What is psychoanalysis?

Dr. Lynn Friedman | Psychologist Psychoanalyst Washington DCPeople often ask, “What is Psychoanalysis?” What are its benefits? How does it help? Psychoanalysis is a form of intensive psychotherapy. Also, it is a theory and a research method.  Psychoanalysis can help change your character or personality, in some deep and fundamental ways. For what kind of difficulties do people seek psychoanalysis? What are the goals of psychoanalysis? How does it work? What methods are used? And are there psychoanalysts in Washington DC?  How can one find a psychoanalyst outside of Washington DC.  Each will be addressed in turn.

People seek analysis for:

  1. difficulty having intimate relationships
  2. difficulty identifying and achieving work-life goals
  3. anxiety
  4. depression
  5. trouble with intimacy
  6. family difficulties
  7. consistently underachieving in school, college or graduate school
  8. underachieving at work
  9. anxiety about abandonment and trust
  10. writer’s block
  11. impostor syndrome
  12. workplace (or school) conflicts such as difficulty with authority, and colleagues and/or failure to progress
  13. self-sabotaging behavior and thoughts
  14. a wish to understand one’s feelings and one’s internal world
  15. fear of success
  16. many other difficulties

The goals of psychoanalysis

A successful psychoanalysis leads to character development and character change. It helps individuals become more secure, confident, thoughtful, assertive, serene, whole and mature. They may resolve difficulties with abandonment and intimacy. They may become more able to step back and appreciate the perspectives of others. Psychoanalysis can unleash creativity. With a successful analysis you may derive more enjoyment in work and play. These changes may lead to closer relationships with partners, family, friends, bosses, subordinates and colleagues.

How is psychoanalysis transformative?

Character changes as we learn more about ourselves. All of us have parts of ourselves that cause us pain. Yet, sometimes we ward off those parts of ourselves. Feeling sad, angry, helpless, hurt, frightened, angry, abandoned or vulnerable is uncomfortable. Therefore, we, unconsciously, avoid them. In this way, we protect ourselves.

Avoiding feelings is a way of protecting ourselves

There are many ways to avoid feelings. For example, we might make sure that we are busy all of the time – too busy to reflect about what we feel and why we feel it. Or, we might compartmentalize so that we don’t have to think about our painful feelings. Or, we might attribute our feelings to others – and lament that they are critical of us when, actually, we are critical of ourselves. We might shut others down; thus, making it difficult for them to get close to us. We may not listen to them because if we do listen, then, we may feel something that we do not want to feel. This is understandable. But, unfortunately, it doesn’t lead to intimacy or mutuality in relationships. Psychoanalysis may help us to know ourselves more fully – so that we can make deep and abiding changes and lead more fulfilling lives

Gaining access to the parts of ourselves that we have avoided isn’t easy. This is why when individuals have been struggling with discomfort, dissatisfaction, unhappiness, low self-esteem, avoidance, anxiety or depression for a long-time, they might consider psychoanalysis. In this way, they can take the journey inward with the help of a skilled psychoanalyst.

An example of how psychoanalysis can be useful to a man with difficulties with intimacy

A man enters into a new relationship and begins to fall in love. They agree to be monogamous. But, then he finds himself desperately drawn to other women. He begins to resent having agreed to monogamy. He doesn’t like having, “all of his eggs in one basket”. He’s uneasy about relying on his girlfriend. He feels resentment – but, he has no idea from what well the resentment springs.

He’s fearful of commitment.

He has not yet recognized that his wish to see other women is a frantic attempt to avoid the anxious and panicky feelings that commitment engenders in him. He’s not entirely aware that he is terrified that if he relies on his girlfriend, then, she may dump him. Still worse, he may feel trapped. While his fear of being trapped maybe intense; he has not yet come to appreciate that, at an unconscious level, he is afraid to trust anyone. Similarly, he may be unaware of the childhood antecedents that led to this fear.

What causes these kinds of difficulties?

What causes these types of difficulties? Each person is unique. However, here’s a possibility. Perhaps, his early caretakers were unreliable.  Maybe they were sick and unavailable. Or maybe they had difficulty with drugs or alcohol. Or, maybe they were so bound up in themselves they could not think clearly about, and respond sensitively to, his needs. That is, maybe they lacked the ability to recognize and to be attuned to his emotional needs.

