Psychoanalytic Psychotherapy

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Influence of personal therapy on learning and

development of psychotherapeutic skills

Katarina Åstrand & Rolf Sandell

To cite this article: Katarina Åstrand & Rolf Sandell (2019): Influence of personal therapy on
learning and development of psychotherapeutic skills, Psychoanalytic Psychotherapy

To link to this article: https://doi.org/10.1080/02668734.2019.1570546

© 2019 The Author(s). Published by Informa

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Published online: 12 Mar 2019.

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Psychoanalytic Psychotherapy, 2019
https://doi.org/10.1080/02668734.2019.1570546

Influence of personal therapy on learning and development of

psychotherapeutic skills
Katarina Åstranda† and Rolf Sandellb*
a
St. Lukas Institute of Psychotherapy, Ersta Sköndal Bräcke University College,
Stockholm, Sweden; bDepartment of Psychology, Lund University, Lund, Sweden
(Received 4 January 2018; accepted 12 January 2019)

The aim of the present study was to investigate psychodynamic psy-

chotherapists’ experience of the influence of personal therapy on profes-
sional growth during training with a focus on the acquisition of knowledge
and the development of psychotherapeutic skills. Thematic analysis was
conducted on interviews with former students (N=10) at two training insti-
tutes for psychoanalytic psychotherapy. The resulting theme “professional
subjectivity” indicated that personal therapy was experienced as having a
positive effect on learning and growth of professional skill by facilitating the
development of a theory- and knowledge-based professional subjectivity, a
personally founded, professional attitude. Important elements of this devel-
opment are “shared experience,” “personal influence,” and “knowledge
integration.” The emergence of professional subjectivity proved to be an
important factor in terms of professional advancement for future psy-
chotherapists. Finding and relating to their own subjectivity was crucial in
the process of developing a personally founded, professional attitude in the
clinical work.
Keywords: psychotherapy training; personal therapy; professional develop-
ment; learning; psychotherapeutic skills; professional subjectivity

Traditionally, and as a matter of course, personal therapy1 has been looked

upon as an integral part of a psychotherapy candidate’s training, besides
theoretical seminars and clinical supervision. In the early years, psychother-
apy was generally thought about as a kind of objective examination with the
purpose to interpret and thus make conscious the patient’s unconscious ideas
and feelings. It soon became clear, however, that the therapist’s own uncon-
scious ideas and feelings were blind spots that would interfere with the
therapeutic process. To reduce that hazard personal therapy was recommended
by Freud (1953) as a sine qua non in psychoanalysts’ training, a recommen-
dation that was more or less automatically generalized to the training of
psychotherapists. Previous research has demonstrated the influence of the
individual therapist on qualities of the therapy relationship, on the change
process, and on outcome (Orlinsky, Rønnestad, & Willutzki, 2003) and has
also shown that interpersonal experiences in both personal and professional

