WHAT IS PSYCHOANALYSIS?

Victor Bloom MD

There are many common misperceptions about psychoanalysis. It is that segment of psychiatry and psychotherapy that was originally called "The Talking Cure" and has been known as that method of treatment which utilizes the couch and five fifty-minute sessions of free-association per week, in which the analyst sits behind the patient (analysand) and may or may not take notes or say anything. This form of psychiatric treatment has been the butt of jokes, cartoons and Hollywood movie spoofs for decades, much to the detriment of its reputation. Actually, psychoanalysis is over a hundred years old and millions of people around the world have benefited from it.

Millenia ago, Socrates was heard to have said, "The unexamined life is not worth living." My own take on this observation is that the examined life is hardly bearable. It is hard to face the truth about one's self and the human condition. We have base instincts which the media and marketing have exploited throughout this century. We also have childish and narcissistic needs which can interfere with adult life and distort otherwise realistic, mature perceptions.

Many of us have a tendency to be our own worst enemy, or to shoot ourselves in the foot, or to cut off our nose to spite our face. We repeat self-defeating behavior stemming from unresolved conflicts in our childhood, and tend to blame others for our own shortcomings.

The idea of psychoanalysis is to uncover the truth of our unconscious mechanisms, which hide the painful memories of our childhoods that continue to haunt us. These truths are hidden and repressed or forgotten. But repressed memories do not disappear, they just go underground.

Another favorite defense mechanism is 'splitting', in which our worst characteristics are split-off. We then become two-faced or hypocritical, without realizing it. The worst form of this is the Dr. Jeckyll and Mr. Hyde phenomenon, in which half of the personality is 'good' and the other half is 'evil'. Most often such a person is totally unaware of this condition. The people around him are dumfounded with apparent contradictions and inconsistencies in his or her behavior, and are confused and do not know what to say or do about it.

Psychoanalysis, by using the process of 'free-association' to bring buried memories and feelings to the surface, is also called, "uncovering therapy" or "depth-analysis." It means the analysand works diligently and persistently to say whatever comes to mind, leaving out the editing and censoring function of the mind which is operative and adaptive for everyday living.

A person thereby comes to know his or her deeper self. Many individuals fool themselves into thinking they know themselves, but the conscious mind, the rational mind, is but the tip of the iceberg. Self-understanding by psychoanalysis is an arduous and painful process, but also one which is gratifying, vitalizing and fulfilling. One gets re-connected to all the parts of one's self. That is what we mean by 'getting it together', 'getting-a-life,' becoming integrated and 'healed,' which is the basis of a stable, consistent and trustworthy person.

Ideally, what you see is what you get, you know the person by what he or she says and does. Actions speak louder than words, and we respect a person who does what he or she says he or she is going to do, and means what he/she says and says what he/she means. These are the behaviors which become the admirable traits of "character" and "integrity."

Psychoanalysis is not the only way to achieve wholeness, wisdom and maturity, but in practice it certainly facilitates the process. What is the use of growing older if we do not grow smarter? Many people do not learn from experience! Some think that a person who comes to see a psychoanalyst three, four or five times a week must be very sick to need so much treatment, but that is far from the truth! The fact of the matter is that it takes a much healthier person to withstand the requirement of frequent free-association without coming apart at the seams. Only the most mentally healthy people undertake the rigors, demands and expense of psychoanalysis.

So why do it? Some of us are curious about what makes us tick. Our intuition and common sense dictate that self-knowledge is a source of strength and wisdom. Interest in psychologic insight is fuelled by a healthy curiosity, and is not the curiosity that killed the cat.

As we go through the stages of life, it is good to know more about the phases and complexities of the unconscious processes we are dealing with, the process of learning and growth. One can be mentally healthy and still seek an optimum state to realize the fullness of one's potential.

Dr Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a member of the American Academy of Psychoanalysis and on the editorial board of the Wayne County Medical Society. He welcomes comments at his email address--- vbloom@comcast.net.