Psychoanalysis is a talking cure, based on the method of free association. In its fundamental rule the patient is invited to say whatever comes to mind without restrictions, like considerations of context, decency, feelings of shame or guilt and other objections. By adhering to this rule the patient’s thought-processes will make surprising links, reveal consciously unavailable connections to wishes and defenses, and lead to the unconscious roots of previously irresolvable conflicts. Listening to these associations, analysts will surrender to a similar mental process, called free hovering attention, by which they are following the patient’s communications as well as noticing – at times as if in a waking dream – their own associations as they emerge. With the help of the analyst’s interventions – often interpretations of what transpires in the relationship between the patient and the analyst – a new understanding of the patient’s suffering will arise. Repeatedly applying these new insights to many similar situations renders the patient increasingly capable of recognizing the thought processes that stir their conflicts. Resolving these conflicts and putting them into perspective or at rest will free the patient’s mind from old inhibitions and make room for new choices. (adapted from the International Psychoanalytical Association).
Psychoanalysis is usually, but not always, conducted with the patient comfortably lying on the couch, saying whatever comes to mind, without being distracted by seeing the analyst, who usually is sitting behind the couch. This allows both partners in the analytic endeavour to fully listen to and reflect about what transpires in the session: the patient will feel immersed in their inner world, revive memories, revisit important experiences, talk about dreams and create fantasies, all of which is part of the analytic journey that will shed new light on the patient’s life, history and the workings of their mind.
(adapted from the International Psychoanalytical Association.)
High frequency of sessions – 3 to 5 days a week and several year treatment length
In order to continuously deepen the analytic process, psychoanalytic sessions preferably take place on three, four or five days a week. A lower frequency of sessions per week or the use of the chair instead of the couch will sometimes be necessary. All agreements about the setting (including the schedule, the fee per session and the cancellation policy) will be binding for both patient and analyst, and have to be renegotiated if change is required. The timeframe for doing an analysis is hard to predict; an average of three to five years can be expected, even though any single case may take more or less time for completion. Patient and analyst are nonetheless free at any time to decide to interrupt or end the analysis.
Examining the relationship with the analyst
The psychoanalytic models assumes that early, emotionally charged relationships become encoded in our memory systems as latent expectations. We not only use these as a lens through which we experience current relationships, but we act them out as well, unconsciously pulling others to participate. The analytic setting is designed to allow these unconscious expectations to unfold in the relationship with the analyst, so that they can be explored.
Use of dreams, daydreams and memories
The analyst and patient carefully attend to dreams and daydreams, which are understood as symbolic expressions of our inner wishes, fears and conflicts as well as our beliefs about relationships.