Psychoanalysis

Psychoanalysis, or “talk therapy,” is the most known form of psychological treatment. It is often stereotyped as sitting on a couch and talking about childhood.  While this stereotype may be accurate in appearance, the actual process of psychoanalysis is much more complex.

Brief history of psychoanalysis

Psychoanalysis was first developed by Sigmund Freud in the around the turn of the 20th century.  Freud, through his work as a neurologist, realized that humans experienced mental processes which they were not consciously aware of.  This led to his theory that unconscious memories from childhood could cause mental health problems in adulthood.

Assumptions of psychoanalysis

All types of psychological therapy rely on the certain assumed beliefs.  The core beliefs behind psychoanalysis is that individual human nature is determined by unconscious forces including motivations, sexual urges, aggressive impulses, and early experiences in childhood. When these unconscious forces conflict with conscious realities, then psychological disturbances can occur.  In order to cure the disturbance, the patient must bring the unconscious forces into consciousness.

Psychoanalysts believe that personality develops based on successive stages in psychological sexual and social development. If a problem arises at one stage, it can result in problems later in life. In order to fix the problem, the problem must be identified, analyzed, and that part of development restructured.

What is the unconscious?

PsychoanalysisAccording to Freud, a person has thoughts, feelings, desires, and memories of which he or she is not even aware.  These are all considered to be the unconscious and they can influence our personalities and behaviors without us even being aware of it.

Goals of psychoanalysis

The main goal of psychoanalysis is to bring unconscious beliefs and memories into the conscious. To do this, the therapist will use an insight-based approach to bring the patient back to earlier stages of psychological development.  Then, they therapist and patient will analyze unconscious forces in order to restructure the patient’s psychological development. 

Psychoanalysis in practice

Psychoanalysis is a highly individualized type of therapy.  A therapist must assess each patient’s case separately and decide on which course of action will be most effective.  Before treatment can even begin, patients must be assessed for their ability to respond to psychoanalysis and also for which model will be most effective.

Most commonly, psychoanalysis involves the patient talking about his or her childhood and past. The therapist will analyze the past events for patterns which are also evident in the current psychological problem. The therapist will also search for specific incidences which may have caused trauma or interrupted healthy psychological development, thus are unconsciously causing the current psychological problems.  Dream analysis is also commonly used in psychoanalysis as a way of gaining insight into the past or current problems.

Many psychoanalysts still use the Freud’s original method of having patients lie on a couch during the sessions.  Freud believes that the comfortable setting of the couch would help patients relax so they would be able to remember more of their pasts.  He also believed it was important for the therapist to be out of view from the patient. However, modern psychoanalysis does not require patients to recline on a couch.

Psychoanalysis techniques are generally divided into two separate groups.  The first group consists of the “classical” techniques which involve an open dialogue between the patient and therapist.  The therapist may ask specific questions, ask about the patient’s feelings or thoughts, or explain how the patient’s unconscious is causing problems.

Classical psychoanalysis techniques primarily focus on the past to show how it is affecting the patient’s current situation.  Newer psychoanalysis techniques challenge this method by focusing on some current problems and their resolutions.

There are many other variations on psychoanalysis including group therapy, role playing, free association, and combinations of psychoanalysis techniques with other methods.

How successful is psychoanalysis?

Psychoanalysis has often been criticized because the success of treatment greatly depends on the skill of the therapist. Further, psychoanalysis generally takes a long time of regular therapy before the problem is treated.  However, studies do show that psychoanalysis is very effective in most willing patients.  One recent study into psychoanalysis shows that it is more effective than shorter-term types of therapy such as cognitive behavior therapy.

Benefits and downsides of psychoanalysis

Studies show that psychoanalysis can be very effective in permanently treating psychological problems.  However, psychoanalysis typically requires a long-term commitment from both the patient and the therapist in order for results to be evident.  This can be very expensive and time consuming for the patient. Further, psychoanalysis may not be as effective for certain types of people (such as those unwilling to openly discuss their pasts) or for certain conditions (such as psychosis).  On the plus side, psychoanalysis can give immediate benefits as many people feel emotional relief from being able to discuss their feelings in a non-judgmental environment. 

Who is an ideal candidate for psychoanalysis therapy?

Psychoanalysis can be used to treat a wide range of psychological problems, especially depression, anxiety disorders (including specific phobias), sexual disorders, personality disorders, and obsessions. In order for psychoanalysis to be successful, the patient must be willing to commit to long-term treatment.  He or she must also have a desire to know more about the psychological problem and its root.  Because patients must openly discuss personal issues about their pasts with the therapist, it is very important that patients choose a psychoanalyst with whom they feel comfortable.

References:

Carey, Benedict. “Psychoanalytic Therapy Wins Backing.” New York Times. 30 Sept 2008. Retrieved from www.nytimes.com. Web. Sept 2011.

Knight, Robert. “Evaluation of the Results of Psychoanalytic Therapy.” American Journal of Psychiatry 98 (1941): 434-446. Retrieved from www.ajp.psychiatryonline.org.

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