*Corresponding author. Email: rolf.sandell@psy.lu.se

†
Deceased
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-
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distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered,
transformed, or built upon in any way.
2 K. Åstrand and R. Sandell
life domains are important sources of influence for professional development
(Rønnestad & Skovholt, 2003).
When empirical research on its value is concerned, the contribution of
personal therapy to personal as well as professional development and growth
has been shown in several empirical studies (e.g. Bike, Norcross & Schatz,
2009; Mackey & Mackey, 1994; Macran & Shapiro, 1998; Orlinsky, Schofield,
Schroder, & Kazantzis, 2011; Sheikh, Milne, & MacGregor, 2007) and been
noted by several reviewers. When personal development is concerned, Norcross
(2005) reported that personal therapy will contribute to emotional growth and
improved interpersonal skills, and Orlinsky et al. (2011) found growing support
for its effects on interpersonal sensitivity and empathy through the experiences
of interpersonal dynamics that it offers (Rizq, 2011). Scholars like Orlinsky et al.
also noted increasing self-awareness in terms of understanding of personal
problems, conflicts, and values. These effects are assumed to influence profes-
sional development in turn. Basically, the therapist’s personal therapy will
establish a model for his or her clinical practice in the future. Thus, personal
therapy will offer the therapist the opportunity to test and identify with the
patient’s role (Geller, Norcross, & Orlinsky, 2005; Malan, 1995) which may be
helpful in the clinical situation. It has also been found to deepen and embody, as
it were, the therapist’s understanding in theoretical matters during training
(Geller et al., 2005). By way of modelling or identification, the therapist may
internalize a “therapeutic attitude” (Grimmer & Tribe, 2001). As well, a success-
ful personal therapy will strengthen the therapist’s confidence in the value and
potential of psychotherapy (Rizq, 2011).
As its ultimate purpose, personal therapy is assumed to benefit the quality of
the therapist’s clinical work and should, therefore, manifest itself in treatment
outcomes. In a review, Wigg, Cushway, and Neal (2011) found only indirect
evidence for this, but they advanced the hypothesis that the process of
reflecting on self and others during personal therapy may increase the therapist’s
reflective functioning, which in turn may increase the effectiveness of his or her
clinical work. No doubt, the problem of isolating this influence from that of
other variables will hamper research (Mackey & Mackey, 1994; Orlinsky et al,
2005), and the evidence for the effect of the therapist’s personal therapy on the
patient’s treatment outcome is contradictory (Atkinson, 2006; Gold, Hilsenroth,
Kuutmann, & Owen, 2015; Macran & Shapiro, 1998; Orlinsky et al., 2011;
Sandell et al., 2006). Its value and even existence in training curricula is,
therefore, debatable – and debated.
Studies focusing on the experience of personal therapy during the therapist
candidate’s training have been published by Brenner (2006) and Moller, Timms,
and Alilovic (2009), among others. How personal therapy specifically interacts
with other curriculum-based experiences during training and thereby relates to
possible professional development has been given scant attention, however. This
study aims to contribute to fill this relative gap in the research literature.
Specifically, its purpose is to explore psychotherapists’ personal experiences of
 Psychoanalytic Psychotherapy 3
how their personal therapies have interacted with, and influenced, their acquisi-
tion of theoretical and practical clinical knowledge and competence.

Method
Study participants were 10 psychodynamically oriented licensed psychothera-
pists, eight women and two men, in the age range 40–65 years. Four of the
respondents were psychologists, two were social workers and two had other
vocational education (pedagogy and theology, respectively). All of them were
involved in psychotherapeutic work in public and/or private care, and they had
all been in personal therapy as a compulsory element in their psychotherapy
training. In Sweden, the minimum required length of personal therapy during
training is 125 sessions, typically once a week, but some of the respondents had
had longer therapies than that. Most of the respondents went to personal therapy
during training, but two of the respondents had already finished therapy when
they started training. They had all been in psychodynamic psychotherapy with a
psychotherapist of their own choice. How the choice of personal therapist was
made or the frequency of sessions was not investigated. In order for the
respondents to have a certain perspective of the education but still having
relatively recent memories of their personal therapy, therapists who had been
clinically active 2 years after graduation were selected.
As a way to control for our own views on the issue of personal therapy – that
it is indeed an essential component of any psychotherapist’s training – empirical
data were collected through semi-structured interviews. The interviews were
based on predetermined issues and based on open questions, which were fol-
lowed up with additional questions. The questions were thematically related to
the subject of the study and formed the basis for subsequent data processing,
using thematic analysis (Miles & Huberman, 1994). The interviews were tran-
scribed and meaning-bearing units were identified and coded. Related codes
were grouped into subcategories, which in turn were grouped into three cate-
gories. The data processing finally resulted in an overall theme.

Results
The analysis of the material shows that personal therapy on an overall level
favours learning and emergence of psychotherapeutic skills among respondents
in a way that can be summarized in the theme Development of Professional
Subjectivity. This theme is made up by three categories, Shared Experience,
Personal Influence, and Knowledge Integration. Each category contains subca-
tegories, a total of 13, which in turn are based on a large number of codes. The
outcome of the analysis is summarized in Table 1.
In what follows, the categories are presented with their subcategories.
Although each respondent is unique and differs in many respects from the
other respondents, their interviews, taken together, are assumed to represent
4 K. Åstrand and R. Sandell
Table 1. Core theme and the categories and subcategories on which it is based.

