Psychoanalysis is a talking therapy, arguably the most in-depth talking therapy, and it engages with the unconscious parts of ourselves that lie at the root of the psychic pain and internal conflicts that we experience as human beings.
Within regular and frequent sessions, the patient is invited to say whatever comes to their mind without restriction and, with the help of the analyst’s interventions, new understanding of the patient’s internal world gradually begins to emerge. The patient’s feelings, thoughts, memories, fantasies and dreams are explored within analysis, in order to help the individual work through and resolve present and past emotional difficulties.
As the analysis progresses, the exploration increasingly centres on how the patient's internal world and emotional life is experienced, often in relation to the analyst. Things which might normally go unnoticed, or are pushed aside or avoided, become the focus of the joint exploration. This process of exploring and working through the various unconscious patterns which emerge in the analysis, helps the patient to become capable of recognizing and containing the thought processes which habitually stir up their conflicts.
Recognising, understanding and resolving these familiar conflicts frees the patient’s mind from old inhibitions and make room for new, more adaptive, choices. This is what the analyst Hans Loewald meant when he said that through analysis “ghosts of the unconscious are laid and led to rest as ancestors.”
The setting and structure of treatment
Each session lasts for 50 minutes, and in psychoanalysis the sessions take place frequently, three or four days a week. Meeting regularly and frequently is designed to facilitate a process of supportive exploration, understanding and containment of the emotional experience.
Psychoanalysis recognises that the process of in-depth personal change takes time to occur and cannot be hurried. So, while a time-frame for completing an analysis is hard to predict, it is better to think in terms of years rather than months.
Evidence base
There are now a significant number of well-designed studies and random control trials (e.g., Leichsenring, F. and Klein, S., 2014; Shedler, J., 2010; Tavistock Adult Depression Study, 2015) which demonstrate the efficacy of the psychoanalytic approach. These studies show that psychoanalytic therapy yields good change outcomes which typically increase at long-term follow up, suggesting that patients who receive psychoanalytic treatment experience continuing psychological benefits long after therapy has ended.
