Psychoanalytic Psychology © 2013 American Psychological Association

2013, Vol. 30, No. 4, 621– 626 0736-9735/13/$12.00 DOI: 10.1037/a0034582

THE IMPACT OF MY OWN

PSYCHOTHERAPY ON MY WORK
AS A THERAPIST
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

Nancy McWilliams, PhD, ABPP

Graduate School of Applied & Professional Psychology, Rutgers, The State
University of New Jersey

In this paper I will talk autobiographically about some effects of my personal

psychoanalysis on my clinical work. I do not claim any emblematic status for
my experience; it is idiosyncratic to me, of course, but some aspects of my
personal journey as a patient, and its effects on my work as a therapist, are
consistent with what Drs. Geller, Norcross, and Orlinsky have found about the
connections between receiving and giving psychotherapy.

Keywords: personal psychoanalysis, personal psychotherapy, training analysis

I first became interested in psychoanalysis in 1965, as an undergraduate at Oberlin

College. My political science professor encouraged me to write my junior thesis on the
political theory implicit in Freud’s (1930) Civilization and Its Discontents. The book
grabbed me. I began to read more by Freud and other psychoanalytic writers whose work
was popular then: Erikson (e.g., 1950), Fromm (e.g., 1941), Horney (e.g., 1950), Marcuse
(e.g., 1968), Norman O. Brown (e.g., 1959), Rollo May (e.g., 1967), and most influen-
tially, Theodor Reik (1948, 1953, 1957a, 1957b).
Reik’s work (e.g., 1948, 1953, 1957a, 1957b) spoke to me because he talked about sex
differences without assuming that female psychology was somehow a deviation from the
male norm—an attitude I had never encountered in that era just before the feminist
resurgence. (Even Oberlin, the first college to admit women on an equal basis with men,
had a “nepotism” rule under which the often brilliant, doctoral-level wives of professors
were not allowed to teach except as adjuncts.) After I married, graduated, decided on a
career in clinical psychology, and moved to Brooklyn, I wrote to Dr. Reik, asking if he
would see me and give me advice on my career. I wanted to meet one of the people who
had been close to Freud while there were still a few of them left.
Reik graciously consented. He treated our meeting more as an intake interview than
as career counseling and urged me to be analyzed. He sent me to the clinic connected with
the National Psychological Association for Psychoanalysis (NPAP), the institute he had
founded when the New York Psychoanalytic Institute rejected him because his doctorate

Correspondence concerning this article should be addressed to Nancy McWilliams, PhD, ABPP, 9
Mine Street, Flemington, NJ 08822. E-mail: nancymcw@aol.com

621
 622 MCWILLIAMS

was in psychology rather than medicine. I didn’t know all that vexed psychoanalytic
history then; I was 23 years old, liked Reik’s ideas, and knew he had been Freud’s protégé.
It made sense to me to go into analysis: I was in New York, where one could be seen
affordably by experienced people. I could just manage the $15 fee of the analyst to whom
the clinic interviewer assigned me. I approached treatment cerebrally, as the obvious thing
to do for professional reasons. I assumed that other approaches had by now superceded
psychoanalysis proper, but on the same principle as my having studied classical before
popular music and Latin before French, I thought I should experience the original
paradigm. Although I was completely out of touch with any personal need for therapy, it
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was the profound therapeutic effectiveness of my analysis that eventually determined my

