Psychoanalysis (A Short Definition)
Psychoanalysts starting with Sigmund Freud came to realize that so much psychic suffering is linked to feelings and experiences that, for most people, are not conscious. Freud was most famous perhaps for listening closely to his patients, in order to understand them. In particular, he suggested that it may be very important to listen for aspects of people’s experience of which they may not be so aware. This core principle is not the only one relevant today: it only provides the basis for answering the question of how the therapeutic relationship can help the patient change his/her maladaptive ways. There are other important and unique aspects of the psychoanalytic approach. Many of these focus on both discovering a hidden understanding over the course of conversations with patients, as well as a distinct kind of change in patients’ feeling understood by their therapist in the context of a unique and intimate relationship.
Studies of actual psychoanalytic psychotherapy and of another common model of treatment, cognitive-behavioral therapy, have found important overlaps between the two. In fact the originator of cognitive-behavioral therapy, Aaron Beck, began his clinical life in learning psychoanalysis, then felt that the restrictions of analytic technique taught back in the ‘70s were too limiting. Since then, both cognitive-behavioral therapy and psychoanalytic treatments of various kinds have developed to include elements of one another’s approach. The focus on how a patient’s thoughts affect their thinking and behavior in life, and how to effect meaningful and operational change, have become important for all kinds of psychotherapists.
Most recent research has shown that change is facilitated by the experiences patients have within the therapeutic hour as well as outside of it, inspired by the therapeutic work. Psychoanalytic work is focused very much on the present (i.e. experiences ‘in the room’ with the therapist) and the future in all its potential. The previous emphasis upon interpretation of the meaning of the past, which Freud began, has given way to a more subtle and complicated appreciation of the ongoing, present therapeutic relationship as an agent of change. At times and to different degrees with different patients, this will also require a deeper understanding of the past, but hopefully always with an effort to help patients meaningfully manage their emotional difficulties. This process is illustrated with commentary in _our principal extended clinical example_ [internal link, Clinical Case A2]