What is Psychoanalysis?
When people ask what psychoanalysis is, they usually want to know about treatment. We already have an idea of the analytic situation from a thousand cartoon images; patient lying on the couch with the analyst sitting, pen and notebook poised, behind him. Even jokes may familiarise us with some of the essentials of analytic technique - "How many psychoanalysts does it take to change a lightbulb?... Just the one - but it takes a very long time, and the lightbulb has got to want to change".
As a therapy, psychoanalysis is based on the observation that individuals are often unaware of many of the factors that determine their emotions and behaviour. These unconscious factors may create unhappiness, sometimes in the form of recognizable symptoms and at other times as troubling personality traits, difficulties in work or in love relationships, or disturbances in mood and self-esteem.
Because these forces are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts of will, often fail to provide relief. Psychoanalytic treatment demonstrates how these unconscious factors affect current relationships and patterns of behavior, traces them back to their historical origins, shows how they have changed and developed over time, and helps the individual to deal better with the realities of adult life.
Analysis is an intimate partnership, in the course of which the patient becomes aware of the underlying sources of his or her difficulties not simply intellectually, but emotionally - by re-experiencing them with the analyst. Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind. These conditions create the analytic setting, which permits the emergence of aspects of the mind not accessible to other methods of observation. As the patient speaks, hints of the unconscious sources of current difficulties gradually begin to appear - in certain repetitive patterns of behavior, in the subjects which the patient finds hard to talk about, in the ways the patient relates to the analyst. The analyst helps elucidate these for the patient, who refines, corrects, rejects, and adds further thoughts and feelings.
During the years that an analysis takes place, the patient wrestles with these insights, going over them again and again with the analyst and experiencing them in daily life, in fantasies, and in dreams. Patient and analyst join in efforts not only to modify crippling life patterns and remove incapacitating symptoms, but also to expand the freedom to work and to love. Eventually the patient's life - his or her behavior, relationships, sense of self - changes in deep and abiding ways.
Is Psychoanalysis only a Therapy?
Although psychoanalysis began as a tool for ameliorating emotional suffering, it is not only a therapy. It is, in addition, a method for learning about the mind, and also a theory, a way of understanding the processes of normal everyday mental functioning and the stages of normal development from infancy to old age. Furthermore, since psychoanalysis seeks to explain how the human mind works, it contributes insight into whatever the human mind produces, from great works of art to weapons of mass destruction. In so doing, it has had a profound influence on many aspects of twentieth-century culture.
As a general theory of human behavior and experience, psychoanalytic ideas enrich and are enriched by the study of the biological and social sciences, group behavior, history, philosophy, art, and literature. Freud himself wrote about all these subjects, while twentieth century artists and writers took up his ideas in their practice. His influence reverberates in Henry James and Virginia Woolf, Alfred Hitchcock and David Lynch, the art of the Surrealists and the lure of advertisements.
As a developmental theory, psychoanalysis contributes to child psychology, education, law, and family studies. In childcare, the emphasis has shifted from 'controlling' and 'moulding' children, to 'nurturing' and 'facilitating' their development within safe 'boundaries'. It is a testament to the cultural changes that have taken place in the last fifty years that Ernest Jones' statement now sounds like a well-worn cliché: "Love is as necessary for a child's mental development as food is for its bodily development". Through its examination of the complex relationship between body and mind, psychoanalysis also furthers our understanding of the role of emotions in health as well as in medical illness.
In addition, psychoanalytic knowledge is the basis of all other dynamic approaches to therapy. Whatever the modifications, the insights of psychoanalysis form the underpinnings of much of the psychotherapy employed in general psychiatric practice, in child psychiatry, and in most other individual, family, and group therapies.
Building on Freud's ideas and ideals, psychoanalysis has continued to grow and develop as a general theory of human mental functioning, while always maintaining a profound respect for the uniqueness of each individual life. Ferment, change, and new ideas have enriched the field, and psychoanalytic practice has adapted and expanded. But psychoanalysts today still appreciate the persistent power of the irrational in shaping or limiting human lives, and they
therefore remain skeptical of the quick cure, the deceptively easy answer, the trendy or sensationalistic. Like Freud, they believe that psychoanalysis is the most sophisticated tool for obtaining further knowledge of the mind, and that by using this knowledge for greater self-awareness, patients free themselves from incapacitating suffering, and improve and deepen their relationships.
Who Can Benefit from Psychoanalysis?
The person best able to undergo psychoanalysis is someone who, no matter how incapacitated at the time, is basically, or potentially, a sturdy individual. This person may have already achieved important satisfactions - with friends, in marriage, in work, or through special interests and hobbies - but is nonetheless significantly impaired by long standing symptoms: depression or anxiety, sexual incapacities, or physical symptoms without any demonstrable underlying physical cause. One person may be plagued by private rituals or compulsions or repetitive thoughts of which no one else is aware. Another may live a constricted life of isolation and loneliness, incapable of feeling close to anyone. A victim of childhood sexual abuse might suffer from an inability to trust others. Some people come to analysis because of repeated failures in work or in love, brought about not by chance but by self- destructive patterns of behavior. Others need analysis because the way they are - their character - substantially limits their choices and their pleasures. And still others seek analysis definitively to resolve psychological problems that were only temporarily or partially resolved by other approaches.
Adapted from the American Psychoanalytic Association website.