career path as a psychologist and psychoanalyst.
That I unconsciously knew I needed treatment is beyond doubt. Although I saw myself
as an emotionally healthy person and described myself as having had a happy childhood—
not an entirely inaccurate perception—I had suffered many ungrieved losses, including the
death from cancer of my mother when I was 9 and the death of my beloved stepmother
from the same illness in my third year of college. My father, who (I later figured out) had
some brain damage from early encephalitis, was a loving, devoted man of rock-solid
integrity, yet he could see no shades of gray, went into scary rages, and threw people out
of his life when they disappointed him. I had never been overtly rebellious: I felt I had to
be extraordinarily “good” or risk his rejection. In order not to burden my stressed-out
family, and because my mother had deliberately fostered my self-reliance as she had
anticipated her death, I was counterdependent to an extreme degree and could not express
need or vulnerability. I unconsciously viewed men as attractive but dangerous and women
as loving but weak—a serious problem for my self-representation.
I was lucky in the analyst NPAP assigned me. Lou Berkowitz was warm, smart,
flexible, and evidently free of a need to dominate. Psychoanalysis was not his “day job:”
He was executive director of the Educational Alliance, a settlement house on the Lower
East Side of Manhattan. His evident acceptance of my leftish politics was a welcome
change from my father’s attitude, though I could assimilate that corrective experience only
after a long period of real terror that Lou would contemptuously interpret my political
involvements as “acting out” or “oedipal rebellion” (of which there were elements, but
fortunately, he seemed to take the position that everything has dynamics, and that one
doesn’t judge a political position by its psychic origins, but by its probable effects). My
recurrent anxieties that my mild-mannered, Jewish, social worker/analyst would turn out
to be my angry right-wing father was a huge lesson in the power of transference: I knew
intellectually that it was unlikely that Lou held my father’s opinions, but I could not get
rid of the fear for months.
Lou did not act as if he knew more than I did (though in retrospect I can see that he
often did), and he tended to interpret very little, instead urging me to say everything, to
feel my feelings, to explore my dreams, to figure myself out. The respect in his demeanor
was healing in itself. Given my father’s affinity for nonnegotiable pronouncement, I was
hypersensitive—I still am, actually—to being talked down to by men in authority. Many
people find analytic silence depriving, but I experienced it as egalitarian and empowering,
a vote of confidence in my capacity to be honest with myself in radical, liberating ways.
My internal dynamics are mainly hysterical, and so Lou’s relatively nondirective style
was a good fit for me. Freud originally developed psychoanalysis as a treatment for
women with hysteria, most of whom we would now see as dissociative, who uncon-
sciously saw themselves as weak and at chronic risk of abuse from powerful men. He took
their subjective experience seriously and tried to learn from them (Breuer & Freud,
 IMPACT OF MY OWN PSYCHOTHERAPY 623

1895/1955). Although from my perspective, even then, he didn’t always get it right (and
knew as much, famously noting his perplexity on the question of what women want), I
appreciated his noting the limits of his understanding rather than assuming patriarchal
omniscience, and I was grateful for my analyst’s apparent identification with Freud’s
openness to being taught by his patients.
I stayed in 3-times-a-week treatment for 4.5 years and terminated naturally, based on
a mutual agreement that I was ready to see if I had internalized the process sufficiently to
do okay on my own (cf. Geller, 2005, on boundaries and internalization). I was impressed
with what Lou and I had accomplished, especially when our setting a termination date
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

temporarily brought back old symptoms that had gone away so quietly that I had forgotten
the pervasive anxiety, somatization, defensiveness, and acting out that I once thought was
just part of life. I was also stunned again by the power of transference during the
termination phase: Despite the fact that I was the one who brought up the question of
ending, and I was the one who suggested a 6-month period to accomplish it, once the date
was set, I had endless dreams that my mother was dying or my father was throwing me
out of the family. It was a powerful lesson in the limits of conscious rationality, perhaps
especially when it comes to separation. I remember thinking that abandonment (being left
rather than leaving) must be our earliest template for separation, as we become capable of
understanding separateness before we have the motor controls to initiate it ourselves.
I made important changes during my analysis in the areas I have mentioned—my
denial of my need for others got softened, my emotional life became a source of joy and
vitality that did not have to be intellectually distanced, and my internal images of gender
and power were significantly transformed. I came to understand in a deep way, in the
prevailing terms of the predeconstructionist era, that power could be feminine and warmth
and vulnerability could be masculine. Without my analysis, my marriage would have
certainly failed. And I probably would not have had my daughters (I came to understand
that I unconsciously equated being a mother with dying, and despite my enjoyment of
nurturing roles, I had innumerable rationalizations for not wanting children). My career
would have been punctuated with a lot more self-destructive enactments, too.
At later points in my life, I had two other therapies with different analysts, my original
analyst having died suddenly a few years after I terminated. I went once a week for 4 years
to a female, medical, object-relations-oriented analyst in my mid-30s, and one year with
a male, self-psychologically oriented psychiatrist in my 50s. I used the couch both times,
despite the once-weekly frequency, as I felt most comfortable that way, less overstimu-
lated by the physical presence of the analyst. (I think this is common for highly
interpersonally sensitive patients, especially those with hysterical or schizoid dynamics.)
In both therapies, life-stage issues came up that had not been active during my first
treatment, and both analysts, despite radically different personal styles, were significantly
helpful.
But the point of this panel is to talk about how personal therapy affects one’s practice
as a therapist, so let me move on to how I think my analysis shaped my later clinical work.
First, and probably most important, analysis gave me faith in the process. I know in
my bones that psychotherapy heals. I assume I convey that conviction to my clients, not
only verbally, but also with countless nonverbal cues. Hope matters in therapy, and my
sense of therapeutic hope is genuine and deep.
Second, analysis helped me identify with the complex feelings that go with the role of
client. Despite my bravado about entering analysis for sheerly professional reasons, I was
shocked to find myself worried that someone would see me going into my analyst’s office.
The first time I lay down on the couch, consciously excited and confident about doing a
 624 MCWILLIAMS

