Psychoanalysis is a psychotherapy and also a psychological theory. It was founded by Sigmund Freud and is the forerunner of depth psychology.
What is psychoanalysis?
Psychoanalysis is a psychotherapy and also a psychological theory. It was founded by Sigmund Freud and is the forerunner of depth psychology. Psychoanalysis can be divided into three areas. From the scientific perspective, psychoanalysis deals with unconscious psychological processes. Numerous different psychoanalytic schools have scientifically developed Freud’s theories and added various concepts to them. Well-known successors of Freud are, for example, Melanie Klein, a pioneer in the field of child psychoanalysis and object relations theory, or Heinz Kohut, the founder of the self-psychological direction of psychoanalysis. Psychoanalysis can also be considered methodologically. It has developed its own methods of studying the human psyche. However, psychoanalysis has gained real popularity even among the general population only as a therapeutic method. Thereby psychoanalysis, in contrast to behavioral therapy, claims to grasp the cause of psychological suffering and to heal it.
Treatments and therapies
The basis of psychoanalysis as a therapeutic method is that the current psychological development of the person is based on experiences from the past. This means that all the desires, cravings, needs, and feelings a person has today are linked to events from his or her past life. However, these causal connections influence behavior more on an unconscious level and are rarely perceived by the person himself. According to psychoanalysis, every person possesses an unconscious mind, which has a great influence on the actions and thinking of the individual. The unconscious is especially involved in mental problems and mental illnesses. Freud’s claim for psychotherapy was to bring into consciousness these unconscious parts that influence people daily in their actions and thoughts. Psychoanalysis is thus a revealing therapy. The idea behind bringing awareness is that by looking at the unconscious connections of their condition, the patient can experience insight and understanding. The goal of psychoanalysis is to reshape and restructure the patient’s personality so that traits that contribute to the maintenance of the disorder lose influence. A variety of treatment methods are available to achieve this goal. Classical psychoanalysis is a long-term procedure with three to five one-hour sessions per week. During these sessions, the patient lies on a couch and speaks out everything that comes to mind. This is called “free association.” The analyst listens and offers the patient interpretations of these associations. Classical psychoanalysis involves up to 300 sessions and can take several years. Today, this procedure is rarely used due to its high cost, but was recommended by Freud especially for the treatment of profound and prolonged psychological disorders. Less time-consuming are medium-term psychoanalytic therapy procedures such as dynamic psychotherapy, depth psychology-based psychotherapy or longer-term halting therapy. These methods tend to be conflict-centered, i.e., there is no free association, but the therapist focuses on the conflict with the patient in the here and now with a view to the underlying original conflicts. The positive effect of depth psychological methods has been scientifically proven, especially in depression, panic disorders, borderline disorders and post-traumatic stress disorders. Short-term analytical therapies are suitable for short-term crisis intervention and emergency treatment. These comprise no more than 25 sessions. Patient and analyst concentrate on working out and clarifying a core conflict. A well-known psychoanalytic brief procedure is focal therapy according to Michael Balint.
Diagnosis and methods of investigation
Diagnosis in the form of an initial interview precedes every psychoanalysis. The main purpose of this is to determine whether the patient with his problem is at all suitable for psychoanalysis. The focus is on the transference and countertransference processes typical of psychoanalysis.The therapist himself is rather a participating observer than a leader of the conversation. He should record the patient’s life circumstances and take into account his life development. Various procedures are used as initial anamnesis. The interactional interview according to Balint has, in addition to the above-mentioned goal, also the claim to highlight temporal connections between the occurring symptoms and the life-historical events. The psychoanalytic initial interview according to Argelander focuses more on the recording of unconscious messages and expressions of the patient. From this, conclusions are then to be drawn about earlier experiences. Life history and biographical data play a negligible role here. The depth-psychological biographical anamnesis according to Dührsen and Rudolf aims to record the psychosocial and developmental psychological factors from the patient’s current and past life as completely as possible. The patient’s medical history and life story are taken into account, as is the current social life situation. With the help of the structural interview according to Kernberg, a distinction is to be made between the three main types of personality organization. For this purpose, the neurotic functional level, the borderline functional level and the psychotic functional level are determined. The patient’s experience of illness and expectations of treatment can be assessed using the diagnostic interview for Operationalized Psychodynamic Diagnosis. The setting in which the interviews are conducted is usually very similar. Each of these interviews lasts approximately one hour. Basic goals, such as initiating a therapeutic relationship and assessing causative conflicts, are also the same. However, the focus of the interviews varies greatly. As an alternative to the interviews, the biographical anamnesis procedure can also be used for diagnosis. The psychological, medical, and social developments recorded there give the therapist a comprehensive overview of the patient’s entire personality development.
