Psychoanalysis Today

Psychoanalysis is at once a way of learning about individual people, a comprehensive theoretical understanding of personality and behavior, and a unique therapeutic process. As a therapy, psychoanalysis is based on the tendency of people to repeat destructive emotional or behavior patterns that originate outside of their awareness. 

By creating a consistently non-judgmental space, the analyst helps people talk about feelings, thoughts and fantasies they didn’t know they had. By accepting all these thoughts and feelings as valuable information, the analyst helps people learn to tolerate painful feelings and accept the disturbing and sometimes intriguing parts of themselves. In the context of this safety, a person addresses the underlying sources of his or her difficulties not simply intellectually, but emotionally, often by re-experiencing them with the analyst. When verbalized, intense feelings that come up with the analyst can be worked through, breaking old habits and developing new ways of responding. 

Because psychoanalytic theory describes unconscious forces driving behavior, it also helps us understand how people work with or against each other, within or between groups. Such understanding is crucial for understanding organizational failures and social problems, and for designing successful organizational and social interventions.

Myths & Realities 

When people think of psychoanalysis, they often think of the theories and method of treatment first introduced by Freud over 120 years ago. Many people are unaware that psychoanalytic ideas have continued to change and evolve, based on clinical experience and research in many fields. Compare myths and realities about psychoanalysis.

Myth: Psychoanalysis is not evidence based. There is little if any research supporting its efficacy.

While psychoanalysts were slow to launch traditional research about psychoanalytic and psychodynamic therapy, in recent decades, we have seen an explosion of research on psychoanalytically-influenced therapies and psychoanalytic concepts, including ample evidence supporting the efficacy of psychodynamic therapies. Faculty member Dr. Stephen Soldz provides a concise but comprehensive review of the current literature in his blog post on Research on Psychodynamic Therapies.

Myth: Psychoanalysis discriminates against people with less typical sexual orientations and gender identities.

Psychoanalysis aims to understand individuals in their full complexity, accepting each person’s identity and psychic functioning, including sexual preferences. Gender identity and sexual orientation are very basic aspects of who we are, rooted in very early life and affected by both biological dispositions and early experience. Rather than rejecting non-heteronormative identities, today’s psychoanalysts seek to understand and help each individual address causes of psychic suffering. These causes may include internal conflicts or conflicts with the external world around sexual and gender identity. In this area and more generally, psychoanalysts encourage people to more fully understand themselves at all levels.

Myth: Only those with an advanced degree in medicine, psychology or social work can study psychoanalysis.

Some training institutes still require an advanced degree from one of these three disciplines to become a psychoanalyst. However, other institutes and schools consider psychoanalysis to be a unique field of study in its own right and do not require prior training in any other profession. These programs prepare students with the common knowledge that all mental health professionals share, while providing them with full psychoanalytic training. Doors to psychoanalytic training are now open to any capable and motivated post-bachelor’s student who is interested in understanding unconscious forces.

Myth: People must attend psychoanalysis 3-4 times a week.

Psychoanalysts see people on a schedule that best meets the needs of the individual person. This means that some people are seen more frequently than others. Often, they are seen on a weekly basis, but some people choose to attend more or less frequently than that.

Myth: People need to stay in psychoanalysis for many years or even the rest of their lives.

It does take time to form a meaningful therapeutic alliance between a patient and analyst. However, the length of time required is very dependent on the particular needs and character of the individual person in treatment and varies accordingly.

Myth: Psychoanalysts are emotionally removed from their clients and only provide intellectual interpretations to bring unconscious motivations into awareness.

Many analysts are trained to study their countertransference reactions to a patient as a way to better understand the person and to use these feeling states therapeutically in treatment. Using countertransference, emotional communications can be very effective and can be used instead of or in addition to intellectual interpretations.

Myth: The psychoanalytic session focuses on the recreation of the past.

The relationship between the patient and the analyst and what transpires between them in the here and now is an important element of the therapeutic process. This relationship allows the analyst to understand and work to modify repetitive patterns, freeing the patient to experience growth and the possibility of a more satisfying life.

Myth: Psychoanalysis is the study of transference, countertransference and resistance as understood through the lens of the oedipal stage of development and is therefore only useful for those with a neurotic character structure.

Although analysis has retained the classical psychoanalytic focus on transference, countertransference, and resistance, psychoanalysts now understand that the transference can also be a narcissistic one, in which feelings and patterns of defense from the first years of life are revived. This opens up a broad range of issues and patients to the benefits of psychoanalysis.

Myth: Psychoanalysis is only effective in a one-on-one clinical setting.

Understanding unconscious processes such as symbolic communication, resistance, repetition, transference and countertransference helps to inform other areas of study. Appreciation of these factors is valuable not only when working with individuals, but also in other settings where destructive or repetitive patterns of behavior interfere with progress. Consequently, psychoanalysis, in concert with other disciplines, increases understanding of group functioning, social and cultural phenomena, and the requirements for social change.