Subcategories Categories Core heme

Experience as a Patient Shared Experience Development of Professional

Empathy and Understanding Subjectivity
Safety and Responsibility
Respect and Humility
Self Awareness Personal Influence
Conviction
Sanctuary
Theory Knowledge Integration
Method and Technique
The Trade
Role Modelling
Relations to the Position as
Student
Linking the Professional and
the Personal

their collective experience of the development process. The results will, there-
fore, be reported in the form of a story, a narrative as it were, with shades that
reflect individual experiences.

Shared experience
Experience as a Patient/“… so important an experience to bring along … of
sitting on ‘the other side’.”
Personal therapy offers a unique opportunity to broaden the perspective and
share the patient’s experience which would be difficult to apply in other ways. The
personal experience of being a “patient” is transferred to the clinical work in a more
or less unconscious way and is believed to promote the therapy process. It gives the
future therapist a sense of reciprocity in the encounter with the patient.

“There is an incredible value in knowing yourself, knowing how it feels.”

“To this day when I meet patients, I can think, based on my own experiences, how
it may be for the person who is there. It’s cool really, still today, I think so.”

Empathy and Understanding/“To recognize and understand … I think that …

is part of the empathetic development.”
The experience of personal therapy results in a kind of recognition and
identification with the patient’s experience, an understanding of the patient’s
problems as well as of the vulnerability a patient may experience being in
psychotherapy. To realize and learn what can be difficult and painful and what
can be helpful from the patient’s point of view are important lessons for the
respondent’s own clinical work.
 Psychoanalytic Psychotherapy 5
“Well, you get to think that there are some kind of common processes that we
humans… need to get through in therapy to sort of coming to insight and feeling a
bit better.”

“It will be a help… for yourself. The experience of being in therapy, that it is great,
the best thing you can do, but also very hard at times.”

Safety and Responsibility/“… it’s a feeling of security to have experienced it

yourself.”
Personal therapy makes one feel more secure in one’s clinical work. It will
make it easier to endure the uncertainty that the future therapist experiences in
patient work. Confidence in one’s own ability increases and comparison with the
notions of how a therapist “should be” decreases. It is also perceived as a matter
of responsibility towards the patient to have a personal knowledge of what it
means to be in therapy.

“It gave a sense of security. I was able to lean a bit on my own experience of being
a patient.”

“How would you dare to sit there and be a psychotherapist when you don’t know
what it means to sit in the other chair? I would never dare, I think you have that
responsibility”

Respect and Humility/“Having experienced it yourself breeds humility, respect,

openness…”
Personal therapy helps the future therapist perceive the similarities between
all human beings in terms of the struggles of life, thereby reducing the risk of an
us-and-them thinking and an omnipotent attitude towards therapeutic work.
Being able to share the patient’s experience is a matter of respect. Through
personal therapy, the student realizes that self-exploration never stops, as there
will always be things to work on. That understanding breeds a humble attitude
towards patient work.

“Respect… I must be able to put myself in the opposite role. If you can’t do that,
then you haven’t understood. Then you take on an omnipotent role… which I don’t
want to do.”

“If you think you know everything and have nothing more to learn, that you don’t
need therapy yourself… then you have real problems.”

Personal influence
Self Awareness/“I can’t understand another person … if I don’t understand
more about myself.”
Self-awareness is seen as a decisive factor in maintaining a psychodynamic
approach. Being a therapist without sufficient self-awareness is considered to be
directly destructive to the patient. Awareness of one’s own internal processes
increases the understanding of what is happening in the therapy room and in the
6 K. Åstrand and R. Sandell
therapeutic encounter. It is helpful in terms of distinguishing what comes from
the patient and what originates in one’s own inner world and provides a sense of
confidence to use one’s own feelings and reactions in the therapeutic work to a
greater extent. In the event of lack of progress or problematic situations in
therapy, it is possible to return to one’s own internal processes to try to under-
stand more about the patient and the process. Personal therapy allows self-
reflection, which is crucial in order to maintain a reflective attitude and be
professional in one’s clinical work.

“When you don’t understand a patient, you simply have to go back to your own
analysis and try to understand more about yourself. I’m responsible for working
more with myself.”

