Psychoanalysis, Freud’s brainchild, is the mother and father of talking therapies – in its style as well as in its family tree. You lie on a couch and talk. You say whatever comes to mind. The therapist comments on and interprets what you say.
The recurring themes and the gaps in what you say reveal to the therapist the workings of your unconscious mind. “It’s like a black hole in outer space” says Lesley Murdin who trains psychotherapists at the Wesminster Pastoral Foundation in London, “you don’t see it but you know it’s there because the stars you can see are circling around it.”
The black holes of the mind are repressed unconscious memories of unresolved conflicts, frustrated desires, and unfulfilled relationships. They may emerge in safe symbolic forms, particularly when we dream. But normally they lurk unseen, influencing our actions and feelings. The analyst interprets this influence to enable us to understand and resolve these ancient conflicts.
Infancy and childhood are very important: desires often develop before the capacity to satisfy them. The Oedipus Complex looms large here. This is not just about marrying your mother and killing your father or vice versa. It symbolises the tension in any relationship – by drawing close to one person you exclude others. You may suffer when other people exclude you.
Revealing the black holes in your unconscious helps you understand your problems, but transference – replaying traumatic events with the therapist as a protagonist – takes the process further. Freud initially regarded transference as a nuisance and tried to prevent it. Patients fix on the analyst and draw them into their conflicts. This distorts the analysis but it allows the therapist to replay the conflict and guide it towards a more satisfactory conclusion. Transference is now central to the Freudian approach.
Analysis is not for the faint-hearted. Sessions are 50 minutes a day, 5 days a week for 3 years or more. You may feel worse before you feel better. You may still be miserable at the end of it but you will have an understanding of why you feel that way. Even Freud only aimed “to transform neurotic misery into normal human unhappiness”. If you just want to be happy there are other, less demanding therapies to try.
Rigorous evaluations of the benefits of any psychotherapy are rare – standardisation and measurement are impossible. This has tempted some insiders to claim that analysis is beneficial for everybody, sick or well. Outsiders are less enthusiastic, but even sceptics acknowledge the value of Freudian therapy for special groups of patients – like disturbed adolescents.
The variations and modifications of Freud’s practices and theories are impossible to count. The most important purely practical distinction is between Psychoanalysis, which is typically 5 sessions per week and always uses a couch, and Psychotherapy, which may be as little as one session a week and may be conducted with the client sitting face to face with the therapist. Theoretical differences range from refinements by people who see themselves as continuing Freud’s tradition, to radical changes, by those who have set up schools of their own.
Given all these variations, it may be better to begin by choosing a therapist or analyst who works in a way that suits you. Unfortunately there is no statutory register of practitioners in the UK, although there are voluntary registers with agreed codes of practice – see the contact list for details. Friends or GPs can also be useful sources of recommendations. The American Psychoanalytic Association has an excellent web site which allows you to contact therapists by email.
British Confederation of Psychotherapists; http://www.bcp.org.uk/
Phone (0181) 830 5173 FAX (0181) 452 3684 British
Psychoanalytical Society; http://www.psychoanalysis.org.uk/
Phone (0171) 580 4952
UK Council for Psychotherapy; http://www.psychotherapy.org.uk/
Tel: 0171 436 3002 Fax: 0171 436 3013
American Psychoanalytic Association; http://WWW.APSA.ORG/
Phone (212) 752-0450 FAX (212) 593-0571