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Writer's pictureAnnelisa MacBean

The Therapeutic Process

Every now and then I am asked about my work, about my specialization, my orientation, my experience. My approach has certainly evolved over the years and is now, fundamentally eclectic. Take what works, leave the rest, integrate and reinterpret, intuit and experiment.

I am clinically trained, but my roots are in the realms of somatics and spirituality. I am inclined to explore the knowing body and not-knowing depth of the mind; curious about meaning-making, and the interface between our physical and non-physical experiences. Clinical certainty in the form of diagnoses, behavioral techniques, or the healing of symptoms are marginally interesting to me as temporarily supportive structures. But in my experience, sustaining and transformative wisdom is inherent in our symptoms, and it is ultimately more respectful and efficient to attend to symptoms as signals and indicators without imposing an agenda of right/wrong, stopping or fixing. With a background in pre- and peri-natal psychology I am always interested in a person’s past and in being present to the patterns of pain and suffering one can carry from the earliest of life’s imprints. Of course, this is very important and I will address these elements with most everyone. And . . . the therapeutic dimension of my work encompasses much more. I am interested in the care of the psyche, in tendering the heart and collaborating with the soul.

In order to truly know who and what we are in this human existence, in order to discover the depth of our beings, to know ourselves and be able to see each other, to perceive and receive grace, to suffer consciously, to participate fully in the inevitable disappointment, heartbreak, and deflation that life will often demand . . . how to do all of this, matters to me. To find meaning in our suffering, to tend to it, to even become intimate with it and accepting of it . . . this is an alchemical approach inviting one’s true nature to reflect, effect and influence our lives.


Learning to discover and integrate the purpose and opportunity of pain in our lives, developing a capacity to be non-reactive and open to the possibilities in unwanted experiences is not therapeutically interesting to everyone. I have no fantasy that the work I do is going to be correct or particularly skillful for everyone. I don’t work often with psychotic, borderline, or narcissistic personality organization. Nor with severe depression, anxiety, trauma, or other extreme clinical diagnoses. These situations, in my experience, are best responded to with very specific treatment plans and methodologies that may, over time, create enough personal security and inner space to allow for the perception of one’s true nature, one’s being beyond the confines of matter. My work is oriented more toward the “ordinary neuroses” of love and work, as Freud referred to them, our shared, innate longing for existential meaning and purpose, our innate yearning for intimacy and aliveness, and the reality of the transpersonal and spiritual dimensions of the psyche. My training and interest for decades now has been in the fields of depth psychology and relationally-oriented analytic practice, spiritual emergence, contemplative practices and wisdom traditions . . . with a focus on supporting individuals and families through the transitions of birth and death, real or metaphorical.

In my experience, the most important factor in consulting therapeutics is the relationship between me and my client(s), and not the technique or theory I employ. It is neither theory nor technique alone that reveals a client’s unique and individual path to healing. While important and useful, these tools are secondary to psychic, emotional, and spiritual resonance and attunement; secondary to the love that is there in the field when we meet in this way.


Even Freud is known to have said that “in essence psychoanalysis is a cure through love.” However, some colleagues and psychological programs disagree, asserting that love has no business in psychologically therapeutic relationships. For me, there can be no psychological therapy without love; love is the basis for “soul-tending.” I am not speaking about the expression of erotic love, of course, but of ananda, the love that arises naturally when a doula bears witness to the birth of a new soul or supports the passing away of a life. My work is a faithful and willing surrender to an alchemical process where client and therapist come together in a vessel charged with the intention to envision, discover and recover the precious and unique golden truth inside each human heart. It is not easy work. And at times it is really hard. Sometimes boring or annoying. Often lonely. Frequently hopeless, appearing useless . . . And occasionally utterly alive, liberating. A pact of love and courage between two souls, therapy is the process of clearing a path into the psyche with a comrade on the journey of life. I sense this is needed in the world, perhaps now more than ever . . .



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