“Being able to keep some distance to myself and my reactions through transference
and countertransference, Those are my most important tools as a therapist, and
they become totally useless unless I’m able to keep track of them.”

Conviction/“It has a great influence, having the personal experience that this
works and can change one’s life.”
The experience that psychotherapy really works brings a high level of
confidence in that way of coping with one’s problems. It is important for the
future therapist to be able to pass on this experience to the patient. The
experience in personal therapy that one’s life story is co-created and confirmed
with one’s therapist is important and increases trust in the patient’s narrative.

“It has helped me and therefore I know it’s true, it works. Otherwise I wouldn’t
know. And that’s something you pass on to your patient. I think that’s really
important. It creates a sense of security and calm in the patient knowing that
you have… that you believe in this, know that this works.”
“It makes me believe them whatever they say. Because sometimes it’s… you think
it’s incredible… I believe what they say until they say something else.”

Sanctuary/“Constantly having a forum of my own, a sanctuary and a retreat, to

help processing my experiences.”
Personal therapy is described as a room for oneself, a place of recovery, in a
time-consuming study situation. It brings the respondent perspective and helps
her/him cope with the stress of being constantly assessed in an educational
environment where performance and achievement are in focus.

“It’s a prerequisite during training… in order to cope with it all.”

“You get the feeling that you are unique. Personal therapy gives you so much in
that way. You are seen and you are good enough and all these things that you get to
work with… I think that’s very important.”

Knowledge integration
Theory/“You can’t learn just by reading, you have to feel it.”
 Psychoanalytic Psychotherapy 7
Personal therapy helps to deepen the student’s acquisition of theoretical
knowledge and favours learning, understanding, and integration. The knowledge
thus acquired is confirmed and consolidated by linking it to personal experience
and supports the candidate therapist’s motivation to immerse in theoretical
studies.
Experience from personal therapy facilitates the student’s search for a link
between intellect and sentiment. It helps maintain an open-minded approach in
the therapeutic work and reduces rigidity in following a specific theoretical
model. This flexibility enables an increased feeling of freedom in clinical
work and reduces the risk of making simplifications and generalizations.

“Reading something and at the same time having a personal experience gives what
you read another meaning.”

“There are compartments where you sort things in. What you experience in
personal therapy creates these compartments where you… when you read you
can sort it in there.”

Method and Technique/“… it was a way for me to take in what was said and
connect to it in another way.”
Experience from personal therapy makes it easier for the student to deal with
the practical aspects of training, such as patient work and supervision. It
provides an emotional backdrop that prevents supervision from being a purely
intellectual discussion. By being in therapy oneself, various aspects of the
therapeutic process become clearer, and understanding increases when personal
experience can be linked to one’s clinical work. The opportunity to experience
the psychotherapeutic process from two perspectives enriches the learning
process.

“It helped me to acquire knowledge through supervision in a different way. Not

that I understood things differently, but it gave me a better chance to pick up what
was said and integrate it in another way. Things were clarified.”

“Supervision wouldn’t be constructive without your own experience from personal

therapy. It would probably be either a very intellectual practice without emotion-
ality or very distanced from the patient.”

The Trade/“It’s difficult to have it transferred in any other way than by trying it
out on your own…”
Personal therapy gives a unique insight into how therapeutic work can be
performed and provides a possibility to experience how therapeutic interven-
tions are, or may be, perceived, which reduces the risk of being overly
instrumental and technical in one’s own clinical work. Being a patient and
experiencing how it feels when different therapeutic interventions are used
gives the student a deeper understanding of what psychotherapeutic work
means and how it works in practice. The personal experience of seeing the
8 K. Åstrand and R. Sandell
method implemented in practice provides another dimension to learning. What
is perceived as most beneficial in personal therapy can be applied in patient
work and tested there.

“I see it a lot like a craftmanship, so obviously that part of personal therapy fills a
function. That’s the psychotherapist you get closest to. You get to see a psy-
chotherapist at work… to see how the work is done is largely done in personal
therapy.”

“Some aspects of psychotherapy are more of craftmanship… seeing it done gives

something, a personal experience of what it feels like.”

