When I meet someone new and say that I’m a psychoanalyst, they often say, “Oh, you’re a Freudian.” Well, no, not exactly. Psychoanalytic thinking has come a long way since Freud, and there are now many different schools of psychoanalysis. But to explain that would take a long time and it’s not usually appropriate in a social situation; so I let it go. What I want to explain to them is complicated. I am not a silent analyst, which is what most people associate with Freud. In reality, he was quite talkative and had quite permeable boundaries with his patients. I am not a Freudian in either of these ways—I’m not silent and I do not have relationships with patients outside of my office. In addition, the popular idea of Freudian psychoanalysis is that patients lie on the couch and come five times a week. Many of my patients sit in a chair or on the couch and none of them come five times a week. Some patients come three times, but most come once or twice. Rarely, in modern times, do patients have the time or money to come more than two or three sessions a week. For all these reasons, I do not fit the stereotype of a Freudian analyst.
However, despite many modifications through the years, three of the keystone ideas in any school of psychoanalysis come from Freud. First, Freud believed that multiple sessions per week and lying on the couch increases regression, which facilitates early relationships being repeated in the interaction with the analyst. Second, the analysis of “transference,” Freud believed, is the major method of psychoanalysis. Transference is transferring feelings from a childhood relationship onto an adult relationship. Much of the unhappiness that brings people to seek help is the result of early childhood relationships (i.e., parents or siblings) being repeated without awareness. Sometimes they are repeated with aging parents. CLICK HERE.
Psychoanalysis heals the compulsion to repeat self-destructive or destructive behaviors learned in childhood by making them conscious. In psychoanalysis, the problems which originated in the interactions with significant others in childhood are enacted in the transference and become conscious and accessible to change. For example, one of my patients unconsciously experiences any correction or criticism as her father telling her she’s second rate. When her husband suggests she is driving too fast, she explodes at him and does not realize she is responding to him as if her husband was her father. Similarly, when her boss asks her to finish a report, she responds in a rage as if her boss was her father. Transference is acted out in everyday life, but remains unconscious. But when it unfolds in psychoanalytic treatment, the analyst can interpret it and make it conscious to the patient. The analyst also behaves differently than the parent or sibling with whom the troubled relationship began. In different types of psychoanalysis, the degree to which the analyst interprets may differ, but in all psychoanalytic work the analyst works hard, but not always successfully, to not repeat the original traumatic dynamic.
A third important keystone of psychoanalytic work is based on Freud’s concept of “resistance.” Many therapies rely on the rationality or consciousness of the patient. They assume the patient wants to feel better and just doesn’t know how. But psychoanalysis assumes that as much as the patient wants to get help and feel better, he/she also has a compulsion to repeat the troubled behavior (or relationship) and will unconsciously resist help and change. For example, another patient complains of feeling terrible about his relationship with his girlfriend and pleads with me to help him—but he comes 10 to15 minutes late every session and often cancels.
Although many psychoanalysts disagree with some of Freud’s ideas (i.e., instincts, Oedipal complex, etc.), the vast majority would agree that Freud contributed these three core elements of psychoanalytic work that have stood the test of time--regression, transference and resistance.