What is Psychoanalytic Therapy?
Growing up, I loved mysteries. It started with books such as Encyclopedia Brown and Nancy Drew, and later watching shows like Columbo, X-Files and Twin Peaks on TV. Following the clues and interviewing people in search of the hidden truth always fascinated me. I very much aspired to attain the wit, artistry, intuition and logical reasoning that the detective needs to possess.
When I learned about psychoanalysis in graduate school, I realized that my calling was here because Sigmund Freud was the master detective, a curious and creative scientist persistently trying to uncover the hidden unconscious meanings behind his patient’s presenting problems, insisting on there being something else beyond what was being said. He realized that in order to understand certain human thoughts and behaviors, you really have to dig deep beneath the surface of the mind where irrational forces have been pulling the strings the whole time. Self-inflicted misery is our biggest mystery to solve.
Psychoanalysis has endured over the past century as a rich, provocative field of study contributing to not only psychology but to sociology, philosophy, and cultural theory. The fact that psychoanalysis has historically centered the experiences of upperclass, heterosexual, European patients does not erase the importance and applicability of its ideas on a universal level. Contemporary clinicians of all colors, from all over the world, have expanded on certain aspects of Freud’s work, re-interpreted and re-translated his writing, and adapted psychoanalysis to suit the unique needs of different cultures, different kinds of illnesses, age groups, and socio economic classes.
What follows is a basic description of principles and values that all psychoanalytic practitioners can agree on:
Psychoanalysis invites us to consider that we are not fully in control of our minds, that we experience unresolved conflicts, ambivalences, and forbidden wishes and fantasies, all of which emerge from the lasting traces of past memories from when we were much younger. As subjects formed by language, our unconscious experiences are always mediated by the social discourses and cultural norms of the times we are living in. This is to say that an unconscious conflict will always reflect the time and place the patient is living in.
This anxiety-provoking material has been repressed in the unconscious, persistently finding means of expression through neurotic symptoms that cause psychic pain to the individual. And even as we defend, manage and suppress this pain, these very same defensive mechanisms can often lead to even more suffering. Therefore a constant balance is maintained between the expression and repression of impulses perceived as dangerous to the psyche.
What often prompts someone to seek professional help is a crisis that emerges when this balance gets disrupted in a major way. Perhaps increasing stress builds up to a sudden panic attack, or an impulsive and uncharacteristic action comes out of nowhere, or your dreams have turned into daily nightmares and the avoidance of sleep. These experiences may be scary and disturbing, but they provide an opportunity for insight and working through in therapy, like a light guiding you into a dark tunnel. You can decide to put down your defensive tendencies in favor of knowing what it’s in that dark tunnel. This is deep, painful work. One’s suffering must be great enough to engage in a process as costly and rigorous as psychoanalytic treatment. The therapist’s office is the only place where we allow the painful material to surface for the purpose of healing and change.
We need to speak to another person in order to listen to what our unconscious is telling us. It is impossible to see our own blind spots, to know what is hiding from our awareness. The therapist, the compassionate detective, is listening closely to everything you say- and don’t say- about yourself. Rather than a set of techniques used, the psychoanalytic therapist has a certain way of being with your experience with an evenly suspended attention. There is but one rule to follow, which is that of “free association”- you must speak everything that comes to mind without judging what you will say, especially things you are afraid to talk about, or things you’ve never said to anyone else, or even silly and non-relevant thoughts. This simple rule is actually extremely difficult to follow! Similar to meditation’s command to focus on your breath, part of the work is continually having to notice our natural “resistance” to the process.
As you start to speak freely in therapy, you will feel the relief of being able to put vague, overwhelming bodily sensations into more sturdy thoughts and ideas, granting you some necessary distance as an observer of your experience. At times, a cathartic emotional release can feel liberating, yet this is not all that the work entails! By speaking your desires and what you really want out of life, you can redirect your mental efforts towards more fulfilling creative activities, discovered from having greater spaciousness and abundance of energy that has been freed up from inhibition.
Ultimately, psychoanalysis aims at restoring the aliveness and the possibility for satisfaction in your life, in both work and love. We never aim to get rid of the unconscious, for this is impossible. We learn to live with uncertainty, to be less afraid of our fantasies and strong emotions, and even start to enjoy the experience of not knowing. Psychoanalysis doesn’t promise enlightenment or everlasting happiness, but assures us that an ordinary life, with its expected ups and downs, is attainable. This ordinary life is absolutely worth living if we accept ourselves fully, even the part of ourselves that remain a mystery!