Role Modelling/“You have a model, in your own therapist, how to be a

therapist.”
An essential aspect of personal therapy is to provide an identification
model, a role model for what being a therapist can be like. The first-hand
experience gives the student an external reference and a live model of a
psychotherapeutic approach, which helps navigate when it comes to designing
a personal role as a therapist and growing into it. The attachment to one’s
own therapist becomes a template how to connect to one’s own patients. The
role modelling aspect of personal therapy is mainly positive, but negative
identification may occur and the therapist can become a warning example of
how not to work. There is also a risk that the comparison becomes stifling
and impedes the emergence of personal expression, resulting in an unfortunate
alignment and correspondence with fantasized opinions in the therapeutic
community. The dual roles of personal therapy, being both patient and future
colleague, can lead to role confusion for both parties. It is important to not
just imitate the therapist, but rather assimilate parts that feel right and come
naturally and thus make the knowledge one’s own.

“He or she becomes a role model in a kind of way… it’s a relationship that
you use.”

“You notice things in the other person that feel right for you and you assimilate
them and make them your own.”

“Today, when I work, I have my therapist on my shoulder. I do a bit like she does.”

“I was in personal therapy and had an experience I didn’t like… I didn’t want to
work that way. It became clear to me thanks to that experience.”

“It’s important to be yourself, to follow yourself. It’s not explicit, but there are
these expectations of how to do it, to do it the same way as the older colleagues.”

Relations to the Position as Student/“Discussions and conversations during

training … were zero.”
 Psychoanalytic Psychotherapy 9
The fact that personal therapy is mandatory during training can be proble-
matic. It may reduce motivation, which is a crucial factor for a psychotherapeu-
tic process to be successful. Having personal therapy as an integral part of
psychotherapy training is considered positive “in principle,” but at times the
total training workload can be quite heavy. The economic aspect is also impor-
tant; expenses for personal therapy are significant, and the fact that these costs,
in Sweden, are not covered by the training institute (or the state) can be a
problem. Although there is a strong link between personal therapy and training
on an individual basis, more active attempts to integrate it with other compo-
nents of the curriculum would be positive.

“Going to psychotherapy because you have to, for me that’s all wrong.”

“In the most intensive study periods, clearly it was a lot of work.”

Linking the Personal and the Professional/“I feel that it’s interlinked, it’s
interlinked for me.”
Personal therapy links professional and personal aspects during training.
Improved self-understanding benefits the integration of professional and personal
parts into a whole. Personal therapy makes it possible to focus on oneself as a
person rather than a student, and it facilitates maintaining and valuing the genuine
personal self in the role as a future psychotherapist. The risk of losing oneself in a
template for how a therapist “should be” is reduced. Experience from personal
therapy gives the student an understanding of psychotherapeutic theory and work
that would be difficult to get any other way. Integration of knowledge based on
personal therapy and theoretical and methodological studies facilitates the devel-
opment of a psychotherapeutic attitude, anchored in the individual, and enhances
one’s self-reliance as a psychotherapist. Through one’s own experience in therapy,
knowledge is internalized on a more personal level.

“My professional self has settled down. Theory and practice have been integrated
into me and I feel much more confident in my role… and my personal therapy is an
important part of that.”
“So that’s a knowledge I couldn’t have got in any other way. I couldn’t have
learned it simply by reading, I couldn’t have learned it by discussing it with
someone else, but it’s based on my own experience of being a patient and being
in personal therapy.”

“I think it’s important for a therapist to land in something that feels familiar and a
bit like one’s own truth. How to look at the world, simply.”

Summary: development of professional subjectivity

In summary, subcategories and categories converge in the theme Development of
Professional Subjectivity. In this context, the concept “professional subjectivity”
means a psychotherapist in clinical work being well-founded in psychoanalytic
10 K. Åstrand and R. Sandell
theory and method, but also firmly anchored in an inner personal attitude
regarding the theoretical basis. Emotional and cognitive integration of interper-
sonal and intrapsychic experiences in combination with a solid theoretical
anchorage and clinical experience makes it possible for the therapist to use
intuition, creativity, and flair in the specific patient meeting. The underlying
theme in the interviews is a gradually emerging, personally founded, profes-
sional attitude. It concerns relating to and integrating theory and method and
using oneself in one’s clinical work, on a personal as well as a professional
level. Together the three categories Shared Experience, Personal Influence, and
Knowledge Integration explain and provide the conditions for the Development
of Professional Subjectivity.

