A publication of the Washington Baltimore Center for Psychoanalysis

Share This Post

Today’s Analyst at Work

J. David Miller, M.D.
Member, Washington Baltimore Center for Psychoanalysis
July 2018 | Volume 5 | Issue 7

When I tell people I’m a psychiatrist, sometimes they ask, “So, are you a Freudian, a Jungian, or a Kleinian?” As an insight-oriented therapist and psychoanalyst, I think we have entered a new era in which such labels no longer fit. Like many of my colleagues, I value several conceptual models, which raises a question: how do I make sense of complex clinical situations without the help of a unified theory?

What works for me is to hold the theories I know in reserve, in the background. Since they are based on empirical evidence, I consider them to be “science,” but I also approach clinical work as an “art,” often relying on intuition, or inspiration. As I listen with open-minded attention, I wait for a clarifying synthesis to emerge, perhaps linked to a theory I hold “on call,” perhaps not. The most useful synthesis often comes unbidden and abruptly, seemingly out of the blue.

The idea that art and analysis both rely on inspiration is a central thesis of Ernst Kris, who was first an art historian and later a renowned psychoanalyst. In his collected essays of the 1930s, Psychoanalytic Explorations in Art, he writes, “wherever art reaches a certain level, inspiration is at work.” Twenty-five years later, in his paper on “Insight in Psychoanalysis,” he states that “the good analytic hour” depends on inspiration, which he describes as follows: “…(it) all begins to make sense…one of the associations has suddenly lifted the veil…associations suddenly ‘converge’…the material comes as if prepared…outside awareness…”

In line with Kris, I find that analytic therapy reaches its potential when both participants open themselves to this preconscious creative process.

Explore more in PsychBytes


A favorite amusement during my elementary-school years was a puzzle-map of the United States. The puzzle pieces comprised all the states. The top of the puzzle went beyond the USA halfway up Canada, and the bottom ended halfway through Mexico.

Mad or Sad?

Here I am, taking comfort in the sunroom and emailing off another cartoon to my sister. I have two sisters and have always been especially close to sister number two, Patti. It could be said that we are close because we are nearer in age, but really, we are close because we are pretty much on the same wavelength. We enjoy a lot of the same things including guffawing over clever memes. We like to laugh.

Content Edit Request

Please submit one request at a time.