When people search for a psychoanalyst, they may already have some idea of what psychoanalysis is. Perhaps they have read Freud or Lacan, heard about the unconscious, or simply feel that conventional ways of understanding their difficulties have not quite answered the questions they are asking.
But what does a psychoanalyst actually do?
And what is psychoanalytic therapy?
These questions are worth exploring because psychoanalysis is not simply a technique for treating a particular set of symptoms. It is a particular way of listening to and thinking about human experience. At its centre is the idea that we are not always fully transparent to ourselves. What we consciously intend, say or believe does not necessarily account for everything that happens in our lives. Sometimes something else seems to be at work.
A pattern repeats, a relationship becomes difficult in a familiar way, a particular feeling returns. Then, We find ourselves wanting something and, at the same time, doing something that seems to move us away from it. Psychoanalysis takes these contradictions seriously.
What does a psychoanalyst do?
A psychoanalyst works with people who want to explore the deeper questions underlying their difficulties. This might involve anxiety, relationship difficulties, dissatisfaction, recurring patterns, questions about identity, feelings of emptiness, self-doubt, or experiences that seem difficult to understand despite considerable reflection.
Psychoanalysis does not assume that there is always a straightforward explanation for these experiences. Instead, the work begins with listening.
What does a person say?
What keeps returning?
What seems to happen despite their conscious intentions?
What do they desire?
What do they avoid?
What are they finding difficult to say?
The unconscious is therefore not treated simply as a hidden collection of memories. In psychoanalytic thinking, it can be encountered through the ways we speak, the things we repeat, contradictions in what we say, slips of the tongue, dreams, fantasies and the particular ways in which we relate to other people. The aim is not simply to uncover a hidden answer once and for all. Psychoanalytic work creates a space in which these questions can be explored.
What is psychoanalysis?
Psychoanalysis began with the work of Sigmund Freud and has developed considerably since then. One of its fundamental ideas is that we are not completely transparent to ourselves.
We can consciously want one thing while repeatedly finding ourselves drawn towards something else. We can understand intellectually that a particular situation is not good for us and still find ourselves returning to it. We can know that a relationship pattern is familiar and yet struggle to understand why it continues to have such a powerful hold on us. Psychoanalysis takes these contradictions seriously. Rather than immediately trying to eliminate them, it asks what they might reveal.
Contemporary psychoanalytic traditions have developed in different directions. Some remain closely connected to Freud, while others have developed through the work of thinkers such as Jacques Lacan, whose approach placed particular emphasis on language, desire, the unconscious and the relationship between the subject and the Other.
What is psychoanalytic therapy?
Psychoanalytic therapy draws on psychoanalytic ideas and ways of listening what is taking place within a psychotherapy or counselling setting. The precise form of treatment can vary between practitioners and psychoanalytic traditions. For some people, psychoanalytic therapy can be particularly meaningful when they feel that they have already tried to understand their difficulties but continue to encounter the same questions. For example:
- Why do I keep repeating the same relationship patterns?
- Why do I become anxious when someone becomes distant?
- Why do I lose interest when someone becomes available?
- Why do I keep questioning whether I am enough?
- Why do I know what I want but find myself doing something else?
- Why do certain experiences continue to affect me long after they have ended?
- Why do I feel dissatisfied even when things seem to be going well?
These are not necessarily questions that can be answered through advice. They may require a different kind of conversation.
Is psychoanalytic therapy only for severe psychological problems?
No.
Psychoanalytic work is not limited to people experiencing a particular diagnosis. Someone might seek psychoanalytic therapy because they are experiencing anxiety or depression. Someone else might come because of difficulties in a relationship, dissatisfaction with their life, questions about identity or a sense that they are repeatedly encountering the same difficulties.
Sometimes there is no clearly defined problem at all. A person may simply have the feeling that something is not quite right. They may be functioning well externally while experiencing an internal sense of conflict, dissatisfaction or uncertainty. This can also be a reason to seek therapy.
The question does not always have to be “What is wrong with me?” It can be:
“Why am I experiencing my life in this particular way?”
What happens during psychoanalytic therapy?
There is no single script for a psychoanalytic session. You may talk about what has happened during the week. You may speak about a relationship, a conflict, something that has been troubling you, a recurring thought or something that has recently happened.
You may also notice that certain subjects repeatedly return to the conversation. The therapist listens not only to the content of what is being said but also to how it is being said and to what emerges through the conversation.
The relationship between therapist and client can also become important. For example, you may find yourself feeling misunderstood, disappointed, particularly eager to please, reluctant to speak about something, or uncertain about what the therapist thinks of you. These experiences are not necessarily interruptions to therapy. They can become part of the material that is explored.
Do I have to lie on a couch?
Probably one of the most familiar images of psychoanalysis is the patient lying on a couch while the analyst sits behind them. This image comes from the history of classical psychoanalysis, but it does not describe every form of contemporary psychoanalytic therapy.
Many psychoanalytic practitioners work face-to-face with clients. The physical arrangement is not what makes a therapy psychoanalytic. What matters more is the way the practitioner listens and the theoretical orientation informing the work.
Psychoanalysis and the unconscious
Perhaps the most distinctive feature of psychoanalysis is its interest in the unconscious. The unconscious does not simply mean everything that we have forgotten. It can appear in surprisingly ordinary moments.
You might say one person’s name when you intended to say another. You might repeatedly find yourself attracted to a particular kind of relationship. You might have a dream that stays with you. You might find yourself unable to say something that you consciously believe you want to say. Or you might notice that the same situation seems to happen again and again.
Psychoanalysis is interested in these moments because they can reveal something about the way desire, language and experience are organised. This does not mean that every slip of the tongue has a hidden meaning or that every dream contains a secret message. It means that what seems insignificant can sometimes become meaningful when it is explored in the context of a person’s particular history and way of speaking.
Why do people choose psychoanalytic therapy?
People come to psychoanalytic therapy for many different reasons. Some are struggling with anxiety, depression or persistent self-doubt. Some are experiencing difficulties in relationships. Others feel stuck in patterns they understand intellectually but cannot seem to change. Some have already tried other forms of therapy and are looking for a different way of approaching their experience. And some simply want to understand themselves more deeply.
There is no single type of person who seeks psychoanalytic therapy. What often matters is a willingness to become curious about one’s own experience. Not necessarily to find a quick explanation, but to ask questions that may not have been asked before.
Psychoanalytic therapy in Sydney
Finding the right therapist is not simply a matter of choosing a particular therapy label. The practitioner’s training, professional registration, clinical experience and theoretical orientation all matter. So does the relationship that develops between you and the person you are working with.
Psychoanalytic therapy may be worth considering if you are interested in exploring not only what is happening in your life, but also the meanings, desires and patterns that may be shaping how you experience it.
My practice, The Underthought | Psychoanalysis Practice, is grounded in psychoanalytic thinking and a Lacanian orientation. I work with adults experiencing difficulties such as anxiety, relationship problems, self-doubt, recurring patterns and questions around identity and life transitions.
I am a registered counsellor with the Australian Counselling Association and PACFA, and my clinical work is informed by extensive study of psychoanalysis. Sessions are available in Sydney and online across Australia.
You do not need to arrive at therapy with a clear explanation of what is wrong.
Sometimes a first conversation can simply begin with what has brought you to consider therapy.
Learn more about psychoanalytic therapy and the first session.