Generally speaking, psychoanalysis tries to understand: to understand the
underlying mental processes, such as: Why do I fear? Why am I obsessed with
certain things/ideas/images? Why do I keep seeking certain types of
relationships? Why can I not quit smoking?
It tries to put words where there are only symptoms, making
conscious what is not, finding meaning.
At first the analyst has several preliminary interviews
with the patient, normally between three and five sessions; with the
information the analyst gathers, he will make a diagnosis and offer a specific
treatment plan.
Within psychoanalysis there are several ways of working
depending on the patient, their disorder and their underlying personality
structure. On one hand, there is the so-called psychoanalytic psychotherapy,
which is held face-to-face once or twice a week. On the other hand, we have
psychoanalysis itself. Here, the patient lies on the couch and sessions are
held three to four times a week. Often the idea of lying on the couch scares
patients, so working face-to-face would be the initial phase. When the patient’s
confidence in the therapist increases, it may be possible to change from a
psychoanalytic psychotherapy to psychoanalysis. Lying on the couch, with the
therapist sitting behind the patient, provides the patient with more freedom to
talk without having to take into account the facial expression of the analyst.
They can more easily associate and are able to remember things long forgotten,
which in turn, provides more access to their own personal history.
The basic rule of psychoanalysis is that the patient has
to say everything that goes through their mind, even though it seems that it is
not important, embarrassing or unpleasant. They can talk about anything they
want: about the past, present, future, fantasies, anecdotes, etc. Everything
the patient says is important for the analyst, who maintains an “unconscious listening”,
called floating attention. Psychoanalysis offers patients a different kind of
listening; a bias-free listening, a listening that allows the therapist to hear
the different levels in the patient's discourse, beyond their symptoms.
In the healing process, the psychoanalyst will be guiding
the patient, questioning him, pointing out contradictions, lapses and interpreting
them. The psychoanalyst tells the
patient what is unknown to them, but what the patient has transmitted through
lapses, dreams, fantasies, etc., revealing their unconscious. This way the
patient feels relieved from the burden within them.
A crucial issue in psychoanalysis is the relationship that
develops between therapist and patient, called transference. Through the
continuity of the sessions, the patient unconsciously recreates past and
current relational aspects and their issues. These aspects will be collected by
the therapist, who will provide the patient with a new relational experience.
These new experiences are what lead to changes in the patient. Therefore, psychoanalysis
is not exclusively a "talking cure."
