It’s a pretty hard word, psychoanalysis, a bit longish, quite dated, isn’t it?
Well, let’s get back to the basics. As you probably know, the method was invented by Freud over a century ago.
The purpose was and still is to explore one’s unconscious in order to bring to light the core reasons of one’s suffering and mis-functioning –nothing outdated here.
Let me walk you through a session.
According to Freud’s experience – according to the following generations of therapists’ experience, including mine – that exploration is done best when the conscious ego agrees to step aside if only for a short while, giving us a chance to talk without rhyme or reason, to ramble, perchance to dream. Lying down on a couch helps to relax. Most people appreciate the opportunity to let-go and access to memories, to step back in time, sometimes even to regress into childhood, not just through words but as well through vivid images and strong emotions they can feel in their body. All of this can happen, and some people are not comfortable with that setting or even frightened by the prospect of meeting head on with a past trauma they’d rather put aside. When you feel you’ve been abandoned as a child, being able to look you therapist into their eyes, visually checking their presence can be reassuring and supportive in a very constructive way. In that case, it’s better the patient and the therapist sit face to face.
Anyway, face to face is how we start in my practice, until the patient feels confident enough to lie down, when we both feel the time has come (whether it’ll take just a couple of sessions or longer, it’s hard to tell).
As a therapist, I adjust to the situation : the patient on the couch, or sitting face to face with the therapist, or in-between the patient lying down on the coach, but me sitting not behind but across, allowing the patient to look at the therapist when needed.
Some patients close their eyes lying down on the couch, and plunge within themselves, which is hard to do when you sit face to face. Occasionally, the therapist too may close his eyes (not because he’s falling asleep, although nobody’s perfect!) but to follow the mental images that arise at what the patient is saying.
At some point, the therapist may unveil to the patient something that’s there with all its potent strength but without the patient ever noticing. On a very basic level psychoanalysis is about giving the patient that chance to hear, visualize or even feel some unconscious scenario, the therapist acting as the patient’s eyes, ears, body, to reveal the patient’s unconscious motives. This can happen through an odd word, a variation in tone, the enigma of a dream, the sudden burst of an emotion, a pattern of repetitive failures. This opening to an inner truth can occur in a split second and the patient may not be able yet to acknowledge it, therefore the process takes time.
It takes time not just because of resistance on behalf of the patient, but because the process itself, the path to oneself, matters us much as the goal.
It’s not, or not just, a matter of “unlocking the past”. In the case of a repressed trauma, that work certainly is necessary but it doesn’t stop there. There is the trauma, no doubt, but there also is the way that trauma has been processed by the patient’s mind.
From there on, the goal is no less than helping the patient access to their desire – not an easy word to handle, for it carries a strong sexual innuendo, whereas desire engulfs one not just in that limited sexual meaning but as a whole, in a relationship both to oneself and to others.
In a way, one could say the patient becomes the analysand : from someone “in suffering” (the very etymology of the word patient) to someone active upon their suffering, with the help of the analyst.