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Psychoanalysis Is Alive and Well

How Contemporary Psychoanalysts Help You Lessen Pain and Increase Satisfaction

By Fred Pisoni, PsyD

shutterstock/Africa Studio
Source: shutterstock/Africa Studio

The image that many people have of psychoanalysis is from the 1950s or even earlier. Times change and so has psychoanalysis. Here are some of the ways that modern psychoanalysis has evolved to stay fresh and relevant as well as to help you find relief from painful emotional symptoms, improve personal relationships, and more deeply understand yourself.

Patterns, not Parents

Modern psychoanalysis does not focus on doing an archeological dig back to childhood and the interactions with parents during those early ages. Of course there may be important events that occurred in early childhood and as those come up they will be explored, but the main focus is on the present.

Together, you and the analyst look for patterns in present-day relationships and at work or in school that contribute to unhappiness, fear, disappointment, reduced utilization of potential, and emotional pain.

There may be patterns you are aware of and there may also be patterns, especially at the beginning, that are out of awareness (unconscious). The goal is to explore thoughts, feelings and actions so that patterns can be identified and then understood. As these patterns are understood, you become freer to make choices that enable increased pleasure in interpersonal relationships and increased satisfaction at work or in school.

"Tonya" sought help because of her decade long, persistent, intense worries about how her performance at work would be "graded" by her supervisor. Her hopes and worries rose and fell on every nuance of her supervisor's comments. She was aware that she had had the same worries and fears throughout her schooling.

As this painful pattern was explored Tonya came to see that, largely out of her awareness, she had the worrisome idea that she was not a good person and not really liked by others. Her underlying worry was that unless she got "straight A's" on all academics and on all work projects, people would not like her, find her interesting, or want to be with her.

As Tonya became more aware of that pattern and as the emotional engine driving the pattern was explored and better understood, she was able to begin to like herself and start to connect to other people. The unrelenting stress she had felt at work lessened. And she began to date for the first time in her life.

Psychotherapy & Psychoanalysis: Not Two Completely Different Things

The distinguishing aspect of working from a psychoanalytic mindset is the focus on exploring thoughts, feelings, and actions looking for patterns and the emotional meanings of those patterns. The frequency of sessions can vary from once a week to several times a week. There is no sharp dividing line between psychotherapy and psychoanalysis based on frequency. It is the search for patterns and the emotional meanings of those patterns that makes the work psychoanalytic.

Analysts are People Too

Gone are the days of the analyst being silent and expressionless, like a potted plant in the corner. Analysts are human just like the people they work with. Their warmth, seriousness, and humor are no longer hidden.

To Couch or Not to Couch

Drawings in The New Yorker and other publications always show the analytic patient lying on a couch. Contrary to those drawings and contrary to a common impression, use of a couch is not a requirement. The deciding point on whether to use the couch is whether it would be helpful by minimizing distractions when thinking and talking about one’s emotional life. For some people using the couch is helpful in that regard while for other people sitting in a chair is the most helpful approach. There is no "right" answer. Or said differently, the right answer is the one that works best for each individual.

What has Stayed the Same

Other aspects of psychoanalysis have remained the same over time.

  • Analysts try to help people derive increased pleasure and satisfaction in their interpersonal relationships and work.
  • Psychoanalysts have a deep respect for each person as a unique individual.
  • The aim is to increase an individual's ability to be both well-connected to others and also, at the same time, be their own, separate, person.

Contemporary psychoanalysis continues to change and evolve as it strives to help people lessen their inner suffering in today's modern, hectic world.

You can learn more about contemporary psychoanalysis at the upcoming Annual Meeting of the American Psychoanalytic Association. Visit for more information.

About the Author: Fred Pisoni, PsyD, is a clinical psychologist and psychoanalyst. He works with adults, adolescents and children. Dr. Pisoni has a private practice in McLean, Virginia.