couch

Psychoanalysis

Modern day psychoanalysis has traversed great distances over the past one hundred years since Freud discovered treating emotional ailments by addressing a patient’s ‘unconscious inner world processes’.  Although psychoanalysis continues to have somewhat of an image problem in our society for many reasons, some valid, it remains to be the most a solid form of lasting treatment for a wide range of long-standing emotional, psychological, and relational difficulties.  It is indeed often found it to be the premier treatment for people struggling with depression, anxiety, low self-esteem, plaguing feelings of dissatisfaction, a vague feeling something just isn’t ‘right’, difficulties in relationships, self-criticism or hatred, shame, on so on– the range is endless.

When we look at the current healthcare system’s approach to mental and emotional health, we find it is largely based on quick fixes, ‘evidence-based’ models of symptom reduction, psychotropic medications, and short-term time limited cognitive-behavioral treatments.  These certainly have their place, but psychoanalysis offers an alternative where a person can approach and address the roots of their difficulties and help them gain an experiential understanding of a fuller range of their feelings and anxieties, portions of which have likely remained underground and unknown for one’s entire life and thus have never had to opportunity effectively understand and deal with them.  Often times a person gives psychoanalysis a try after trying myriad other forms of therapy that have not satisfactorily resolved their difficulties.   With the goal of addressing and modifying one’s deep core inner self, psychoanalysis is designed to open up new possibilities of feeling differently about oneself, one’s relationships, and one’s experience of the world.

A little more detail…

Psychoanalysis is based on the observation that people are often unaware of the factors that determine their feelings, thoughts and behavior.  Because of the vast range of these unknown (yet waiting to be discovered) aspects of ourselves, we end up merely repeating what we know even though we may realize it is detrimental to ourselves.  This is why the advice of others, self-help books, and even tremendous self-effort may help on some levels but likely won’t yield lasting characterlogical changes and resolve enduring inner struggles.

The foundations of how we experience ourselves, others and the world is largely established early in our lives as our earliest experiences and fantasies of our parents, siblings and others are formed inside of ourselves.  The versions of these relationships solidify inside ourselves and help form our character, which is part of our core self and greatly influences how we experience our emotional and relational life.  By now, of course, these early memories have gone underground and are inaccessible to conscious memory, but the structures they have helped form remain.  In psychoanalysis, derivations of these inner relationships will be repeated in the ‘here and now’ with the analyst.  To help facilitate and bring these relationships more to the fore and into awareness, in particular their problematic aspects, you are encouraged to speak whatever thoughts or feelings come to mind, a process much easier said than done. Often times a person finds that laying on the couch helps facilitate this process, but this is merely an option.

The analytic process involves a highly interactive and living relationship, one that is very intimate yet at the same time very formal.  One image I used to have about psychoanalysis was that of a person laying on a couch just talking while the analyst passively listened and doodled on a notepad.  The actual experience, however, is a far cry from this saturated perception.  Although the work is largely focused on understanding what is going on inside of you, the relationship you and I form is integral to this process.  Current derivatives of your early world manifested in your experiences of your daily life gradually become illuminated through your ‘here and now’ experience in the consulting room and of me, or at least your image of me.  I would help you to understand and put into words whatever might be going on inside of you—sometimes these states of mind are so early that they cannot yet be expressed in words.

This process may sound intriguing, or downright frightening, or perhaps some of both.   It is a process that at times can be quite disturbing as long-standing problematic areas and feelings move to the surface where they then have the potential of being understood and worked through.  This unsettling process of discovery and change is not a solo endeavor but one shared with me, a well-trained and experienced co-participant who listens diligently, patiently and without judgment.

Sometimes people may feel or think coming to therapy four or five times a week, or even two or three, is self-indulgent.  Psychoanalysis requires such frequency to get to the roots of one’s difficulties.  It also helps sustain and support deeper contact with oneself and counteracts the very human tendency to snap back to the familiar.  Establishing better relationships among the different parts of yourself, modifying deep internal structures, and reclaiming lost parts of yourself is serious work.   Establishing greater awareness and lasting changes in both your inner and outer world should actually help free you from self-indulgence while simultaneously increasing your capacity to engage more satisfactorily in your relationships with others and the outside world.

Hence, psychoanalysis remains an alive and active method of helping people to live better and more satisfying lives. The psychoanalytic process is arduous and takes time, a process that stands in contradistinction to many of our current cultural values.  On the other hand, it carries with it the power to transform your life in ways that cannot be easily put into words or even imagined.