Psychoanalytic Therapy is a one of the various types of therapy that is based on the talk therapies and theories by Sigmund Freud. It explores how the unconscious mind influences thoughts, behaviors and feelings. His views and theories still continue to influence current practice of psychologists and counselors. Many people have developed their theories after getting inspired from Freud’s psychoanalytic theories. His theories provide a system for the dynamic approach to psychotherapy.
Freud was a deterministic as according to him, one person’s behavior is determined by irrational forces, unconscious desires and biological drives which develop as people go through the psychosexual stages in their life. Unconscious stores all our experiences, memories and repressed content of our mind. According to Freud, anxiety can occur when our desires, motivations and urges that comes through id (part of our personality) doesn’t get fulfilled. It can be considered a state of tension that occurs due to failure of goals or expectations.
Now, let’s look at the Freud’s Psychoanalytic Therapy in detail :
Goals of Psychoanalytic Therapy
The main goal of Psychoanalytic Therapy is to increase daily functioning that involves reduction of symptoms and resolving unconscious conflicts. The psychotherapist helps the client to make the unconscious material come in conscious awareness while managing the negative feelings and anxiety well and to strengthen the ego so that one can deal with the instinctive guilt and urges.
This therapy helps to modify the personality structure and contributes in moral character development. It also focuses on the childhood experiences that shape out to be the adult personality. So, the therapist discusses, reconstruct and interprets the client’s childhood experiences and solves the problems that the clients have in their life. It also contributes in developing insight about self, intellectual understanding and unconscious mind. It goes in depth about emotional and behavioral issues and addresses the root causes of their psychological issues.
How Psychoanalytic Therapy works?
Before starting with this therapy, both the therapist and the client should be aware that it involves long-term and intensive therapy sessions. In these face-to-face sessions, the clients sit on the couch and engage in talk therapy. Clients report their feelings, experiences, thoughts and desires to the therapist. This helps to develop deep, uncensored and insightful reflections. Simultaneously, the therapist observes the non-verbal cues of the client that helps in the interpretation of the client.
Clients receive a trustful and non-judgmental environment where they express themselves freely. Any socially unacceptable, illegal and irresponsible information is allowed to share with the therapist. It involves few sessions per week but is long-term. Once they have resolved their distressed symptoms, identified, clarified and managed emotional issues and develop adaptive functioning. Termination at the end is done carefully as it can cause feeling of separation in the client.
Therapeutic Relationship
A supportive, non-judgmental and caring therapeutic alliance is developed in psychoanalytic therapy which makes the process of catharsis easy and smooth for the client. The therapist acts as an active listener who listens to everything that the clients have to say in the session and then helps them to develop insights about it.
The main component of the psychoanalytic therapy is the transference that should be managed really well. Transference is the client’s unconscious feelings that they shift from the main agent to the therapist. It involves repetition of the past in the present. The client brings back the old unconscious patterns in the current life with the therapist.
These feelings that can be developed towards therapist can be positive or negative depending upon the past experiences. The therapist works through these feelings and allows the client to make new choices in life. The relationship with the therapists seems like a creative, fresh and correct experience. But not all feelings can be put under the category of transference and can be insightful about the client’s reaction patterns and should be corrected in the therapy only.
Countertransference can also occur which involves therapist’s emotional reactions to the client. Therapists should be aware of and manage the countertransference according to the benefits of the client. Therapist’s ability to be self-understanding and establishing boundaries is essential in the psychoanalytic therapy. Therapists should also develop objectivity and not react in anger, love, adulation and any other emotion.
Techniques used in Psychoanalytic Therapy
In Psychoanalytic Therapy, a variety of techniques are used to deal with a person’s maladaptive behavior:
1. Free Association
It is a technique that plays a very important role in the psychoanalytic therapy. It involves client speaking freely whatever comes to their mind doesn’t matter how much painful, stupid, illogical, irrelevant the detail is. The main goal of this technique is to let the clients speak in such a flow that they start speaking without any filter and let the content in unconscious mind also come in conscious awareness. The client will show resistance but the therapist has to manage that hesitation with support, non-judgmental attitude and empathy.
It is a basic and an easy tool to let the doors open for the repressed thoughts, feelings, conflicts and desires to go from unconscious to conscious so that it can be identified and then managed properly in the therapy sessions. This speaking out freely technique helps in release of intense feelings and emotions that were blocked which leads to catharsis which is essential for the client to experience. It is the therapist’s responsibility to understand and make sense of the vague things that the client said in the sessions. After interpreting the material, client is also made to understand all of it. Besides the surface content, hidden meaning is also essential to identify.
