The Psychoanalytic psychotherapy Is based on an increased understanding of our inner world aimed at solving our emotional problems.
Its roots are found predominantly in the psychoanalytic approach of Freud , But other authors such as Carl Jung And Melanie Klein also focused on expanding and developing the concept and application of these therapies.
In therapy, the patient's world is explored and the patient is able to make sense of their situation, feelings, beliefs, behaviors and memories. The purpose of this is to increase understanding of how to relate to yourself and to other people.
This therapy is related and uses as a basis the concepts of the Topographic model On the mind developed by Freud. The Austrian neurologist saw the human psyche structured in three parts:
- The it , Which is the primitive and instinctive component of personality.
- The I , Which is the part of the id modified by the influence of the external world and works rationally
- The superyo , Which incorporates the values and morals of society to control the impulses of the id.
Psychoanalytic therapy also uses the concept of"unconscious", the level of consciousness that, according to Freud , Comprises mental processes inaccessible to consciousness but which influence the judgments, feelings and behaviors of people.
What kind of people can benefit from it?
Although originally conceived, it aimed to help people with neurosis , Psychoanalytic therapy is not limited to people with mental health problems; Many people who experience a loss of meaning in their lives or who are seeking fulfillment can also benefit from this type of therapy.
This therapy provides effective treatment for a wide variety of psychological disorders, as a treatment for itself and as adjunctive treatment for other types of therapy.
Sometimes people seek help for specific reasons such as eating disorder, psychosomatic conditions, obsessive behavior or phobias. Other times help is sought because of more general feelings of depression , anxiety , Difficulty concentrating , Job dissatisfaction or inability to form satisfactory relationships.
Psychoanalytic therapy can benefit both adults and children and adolescents. It can help children who have obvious behavioral difficulties at home or at school. This includes personality problems, learning , to Bedtime ...
How does psychoanalytic therapy work?
The relationship with the therapist is a crucial element in psychoanalytic psychotherapy. The therapist offers a private and safe environment that facilitates the process of therapy through the following techniques:
Free association
Psychoanalytic therapy, unlike other modalities, is a poorly structured approach. The therapist, in this case, invites the patient not to have to plan what he is going to say.
The Free association Encourages the patient to say what is going through the mind regardless of whether it is related to what was discussed in the session last week or a few minutes ago.
The underlying theory asserts that only when the patient does not feel the need to produce coherent and purposeful communications will he be able to allow unconscious meanings to emerge through their spontaneous associations.
Interpretation
Traditionally, psychoanalysis has been associated with the notion of"interpretation". Interpretation was originally defined as"bringing the unconscious into consciousness." The main function of the therapist in Freud's time was to interpret, that is, to translate the unconscious meanings of the patient's conscious associations.
At present, interpretation is also defined as those interventions related to interpersonal issues.
Transfer
Therapeutic transfer refers to the redirection of feelings that the patient feels for a significant person in their life towards the therapist. The transfer is a projection of feelings And attitudes towards the therapist that emerges through the psychoanalytic dialogue that is maintained during the sessions.
The transference can be positive, when positive feelings are moved towards the therapist, or negative, when the projected feelings are of hostility.
Contemporary models emphasize the"here and now", referring to an exploration of the patient's current relationships including, and prioritizing, the relationship with the therapist, understood as an update of the internal relational models.
Interpretations, therefore, emphasize the process of interaction between the patient and the therapist (a transference interpretation), leading to connections to other relationships in the patient's life.
Countertransference
It refers to the set of conscious or unconscious attitudes and affective reactions that the therapist forms towards his patient throughout the therapy.
It is necessary that the psychotherapist takes into account their limitations, complexes and resistances before starting a therapy, so that it does not negatively influence this one.
goals
In general terms, psychoanalytic therapy differs from other types of therapy because it has the purpose of making permanent changes in the personality and in the Emotional development .
This therapy helps alleviate distress by understanding and changing the emotional and relational problems of the person, rooted in the unconscious. These problems are solved by helping the individual to experience and understand the feelings that they entail.
The goals of psychoanalytic therapy have evolved over time. At first, they were formulated in general metapsychological terms; "Making the unconscious conscious"was the central purpose of Freud's topographical model.
According to its subsequent structural model of the mind, the treatment had the purpose of strengthening the position of the ego within the structure of the personality, promoting its autonomy and improving the Impulse control Instinctive.
"Psychoanalysis does not come to make pathological reactions impossible, but to give the patient's self sufficient freedom to decide one way or another"(Freud, 1923)
Surely the most significant change in therapy goals since Freud's time is that many less psychotherapists nowadays consider that the recovery of repressed memories is the primary goal of analytic work.
