A century ago, Sigmund Freud developed the concept of psychoanalysis. Initially, it was considered neither part of philosophy nor psychology, but it eventually became the foundation for the field of psychoanalytic therapy. So, what is psychoanalysis?
Psychoanalysis posits that the human mind, in addition to consciousness, also contains the unconscious. This is a repository of thoughts, desires, feelings, and memories that we are not aware of, but which influence the conscious part of our lives.
For example, a person may have had a traumatic experience as a child. To avoid re-traumatization, the mind's defense mechanisms push this memory into the unconscious. In adulthood, this trauma can continue to provoke conflicts within the person's consciousness, hindering their harmonious development as an individual.
While psychoanalysis explores the personality as a whole, psychoanalytic therapy identifies such unconscious conflicts and analyzes the deep-seated causes of a person's psychological problems. The goal of this approach is to apply methods of deep psychoanalysis to uncover and resolve the client's troubling issues.
Freud planted the seeds of modern psychoanalytic theory, but it has since evolved, creating various approaches and branches. All of them offer their own concepts of human mental development and dynamics, and thus are called psychodynamic. Here are some of the most well-known:
- Jungian Psychoanalysis is known for its categorization of personality types and the idea of the collective unconscious.
- Ego Psychology focuses on the ego and the adaptation of the personality.
- Lacanian Structural Psychoanalysis views language as the key to deciphering the unconscious.
- Neo-Freudian or Humanistic Psychoanalysis by Fromm shifts the focus from Freud's biological emphasis to a social one.
Before the advent of psychoanalysis, the treatment of mental issues was exclusively approached through medication. This method initiated the development of psychotherapy as a way to improve mental health through verbal interaction between the patient and the therapist.
Techniques of Psychoanalysis
Regardless of the method of psychotherapy, the goal is the same: to identify the client's internal conflict and its causes hidden in the psyche, and to work through it. A psychoanalyst has several techniques in their arsenal to achieve this result.
Free Association Method
The client tells the therapist everything that comes to mind. Sometimes the psychoanalyst gives the client specific words to trigger associations ("mother," "sadness") and then observes the client's initial reaction and interprets it. This technique is particularly effective in exploring the unconscious.
Dream Analysis
Sigmund Freud paid special attention to this technique, as dreams are like gateways to our unconscious realm. When we sleep, the mind's defense mechanisms weaken, and our consciousness becomes especially vulnerable. The client recalls and reproduces their dreams, and together with the psychologist, they explore their meaning, as well as the repressed emotions and desires that lie behind them. Dreams are considered a unique language of the unconscious. It is believed that if a person remembers their dream and can describe it, the dream, through symbols, wants to convey something to the conscious mind, which can be explored.
"Freudian Slip"
Behind this ironic phrase lies another psychoanalytic technique. These are mistaken actions and phrases, slips of the tongue, and pauses that seem accidental and unmotivated, but all contain keys to our unconscious.
The psychoanalytic therapist encourages the patient to voice all their feelings and thoughts, even if they seem inappropriate and cause shame, pain, or disgust in everyday life. A person may feel resistance. However, this resistance indicates the presence of an internal conflict in the client's consciousness, which should be noted and explored.
In psychoanalysis, the therapist's task is to help the client become aware of their thoughts and desires, acknowledge them, and integrate them into the realm of the "conscious." This way, the person can resolve the causes of internal conflicts that previously caused resistance.
Transference and Countertransference: Features of Psychoanalysis
In the process of psychoanalytic therapy, special relationships full of trust develop between the client and the therapist. The patient may begin to unconsciously transfer feelings onto the therapist that do not actually relate to them. These feelings are often directed towards someone else, usually authoritative figures in the client's eyes. This unconscious behavior is called transference, and the psychoanalytic approach pays special attention to it during therapy.
For instance, a patient might start feeling irritation towards the psychotherapist but suppresses the emotion, not realizing it. As a child, the client might have often been the target of their father's anger. They learned to suppress and not acknowledge their irritation to avoid conflicts. Unconsciously, they transfer their feelings towards their father onto the psychotherapist, fearing to show their irritation and encounter a similar angry reaction.
By identifying such transference, the client can recall and re-evaluate the experiences they went through in the past. Even though this experience was repressed into the unconscious, it can still influence the client's current relationships with others.
A psychoanalyst might also unconsciously feel various emotions and react to the patient, thus engaging in countertransference. It is equally important for them to notice their own emotional reactions in response to the client's behavior. In psychoanalysis, understanding one's own unconscious can become the key to successful therapy, facilitating a better understanding of the patient's unconscious.
Is Psychoanalysis Always Conducted on a Couch? How a Session Unfolds
The classic image of a psychoanalysis session involves the client lying on a couch and talking to the psychologist. In classical psychoanalysis, this is indeed how it looks: this format allows the client to concentrate on themselves and delve deeper into their unconscious.
At the same time, the psychoanalytic wave is moving away from classical psychoanalysis towards humanistic therapy, where the client and therapist maintain eye contact. In this method, face-to-face communication provides the individual with valuable experience of direct interaction with others and building relationships with them. Each format of working with a therapist has its advantages, and the client can choose what suits them best.
During the initial sessions, the therapist identifies the issues that brought the patient to therapy. Since psychoanalysis explores the client's psyche as a whole, and psychoanalytic therapy works with specific client issues and difficulties, the duration and intensity of therapy for each method vary.
Therefore, it is crucial to discuss the setting, or the initial conditions for undergoing the therapy course. The therapist and client can agree on the frequency and duration of sessions, the norms and rules — this is like an oral contract that is agreed upon by the client and therapist before starting the work.
Classical psychoanalysis involves sessions several times a week, whereas psychoanalytic therapy often limits to one session per week. Both methods deeply explore your psyche and thus require long-term work with a therapist, ranging from several months to several years.
Goals and Outcomes of Psychoanalysis and Psychoanalytic Therapy
Psychoanalytic therapy aims at a deep exploration of the client's psyche and internal conflicts. This method involves creating a safe space where the client can open up and freely communicate with the psychotherapist about things they have never shared with anyone before. The psychoanalyst acts as a guide who does not interfere with the process but gently helps the client find the key to the prison they have built for themselves.
Unlike other methods, psychoanalytic therapy does not work through the prescription of medications. It aims to resolve the patient's problems through verbal and non-verbal methods. Here are some of its goals:
- Alleviate Suffering, Not Cure. In psychoanalysis, there is no single correct outcome that every psychologist aims for. Therapy adapts to the unique characteristics of each patient, as a treatment that helps one person might harm another.
- Uncover the Client's Potential. During psychoanalytic therapy, the patient finds their own points of support and resources to grow, learning both empathy and rational analysis of the world.
- Create Conditions for Personal Responsibility. The client learns to be independent, responsible, and unafraid to face life's challenges. To some extent, the patient learns to be their own therapist.
- Change the Client's Attitude Towards Themselves and the World. This helps the person view their problems and themselves differently, rather than feeling powerless and resorting to self-criticism. Through therapy, the patient gains new tools for critical thinking, can reassess their experiences and beliefs, and start taking action.
- Overcome Patient Resistance. Our psyche resists even positive changes—development does not come easily but occurs through the dismantling of old beliefs and the building of new ones. Transference is an example of patient resistance, which is given special attention in psychoanalysis.
If these goals are achieved, the following effects can be expected from psychoanalytic therapy:
Ability to cope with difficulties independently
Relief from painful symptoms
Capacity to deeply understand one's past, thoughts, and actions
Increased self-esteem and better self-understanding
Improved relationships with loved ones
Elimination of destructive behaviors and enhanced self-regulation
