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What is the Psychoanalytic Way of Thinking? Can it Help Us in This Short Term World? Written by Dr Linda Berman Part 2.

……Or Is The Therapy Couch destined for the Scrapheap?

In this short-term, throwaway, bargain-basement culture, we may wonder whether an approach that inclines towards the long-term, and the more expensive, can be helpful to us. Or will it fall by the wayside?

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Image: Brandon Giesbrecht. Flickr.

What IS Psychoanalytic Thinking?

This way of thinking involves a focus on the unconscious, the part of the mind that is not immediately available to our conscious awareness. The unconscious is a repository for hidden fantasies, thoughts, feelings and memories, which may motivate us in our daily lives.

Psychoanalysis aims to help us access such concealed aspects of ourselves, to bring the unconscious into the conscious, in order that we can learn to live more fully and be less afraid of what might lie within.

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Psychoanalysis also uses the relationship between therapist and patient as an arena within which to explore sometimes self-defeating ways of being in relationships. These may have developed in childhood.

Past behaviours will inevitably be repeated symbolically in the therapy relationship. The space between therapist and patient becomes a kind of ‘theatre’ in which to reactivate and re-act aspects of one’s past experience. Feelings and behaviours towards the therapist will inevitably reflect aspects of the patient’s primary caregivers. This is called the transference.

Psychoanalytic ways of thinking emphasise the importance of early experience in contributing to personality development.

Psychoanalysis itself is a long and intensive form of therapy, aimed at discovering with the patient repressed thoughts and feelings. This is achieved through the interpretation of dreams, fantasies and memories, using the technique of free association. We all have defense mechanisms which protect us from painful thoughts, feelings and memories.

Psychoanalytic psychotherapy resembles psychoanalysis in terms of technique and approach, but it is often shorter and less intensive.

Psychoanalytic Thinking Has Changed with the Times

Freud was the founder of psychoanalysis; however, this school of thought has not remained static, but has developed and grown over the years. Whilst there may be fewer people practising ‘pure’ psychoanalysis than there were, the influence of psychoanalytic theory has been enormous. Many therapists are more eclectic in their approach, whilst valuing the learning from psychoanalysis.

Literature, literary criticism, art and film have particularly been influenced by Freud’s theories.

As W.H. Auden said in his poem In Memory of Sigmund Freud:

to us he is no more a person
   now but a whole climate of opinion

under whom we conduct our different lives: (Auden)

 

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Sigmund Freud with Stephan Gabriel, (1921-2015) his grandson and brother of Lucian and Clement.

Image: Wikimedia Commons

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Psychoanalytic Congress, 1911. Wikimedia Commons.

 

Addressing Criticisms of Psychoanalysis.

Some have criticised psychoanalysis for the fact that it takes time and is therefore expensive, especially in this throwaway and short-term culture, where thinking for oneself has been eroded.

Others regard psychoanalysis as having insufficient evidence-base for its effectiveness; they feel it is lacking in scientific credibility. Bowman sees this attack as ‘a defence against psychoanalysis.’

Indeed, it is so often the case that insights into the unconscious that emerge through the process of psychoanalysis may be experienced as threatening. Confronting one’s true feelings and motivations is not for the faint-hearted. Perhaps sometimes it is easier to criticise than to consider.

Manualised treatments, such as cognitive behavioural therapy, may be researched in a way that takes into account their ability to be predictive and generalised in approach. Psychodynamic psychotherapy, however, can never be so reduced, technique-driven or inflexible; nor can it be fitted into such mechanized and systematized methods of measuring efficacy:

‘Evidence-based demands and standardisation sought through State regulation and the NHS approach are contradictory to the psychoanalytic view of the uniqueness of the individual. What may prove therapeutic for one client may be totally inappropriate and ineffective with another. Psychotherapy is not a technique to be learnt and universally applied but is an exploring of human subjective history and experience. It cannot be ‘forced to happen’ and certainly cannot be guaranteed in the form of an ‘offer.’’

(Leader, 2008).

Research

However, despite these issues, reliable and thorough  research has been successfully carried out. It has indicated that there is definitely ample evidence for the efficacy of psychoanalytic approaches. (Peter Fonagy)

This  research revealed that, as a treatment for severe depression, psychoanalysis was much more successful than CBT. The effects lasted longer after therapy than with CBT, and the research appeared to reveal that CBT became less effective as time passed.

