Today a wide variety of “talk- therapies” are available. Dr. Steven Nickoloff, a board-certified psychiatrist and psychoanalyst in Birmingham, Michigan, provides a confidential, personalized and effective space for his patients. This safe space in Downtown Birmingham is a warm and inviting office environment.
The objective of psychoanalytic, or insight-oriented, psychotherapy, is for both patient and doctor to develop a more in-depth and coherent understanding of one’s emotional life and behavior. This increased awareness allows the development of new solutions to what are often old, or lifelong, problems. A few examples of common problems that can be helped are depression, harsh self-criticism, various types of anxiety, the inability to form close relationships and the tendency to form painful, conflictual relationships. Dr. Nickoloff works collaboratively with adults and adolescents, individually or as couples.
Achieving psychological change and relief of emotional pain and symptoms is difficult for many reasons. We are all influenced by important forces and beliefs that lie outside of our conscious awareness. These unconscious factors are usually the result of repeated experiences earlier in life that have become so automatic that we aren’t aware of them. Because these forces are largely unconscious, the advice of family and friends, the reading of self-help books, or even the most determined efforts of will often fail to provide relief. The best way to address these problems is to meet regularly for psychotherapy, once or more per week for 45 minute sessions at regular times.
In Dr. Nickoloff’s work as a psychotherapist, he encourages his patients to speak with as few restrictions as possible about their present situation, their past experiences, their hopes and dreams. In contrast to discussing a problem with a friend, here the task is to report one’s thoughts in an unedited way. This material may sound scattered at first, but over time patterns emerge and become increasingly clear. Most commonly these involve ways of relating to others, ways of thinking about oneself, and patterns of handling or avoiding various emotional states. Often the patterns observed in one’s adult life share a striking similarity to early formative experiences; it is a very similar drama, only enacted with different players. These common patterns may be played out in the work setting, in intimate relationships, and so forth; commonly the way a given patient interacts with the analyst over time takes the same shape as well.
It is important to note that the kind of understanding and awareness described above is not something only conveyed from doctor to patient; rather, a main goal is to help the patient develop their own capacity to listen to themselves, to recognize and understand his or her own patterns. This growing capacity and awareness lead to the ability to recognize problem situations in their everyday world, and consciously make different choices that are more adaptive and better suit their purposes. This often takes a lot of effort initially, but over time new habits are developed that feel increasingly authentic.
Everyone is different, but the type of results commonly seen as treatment progresses include a reduction or elimination of the initial painful symptoms, a clarity of how certain experiences in life have shaped the current person, improvement in relationships with others and deepening of emotional connections with others, and the loosening of longstanding inhibitions which have hindered one’s personal or professional growth. Another way of saying this is that this work aims to expand and enrich the emotional texture of one’s life experience.
Some problems are more persistent, or more deep-seated, than others, and sometimes more is needed than a once- or twice-weekly therapy. This may be the case even for individuals who have been exceptionally successful in most other areas of their lives. Psychoanalysis is a more intensive, more in-depth, version of psychotherapy, typically practiced three to five-times per week. It is the most effective of the long term psychotherapies, allows the most ambitious treatment goals, and offers hope where less intensive treatments have not succeeded in bringing relief from emotional suffering. Like many things in life, the more time and effort is put into something, the more can usually be accomplished.
In psychoanalysis, the patient usually reclines on an analytic couch; for most, having the analyst out of their field of view allows them to speak more freely and be less self-conscious. It is not, however, required. As in therapy, the patient works to report the goings-on in their mind as fully as possible, however there is greater focus on the subtle interactions with the analyst (which repeat patterns from childhood and present day life), and there is greater emphasis on the patient’s internal emotional experience as opposed to the reporting of external events. Problems are understood not just intellectually but at a deep emotional level.
Significant personality growth and change is a realistic outcome in analysis, as is substantially improved sense of self-worth. By developing new ways of experiencing oneself and others, especially those in close, intimate relationships, patients may come closer to fulfilling his or her potential in work and as an intimate partner. Psychoanalysis is certainly a major emotional and financial investment, as is, for example, open heart surgery. Like surgery, it is not for everyone, but for the right person in the right situation, psychoanalysis can be truly life-changing.
Despite mutual love and effort, couples often struggle, and various forms of arguments and emotional distance and distress result. When these difficulties become acute, couples therapy is often chosen. Dr. Nickoloff’s understanding of any given couple is informed both by each partner’s individual psychology, as well as the particular form that the relationship interactions take. Similarly to the descriptions above, each partner is unconsciously repeating patterns from earlier experiences in life, and recognizing those connections can reduce sources of conflict and misunderstanding. Effective relationships also put a premium on communication, and the couples Dr. Nickoloff works with nearly always begin with shortcomings in that area. He actively works to teach couples specific practical strategies for effectively listening to, empathizing with, and responding to each other. Many of the principles of Imago Therapy, as outlined in books by Dr. Harville Hendrix, are commonly used as a framework..
At various times in the treatment of a couple Dr. Nickoloff may suggest one or both partners enter their own individual psychotherapy with a different therapist; similarly, couples sometimes arrive with one or both partners already in individual therapies. Experience has shown that these two forms of treatment offer a complimentary set of benefits, and each enhances the other.