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Frequently asked Questions about Psychoanalytic Psychotherapy: Individual, Group and Couples

Individual

How long does it take?
Everyone wants to get better in the quickest possible time.  Understandably you want to be free from your symptoms and pain.  However, therapy takes as long as it needs to take.  With proper focus this needn’t be forever.   I strongly believe that therapy is something that happens only for a while. It should not become interminable.  Then it would not have been successful.

Will it hurt?
At times, yes it will. Often people have to get worse before they get better.  Addressing issues and feelings that have long been buried can be a painful process.  There are reasons why those painful feelings were buried in the first place.  However, most people come for therapy at a time in their lives when they are strong enough to do this work. And in the therapy you will have a great deal of support from me.  It is important to realise that having gone through therapy the pain will be lessened and its impact on your current life minimised.  It is important to remember that at times therapy will feel very rewarding and enjoyable.

Could I become dependent?

A phase of dependency is a normal part of psychoanalytic psychotherapy.  Dependence may or may not develop but if it does it can be worked through and left behind just as the old problems are left behind.

How does psychoanalytic therapy work?
Here I describe how psychoanalytic psychotherapy works in particular.  Other therapies have a different approach. Most psychological pain is rooted in the way we relate to ourselves and to others.  Our habitual pattern of interacting and indeed of feeling is established in childhood.  If we experience overwhelming trauma or pain at some time in our childhood we develop defensive ways of coping, especially in the ways we relate to ourselves and to others.  For example, we may switch off our feelings and behave as though we are not really there, or later we may start drinking too much or working too hard or we keep having abusive relationships or we have panic attacks or depression or self-hatred etc.  We have developed these patterns of interacting or feeling – unconsciously, not deliberately – to cover more deep-rooted pain.  Many refer to this as “keeping a lid on it”. Often these patterns of interaction or feeling have become habitual and cause us great problems as time goes by.  Psychoanalysts and psychoanalytic psychotherapists refer to these patterns of behaving or interacting or feeling as “defences”.  We are not aware of it but maintaining these defences costs us a huge amount of emotional energy.  Many people who come to therapy for the first time describe feeling exhausted.  In therapy these defences are gradually dismantled and the pain of childhood is slowly faced and worked through.  Destructive, defensive patterns of behaving or interacting that cause problems in everyday life are overcome first, other defences are kept in place only as long as they are useful.  They can be jettisoned when and if they are no longer needed.  Eventually new ways of being in the world are discovered.

Will there be a lot of delving into my past?

We will not be delving into your past for the sake of it.  This is not what therapy is about.  However, there are almost certainly patterns of relating and problems in your current life that are permeated by your old childhood experiences.  Now you have a chance to let go of redundant defences and face the feelings that belong to the past, to put those feelings back where they belong so that you can go on into your future life unencumbered by the past.

Will I get better?
There are no guarantees but my experience has shown that if the assessment is conducted properly and therapy is then undertaken with real commitment the majority of people benefit in a profound way that exceeds their expectations.

Can I really leave the past behind?
As long as you continue to have symptoms like depression and anxiety or compulsive behaviour you are being controlled by your painful past since these symptoms are your way of trying to hold it in check and away from your awareness.  The pain that is seeking to make itself felt is tyrannising you from an unseen place.  You will have a new, more relaxed relationship with your past when you have become freed from the need for these debilitating symptoms.

Is it right for everyone? No.  Some people need to keep their defences intact.  If this is the case a different form of therapy is required and may be recommended.  This could be cognitive behavioural or, in rare cases, psychiatric support.

Group

What is group analysis?
Group analysis is a method that brings together ideas from the social sciences (Elias and others) with ideas from psychoanalysis (Freud and his successors).  The method was founded by S. H. Foulkes and is based on the idea that the essential nature of the human being is social.  The analytic aspect means that repressed feelings are brought into the open through group therapy. The social aspect means that a person can best be helped to become more truly him or herself through honest interaction with others.

Could listening to other peoples’ problems make me worse?
No.  It may seem strange but one of the great strengths of group therapy is in finding out that other people have similar experiences to your own.  We all feel very isolated in our emotional difficulties and the group experience helps us to come out of that isolation and feel connected with others again. This is an absolute prerequisite for a healthy emotional life.

Is it confidential?
Yes. The rules of confidentiality are strict.  No-one is allowed to meet outside the group.  First names are used only.  I check before you join that you do not already know somebody in the group by telling you their surnames only.

Will others have similar problems to mine?
Yes. They may have some problems that are similar and others that are different but even then the emotions that are felt are recognised by us all at some level.

Couples Counselling (or Relationship Therapy)


Will we split up if we have this therapy?

The honest answer is: no-one can tell until you have done the therapeutic work.  The outcome of all good therapy is that you will become more truly yourself.  If you are not right for each other it is better to find this out sooner rather than later and for this to be based on the comfortable knowledge that you are both being true to who you really are.  A relationship based on an illusion was never a relationship in the first place.  Having said that, many couples find that couples counselling strengthens their relationship immeasurably, providing increased understanding of each other and acquiring techniques for deepening intimacy and overcoming conflict in a creative way.