Instead, the purpose of therapy is more related to an enrichment of the capacity for self-reflection. Self-reflection refers to the ability of the mind to understand one's own behavior and behavior in terms of mental states (thoughts, feelings, motivations, intentions).
What are the differences between psychoanalysis and psychoanalytic psychotherapy?
Psychoanalysis, as originally conceived by Freud, was a treatment method restricted to a very specific patient population.
Freud argued that psychoanalysis could only help those patients with neurotic problems who could develop a transference relationship who were motivated, educated and were not currently in a crisis.
Freud was not an optimistic therapist. According to him, the best psychoanalysis could hope for was to change neurotic misery by"common sadness,"and maintained that man's happiness had never been included in the plan of Creation, so he did not consider it as one of the Objectives of psychoanalytic treatment.
According to these norms, psychoanalysis would not have had much to offer those patients who are now referred to psychological help in public health services.
As Freud conceived it (and as some psychoanalysts even now think), the psychoanalysis Should be restricted to those patients who were sick enough to require extensive work but were healthy enough to use this type of therapy.
In other words, patients who were anguished but who retained strength in the self to face the challenges and frustrations of classical analytical mechanics.
The differences between psychoanalysis and its descendants, such as psychoanalytic psychotherapy, raise interesting questions. From the outset, it was clear that although psychoanalytic therapy shared its theoretical origins with psychoanalysis and used the same techniques and therefore was a legitimate descendant, it was not one of the most favored.
Many saw it as a weakening of the classical approach, arguing that it produced a much more superficial change. With the rise of psychoanalytic therapy, psychoanalysis, as Freud predicted, was in danger.
Conventionally, the difference between psychoanalysis and psychoanalytic therapy is conceptualized, partly pragmatically, in terms of the frequency of sessions. Psychoanalysis speaks of at least four or five weekly sessions, while psychoanalytic therapy refers to a maximum of three sessions a week.
Psychoanalysis is also often characterized by the absence of specific objectives, with the aim of a significant change in the personality , While psychoanalytic therapy is described as a type of therapy more focused on more specific goals, such as modifying the behavior and structure of character.
In fact, the objectives of both approaches do not differ significantly; There are hardly any differences in the techniques used or in the theories on which they are based. Both approaches are centered on the interpretation of transference, although in some shorter and less intense psychoanalytic therapies only some aspects of the transference are interpreted.
Criticism, empirical evidence and current state
Psychoanalysis and psychoanalytic therapy have created much controversy throughout history and have received numerous criticisms.
Although the main ones have to do with the lack of empirical research, psychoanalysis has been criticized for other reasons.
Some criticisms of classical psychoanalysis have to do with the duration of therapies, which made the resolution of emotional problems too costly and long, and with the essentially conflicting nature of the unconscious.
Psychoanalytic theory also holds that certain psychic processes occur in the way they occur due to a fixed biological determinant and justify certain ideologies and values based on a supposed biological origin.
These assumptions leave aside the importance of culture in the development of people, which greatly influences the attitudes, values and thoughts of each.
It should be borne in mind that the time in which Freud established his theories is very different from the present one, so there are few that are not obsolete. Freud lived in an age in which sexuality was very repressed; Hence their theories are so closely related to sex.
Historically, the psychoanalytic community has not got along very well with empirical research. Freud had a position of rejection to the empirical investigation under the argument of opposing to establish laws in name to the particularity of the individuals.
Thus, psychoanalysis has sometimes been called pseudoscience because of the lack of scientific rigor that demonstrated that theories and therapies were effective. Cognitive psychology, Evolutionary psychology , the neurobiology and the psychiatry Have criticized psychoanalysis for relying on obsolete theories and hypotheses that lack empirical proof.
In the last two decades there has been an increase in the number of investigations related to psychoanalytic psychotherapy and its effectiveness. At present, it can be safely affirmed that the empirical evidence about this therapy is strong and credible. Psychoanalytic psychotherapy has been shown to be effective in treating a wide range of mental health conditions and disorders.
The evidence Studies and reviews Indicate that the benefits of psychoanalytic treatment are not transient: they last in time and even after remission of symptoms.
For many people, these therapies promote the development of internal resources and capabilities that enable them to live richer, free, and satisfying lives. In 2009, the American Psychological Association (APA) recognized the effectiveness of therapies based on psychoanalysis because of strong empirical evidence.
It has been suggested that the effectiveness of the therapy is more related to the quality of the therapist than to the technique used or the training that has been obtained.
References
- Lemma, A. (2003). Introduction to the practice of psychoanalytic psychotherapy. Chichester: John Wiley & Sons.