Type of Therapy – Psychoanalysis

What Is Psychoanalysis?

Psychoanalysis, also known as “talk therapy,” is a type of treatment based on the theories of Sigmund Freud, who is frequently called the “father of psychoanalysis.” Freud developed this treatment modality for patients who did not respond to the psychological or medical treatments available during his time.

Freud believed that certain types of problems come from thoughts, feelings, and behaviors buried deeply in the unconscious mind. Therefore, the present is shaped by the past — an individual’s current actions are rooted in early childhood experiences.

Psychoanalysts help clients tap into their unconscious mind to recover repressed emotions and deep-seated, sometimes forgotten experiences. By gaining a better understanding of their subconscious mind, patients acquire insight into the internal motivators that drive their thoughts and behaviors. Doing so enables patients to work toward changing negative, destructive behaviors.

What Does a Psychoanalyst Do?

Using the principles of psychoanalytic theory, an analyst provides therapy. During the therapy sessions, the psychoanalyst listens as the patient discusses fantasies and dreams and narrates experiences. The therapist searches for recurring patterns or events from the past that may play a role in the patient’s current problems. A psychoanalyst also:

• Meets with patients individually
• Holds sessions approximately four times a week for 50 minutes or longer each session
• Encourages patients to self-identify their emotional states
• Helps patients understand the subconscious factors that drive their behavior
• Maintains patient confidentiality
• Keeps detailed notes of each session

What Issues Can Psychoanalysis Treat?

Psychoanalysis is used to treat a variety of conditions and emotional problems in both adults and children. A variety of issues typically respond well to this type of treatment, including:

• Anxiety
• Depression
• Panic attacks
• Phobias
• Obsessive behavior
• Trauma
• Eating disorders
• Self-esteem problems
• Sexual difficulties
• Relationship problems
• Self-destructive behaviors

How Does Psychoanalytic Treatment Work?

Numerous assumptions underlie the theories behind psychoanalysis. Firstly, three functions exist within everyone’s personality — the id, ego, and superego. The id, comprising both instinct and basic fundamental drives, is unconscious energy; it also includes aggressive and sexual tendencies. The conscious mind, or the ego, serves to keep the id in check by exerting a moderating influence. Finally, the superego represents the external reality, including conscious thoughts, feelings, and behaviors, which reflect parental or societal mores and values.

These three components form the structural model of what we know as personality. The interaction between the three presents a struggle for dominance, which takes place within every person. Psychoanalytic treatment helps alleviate the underlying tensions that occur between the id, ego, and superego. In an attempt to balance these three mental functions, patients must unveil their unconscious thoughts and feelings.

In most traditional psychoanalysis therapies, the patient lies on a couch while the therapist sits behind the patient to prevent eye contact. This position helps the patient feel comfortable, so he or she can reach a more intimate level of discussion with the psychotherapist.

Psychoanalytic therapy typically comprises a long-term course of treatment. Clients often meet with their therapist at least once a week and can remain in therapy for a number of years.

Psychoanalytic Techniques

A variety of therapeutic techniques are used during psychoanalysis, all of which are employed in an attempt to maximize insight and gain awareness into the patient’s behavior. Some of the more popular methods include:

• Dream analysis — In psychoanalysis, dream interpretation is used to reveal unconscious thoughts. Freud thought that repressed ideas and feelings rise to the surface of the mind through dreams. However, the content of dreams is often altered. Therefore, the psychoanalyst must help the patient interpret and understand the dream’s substance to discover its hidden meanings.
• Free association — During free association, the patient is encouraged to talk about anything that freely comes to mind. The psychoanalyst may read a list of random words, and the patient simply responds with the first associations that occur. Repressed memories often emerge during the process of free association.
• Interpretation — The psychoanalyst helps the patient explore memories and personal narratives in detail, and while doing so, analyzes them. The therapist looks for some common themes in the patient’s stories. One, the so-called “Freudian slip,” occurs when patients accidentally reveal something important when making random conversation. The psychoanalytic therapist provides an interpretation of the patient’s inadvertent choice of word or phrase.
• Transference — Patients engage in transference when they transfer feelings they had for someone in their past to the present. Transference sometimes takes place between the patient and the therapist. Patients may apply certain feelings toward the therapist that actually relate to someone from their past.

