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What is Psychoanalysis?
Psychoanalysis exists as a body of theory based on Freud's understanding of neurosis and its treatment, starting in the 1890's, and built on and elaborated since then by Freud and his followers. This body of theoretical concepts, extraordinary at the time, enabled the development of clinical practice by Freud and those around him until, subsequently, psychoanalysis spread throughout Europe, America, South America and is now expanding yet further afield. Freud's theories of the origins of the neuroses grew to encompass a general model of the mind and mental functioning, which went hand in hand with the development and constant refinement of clinical treatment. Freud's understanding of the drives, aggression and sexuality, recognized in his adult patients and which he traced to childhood, caused outrage in the medical profession of his time. His work is now recognized as basic to the understanding of child development, childhood disorders, the struggles of adolescence and all aspects of adult mental functioning.

The keystone of psychoanalysis is the concept of the unconscious, the deep structures in the personality of which the person is unaware but which exerts a huge influence on life and behaviour. Each person has resistance to acknowledging these unconscious elements and establishes defences; when the internal world is explored in analytic treatment, discoveries are made that reveal how current relationships and life patterns are influenced by experiences from the past, often as repetitions of dysfunctional or maladaptive behaviour. An understanding of the elements of early relationships, as well as the relationship with the analyst, will be sought. Recognising the emotional power of early relationships, how the past influences the present, in setting patterns of behaviour in adulthood can give people choices not experienced before.

There is a range of problems that are treatable by psychoanalysis: depression, anxiety, obsessions, dissatisfaction within relationships, both personal and professional, and problems with self-image, somatic symptoms, and mood and thought disorders. Not only symptom relief can be experienced, but also through the reflective process, greater self-knowledge and a firmer sense of self and one's own mind can be found, as well as furthering potential in the external world.

Psychoanalysis is distinguished from other therapies in its defining concepts of free association, interpretation and transference. The treatment usually involves four to five sessions weekly and continues for a number of years. This is to enable the resistances encountered in bringing repressed material into a patient's conscious mind to be worked through and resolved. The patterns of disturbance that bring someone into psychoanalysis require work and commitment on the part of both analyst and patient to allow for psychic change. In intensive work, there is a continuity of experience, a building up of trust in the analytic setting, within which a patient can feel secure enough to explore his internal world. Most analysts recognize and use dreams as an opportunity to understand the unconscious; dreams act helpfully as a guide to unconscious elements, early experiences, hidden wishes, as well as external experiences.

The psychoanalytic setting, i.e., regular sessions, use of the couch, the basic rule of free association (saying what comes to mind), is important in establishing the treatment. The analyst "hears" both verbal and non-verbal communication and helps the patient to understand his unconscious conflicts and hidden unconscious meanings, which can lead to insight in the patient and profound changes in his life. It is of great importance that the analysis should be brought to a proper ending, where the patient leaves an important relationship intact and autonomous, with new horizons in view and a new way of thinking at his disposal.

© 2017 British Psychoanalytic Association