Questions about Psychoanalytic Psychotherapy: Individual, Group and Couples
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
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
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
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
Is it right for
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.
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.
(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.