Discussion
The aim of the study was to investigate the qualitative aspects of the influence of
personal therapy on professional development during psychotherapy training.
The results show that personal therapy is important for professional development
and has a positive impact on learning by favouring the emergence of a theory-
based and knowledge-based professional subjectivity. Key elements in this
development are shared experience, personal influence, and knowledge integra-
tion. Finding, acknowledging, and relocating one’s own subjectivity to the
professional realm is crucial in the process of developing a personally founded,
professional attitude. It is a matter of integrating intrapsychic and interpersonal
experiences on both a cognitive and emotional level.
Personal therapy deepens the acquisition of both theoretical and practical
knowledge. By linking to personal experience, the acquired lore is consolidated,
which facilitates knowledge integration. Psychoanalytic theory and psychody-
namic method gradually permeate the future psychotherapists, which gives them
a more personal understanding of what psychodynamic psychotherapy is and
helps them find their own personal and subjective expression in therapeutic work.
Experience of personal therapy also makes it easier to create a link between
intellect and feeling, which reduces the risk that therapeutic work becomes
overly instrumental and technical. The therapist’s theoretical and clinical foun-
dation in combination with a personal approach and responsiveness to the
individuality of each patient meeting deepens and enriches the psychotherapeutic
process. The personal experience of seeing – and feeling – the method being
translated into practice gives learning a further dimension.
Personal therapy provides an opportunity for future psychotherapists to learn
about what psychotherapy is and how a therapist can be (Norcross, 2005). Role
modelling gives an external reference in the design of one’s professional role,
which facilitates the internalization of a personal psychotherapeutic approach.
The dual roles in personal therapy, being both a patient and a future colleague,
are enriching but may also entail difficulties in terms of expectations, compli-
ance, stress, distraction, focus shift, and role mixing (Geller et al., 2005; Kumari,
 Psychoanalytic Psychotherapy 11
2011; Moller et al., 2009; Wilson, Weatherhead, & Davies, 2015). With a so-
called reporting system – which Sweden’s is not – the exposure and anticipated
assessment involved will likely add to these difficulties.
Personal therapy has an intrapsychic as well as an interpersonal influence. Self-
exploration helps to relate to and understand what is happening in the therapeutic
process. Increased self-awareness and awareness of internal processes make it
possible to maintain a professional attitude while increasing one’s ability to use
one’s genuine personality in therapeutic work. Personal characteristics have been
shown to be of great importance for the therapeutic treatment outcome (Geller et
al., 2005; Sandell et al., 2000). Personal experience increases empathy and under-
standing. The insight that self-exploration never ends but is a lifelong process,
breeds a respectful and humble attitude towards patients and clinical work. To be a
patient oneself gives a personal experience of the interaction in therapeutic pro-
cesses and a sense of reciprocity in the encounter with one’s own patients. The
therapist’s personal experience unconsciously influences her or his own work with
patients and benefits the therapy process and the therapeutic alliance. Similar
results have been described earlier (Brenner, 2006; Norcross, 2005).
The concept of professional subjectivity refers to an aspect of therapeutic
competence that has not previously been much explored in psychoanalytic and
psychotherapeutic research. Through personal therapy, the importance of an
independent, subjective attitude to theory and methodology is clarified
(Sandler, 1983). Psychoanalytical theory becomes alive and can be implemented
and expressed in a personal way. Indeed, following a sample of therapists during
their training and 5 years thereafter, Carlsson, Norberg, Schubert, and Sandell
(2011) found systematic change towards the formation of an autonomous ther-
apeutic identity. Personal aspects will not be obstacles but rather prerequisites
for the development of professional psychotherapeutic skills (Mackey &
Mackey, 1994). That personal therapy becomes a link between the professional
and the personal during training has indeed been shown in previous studies
(Sheikh et al., 2007; Wilson et al., 2015).
Psychotherapy is an intersubjective process between patient and therapist. The
patients explore themselves and their relationships. In order for the therapist to be
able to participate in this process, it is vital to be in touch with one’s own
subjectivity. It is true that subjectivity is often considered to be problematic and
undesirable, while an objective approach is emphasized as a guarantee of profes-
sionalism and reliability. The results in this study show that professional subjectiv-
ity is perceived rather as an asset and a necessity in psychotherapeutic work.
Without it, the therapist refers to knowledge and experience that has not yet been
processed and internalized and is thus deprived of a large part of the tools that can
facilitate and improve clinical practice. The present study shows that personal
therapy has a positive impact on learning and development of psychotherapeutic
skills, confirming results from previous studies. The study also presents new
findings, here referred to in terms of “professional subjectivity.”
12 K. Åstrand and R. Sandell
Limitations
Rather than to establish whether or not personal therapy is necessary for psy-
chotherapy training, the aim of this study has been to investigate subjective
experiences of its meaning for the professional development. Previous research
has found it difficult reliably to differentiate the influence of personal therapy from
that of other variables (Mackey & Mackey, 1994). In this study, also, it is difficult
to unequivocally value and interpret the findings. All respondents have undergone
training therapy, but during the interviews, it emerged that some of them had
already completed their personal therapy when training began, while others had
been in personal therapy during the course of their training. This factor was not
used as an inclusion criterion but may have influenced the results of the study.
Thus, some respondents expressed difficulties distinguishing between the experi-
ences from personal therapy and other therapies they had undergone, which may
have affected the validity of the study in a negative way. However, the predominant
and general experience of the respondents was that personal therapy had had a
major impact on their professional development during training.
The study is based on a limited number of participants, all of whom are
psychodynamically oriented. This is likely to limit the generalizability and
transferability of our conclusions to psychotherapists in general, especially
those of other orientations. Also, the shared pre-understanding of the participants
and the authors of the study may have caused some aspects of personal therapy –
especially some negative ones – not being addressed, thereby affecting both the
collection and the analysis of the data.

