Frequently asked questions about Psychotherapy

  1. What is psychoanalytic psychotherapy?
  2. What sorts of people go to psychoanalytic psychotherapy?
  3. How does psychoanalytic psychotherapy help?
  4. How much time does it take?
  5. Is psychoanalytic psychotherapy the same as counselling?
  6. Is it the same as going to a psychiatrist?
  7. How much does it cost?
  8. What is its history?

What is psychoanalytic psychotherapy?

Psychoanalytic psychotherapy is a process that takes place in a relationship between psychotherapist and client, working in depth together to explore the client's distress. It is based on the understanding that memories and feelings that were too painful for the person to bear in the past were repressed into the unconscious where they continue to exert a powerful but hidden influence on the person's current life. One of the ways we become aware of this phenomenon in our lives is when, to our dismay, we discover that we have been repeating over and over again patterns of relationships or life choices that we belatedly recognize were destined to bring us pain. In therapy, the client is enabled to access and understand these hidden influences, and thus hopefully do something about this repetition.

In practice, psychoanalytic psychotherapy takes the form of the client talking, encouraged by the psychotherapist to say whatever comes to mind. As this happens, the client becomes more able to acknowledge and express feelings and ideas that have been deeply buried. Psychoanalytic psychotherapy enables the client to recover parts of themselves and experiences that have become split-off from conscious awareness. As these split-off parts of the self are available for experiencing and reflection, they can be re-integrated. New levels of insight into one's way of being and functioning in the world develop and over time a new structure or meaning can emerge out of the joint task that is the therapy.

The therapeutic environment leads to the development of a particular relationship with the psychotherapist. Feelings that have their origins in the closest relationships of the client's past are reawakened and become vividly alive in the present. These feelings then become available for working through to a better resolution this time around.

Dreams are important in this form of therapy. It was Sigmund Freud, the founder of psychoanalysis, who spoke of dreams as the 'royal road to the unconscious'. Dreams and what they bring to mind often reveal forgotten or disowned experiences in unexpected ways. Freud, his contemporary Jung, and many psychoanalytic writers since then have delved deep into the world of the dream and provided ways of understanding what might be happening in the 'mysterious theatre of the mind'.

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What sorts of people go to psychoanalytic psychotherapy?

Many people who suffer from lack of confidence, from anxiety states or panic attacks, sadness or depression, obsessions, compulsive behaviour such as eating disorders, repeated problematic relationships or personal difficulties can be helped by psychoanalytic psychotherapy.

A person sometimes looks for this type of therapy if he or she feels life has lost meaning or is deeply unsatisfactory in some way. Or perhaps they are experiencing emotional distress within themselves or in their relationships.

An individual who has had some kind of breakdown may also be helped. He or she may feel that they have a problem but not be able to name exactly what is wrong. Or someone may know what the problem is but feel unable to resolve it.

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How does psychoanalytic psychotherapy help?

The psychotherapist provides a reliable and safe space where clients can explore both their immediate problems and whatever anxieties and difficulties underpin them.

This exploration leads to a greater degree of understanding of oneself and of one's way of being in the world. The insight thus gained is not simply an intellectual knowledge but grows out a fuller connection with emotions, and is in this way an 'emotional knowing'.

With the gaining of this knowledge, possibilities for change open up. The processing of feelings means that energy that has formerly been used to manage disturbing feelings is released for other purposes. Life may then be lived more creatively.

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How much time does it take?

The psychotherapist and the client usually meet once or twice a week. The sessions are normally fifty minutes, though this varies according to the particular training of the therapist.

The length of time the therapy will last depends on many factors. Because this form of therapy helps individuals to come to know themselves at a deeper level, to understand unconscious processes affecting their feelings and behaviour, it is a longer-term therapy. But differences are felt and changes are achieved along the way as the therapy proceeds.

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Is psychoanalytic psychotherapy the same as counselling?

There are similarities in that counsellors also work with individuals who are in emotional distress. However, counsellors usually focus on current problems and work with a client over a shorter time scale. Psychoanalytic psychotherapy gives an individual the opportunity to go beyond their current difficulties allowing connections of these difficulties with past experiences. Therefore the time period for psychotherapy is longer.

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Is it the same as going to a psychiatrist?

No. A psychiatrist is a medical doctor who has done additional training in psychiatry. However, some psychiatrists are also psychoanalytic psychotherapists. Generally a person visits a psychiatrist as an outpatient once a month or once every six weeks. Usually the doctor and patient meet for 10-15 minutes. The psychiatrist may prescribe medication.

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How much does it cost?

A fee is arranged between the therapist and client. Some therapists may operate a sliding scale of costs and the fee may be negotiated between the therapist and the client

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What is its history?

Psychoanalytic psychotherapy has its basis in psychoanalysis and uses the same working concepts. Sigmund Freud was the founder of psychoanalysis, soon followed by Carl Jung.

Other major thinkers and practitioners in the field have been Melanie Klein, Donald Winnicott, John Bowlby, Wilfred Bion, Jacques Lacan and Anna Freud.

More recent writers include Thomas Ogden, Janine Chasseguet-Smirgel, John Klauber, Ron Britton and Adam Phillips.

Further sources on information concerning psychoanalytic psychotherapy may be found, in summary form, on the Psychoanalytic Electronic Publishing (PEP) web site.

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