How Psychoanalysis Works? Part 2
In all situations, whether with children, adolescents, or adults, one major goal of analytic therapy (regardless of intensity), is the delineation of the unconscious determinants of the patient's current symptoms. Unconscious wishes, defenses, and moral conflicts are derived from previous, especially childhood, conflictual situations which either may have occurred in reality or may have been perceived by the child as if they had really happened. In other words, the old conflicts are assumed to persist in the unconscious mind and are viewed as causative of the patient's suffering.
How is therapeutic work accomplished?
A major tool utilized in a psychodynamic therapy is what is labeled as addressing or analyzing the transference. Transference is a universal psychological phenomenon in which a person's relation to another person has elements which are similar to and/or are based on his or her earlier attachments, especially to parents, siblings, and significant others. This phenomenon has been studied empirically. "Transference may be ubiquitous in people's everyday interpersonal interactions and important relationships," says psychologist Susan Andersen of New York University. "It can lead to emotionally painful consequences or to feeling connected, bonded, and comfortable" (quoted in Science News Online, June 9, 2007; Vol. 171, No. 23, https://www.sciencenews.org/article/past-impressions).
In a psychodynamic therapy the relationship to the analyst or therapists promotes an accentuation of feelings towards the analyst/therapist. As in any other relationship the patient sees the analyst not only objectively but imputes qualities to the analyst which are based on qualities of other important figures in his or her earlier life. In real relationships, the other person gratifies or rejects, demands gratification or provokes rejection; both parties may mutually gratify or mutually reject. In the therapeutic relationship, one member of this dyad, the therapist, attempts to be as open as possible to the patient’s feelings. The analyst attempts to limit gratifications of the patient's desires and attempts to control counter-reactions to patients' attempts to provoke gratification or rejection.
In this setting, the analyst/therapist attempts to understand the meaning of the patient's verbal and non-verbal communications. The analyst communicates his or her understanding to the patient in order to broaden the patient's view of him or herself. During this process, rather than gratifying or rejecting the patient, the analyst examines the nature of the patient's conscious and unconscious desires, defenses, and moral demands as they may be reproduced in the relationship to the analyst. The analyst/therapist communicates his understanding (interprets) to the patient. The analyst/therapist experiences reciprocal feelings towards the patient (countertransference). The analyst/therapist tries to understand how these feelings within him/herself are related to the therapist’s own personal issues and how they may be provoked by the patient.
Over time, understanding the nature of the complex interactions between patient and therapist can help the patient deal with interpersonal issues in his or her life more effectively as a result of understanding how problematic issues in current life are derivatives of issues form the past.