Psychoanalytic Treatment: Goals and Objectives

One of the primary aims of psychoanalysis is to help patients identify the hidden thoughts, behaviors, and desires that are creating problems in their day-to-day existence. The objective is to help patients understand the issues that have caused deeply rooted problems and a maladaptive perspective on life. Psychoanalysis assists the patient in adopting a fresh viewpoint. This new attitude can generate significant change and growth in the patient’s life.

Psychoanalysis: Myths and False Stereotypes

Numerous false stereotypes and myths are associated with psychoanalysis. The general public typically holds an outdated view of psychoanalysis, perhaps gathered from television or movie portrayals of psychoanalysts, which is far from accurate. Some of the most common stereotypes of psychoanalysis include:

• Psychoanalysis Lasts Forever
  While it’s true that psychoanalytic treatment takes longer than other types of therapies, the patient does not undergo treatment forever. The goal of treatment is to help patients develop a deeper understanding of their unconscious thoughts, feelings, and memories to generate permanent growth and alterations in personality. The deep level of understanding required in psychoanalysis does not develop overnight, which is why a patient may be in therapy for a number of years.
• Psychoanalysis Is Not a Real Science
  It’s a myth that psychoanalysis is fake science. Psychoanalytic theory and practice have been the subject of numerous research studies over the years, which have proven both their accuracy and efficacy. In fact, psychoanalysis therapy often succeeds when other types of treatment have failed. Psychoanalytic therapy is a nationally recognized treatment that is recognized by major insurers, who reimburse patients for treatment.
• Psychoanalysis Is Only About Sex
  Although Freud did popularize the term “libido,” he did not intend for the term to applied only to sexual desire. In psychoanalysis, libido refers to the energy or life force that drives all human behavior, not solely sexual passions. Although lust often drives behavior, it is not the motivator for every action. Psychoanalysis focuses on many other aspects of experience that drive behavior.

When Is Psychoanalytic Therapy Recommended?

Psychoanalysis is better suited for some patients than for others. It is particularly useful for those people who want to develop an in-depth understanding of their internal motivators. This therapy also works well for those who want to make sense of their experiences and deal with the heart of the dilemma rather than just its manifestations. The patient in psychoanalysis typically must undergo long-term treatment, which indicates both willingness and commitment to what sometimes can be a painful growth process.

Psychoanalysis: Limitations and Effectiveness

As with any therapy, psychoanalysis has both advantages and disadvantages. Some of the benefits of this therapeutic method include:

• Psychoanalysis gets to the basic cause of the problem rather than simply addressing its symptoms.
• People who don’t respond to conventional therapy or medications sometimes respond to psychoanalysis.
• Provides an in-depth insight into the origins of certain thoughts, feelings, and behaviors.
• Biological research supports at least a portion of Freud’s claims.
• A broad examination of the self, such as that offered by psychoanalysis, can lead to positive growth over time.

Some of the potential drawbacks of psychoanalysis include:

• Certain ideas, such as “penis envy,” are outdated.
• Patients may find it both painful and unpleasant to discover memories that they have repressed, sometimes for many years.
• It is not an appropriate treatment for some mental health problems, such as schizophrenia and bipolar disorder.
• It can be both expensive and lengthy, so it requires a deep level of commitment from both patient and therapist.

Psychoanalyst: Education, Training, and Licensing

To become a psychoanalyst, a therapist must undergo specialized intensive training approved by the American Psychoanalytic Association. To apply to a psychoanalytic training program, the candidate first must have a bachelor’s degree, along with a graduate degree in a mental health-related field. The candidate should also have previous training and experience as a therapist. Several types of graduate degrees are acceptable for candidacy into a psychoanalytic training program, including:

• Doctor of Medicine, or M.D.
• Doctor of Osteopathic Medicine, or D.O.
• Ph.D. in psychology or social work
• Master’s degree in counseling, social work, marriage, or family therapy

After potential candidates meet all the requirements, they can apply to a training program in psychoanalysis, which typically comprises the following three components:

• Detailed personal analysis
• A didactic curriculum
• Supervised, hands-on psychoanalytic clinical training

This training thoroughly prepares the student to become a skilled, knowledgeable, and confident psychoanalyst.

Psychoanalysis is an important psychological therapy method that can provide lasting benefits to patients — even long after treatment has ended. Psychoanalytic therapy helps individuals gain an in-depth understanding of the psychological roots that drive their thoughts and behaviors. This process of self-exploration helps the patient gain insight into their own behavior and motivators, which leads them to make healthy, even life-altering, changes.