If this was the case, at a level outside of his awareness, he may have felt that he couldn’t rely on his primary caretakers. Yet, he needed them. As a small child, perhaps he attempted to avoid counting on others. Now, as an adult he may encounter others who are reliable. But, he neither knows how to assess who is reliable nor how to trust anyone. So, intimacy feels unsafe and dangerous.

His fear of being trapped is so great that he begins to surreptitiously date other women. When his lover learns this, she rejects him. He feels bereft and abandoned.

Those who know him well recognize that he’s caught in a bind.  If he’s committed and monogamous, he feels trapped. If he dates others in order to alleviate the frightening feelings of being engulfed or controlled, he loses the woman for whom he cares.

In this example, how does the psychoanalyst help?

Often, a person with these kinds of struggles can benefit, significantly, from psychoanalysis, IF he has the capacity to make a commitment to this sort of treatment. Of course, this is a big IF because if he enters psychoanalysis, ironically, he will experience the very same anxieties with his psychoanalyst that he experiences in relationships. Unconsciously, he will feel drawn in some way to two-time his psychoanalyst in the very same way he two-times his girlfriend. He may find that as he’s talking to his psychoanalyst he also seduces someone else into a similar role. So, that as with his girlfriend, he doesn’t risk having, “all of his eggs in one basket”.

This is, “good news”, “bad news”. The “good news” is that if he can allow himself to hang in there with psychoanalysis, he can come to learn about what is so frightening about commitment for him. The “bad news” is it won’t be easy. And he will have the urge to do what he does everywhere else, to flee.

The unique virtue of psychoanalysis is that the psychoanalyst (hopefully) will not respond like the rejecting lover. Instead, she will gently help him become aware of his fears and understand them.

What methods are used in psychoanalysis?

Psychoanalysts use many methods to help analysands to become more self-aware. These include: regular and frequent appointments – 4 or 5 times a week – over a significant period of time, creating a safe and confidential atmosphere, asking the person to talk about their life: the “there and then”, the “here and now” and their hopes and fears about the future, “free association”, dreams, “flash thoughts”, day dreams, fantasies and the couch. Let’s address each in turn.

Frequent, psychoanalytic, appointments four or five times a week over a period of several years

Typically, people come to psychoanalysis to deal with difficulties that have troubled them for many years. For some previous therapy did not allow them to fully resolve their difficulties. Others have never had treatment. However, they intuitively recognize that a more intensive approach is warranted in order to overcome their difficulties.

For example, they may struggle with long-standing difficulties, such as:

  • expressing their feelings
  • asserting themselves
  • making commitments
  • establishing and maintaining intimate relationships
  • developing satisfying relationships with family
  • relating to bosses and coworkers
  • feeling anxious or inhibited
  • feeling depressed
  • selecting friends or lovers who are consistently unreliable or disappointing
  • completing or excelling in school or college
  • writer’s block
  • despite success, feeling like an imposter
  • being so eager to please those in authority that they don’t know who they really are or what they really want
  • identifying and pursuing their work-life goals
  • not getting what they want out of life.

Since the origins of these troubles may be largely outside of their conscious awareness. Consequently, they need help getting to know themselves more fully. To heighten awareness of one’s inner feelings and motivations, analysands come several times a week.

Sometimes the recommendation for psychoanalysis surprises people

Often, successful people who are struggling with a knotty and persistent difficulty are surprised at the recommendation for psychoanalysis. In particular, they find the frequency, the time and the cost daunting. Beyond this, at some level, they may be afraid of the intensity of the treatment. They may fear that the recommendation for multiple sessions per weeks reflects the depth of their pathology.

However, the reality is that this is not the case. Rather, the frequency of sessions is vital to helping a person to truly know themselves. It provides a continuity that allows for self-reflection, exploration and revelation. Unlike a less frequent therapy in which the person talks about their day-to-day challenges, meeting daily allows the individual to make connections between their early experiences, their current behavior, how they relate to others, including importantly, their psychoanalyst. Most analysands find that the frequent meetings intensifies the process, leads to greater openness, and a more comprehensive understanding of themselves.

