Distinguishing Psychoanalysis From Other Mental Health Treatments

Strong empirical evidence supports the thinking that psychoanalysis brings about positive outcomes, including symptom remission, increased psychological and emotional flexibility, strengthened view of self, and improved capacity to engage in healthy and mutually satisfying relationships.   Not only is there evidence to show the efficacy psychoanalysis, evidence also points to the continued benefits of psychoanalysis, long after treatment has ended.  This is important, since other modes of treatment, such as behavior modification, have higher recidivism rates and therefore, cannot make a similar claim.

So, what is psychoanalysis?  Johnathan Shedler, psychologist and author of the important 2010 paper “The Efficacy of Psychodynamic Psychotherapy” writes there are 7 distinctive features of psychoanalysis.  

  1. Psychoanalysis Focuses on Affect and Expression of Emotion

The focus is on exploring and expressing the patient’s full range of emotions, including troubling ones, one’s that seem contradictory, and even one’s not initially understood or recognized.  Emotional insight, as distinct from intellectual insight, is central in leading to change and takes priority in the treatment.

  1.  Psychoanalysis Explores the Patient’s Attempts to Avoid Difficult thoughts  

      and Feelings

“Resistance” is the term used to describe the complex range of things we all do to avoid difficult or troubling thoughts, feelings, or experiences.  Psychoanalysis looks to explore the patient’s resistances.  But not in a judgmental or critical way.  Rather, Psychoanalysis honors the patient’s need to keep certain painful things away from awareness, and works carefully with each patient not to re-injure or traumatize, while remaining curious and open about all behaviors.  

  1.  Psychoanalysis Looks to Identify Recurrent Themes and Patterns

Psychoanalysis looks for repeating patterns of behaviors, thoughts, fantasies, and experiences.  Often, patients are aware of recurrent themes in their lives, like the woman who is drawn to the unavailable romantic partner, time after time.   Often, however, patients are unaware of recurrent themes, and learning about them becomes part of the process of learning about and understanding the self.  

  1.  Psychoanalysis Explores Past Experience and Personal History

Your personal history is important.  Who your parents were, how you were raised, how you were loved, and what your important experiences were all comprise part of who you are today.  Exploring your past provides clues to understanding who you are and why you feel and behave as you do.  Exploring your past also provides an opportunity to heal some of the scars from past injuries and makes it possible to resume a satisfying life.  

  1.  Psychoanalysis Examines the Patient’s Interpersonal Relations

Psychoanalysis wants to understand the whole person.  How we relate to others, how we feel about others, how we establish—or fail to establish—ties with others, how we conduct our relationships—what, for example, do we do when we are disappointed by others—these are important parts of personality and central to understanding the whole person.

  1.  Psychoanalysis Focuses on the Therapy Relationship

What makes Psychoanalysis unique is its focus on the relationship between the patient and the analyst.  This is an important interpersonal relationship, and one in which patterns of relating are likely to “show up.”  For example, a person who distrusts others may also come to feel distrust for the analyst.  Psychoanalysis looks to explore what “shows up” and offers the unique opportunity to rework and correct mis-attunements right then and there, in the living relationship between patient and analyst.  

  1.  Psychoanalysis Privileges Fantasy and the Unconscious

Psychoanalysis encourages patients to speak freely without limitation about what’s on their mind.  Patients are encouraged to talk, to share fantasies, and to bring in their daydreams and night dreams.  Often important but hidden aspects of self emerge such as authentic needs and longings that might have been previously banished or forbidden but which were festering and generating painful symptoms.

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