very grown-up thing, I found myself trembling with a child’s anxiety about safety. I
quickly realized how much emotional power my analyst’s role gave him. I felt exposed,
out of control, vulnerable to being criticized and shamed. And I wasn’t even coming for
a “disorder,” so I could only imagine the sense of stigma others had.
Such insights increased my empathy for anyone in the patient’s chair, underscoring the
value of the therapist’s being welcoming and egalitarian. At the same time, given my
visceral apprehension despite my analyst’s warm, collaborative manner, the experience
sent an indelible message about the limits on therapists’ control over how they are
perceived, an early insult to my omnipotence and a critical lesson in professional humility.
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I am still bemused when colleagues assume that simply because they feel or act warmly,
they will be experienced as “good objects” by their clients.
My analysis expanded my empathetic capacities in other ways. I became slowly,
painfully familiar with my blind spots, and with my vanity, greed, envy, sadism, and other
unattractive features, which were only possible to admit and explore because of my
analyst’s matter-of-fact acceptance. I found psychotic and borderline as well as neurotic-
level dynamics in myself. I got to know my inner psychopath, narcissist, drama queen,
introvert, and all the other potentials we share by virtue of being mammals. At the same
time, I came to generalize about human nature less and to appreciate psychological
diversity more as I took in the fact that, despite similarities in their surface behaviors or
symptoms, other people were often quite different from me internally.
Therapy also taught me the power of unconscious resistance and the patience it takes
to change longstanding patterns. The courage required to try something new, as the
amygdala erupts with red alerts, is not an abstract or theoretical notion to me. As my
transferences heated up, I came to appreciate the power of affect, the freedom that comes
with simply feeling it and naming it, and the centrality of emotional insight to psycho-
logical change. Ultimately, such experiences reduced my alarm and reactivity when my
clients went through affect storms. They ultimately contributed to my comfort in leader-
ship roles, too, as I tend not to take it personally when I am the object of powerful,
transference-infused feelings that inevitably occur toward those in positions of relative
power.
As someone who intellectualizes readily, I was particularly fortunate in undergoing the
psychoanalytic process before I knew much about analytic theories of intervention; I could
feel what was helpful without the baggage of viewing it in the light of received orthodoxy.
The experience later helped me evaluate that orthodoxy realistically.
I became exquisitely aware of how painful it is to learn things about oneself that one
has not previously seen. My self-esteem took a dive every time I absorbed new knowl-
edge— even when the knowledge was welcome. This experience taught me to look for my
clients’ shame and resentment, not just their appreciation, when I say something they find
fresh and helpful. My sense of vulnerability was acute during my analysis, as I tried to
dismantle the now-maladaptive defenses that had, in my childhood, sheltered my self-
esteem and sense of safety. In giving up previous ways of protecting myself, I felt
hypersensitive, skinless, and at my utter limit of absorbing any new information about my
shortcomings, frailties, and self-delusions. As I result of my being at the limit of what I
could admit to myself, I was often reactive and defensive in those years (I am thankful that
my husband was a patient man). My vivid memories of this phase give me compassion for
clients and students in a similar state of defenseless reactivity.
As I came to see how my feelings, thoughts, and behaviors followed unconscious
scripts, I slowly gave up omnipotent fantasies I hadn’t realized I had. So much of what I
thought was insight about myself turned out to be rationalization. The evidence accumu-
 IMPACT OF MY OWN PSYCHOTHERAPY 625

lated that I was not in charge of my own mind and that I had warped ideas about my own
power. My dreams revealed the pervasive unconscious belief that it was my dangerous
badness that had killed my mothers. My analyst responded by teasing me about how
powerful I seemed to think I was and suggesting that I should join the human race. Given
how important we now know it is for therapists to avoid a know-it-all attitude, to admit
mistakes, and to work collaboratively, this humbling aspect of my own therapy was
probably particularly valuable to my later practice.
Forty years after I terminated and more than 30 years after Lou’s death, I continue to
draw on my original analysis daily. A man challenges and devalues my interpretation, and
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

