Psychological services may often be desired in times when we long for guidance, advice or “tools” to cope with previous and or ongoing life experiences. Psychoanalytic psychotherapy is often misunderstood as a treatment that should offer advice, coping tools, or direct strategies for living.  Both the patient and the psychologist or psychotherapist are often faced with this dilemma – a hope to find the answer or answers – the so called missing piece to the puzzle that will provide the desired outcomes. However, psychoanalytic psychotherapy or as it is often referred to as psychodynamic therapy does not always provide treatment in that manner.  In reality, its method and value lie elsewhere.

From a psychoanalytic perspective, therapy is fundamentally a conversation: a dialogue in which meaning is discovered rather than prescribed.  Sigmund Freud was explicit that his approach to psychological treatment does not aim to instruct patients on how to live. He wrote that analysis “does not set out to make pathological reactions impossible, but to give the patient freedom to decide one way or the other” (Freud, 1923). The task is therefore not to direct, but to listen to unconscious themes as they emerge in speech, fantasy, and relationship and to allow the unfolding towards outcomes over time.

Freud’s notions were later echoed by other psychoanalytic thinkers who elaborated this position.

Bion (1962) emphasised the therapist’s capacity to remain without memory or desire, allowing the analytic conversation to unfold without imposing solutions. Similarly, Winnicott (1960) argued that therapeutic change arises from the patient’s experience of being understood and not from direct instruction or advice. Insight develops when the patient encounters previously unknown aspects of him/herself within a relational space that may run it’s course over several months or years.

Psychological services may often be desired in times when we long for guidance, advice or “tools” to cope with previous and or ongoing life experiences. Psychoanalytic psychotherapy is often misunderstood as a treatment that should offer advice, coping tools, or direct strategies for living.  Both the patient and the psychologist or psychotherapist are often faced with this dilemma – a hope to find the answer or answers – the so called missing piece to the puzzle that will provide the desired outcomes. However, psychoanalytic psychotherapy or as it is often referred to as psychodynamic therapy does not always provide treatment in that manner.  In reality, its method and value lie elsewhere.

From a psychoanalytic perspective, therapy is fundamentally a conversation: a dialogue in which meaning is discovered rather than prescribed.  Sigmund Freud was explicit that his approach to psychological treatment does not aim to instruct patients on how to live. He wrote that analysis “does not set out to make pathological reactions impossible, but to give the patient freedom to decide one way or the other” (Freud, 1923). The task is therefore not to direct, but to listen to unconscious themes as they emerge in speech, fantasy, and relationship and to allow the unfolding towards outcomes over time.

Freud’s notions were later echoed by other psychoanalytic thinkers who elaborated this position.

Bion (1962) emphasised the therapist’s capacity to remain without memory or desire, allowing the analytic conversation to unfold without imposing solutions. Similarly, Winnicott (1960) argued that therapeutic change arises from the patient’s experience of being understood and not from direct instruction or advice. Insight develops when the patient encounters previously unknown aspects of him/herself within a relational space that may run it’s course over several months or years.

More recent psychodynamic research supports this view. Busch (2015) highlights that symptom relief often follows increased reflective functioning, as patients recognise emotional meanings behind their difficulties. Lemma, Target, and Fonagy (2011) further demonstrated that insight-oriented work, such as psychoanalytic psychotherapy fosters lasting change by transforming how patients understand themselves and their relationships with themselves and others.  In this way, the psychoanalytic process is not solution-focused. No, it is insight driven and it is experiential.  The hope within this approach to treatment of mental health matter is that emerging over time through repeated conversations resolve is to occur. As unconscious conflicts become speakable, patients often find that their presenting problems lose their grip. Change occurs not because the therapist provides answers, but because the patient discovers new ways of understanding their inner world.

Bibliography
Freud, S. (1923). The Ego and the Id.
Bion, W.R. (1962). Learning from Experience.
Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship.
Busch, F. (2015). Creating a Psychoanalytic Mind.
Lemma, A., Target, M., & Fonagy, P. (2011). Brief Dynamic Interpersonal Therapy.