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By Nuno Cristiano de Sousa


Psychoanalysis is a concept that is increasingly present in everyday language. Yet, it remains either shrouded in mysticism that places it up at the level of science-of-the-illuminated or down to a status of approach that only looks at human suffering as something that comes from an emotional conflict related to sex. Both cases are equally unfavorable for understanding it.

To understand what psychoanalysis is today, we have to go back to its origin to have the context to what has been its evolution since it was established as a clinical method by Sigmund Freud in 1900, with the text “The Interpretation of Dreams.”

Until then, mental health disorders were poorly studied and predominantly treated with methods based on prejudice, many of which persist.

In his journey as a neurologist, Freud crossed paths with the french physician Josef Breuer, who was already trying to study patients diagnosed with mental health problems and used hypnosis as his primary method. However, Breuer noticed that patients diagnosed with hysteria symptoms eased when they explained their symptoms to him, which was an atypical procedure in the usual context of doctors putting patients in the position of “recipients of information and instructions.” Actually, It was a patient, the famous Anna O., who coined the term “talking cures.” Interestingly enough, Freud once described her as the true founder of the psychoanalytic approach.

This historical vignette serves to introduce two aspects that are crucial in this new approach that was established: 

1) Symptoms began to be looked at as manifestations of emotional suffering resulting from individual experiences rather than reduced to a physiological dysfunction;

2) Treatment took place through “talk therapy” and not through medical procedures.

At this point, the approach that has been embedded in psychotherapies over the last decades is founded, and throughout the last decades, the theoretical approaches have multiplied (cognitive-behavioral, phenomenological, familial, etc…).

Psychoanalysis then opened the doors for developing psychotherapies, but today it can be classified as a distinct theoretical body.

Referring to Freud’s own words (1914), the concepts of unconscious, interpretation, resistance, and transference define psychoanalysis. A casual way to explain these concepts is that psychoanalysis analyzes the mental processes underlying symptoms and behaviors by interpreting what the patient freely speaks during the consultation and how the patient relates to the therapist. 

Some of the founding concepts of psychoanalysis are partially used by other theoretical fields. Still, only psychoanalysis uses them fully and together, and here is where the fundamental difference between psychoanalysis and psychotherapies lies. Psychoanalysis works on the investigation and understanding of symptoms; psychotherapies work on the elimination of the symptoms. So they are different approaches with different purposes, although they share some theoretical concepts and work on mental health.

Paraphrasing Freud, psychoanalysis combines itself into a method of research and treatment. It is not the fruit of theoretical speculation, but of experience, so it is not finished but in transformation. 

This transformation happened through various psychoanalytic schools of thought headed by authors who took off from Freud’s work and expanded his first psychoanalytic theories. This proliferation is crucial as it enriches and complexifies the theories and practices.

These theoretical frameworks differ in the way they think about the significant problems that psychoanalysis has set out to understand the human psyche, such as nature versus culture, the place of aggression, and early relationships.

Although some psychoanalysts may relate mainly to a specific psychoanalytic school, contemporary psychoanalysis should consider the contributions of the various authors, since only this way will it be possible to maintain a critical spirit and a flexible mind that is useful for patients.

So, with all of this, psychoanalysis is a psychotherapeutic process for all who are willing to gain a deep understanding of themselves through a journey of deep reflection on the interaction between their personalities and the different dimensions of their lives. This process will bring inner resources more structured, adaptable, spontaneous, and independent.

Psychoanalysis is not a process for those who want immediate answers or generic tools for dealing with daily conflicts. Instead, it takes its time to explore perspectives, grow ideas, and explore them in the way we explore our lives.

As a theory, psychoanalysis is helpful to gain an understanding of the whole range of mental health issues, cultural and social dilemmas. However, each psychoanalyst naturally may have more experience or investment in particular matters, so that may be considered when searching for therapy.

If you are considering psychoanalysis for your psychotherapy and relate to the approach but are not yet sure if it will resonate with you, you can book the first session with a referred therapist or one you know the work of. By the end of the session, you will probably have a clearer picture of how the approach makes you feel. During the session, you will also be free to ask as many questions as you need to feel assured that the approach and therapist make sense to you.