What is psychoanalytic therapy?
There are many types of psychotherapy, one of which is psychoanalytic therapy. In this article, we will be outlining how psychoanalytic therapy works.
Psychoanalytic therapy is talk therapy based on Sigmund Freud’s theories of psychoanalysis. It explores how the unconscious mind influences one’s thoughts, feelings and behaviours. It also examines how experiences, often from childhood, may be contributing to current experiences and actions. This helps individuals become aware of hidden meanings or patterns in what they do or say that may contribute to their problems.
Through understanding these patterns, psychoanalytic therapy can:
Reduce confusion about what helps and what doesn’t
Identify changes that can be made in an individual’s life
Help individuals come to terms with what can’t be changed
There are three main techniques used in psychoanalytic therapy: dream interpretation, free association, and transference.
Using dream interpretation, psychoanalysts may interpret dreams to get insight into the workings of the unconscious mind. According to Freud, this technique is the most important technique in psychoanalytic therapy. In psychoanalytic theory, dreams may represent wish fulfilment, unconscious desires, and conflict going on in an individual’s life. They contain both manifest content (information from the dream as the dreamer remembers it) provided by the dreamer, and latent content (represents the symbolic meaning embedded within the dream) pulled from the manifest content.
Free association is an exercise in which the psychoanalyst encourages you to freely share your thoughts through talking or writing. This might not be a linear thought pattern. The individual could list an incoherent stream of words or jump randomly from one emotion to another. This could cause the emergence of unexpected connections and memories.
Transference is when an individual projects their feelings about another person onto their psychoanalyst. The individual is then made to interact with their psychoanalyst as if they were that person. This helps the psychoanalyst understand how they interact with others.
Psychological problems that psychoanalytic therapy can help with
Psychoanalytic therapy is not recommended for psychotic illnesses but can be very helpful in relapse prevention after a psychotic episode has ended.
In the psychoanalytic therapy sessions, the therapist would wait for the patient to talk. This can lead to moments of silence and even make the individual feel that the therapist is unhelpful. However, this is not the case. The psychoanalyst waits for the patients to speak because they are interested to know what is on their minds and there is no structure to the sessions. This means that individuals are free to talk about anything on their minds.
Upon expressing the things on their mind, the psychoanalyst will point out particular difficulties in talking or thinking about certain things and make sure that the patient knows that it is important to understand what might get in the way of talking about these things.
Focuses on emotions - Psychoanalytic therapy explores the full range of emotions a patient might be experiencing.
Explores avoidance - Through finding out what the patient is avoiding, the psychoanalyst can work with the patient to understand why such avoidance occurs.
Identifies recurring themes - Some patients don’t know how to stop self-destructive behaviours, while others are not aware of these patterns. Through psychoanalytic therapy, patients are able to identify why these behaviours occur and how to stop them.
Explores past experiences - This helps people explore their pasts and understand how it might affect their present psychological difficulties. It also helps patients get rid of the negative effects of their past experiences and live more fully in the present.
Explores interpersonal relationships - This allows them to analyse and explore their past and present relationships with others.
Free-flowing - Psychoanalytic therapy allows patients to explore freely compared to other highly-structured therapies, which means they are free to talk about anything, like their fears, fantasies, desires, dreams etc.
Due to the reliance of the ability to confront potentially stressful or triggering experiences, many people underestimate the effectiveness of psychoanalytic therapy.
Research has shown that psychoanalytic therapy is effective in the treatment of both mild and complex mental health problems. For example, psychoanalytic therapy and antidepressant medication can significantly reduce depressive symptoms, compared to antidepressants alone.
Another example would be somatic disorders (physical complaints that initially appear to be medical but after further investigation cannot be explained with medical diagnosis). It has been shown that psychoanalytic therapy is the most effective therapy for this.
How about the effectiveness in symptom reduction and how long the improvements last?
Psychoanalytic therapy has shown moderate to large success rates for reducing symptoms like somatic symptoms, depressive symptoms and anxiety symptoms. Patients also tend to retain these gains after stopping therapy and most continue to improve even after therapy ends while the benefits of other therapies tend to diminish over time.
Risks and side effects
Though there are many benefits and it has proven to be very effective, psychoanalytic therapy can have risks and side effects. This is because talking and thinking about emotional problems can be difficult, as well as facing the past and the truth. This also means that some people may feel worse before they feel better, and some may even feel very angry, have their depression get worse, or feel too criticised.
Therapists understand that psychoanalytic therapy is not for everyone. Therefore, there are a range of alternative treatments that a therapist might talk about during your assessment before any sort of therapy.
Some of these alternatives might include:
Cognitive behavioural therapy
Despite these alternatives, some may choose to only take medication, and some may even choose not to seek professional help.