What is psychoanalysis? and What does Psychoanalysis look like in Practice?

Psychoanalysis operates on the premise that there exists a knowledge not known to ourselves, an unconscious knowledge. If one worked in one’s own  best interests and if one is in control we wouldn’t be capable of our own destruction such as in cases of anorexia, addiction, gambling, puzzling anxiety or depression.

Psychoanalytic psychotherapy is a practice that focuses primarily on speech. Language is our connection to reality as reality is grounded in speech. Psychoanalysis is an effective method of treatment for those experiencing disturbances in affect, thought or behaviour. Clinical experience shows that when one symptom disappears it is often replaced by another. Psychoanalysis aims to undo the identifications and fixations that have led to the repetition in symptom-formation.

Clinical practice in the psychoanalytic orientation is preoccupied with the singularity of each client in a case-by-case tradition not a one solution fits all model. Speech provides the means to access what is symptomatic to come to light and allow the conflict and compromises of the symptom to become analysable.

The role of the psychoanalytic psychotherapist is to direct the treatment: to follow the speech of the client to where the symptom and the unconscious are connected. Through speech the symptom manifest content such as anxiety, depression, addiction, eating disorders, panic attacks, OCD and so on give way to the meaning of the symptom. Language plays a role into how an individual experiences their symptom.

Generally, an analysis is conducted by inviting the client to speak freely about their suffering. The psychoanalyst provides a very specific listening which aims at hearing something beyond what is said. This will be exemplified below with two clinical vignettes.

Psychoanalytic psychotherapists work with the variable-length session which means that ending the session on the articulation of a crucial question or the encounter with a contradiction; the time in between sessions is supposed to be used as a time to comprehend the material raised in the sessions and it can be developed and worked on by the client for the next session.

The point of an analytical session is not to achieve closure or resolution to a particular problem in a certain amount of time but through questioning ideas and untangling multiple associative threads, the question then becomes less “What time is it?” or “how long have I got?” to “Why did my analyst stop me at that particular moment?” The sessions become sequences on a continuum.