Psychoanalysis: what it is, and what it isn’t

People often ask what the difference is between psychoanalysis and other approaches to the treatment of psychical symptoms. A website can’t possibly offer a complete answer to the question, but here are some introductory responses.

• People come to psychoanalysis for many reasons. Often, they bring a pain or difficulty from which they want release and from which they cannot release themselves. Psychoanalysis presupposes that this pain or difficulty has unconscious foundations, that is, foundations that are not immediately and readily seen. It therefore aims to bring those unconscious elements to the consciousness of the analysand (the person in analysis). In bringing these to light, and speaking of them, the investments the analysand has in them can be apprehended. In focussing in this way on unconscious and conscious processes, psychoanalysis differs from most other approaches in psychological and psychiatric practice.
  
  
• Psychoanalysis alleviates suffering, and the techniques it uses to do so are different from those of other psychological approaches. Perhaps the technique most greatly contrasting with psychoanalysis is cognitive behavioural therapy (CBT), an approach that presupposes that your symptoms can be alleviated by a therapist showing you why it would be better for you to hold different beliefs about yourself than the ones you actually hold. Psychoanalysis argues that CBT does not alleviate the symptom because it does not treat its foundations, only its instances. The likely effect of CBT is therefore merely a displacement of the disturbing affect not its dissipation or dissolution. To give a concrete example of such displacement: a person’s fear of public speaking might be controlled in the short-term by CBT, but this same person’s migraines might increase.
  
  
• Psychoanalysis does not aim to show anyone the best or right way to live, and it does not presuppose that the analyst can or should function as a model in these things. Instead, psychoanalysis is a process in which you speak to and with your analyst and, through your speech and the analyst’s interpretations, you develop a way of thinking about, and transforming, your symptoms. It is this process that provides the therapeutic effect of psychoanalysis, an effect sometimes referred to as ‘the talking cure’. It is in talking in this very particular way and particular setting that a person in analysis (the analysand) comes to work out how s/he can live more fully and less burdened by the tendency to repeat those behaviours and beliefs that cause pain.
  
  
• A necessary component of developing an understanding of the theory and clinical practice of psychoanalysis is undertaking a personal analysis oneself. Every Lacanian psychoanalyst has been in analysis. One becomes an analyst only through the process of working through one’s own symptoms (for we all have symptoms).
  
  
• Psychoanalysis takes place with an individual. Unlike family therapy or relationship counselling, the analyst does not usually work with the analysand’s partner or other members of her/his family or community. The work takes place between analyst and analysand.