Psychoanalysis

The method of psychoanalysis has developed in breadth and complexity since its Freudian introduction in 1895. These revisions make an enormous difference in the understandings they generate of what people are most fundamentally about. At the centerpiece of human experience is our relationships.

The therapy situation is conceived of as a medium through which mental processes inside the patient can become apparent. Conflicts and inhibitions in living are essentially all derived in various ways from childhood attachments and fantasies. All the content that arises in the therapeutic relationship is generated from the mind of the patient, displaced from the patient’s past.

In this traditional model, the therapy process operates as a kind of time machine, taking the patient back, experientially in the transference, to childhood struggles. The therapist is like the operator of the control panel. Her only significant input is conducting the procedure properly; it does not matter who she herself is, or what she is like.

Psychoanalytic technique, when practiced with sophistication and skill, does not just involve the patient and therapist talking about the past. If revisited exclusively through discussion, the patient’s experience of the past may have an intellectual quality, with issues remaining abstract and not deeply felt or relived.

 

The most central of our earliest problems resurface not in discussion but disguised in the therapeutic relationship. Patients displace forbidden urges, thoughts, feelings onto the person of the therapist. By coloring her in a distant light, patients experience and work through issues as lived and deeply felt realities rather than intellectual abstractions and memories.

People acquire their preferred forms of relating to others from early experiences. So, they are likely to approach the therapist with assumptions based on past relationships, and to weave what they observe about the therapist into their habitual forms of interacting. Thus, the patient’s experience of the therapist is likely to be based on the patient’s own past and his typical ongoing understanding of experience. In other words, the patient lives in the present according to strategies learned from the past.

Rather than regarding the therapy setting as a theater for playing out the past in the present, this interactional approach positions the patient as firmly engaged in the present, using what he has learned from the past. This subtle distinction regards the patient as more actively involved in the present.

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