I flash to memories of times I reacted that way, and of what helped me to re-equilibrate.
A woman beginning to grieve a traumatic history becomes panicky that she is descending
into bottomless depression, and because I know from inside how healing and ultimately
time-limited the process of acute mourning is, I can reassure her credibly. Or I screw up
and have to admit it, and am comforted by remembering when my analyst did that. His
apology for a mistake was, in fact, the final coup de grace to my pathogenic assumption
that authorities, especially male authorities, can’t bear to be wrong. Or a client assumes
some comment of mine is motivated by contempt or hatred, and I associate to how patient
my analyst was with my hostile transferences, how nondefensively he explored them
rather than trying reflexively to “correct” my perceptions.
Perhaps the hardest thing about being a therapist is feeling repeatedly distorted in the
service of clients’ needs to process intense negative feelings, so I am grateful for having
internalized someone who tolerated my hatred with equanimity. Lou was a good model.
I did not identify with him totally or uncritically, though. What he gave me was much
more in the nature of a sensibility than a set of techniques. My style differs from his; I had
to integrate what I saw as the basics of therapeutic responsiveness into my own person-
ality. I was extremely fortunate, though, in working with someone whose temperament
and training made him so helpful to me.
Psychotherapy, as Dr. Geller has said and as I understand it (e.g., McWilliams, 2004),
is inherently all about emotional honesty. That is perhaps the aspect of the work that has
been hardest to maintain and that I most deeply cherish. Hearing and reading accounts of
other clinicians’ personal treatments, I am struck by how many of them learned from their
therapist what not to do. Such lessons are also important sources of professional knowl-
edge, though given the time, money, energy, and hope that we all bring to therapy, they
require the strength to face disappointment with honesty as well. I continue to feel
fortunate that my own analysis, which I entered open-heartedly when I did not yet know
how carefully I should vet a potential therapist, laid such a deep and solid foundation for
my future work.
As I hope this paper has revealed, in most respects my experiences as a patient are
representative of what Drs. Geller, Norcross, and Orlinsky are finding out about the
linkages between receiving and giving psychotherapy. But from a normative perspective
I remain idiosyncratic. With respect to the 20-session average length of treatment, I am
certainly an outlier. My first 20 sessions were very helpful, but they were only the
beginning of a lifelong process, and I am grateful for every hour beyond that initial 20.
Where I was trained, we used to say, “The first year is just saying hello.”

References
Breuer, J., & Freud, S. (1955). Studies on hysteria. Translated from the German and edited by James
Strachey. (The Standard Edition of the Complete Psychological Works of Sigmund Freud: Vol.
II). London, UK: Hogarth Press. Original published in 1895.
 626 MCWILLIAMS

Brown, N. O. (1959). Life against death: The psychoanalytical meaning of history. New York:
Vintage.
Erikson, E. H. (1950). Childhood and society. New York: Norton.
Freud, S. (1930). Civilization and its discontents. In J. Strachey (Ed.), The complete psychological
works of Sigmund Freud, Vol. 21 (pp. 64 –145). London: Hogarth Press, 1971.
Fromm, E. (1941). Escape from freedom. New York: Rinehart & Co.
Geller, J. D. (2005). Boundaries and internalization in the psychotherapy of psychotherapists:
Clinical and research perspectives. In J. D. Geller, J. C. Norcross, & D. E. Orlinsky (Eds.), The
psychotherapist’s own psychotherapy: Patient and clinician perspectives (pp. 379 –404). New
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

York, NY: Oxford University Press.

This document is copyrighted by the American Psychological Association or one of its allied publishers.

Geller, J. D., Norcross, J. C., & Orlinsky, D. E. (Eds.). (2005). The psychotherapist’s own
psychotherapy: Patient and clinician perspectives. New York, NY: Oxford University Press.
Horney, K. (1950). Neurosis and human growth. New York: Norton.
Marcuse, H. (1968). One-dimensional man: Studies in the ideology of advanced industrial society.
New York: Beacon.
May, R. (1967). Man’s search for himself: How we can find a center of strength within ourselves
to face and conquer the insecurities of this troubled age. New York: Signet.
McWilliams, N. (2004). Psychoanalytic psychotherapy: A practitioner’s guide. New York, NY:
Guilford Press.
Reik, T. (1948). Listening with the third ear: The inner experience of a psychoanalyst. New York,
NY: Farrar Straus.
Reik, T. (1953). The haunting melody: Psychoanalytic experiences in life and music. New York,
NY: Farrar, Straus & Young.
Reik, T. (1957a). Myth and guilt: The crime and punishment of mankind. New York, NY: Braziller.
Reik, T. (1957b). Of love and lust: On the psychoanalysis of romantic and sexual emotions. New
York, NY: Farrar Strauss.

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