Image: Sigmund Freud’s famous couch at the Freud Museum, London

Psychoanalysis

Famously referred to as “the talking cure,” psychoanalysis employs speech as a means of working through the problems that cause us suffering in life. In psychoanalytic work, the analyst invites the patient (or ‘analysand’ in psychoanalytic terms) to speak, to put their experience into words—in all its complexity and ambiguity—so that they might begin to hear themselves in a new way.

Within a psychoanalytic framework, the symptomatic forms of suffering we experience are seen as meaningful and significant, the product of our particular personal history and experience. And it is by exploring them and the conflicts that give rise to them, that we can move beyond the anguish they cause us and gain a new understanding of ourselves and what we want in life.

The Unconscious

Central to psychoanalysis is the idea that unconscious factors outside our conscious awareness influence our thoughts, feelings, and actions. The unconscious contains repressed thoughts, experiences, and desires that, due to their traumatic or ego-dystonic nature, have been pushed out of consciousness yet continue to influence us, shaping how we think, feel, and act in profound ways.

Symptoms

In psychoanalysis, symptoms such as anxiety, depression, phobias, and otherwise are seen to be the result of mental conflict where an unconscious desire is partially expressed while being defended against by the conscious mind, creating a compromise between the two opposing forces. In such a way, symptoms are understood to be representative of underlying psychic conflicts. Psychoanalytic work does not aim for immediate symptom relief; instead, it seeks to explore the symptoms and the associations that they give rise to so that we can discover and work through the more conflicts that underlie them – a process that, in turn, often resolves the presenting symptom.

The Psychoanalytic Work

In the psychoanalytic session, we seek to allow the unconscious to speak and be heard. The analysand is invited to “say whatever comes to mind,” no matter how unacceptable, irrelevant, or nonsensical it may seem. In turn, the analyst lends a listening ear, paying close attention to the analysand’s speech, curiously asking questions, emphasizing keywords and phrases, and offering interpretations. This process of “free association” and “open and attentive listening” is the foundation of psychoanalytic work.

Over the course of one’s analysis, the analyst and the analysand work together in dialogue to explore and interpret the analysand’s experience while always listening for how the unconscious expresses itself. By allowing the unconscious to speak and be heard in this way, the analysand arrives at new knowledge about themselves and their experience that was not previously accessible to them, creating the possibility for new ways of being in the world beyond the forms of suffering that mark their current existence.