an other-worldliness that we are intimately connected to (that we have mysteriously created) and yet seem estranged from. “The presence of dreaming reality co-exists with waking consciousness creating an unsteady relationship between two psychological states and two modes of thinking.
What is lost by our growing indifference to dreams? What is their place in our contemporary culture? If historical approaches to dream-work such as psychoanalysis have failed to understand the dream in its complexities, then how do we optimally approach dreams? In essays that follow I will examine the value that dreams hold for our culture and present two ways of understanding and working with dreams: Dream Tending and Social Dreaming.
The Affordable Care Act (ACA) hangs uncertainly over the environment. Increased regulation and consolidation of care is most likely the future and will create a different landscape for health care providers, particularly psychotherapists. California has already received millions of dollars from the US government to set up a health insurance exchange that will be the marketplace for individuals and small businesses to purchase health insurance. According to Katherine Nordal (1). The drive to reform health care delivery systems is well underway with hospitals and large medical specialty groups developing the blueprints for how services will be organized. January 2014 is the target date for implementation of the ACA.
Psychotherapists have been able to preserve a sanctuary for individual private practice over the last 20 years as medicine has shifted to larger group practices and many public sector therapists have had to implement cost-saving “evidenced-based” treatments. The structure and paradigm of psychotherapy is not likely to remain untouched by the ACA. The foundation of this paradigm has been the relational contract between therapist and client who have had the autonomy to collaborate on mutually determined treatment. This foundation has supported the development of diverse, multi-theoretical perspectives and treatment approaches allowing therapists to practice in two domains: 1) helping clients alleviate symptoms, and 2) helping clients grow emotionally. Emotional growth represents a higher order change that involves the transformation of deeply embedded belief systems about self and others and their accompanying behavioral patterns. This second order change takes time.
Three ideas dominate the discussion of the ACA, and will play a critical role in shaping healthcare: affordability, accountability, and integration of care. The incentive to contain costs will most likely lead to a change in the fee structure. Fee for service has contributed to the escalation of healthcare costs by reinforcing utilization. (1) Global payments, echoing the earlier notion of capitation, represents a cost-cutting model where fixed fees for patient care will be pre-set and health care providers will need to work within these budget constraints.
Accountability is the therapist’s Achilles heal. While privacy and confidentiality are the pillars of therapy, accountability has been regarded suspiciously. Therapists have been accountable to the client and to their theoretical orientation that establishes implicit parameters for the evaluation of change. The evaluation of psychotherapy progress is a sensitive, complex, intersubjective process. Yet when therapy is a covered benefit, the insurance company is contractually entitled to information. Therapists have resented this intrusion. Within the systems of care that will emerge, therapists will be held accountable for the effectiveness of their treatment. Evidence-based treatments and outcome measures will most likely be employed to determine what treatments can be provided, and to assess their effectiveness. This eventuality will not only affect the mental health of therapists but will also impact how therapy is practiced, taught and conceptualized.
Integration of care is the more complex and indeterminate part of the ACA and reflects how healthcare will be organized across the continuum of services from hospitals, specialty groups, primary care, and mental health services. Key words such as wellness, prevention, collaboration, and interprofessionalism sprinkle discussions about the ACA. Will psychotherapists become part of large primary care groups or will they maintain their geographical distance without sacrificing their autonomy?
The emphasis on integrated, cost-cutting systems of care threatens the autonomy of the individual provider and the paradigm that supports emotional growth and the time-stilled, non-linear paths this growth follows. These changes concern me since the value that psychotherapy offers to our culture is a place to care for the Psyche. As a psychoanalytically oriented psychotherapist, I fear these changes. I realize reluctantly that I will have to move outside my comfort zone to adapt to the future.
It is imperative for therapists to educate themselves about the ACA in order to understand how their practice will be affected and what new opportunities will emerge. With certain doors closing, other doors will open. What specialties will emerge as the result of therapists working with primary care? Not only will there be more individuals covered by insurance, but mental health services are considered an essential health benefit that will lead to greater utilization of these services.
It will also be important to work collaboratively with professional organizations to advocate for your profession. Change is often a top down process. The big power holders typically make the big decisions. The individual practitioner is not a power holder and will have no impact on the shape of changes set in motion by the ACA.
Bion (2) speaks about the creative process that is involved in learning from experience and change. Creativity involves the dismantling of old models of viewing the world in order to allow for the emergence of new ideas that often are regarded by the psyche as well as by the social group as threatening. Personal belief systems are containers that ground the individual in a familiar reality. Change involves rattling and breaking the container and the ability to tolerate disruption and anxiety. The capacity for transformation involves both the acceptance of the limitations of external reality, and the lessening of one’s omnipotence and one’s attachment to old belief systems.
1. Nordal, K.C., (2012) Healthcare Reform 2012: Implications for Professional Practice, The California Psychologist, Nov./Dec. 2012.
2. Bion, W. (1977) Seven Servants, Jason Aronson
Find out more about the effects of the ACA on psychotherapy practice in Health Care Reform: Preparing the Psychology Workforce by By Ronald H. Rozensky, Ph.D http://www.e-psychologist.org/index.iml?mdl=exam/show_article.mdl&Material_ID=119
Psychologists check Capitol Notes for updates on The ACA http://www.cpapsych.org/associations/13260/files/files/gov-affairs/capnotes/cn13-02.pdf
Check out the California Care website http://www.coveredca.com set up by the State of California for individuals and small businesses to purchase health insurance mandated by the ACA.
It is a challenging and unique aspect of our profession to have one’s professional identity so intimately linked with one’s personal self. The therapist’s identity is an amalgam of professional role that is intertwined with a personal sense of self. The professional and the personal dimensions of self are variables in a complex non-linear equation describing the therapist’s identity.
Becoming a therapist is not a simple process of acquiring skills and an increased efficiency in using these skills. It is a journey, whose curriculum is personal growth and whose learning curve is analogous to the learning curve of life. more »