Creating a confidential and safe atmosphere

A confidential atmosphere allows patients or analysands to begin to speak openly. Except for in a few limited circumstances (which your psychoanalyst can discuss with you prior to embarking on a psychoanalytic journey), your psychoanalyst is legally bound not to divulge your confidences. That is, your communication with your psychoanalyst is completely private. This level of privacy allows you to become aware of, think about and talk about, things that you may have suppressed or denied in the past.

Reclining on a Couch

To promote a focus inward, people recline on a couch, with their psychoanalyst sitting behind them. Often, this helps the analysand to be less preoccupied with what their psychoanalyst is thinking. Also, it may allow them to be more able to look inward and explore their own thoughts. Similarly, it allows both analysand and analyst to reflect, more deeply, on the analysand’s thoughts and associations. Initially, lying on a couch in a psychoanalyst’s office seems unfamiliar. However, with time, most individuals find it helpful in that it allows them to focus on their inner world.

Analysands are helped to share their life story and to think about and talk about their fears and struggles – and, as importantly, the successes, triumphs and satisfactions in their lives. In short, your psychoanalyst will want to know as much as she can about you: all of it, the good, the bad and the ugly. And she will work with you to create a nonjudgmental atmosphere in which you both can speak openly.

Free Association

Typically, things outside of our conscious awareness interfere with the achievement of our goals. The task in psychoanalysis is to help people to become aware of their unconscious anxieties, fears, sadness and obstacles to their efforts toward to self-awareness and self-satisfaction. For this reason, the aim is to access the unconscious. Toward this end, analysands are asked to “free associate”. That is, to say what comes to mind, without censoring. This is unlike everyday talking where, as a matter of tact, one edits one’s thoughts. In psychoanalysis, we ask the individual to report their thoughts without fear of reprisal or regard to the listener.

Of course, this is easier said than done and it takes practice. However, although it may be daunting at the beginning, as you become more comfortable you will become more proficient at “free association”.

Reporting Dreams, Day Dreams, “Flash” thoughts, Fantasies & Slips of the Tongue

Like free associations, dreams, day dreams, ‘flash thoughts’ and fantasies are other ways to access feelings and thoughts that are outside of our conscious awareness. Therefore, individuals in psychoanalysis are asked to report them. Also, both analysand and psychoanalyst attend to the meaning of “slips of the tongue” and to the individual’s demeanor. Notably, Freud characterized dreams as, “the royal road to the unconscious”. Often, conflicts outside of our awareness drive us. The goal of analysis is to make the unconscious conscious. Psychoanalysis attempts to gain a window into the individual’s unconscious. Saying what comes to mind, reporting dreams, describing fantasies and avoiding censorship allows both analyst and analysand to become increasingly aware of the individual’s unconscious fantasies and beliefs. As unconscious fantasies and beliefs become more explicit, or conscious, change occurs.

What if you like this approach but feel that your difficulties warrant a less intensive method?

If you are interested in a psychoanalytic approach but feel that your concerns warrant a less intensive approach, consider seeking a consultation with a psychoanalyst. A careful psychoanalytic assessment will help you to clarify whether analysis is warranted or whether your difficulties might yield to a once, twice or three times a week (insight-oriented) psychoanalytic (aka psychodynamic) psychotherapy. Most psychoanalysts provide psychodynamic psychotherapy as well as analysis. Typically, they are highly proficient at both. So, they are in an ideal position to provide a consultation and make a recommendation to you.

There is a robust, vibrant, psychoanalytic community, here. There are many psychoanalysts in Washington DC.

Seeking a psychoanalyst in Washington DC?

People often ask if I can help them to evaluate whether psychoanalysis or psychodynamic therapy would be helpful to them. As a psychoanalyst in Washington DC, expertise and I welcome these requests. Learn more about what happens when you call for psychotherapy or psychoanalysis.

I am not seeking a psychoanalyst in Washington DC, how can I find a psychoanalyst another locale?

Sometimes people recognize that psychoanalysis is a long-term process. They know that their difficulties require the thorough-going approach that psychoanalysis offers. Yet, they are planning to relocate within the next several months. When this is the case, it’s optimal to find a psychoanalyst in their new locale. Here’s a list of psychoanalytic institutes outside of Washington, DC.

I'm interested in exploring a consultation with you, what's my next step?

I provide psychotherapy, psychoanalysis, clinical consultation, supervision & executive coaching. If you are seeking consultation from a psychologist, psychoanalyst, in DC, feel free to call me: 240.483.3530.