Conclusions
The findings of this study show that personal therapy is experienced as having a
positive effect on learning and growth of professional skills by facilitating the
development of a theory- and knowledge-based professional subjectivity, a
personally founded, professional attitude. The emergence of professional sub-
jectivity seems to be an important factor in terms of professional advancement
for future psychotherapists.
Much more empirical research is needed to advance the field’s understanding
of professional subjectivity and how it is linked to professional competence for
psychotherapists.
The sample in this study is limited and the findings need to be tested in
studies with larger samples and samples with different therapeutic orientations.
According to the present study, professional subjectivity is a process that starts
during training, but the process presumably extends throughout the professional
working life. To begin with, the notion itself and the phenomenon should be
further established as a concept: what are its indications, its antecedents, its
consequents – and can it “be measured”; how is it experienced phenomenologi-
cally; what are its correlates; under what conditions does it develop and under
what conditions is it inhibited; does the “dose” of personal therapy (duration and
 Psychoanalytic Psychotherapy 13
session frequency) influence its development; what role does the personal
therapist have, and how does the future therapist cope with the conflict between
identification and independence? Then, further research should focus on the
effect of continuing professional development on professional subjectivity.
Further research should also focus on the link between professional subjectivity
and common factors in psychotherapy and between professional subjectivity and
the formulation of professional identity.

Note
1. In line with common usage in the research literature “personal therapy” in this study
refers to psychotherapy candidates’ or students’ psychotherapy as a typically pre-
scribed part of their training.

Disclosure statement
No potential conflict of interest was reported by the authors.

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Interview schedule
(1) What associations does the term “personal therapy” give you?
(2) What significance does personal therapy have in psychotherapy training
according to you?
 Psychoanalytic Psychotherapy 15
(3) Did personal therapy affect you with regard to learning and integrating
theoretical parts of training such as lectures and course literature? If so,
in what way – positive as well as negative?
(4) Did personal therapy affect you with regard to learning and integrating
practical parts of training such as supervision and case discussions? If
so, in what way – positive as well as negative?
(5) Has personal therapy influenced you in your clinical work during train-
ing and after? If so, in what way – positive as well as negative?
(6) What significance, if any, do you think personal therapy has in devel-
oping psychotherapeutic skills?