What is a psychoanalytic treatment?

Psychoanalysis and psychotherapy are therapies in which a patient and therapist meet one to multiple times a week in order to help the patient relate better, understand themselves better and feel more satisfied in life. Psychoanalysis was birthed in the 1890’s. The talking cure was counter-cultural then and continues to be so today. Here are two hallmarks of the psychotherapeutic experience.


1. It holds the balance between the medical model and the humanistic model

Our current mental health culture is a skewed too far to the side of the medical model. Meaning, it reduces mental health to science alone (i.e. we have a brain but no mind or heart). Mental health is more the just the sum of its parts. Helping people get better requires science, yes, absolutely. Evidenced based research and neuroscience greatly informs any clinician who takes their job seriously. That said, helping people get better also requires art. Being with people in a way that feels healing, that feels human and not just like the zeros and ones of care requires an art form of “being with”. Psychoanalysis and psychotherapy holds the dialectic between science and art form more than any other theory I know. Today probably the most common way of doing supportive psychotherapy is through utilizing attachment theory. Many who do this do not readily recognize or identify with being psychoanalytic but guess what? Attachment theory came from a psychoanalyst (John Bowlby was a card carrying member of the London Psychoanalytic Society to the day he died)! In psychotherapy there is a balance; science informs the frame within which we work but the humanities (art, music, film, comedy, poetry, dance, theology, philosophy, drama, rhetoric, etc.) inform us about what it means to be human and how to be human with others.


2. It Doesn’t Take Short Cuts 

Psychoanalysis and psychotherapy takes time (ancedotely the average treatment ranges from a few months to several years). Yes, it is expensive. Absolutely. It requires a lot of time and money. Yet, I cannot think of many other things in life more worth the investment*. Psychoanalysis and psychotherapy do not rush the human process. They don’t storm the gates to expose the Crown Jewels in three sessions. Especially Self Psychology (see previous post for more on self paychology) in which the goal is not to focus on the defenses someone has or the pathology but rather to create a relationship in which the health can flourish and take over for the pathology. We focus on healthy tendrils of normal developmental desires that got thwarted early on are focused on. This means that the self psychological psychoanalytic relationship encourages the fragile parts of the self that are still waiting to be understood and welcomed and supported so they can strengthen and take root. That takes time and it’s why I often compare my practice to a greenhouse. It’s an analog to relationships in life that we needed to have in order to develop fully. Development takes time but nothing else could take it’s place. Talk to someone who has gone through the process and they will tell you, the riches of self you gain through a psychotherapy or analysis make life better, fuller and more alive. It’s definitely a teaching someone to fish model over giving them a fish for dinner and then sending them on their way with the recipe.


*I acknowledge the tension between privilege and being able to appreciate these counter cultural reasons enough to undergo a psychoanalytic treatment. This is a troubling tension that each clinician does their best to address in their own way.