About Psychoanalysis
Copyright (C) 1996, American Psychoanalytic Association,

What is Psychoanalysis? When people ask what psychoanalysis is, they usually want to know about treatment. As a therapy, psychoanalysis is based on the observation that individuals are often unaware of many of the factors that determine their emotions and behavior. These unconscious factors may create unhappiness, sometimes in the form of recognizable symptoms and at other times as troubling personality traits, difficulties in work or in love relationships, or disturbances in mood and self-esteem. Because these forces are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts of will, often fail to provide relief. Psychoanalytic treatment demonstrates how these unconscious factors affect current relationships and patterns of behavior, traces them back to their historical origins, shows how they have changed and developed over time, and helps the individual to deal better with the realities of adult life.

Analysis is an intimate partnership in the course of which the patient becomes aware of the underlying sources of his or her difficulties not simply intellectually, but emotionally – by re-experiencing them with the analyst. Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind. These conditions create the analytic setting, which permits the emergence of aspects of the mind not accessible to other methods of observation. As the patient speaks, hints of the unconscious sources of current difficulties gradually begin to appear – in certain repetitive patterns of behavior, in the subjects which the patient finds hard to talk about, in the ways the patient relates to the analyst. The analyst helps elucidate these for the patient, who refines, corrects, rejects, and adds further thoughts and feelings. During the years that an analysis takes place, the patient wrestles with these insights, going over them again and again with the analyst and experiencing them in daily life, in fantasies, and in dreams. Patient and analyst join in efforts not only to modify crippling life patterns and remove incapacitating symptoms, but also to expand the freedom to work and to love. Eventually the patient’s life – his or her behavior, relationships, sense of self – change in deep and abiding ways.

Child and Adolescent Psychoanalysis Child and adolescent psychoanalysis, both offshoots of adult psychoanalysis, share with it a common theoretical framework for understanding psychological life, while also using additional techniques and measures to deal with the special capacities and vulnerabilities of children. For instance, the young patient is helped to reveal his or her inner feelings and worries not only through words, but also through drawings and fantasy play. In the treatment of all but late adolescents, parents are usually consulted to round out the picture of the child’s life. The goal of child and adolescent analysis is the removal of symptoms and of the psychological roadblocks that interfere with normal development.

Is Psychoanalysis only a Therapy? Although psychoanalysis began as a tool for ameliorating emotional suffering, it is not only a therapy. It is, in addition, a method for learning about the mind, and also a theory, a way of understanding the processes of normal everyday mental functioning and the stages of normal development from infancy to old age. Furthermore, since psychoanalysis seeks to explain how the human mind works, it contributes insight into whatever the human mind produces. In so doing, it has had a profound influence on many aspects of twentieth-century culture.

As a general theory of individual human behavior and experience, psychoanalytic ideas enrich and are enriched by the study of the biological and social sciences, group behavior, history, philosophy, art, and literature. As a developmental theory, psychoanalysis contributes to child psychology, education, law, and family studies. Through its examination of the complex relationship between body and mind, psychoanalysis also furthers our understanding of the role of emotions in health as well as in medical illness.

In addition, psychoanalytic knowledge is the basis of all other dynamic approaches to therapy. Whatever the modifications, the insights of psychoanalysis form the underpinnings of much of the psychotherapy employed in general psychiatric practice, in child psychiatry, and in most other individual, family, and group therapies.

Who is a Psychoanalyst? The designation psychoanalyst is not protected by federal or state law: anyone, even an untrained person, may use the title. It is therefore important to know the practitioner’s credentials before beginning treatment.

Graduate psychoanalysts trained under the auspices of the American Psychoanalytic Association have had very rigorous and extensive clinical education. Candidates accepted for training at an accredited psychoanalytic institute must meet high ethical, psychological, and professional standards. These candidates are physicians who have completed a four-year residency program in psychiatry, or psychologists or social workers who have completed a doctoral program in their fields and have had intensive clinical experience. Outstandingly qualified scholar-researchers, educators, and selected other professionals may also be approved for psychoanalytic training. All accepted candidates, whatever their background, then begin six to ten years of psychoanalytic training.

This training consists of three parts. Candidates attend classes in psychoanalytic theory and technique. They undergo a personal analysis. And they conduct the psychoanalysis of at least three patients under the close and extended supervision of experienced analysts. Candidates who plan to treat children attend further classes and, with supervision, analyze boys and girls ranging in age from toddlers to late adolescents.

Besides conducting psychoanalysis, most graduate analysts also practice intensive and brief psychotherapy, sometimes prescribing medication. Many treat couples, conduct family or group therapy sessions, and work with the aging.

Because psychoanalysts are provided with the most thorough education available in normal and pathological development, their training enhances the quality of all their therapeutic work. It also informs their community activities as teachers, supervisors, consultants, and researchers, in the many different settings – hospitals, medical schools, colleges, day-care centers – where analysts are found.

Who Can Benefit from Psychoanalysis? Because analysis is a highly individualized treatment, people who wish to know if they would benefit from it should seek consultation with an experienced psychoanalyst. Still, some generalizations can be made. The person best able to undergo psychoanalysis is someone who, no matter how incapacitated at the time, is basically, or potentially, a sturdy individual. This person may have already achieved important satisfactions – with friends, in marriage, in work, or through special interests and hobbies – but is nonetheless significantly impaired by long-standing symptoms: depression or anxiety, sexual incapacities, or physical symptoms without any demonstrable underlying physical cause. One person may be plagued by private rituals or compulsions or repetitive thoughts of which no one else is aware. Another may live a constricted life of isolation and loneliness, incapable of feeling close to anyone. A victim of childhood sexual abuse might suffer from an inability to trust others. Some people come to analysis because of repeated failures in work or in love, brought about not by chance but by self-destructive patterns of behavior. Others need analysis because the way they are – their character – substantially limits their choices and their pleasures. And still others seek analysis definitively to resolve psychological problems that were only temporarily or partially resolved by other approaches.

Whatever the problem – and each is different – that a person brings to the analyst, it can be properly understood only within the context of that person’s strengths and life situation. Hence, the need for a thorough evaluation to determine who will benefit – and who will not – from psychoanalysis.

We are grateful to the APsaA who have granted us permission to reprint sections of their pamphlet, About Psychoanalysis, © 1996, The American Psychoanalytic Association. Written by the Committee on Public Information - Arlene Heyman, MD and Gerald Fogel, MD (1985)
Revised by:  Irene Cairo Chiarandini, MD, Chair, Jerome Grunes, MD; Arlene Heyman, MD; Barbara Jones, PhD; Frederic Levine, PhD; Jean Roiphe, MD; Ms. Judith Viorst.
http://www.apsa.org