2. Interpretation
After when the client has expressed freely in the free association technique, it is time for the therapist to interpret and explain it to the client. For example, the therapist has to tell the meaning of the childhood trauma, hidden meaning behind dreams, resistances and the therapeutic relationships also. This technique helps in strengthening the ego to include more material that came from the unconscious and speed up the process of uncovering unconscious.
It is done by the therapist keeping in mind the client’s personality and any other important factors that should be considered. This way client becomes able to make sense of their lives and increase the quality of their life. The therapist also notices the reaction of the client to the interpretation to see whether the client is capable and cooperating. But this process should be done carefully and slowly according to the limits and capacities of the client.
3. Dream Analysis
It is an important technique to uncover the unconscious material or hidden meaning behind the dreams. It helps in giving the client some insight about their unresolved problems. During sleep, defenses and filters go down and unconscious material reveals itself indirectly in forms of signs in the dreams so if it is remembered, noticed and analyzed well then it can be a great way to know the repressed content of the unconscious. Freud sees dreams as “royal road to unconscious” as it includes repressed wishes, fears, desires and conflicts that are causing problems in conscious.
Dreams have two types of content: Latent Content (hidden, symbolic and unconscious wishes, desires and fears) and Manifest Content (how dream appears to the client). As uncovering the unconscious is painful and dangerous so it is transformed in symbolic form and it is called Dream Work. Free association is also applied in dream analysis as the client talks freely about manifest content of then dreams. Dreams are a way of understanding repressed material and current life functioning.
4. Analysis of Resistance
It includes dealing with anything that works against the therapy and prevents the client from making progress. It can be defined as the client’s reluctance to bring the unconscious material to the conscious awareness as they are difficult and painful in nature. Resistance is any idea, feeling or attitude that acts as an obstacle in the way of change for a client. During free association and dream analysis, client may face any restriction (unconscious or conscious) that stops them from telling any feeling, experience or thought that was in the unconscious.
It is a natural and automatic guard that is used to prevent any intolerable anxiety that may occur when doors are opened for the unconscious material to flow into conscious awareness. It may also occur when the interpretations are taught to clients to help them gain insight about themselves. So, the therapist has to make sure that a safe and comfortable climate is given to clients so that the chance of resistance is lower. The guard of resistance is important in daily life but should be managed properly with support and guidance from the therapist in the session.
5. Transference
It occurs when clients starts developing similar feelings with the therapist that they had with someone in the past. It is sometimes important as it allows the client to experience feelings that were inaccessible earlier. In the transference situation, therapist makes sure that the client expresses beliefs, feelings, thoughts and desires that were buried in the unconscious. When the therapist gives the interpretation to the client, clients can recognize how they have similar patterns with the therapist like their significant others in the past.
The process of exploring, identifying and interpreting the transference is a core part of the therapeutic process as it helps to achieve awareness and do some required changes in the personality. It contributes in achieving here and now insight about influence of the past on the present functioning.
Critical Evaluation of Psychoanalytic Therapy
This approach of Psychoanalytic therapy emphasizes the importance of sexuality and the unconscious in human behaviour. This approach provides a theoretical base of support for many psychological tests, such as the Thematic Apperception Test or the Rorschach Ink Blots. But also it is time-consuming and expensive. This approach does not seem to work with older clients or even a large variety of clients. Patients who get benefit most from psychoanalysis are mainly middle-aged men and women oppressed by a sense of futility and searching for meaning in life.
Psychoanalytic therapy appears to be effective for those who suffer from a wide variety of disorders, including hysteria, narcissism, obsessive-compulsive reactions, character disorders, anxiety, phobias, and sexual difficulties. But the approach is based on many concepts that are not easily communicated or understood—the id, ego, and superego. This therapy has become associated with people who have major adjustment difficulties or want or need to explore the unconscious.
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Frequently Asked Questions (FAQs) for Psychoanalytic Therapy
What are the different types of anxiety managed in psychoanalytic therapy?
Anxiety is a bad feeling that comes when repressed and unwanted feelings, thoughts and desires come back in the conscious awareness. It also comes due to conflict between id, ego and superego. The different types of anxiety are: Reality Anxiety (when danger is felt like a real danger from the external world), Neurotic Anxiety (fear that one can do something socially unacceptable due to instinctive urges and needs) and Moral Anxiety (fear of one’s conscience that occurs when people do something immoral and then feel guilty).
Which Defense mechanisms Freud talked about in his theory?
Freud talked about various defense mechanisms like Repression, Denial, Reaction formation, Projection, Displacement, Rationalization, Sublimation, Regression, Introjection, Identification and Compensation.
What is Psychoanalytic therapy used for?
Psychoanalytic therapy is used for various psychological issues like anxiety, depression, trauma, self-esteem issues, relationship issues, psychosomatic issues, self-destructive behavior, sexual problems and many others.