Why I have embraced the “free association” technique at long last

“Free association”, a therapy technique (sometimes referred to as “the fundamental rule” in psychoanalysis) in which a person puts himself into a reflective state of mind and notices/talks about whatever seemingly random thoughts, feelings, images, and memories enter his mind at a given time, may at first seem strange to the uninitiated.

When I initially encourage clients with depression, anxiety, or trauma/PTSD to speak freely and notice whatever comes to mind about their symptoms and feelings, and to try to see which associations one’s mind has created between various experiences, events, and images, I am often met with uncomfortable reactions like awkward silence (and statements such as “I don’t know what I’m supposed to say”), puzzlement, or anxious attempts to come up with something to “say” or to get me to direct the conversation.

So I usually say something that I assume might be reassuring, like “It’s okay to just wait and see if something comes up”, or I may even point out that it seems very uncomfortable to come talk with me despite not having something specific in mind for us to talk about. And then I try to offer my best explanation possible of why, despite the initial awkwardness, free association is our friend; how helpful it can be to look at all of the important information that our unconscious minds store for us (especially the “survival” part of the mind that is wired to scout out threats to our survival and protect us from pain) and how much this influences our current reactions and behaviors.

Free association is how I recently learned that a client with a long-standing eating disorder equates thinness with safety, because she was bullied for her weight for many years, and learned to associate being heavy with being abused. Until we discovered this insight, her obsession with thinness was hard to put into context or to change. This was also the technique that helped me discover another client’s experience of a recent, uncomplicated medical surgery as a “repeat” of a past trauma involving medical malpractice from many years before, long forgotten (consciously) by her- although remembered in the form of a severe depression that occurred at the time of both events. And, although it took almost an entire session of seemingly unrelated and unimportant associations, free association helped another one of my middle-aged clients come to realize that her sudden unhappiness in her marriage wasn’t really about unmet romantic needs or the deficiencies of her husband, but about much earlier experiences of being abandoned by her father in childhood, that were coming up as she experienced her son’s attachment to his new girlfriend as a betrayal of her own bond with her son.

Our brains create connections all the time. We react to, relive, and pay attention most to those connections that are activated by current events or triggers and are registered by our brains as salient cues with survival value (information that can help us avoid threats or past traumas). And that’s why, although our reactions often seem to make no sense to us, they really don’t just come out of nowhere. Rather, they might not make sense to us because our conscious minds are not aware enough of which connections are being activated for us to put our reactions into context.

Unfortunately, many people with depression, anxiety, or trauma histories feel ashamed or embarrassed of reactions they have that don’t seem to make sense on a logical level. And that shame leads to wanting to hide those experiences from others, which makes it hard to get help to put things into perspective and discover the contexts that lie at the root of these reactions and feelings. One of the most validating experiences possible is to discover that feelings or behaviors that seemed to make no sense actually did make a whole lot of sense in the situation/situations where they first originated.

Some examples:

  • When losing a job feels like a repeat of being the “dumb” student who could never succeed academically all through elementary school, it’s no wonder that becoming depressed, feeling like a failure, and wanting to give up might be a natural reaction.
  • When being woken up by a friend who calls your cellphone at the wrong moment, feels the same as being “caught off guard” by a raging, alcoholic father who could walk in at any moment in a drunken rage while you were sleeping as a kid, it makes sense when this small event could color your feelings for the whole day.
  • When ordinary stresses of everyday life (paying bills, going to work) remind a person of having to take care of 5 younger siblings at the young age of 7 because Dad died and Mom was in bed with depression, it’s no wonder that he/she could feel totally helpless and start to shut down.

Discovering our most unconscious associations allows us to use our conscious minds to actively create and look for new associations (and train our brains to pay attention to new information, such as how different similar events or circumstances can actually be when you’re a safe, empowered adult versus a helpless, vulnerable child); it allows us to validate our experiences and to feel less shame; it helps us create a storyline of our lives and reactions that makes sense; and it allows us to take the healthy risks that we felt we had to previously avoid.

So…go inside your mind and see what you find…you just might learn something important about yourself!