With this in mind, will psychoanalysis and its ideas survive in the 21st Century? To find out, read next week’s post.

Have you found psychoanalytic thinking helpful? Please leave a comment below.

 

 

 

 

 

 

 

 

23 comments

  2. I’m studying to be a counselor. One of my professors who is I’m pretty sure a psycho dynamic therapist, how does read a paper that argues that there has been studies that show that psychodynamic therapy is at least as effective as every other therapy, and there are some studies, as you pointed out, that suggest that psychodynamic therapy actually is more effective in the long term.

    Personally as I am studying these various theories and such, i’m thinking that there are not just different types of problems, but actually different types of human beings. And that different types of human beings, regardless of their issue, will respond better to different types of treatments.

    I think this is the future of counseling and therapy is to actually admit that there isn’t some common human being and that various things are better suited towards this one human being as a type. Rather, that there are indeed different types of human beings that respond better to different types of therapies.

    But that is a pretty radical idea because most people have to feel that they are only legitimatized within a whole context, including the therapists and the doctors.

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  3. … oh, and I think this is radical because most people cannot think about different types of human beings without actually applying some sort of hierarchy about which type might be better than another type. So we have a long way to go.

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      • Hmm. The first post I made did not post. I was saying that, like you say here, there are studies now that say that psychodynamic theory is at least as effective as any other approach. And I was also saying that I think that there are different types of human beings that respond to different types of therapeutic interventions regardless of the presented issue. That to focus upon a cure-all to various issues or a one-size-fits-all theory of how consciousness functions, might not be as effective as to simply realize that there are different types of human beings.

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      • I do agree with what you say; I think that an assessment process is important to ensure that each person is offered the type of therapy suitable for them individually. Or no therapy if not. Thanks, Linda.

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      • Yes. Of course. I am a counseling student so I have no practical experience yet. But I am feeling that too much emphasis may be being placed uno n proving one intervention or approach as opposed to another upon specific issues. Where as perhaps it is more about the client. Do you know of studies that approach the research in this way?

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      • …I mean. I am not sure there is an unconsciousness. But perhaps with some people, the “talking cure” could work because they have a definite idea that there is an unconscious structure of the psyche which is playing out in the manner Freud said. While there may be other clients which do not have that kind of view, where they need more of a “calling out of ones shit” and specific direction and instruction and homework between sessions.
        what do you think?

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      • Yes I do agree. Not everyone can or should have psychoanalytic psychotherapy. Not everyone wants to or is able to think in this way. This kind of therapy can have enormous success- I’ve experienced that personally and with patients. Also, it can be totally unsuitable for others who. as you say, might need a more direct approach.

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      • It has been found that the relationship is one of the most important factors in good psychotherapy outcome.I think it might be helpful for you to read about the person-centred approach, where the focus is very much on the client.. Anything by Carl Rogers. Also read papers about research into psychotherapy; some of the refs are in my last post. Hope this helps.

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  5. Strange that my posts are being kicked off somehow. The first post, to which the poster that is there refers, disappeared and so I just did another one and it has disappeared.

    In short, I agree that there are studies with suggest that psychodynamic therapy is at least as effective as all the other modes. And there are some studies that suggest that the psychodynamic approach has a longer and more substantial effect.

    And then I suggested that it may be that there are different types of human beings. That perhaps it is not that different issues can be treated more affectively three different approaches or different therapeutical interventions, but that there might be different kinds of human beings who respond better to various types of therapeutic approaches regardless of what issues they present.

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    • Yes I know what you mean. I think it might be helpful to find books and papers about assessment in psychotherapy and what the criteria are. Also the therapy relationship- Petruska Clarkson, ‘The Therapeutic Relationship’ may be helpful here.Also Patrick Casement ‘On Learning from the Patient.’ And anything by this writer.

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      • In my theories class. We are to find our theory. Co incidentally, Rogers client centered does resonate with me. I am going with that.

        Thank you for the suggestions also. I will look into those authors.

        We are indeed told that one’s theory informs the interventions, that one can use many different kind of interventions.

        What I ponder though is if research might be based on types of humans, not like race or gender or culture necessarily, though those are types. But perhaps types are divided up outside of those kind of overt categories. Just thinking.

        Thx.

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