Psychoanalysis

General Description

Psychoanalysis is a theory that studies the functioning and structure of the human mind, as well as a diagnostic and therapeutic method for mental disorders. This hypothesis is based on the belief that individuals possess a series of primary instincts (feelings, desires, memories) which, if they do not emerge due to conscious conditioning, remain repressed and ultimately generate mental health problems.

Sigmund Freud promoted this theory while studying cases of patients with physical symptoms not caused by an organic origin. Psychoanalysis allows for the understanding of behaviors and ways of thinking different from one’s own.

Freudian psychoanalysis is based on three elements:

• Method: investigates unconscious mental processes and serves a diagnostic function.
• Technique: used as a treatment for mental disorders.
• Theory: progressively developed from the experience obtained through the method and techniques.

The main concepts developed in Freudian psychoanalysis are:

• Diagnostic aspects:
• Unconscious: the repository of primary desires, hidden beneath the conscious mind.
• Id, ego, and superego: personality is structured through these three dimensions.
  • Id: the primitive component, representing basic drives.
  • Superego: thoughts derived from cultural and social influence, such as morality and ethics, which inhibit the fulfillment of primary desires.
  • Ego: mediates between the desires of the id and the restrictions of the superego.
  • Psychosexuality: according to this theory, libido governs human behavior and varies depending on the individual’s stage of development.
  • Oedipus complex: the child’s attraction to the mother leads to rivalry with the father for her affection. This conflict results in disobedience and temper tantrums.
  • Defense mechanisms: employed by the unconscious to manage unresolved issues (projection, sublimation, denial, isolation, rationalization, repression).
  • Treatment-related aspects:
    • Free association: the patient expresses emotions without inhibition or judgment, allowing unconscious experiences to emerge naturally.
    • Dream analysis: considered essential due to the belief that dreams represent feelings stored in the unconscious.
    • Analysis of transference and countertransference: transference refers to how the patient relates to the specialist as a representation of past experiences. Countertransference refers to the thoughts and emotions elicited in the therapist during the session.
    • Resistance: refers to the unconscious effort to prevent certain thoughts or memories from emerging, without intentional control by the patient, thereby hindering the therapeutic process in order to avoid confronting deep conflicts and emotional pain.

After Freud developed his theory, many other types of psychoanalysis emerged. Some of them include:

• Lacanian psychoanalysis: developed by Jacques Lacan, closely aligned with Freudian theories. It defines pleasure as a means of avoiding suffering, which may lead individuals to derive enjoyment from what should cause pain. It considers language essential for linking the unconscious with the conscious.
• Relational psychoanalysis: focuses on real and imagined relationships and their impact on mental health. Its treatment is based on the relationship established between the patient and the psychoanalyst (who does not issue value judgments) during therapy sessions.
• Jungian psychoanalysis: although developed by one of Freud’s disciples, Carl Gustav Jung, it diverges from Freudian theory. It downplays the role of libido in human behavior, placing it secondary to psychic energy, considered the true driving force of existence. It also proposes two types of unconscious: individual and inherited (collective unconscious).

Some of the conditions most commonly diagnosed or treated through psychoanalysis include anxiety, phobias, jealousy, relationship problems, grief, addictions, eating disorders, depression, and sexual dysfunctions without a physical origin.

When is it indicated?

Each specialist determines the therapeutic approach used to address their patients’ mental health problems, regardless of their nature. In general, psychoanalysis is indicated for individuals who need to become aware of their unconscious mechanisms.

How is it performed?

Psychoanalysis is based on free association; therefore, during sessions, patients are typically encouraged to speak about whatever they consider relevant, even when it appears meaningless or unrelated to their condition. While listening, the analyst may connect certain behaviors with subconscious motivations and intervene to facilitate the process.

In many cases, especially in relational psychoanalysis, the patient addresses the specialist as if they were a figure from their past. This becomes an appropriate moment for obtaining insights that trigger the emergence of repressed emotions.

Risks

Psychoanalytic sessions do not pose a risk to health.

What to expect from psychoanalysis

During sessions, the patient sits comfortably and discusses issues that currently cause concern.

It is important to understand that psychoanalysis differs from psychotherapy; therefore, the experience is distinct. In psychoanalysis:

• The patient directs the sessions by choosing the topics and pace.
• A close relationship is established between patient and specialist.
• Over time, the patient develops self-awareness, leading to an understanding of the causes of their distress.
• It may be difficult to let go and openly express feelings.

Psychoanalytic sessions typically last between 50 and 60 minutes and are often recommended, particularly in initial phases, three times per week. In some cases, treatment may last for months, while in others, for years.

Specialties in which psychoanalysis is used

Psychoanalysis is a method belonging to Clinical psychology and Psychiatry