What Is Psychoanalytic Therapy And How Can It Help You?

This week, NYC psychoanalyst and clinical psychologist Therese Ragen, PhD helps us to better understand what psychoanalysis is and how it can be helpful.

Hundreds of types of therapy exist. Typing that statement alone was anxiety-provoking. How are we supposed to choose which type is right for us, particularly if we don’t know anything about what we’re choosing between?

In an effort to chip away at choice overwhelm, we look forward to breaking down different aspects of all of the different kinds of therapy out there. Today, let’s dive into psychoanalysis.

We talked with Therese Ragen, PhD, a My Wellbeing member who has over 30 years of experience as a therapist in New York City, about what psychoanalysis is, how it works, and how it can help you.

1. How would you describe psychoanalysis?

Psychoanalysis and psychoanalytic therapy are forms of therapy designed to help people who are suffering emotionally become free of that emotional suffering and pain.

The basic premise of psychoanalytic treatment is that the symptoms people suffer from, such as anxiety, depression, panic attacks, obsessive-compulsive disorder, problems with intimacy, etc. are caused by underlying feelings, conflicts, thoughts, memories, perceptions of which the individual is not fully aware. The therapeutic work is to try to bring these to full consciousness so that the person can gain insight into what lies behind the symptom and work with that, which is the real problem causing the symptom(s).

A corollary tenet is that one’s inner conflicts and present ways of feeling about oneself and others is highly influenced by how one was treated in the past, and one needs to become more aware of that connection in order to more freely Iive in one’s own unique self in the present.

2. How hands on is the therapist in a psychoanalytic-style therapy?

Psychoanalysts vary greatly in how active they are in working with patients. While in the past most analysts were largely silent, making occasional interpretations of what the patient was saying, most modern day analysts are much more active in their sessions with patients.

3. Please share a real but anonymized example of what psychoanalysis looks like in the room.

A patient tells me how angry he is at his wife because she refuses to go to his tenth college reunion with him. She says she won’t know anybody and doubts it will be any fun for her. While my patient’s anger is legitimate, I wonder out loud whether underneath that anger he is feeling hurt. He stops abruptly, and after several seconds of looking down at the floor says (in a very different tone of voice than he’d been using), yes, he in fact realizes he feels very hurt and rejected by his wife for refusing to go with him. We go on to talk about how he seems to haves a knee jerk reaction when he feels the vulnerability of feeling hurt, without even being aware of it, to react with anger instead.

4. How long does analytic therapy last?

The length of psychoanalytic treatment is determined by how deep a person wants to go in the emotional work they are doing. Generally, people leave when they are feeling more comfortable and whole within themselves and their relationships. For many people this can take a few years.

5. Are there personality types that would work especially well with psychoanalysis?

The type of person who works especially well in psychoanalysis is someone who is already “psychologically minded,” meaning someone who is given to self-reflection, curious about their inner world and emotional life, as well as the nature of their relationships.

6. Are there certain personality types that may not enjoy working with psychoanalysis?

People who are more focused on behavior and thinking and give little attention to emotions and inner life probably would not enjoy or benefit from a psychoanalytic treatment.

7. How do you know if psychoanalysis is working for someone?  How do you know if it’s not?

There are three questions one can ask to measure if psychoanalysis, or any other type of psychotherapy, is working:

Is the problem(s) they came to psychotherapy with changing in frequency?  Intensity?  Duration?

For example, do their bouts of depression occur less frequently? When they do occur, are they less intense than they used to be? Do they last for briefer periods of time than they did before?

8. How should a therapy-goer plan for a psychoanalytic session?  What type of work is entailed?

The main work for a person in psychoanalytic treatment is to try to become increasingly aware of themselves and their feelings, thoughts, memories, dreams, behavior, ways of relating. When this occurs, a person is living with more consciousness, fullness and ease.

The more one can simply pay attention to and follow what comes up inside oneself during the session the better, so there is no planning, per se, needed.

9. What is your favorite thing about psychoanalysis?

My favorite thing about psychoanalysis is engaging deeply with people and seeing the amazing changes they make, the strengths and gifts they find within themselves, and how much happier and peaceful they become in their lives.

10. What advice might you give to a therapy-seeker wondering if psychoanalysis is right for them?

Try it!

I suggest people make an initial appointment and see how it feels, get a sense of what the chemistry with the therapist is like. You may need a couple of sessions to decide. If you’re not satisfied, ask yourself does it seem to be the method of therapy or the personality of the therapist—or both—that is not working for you?

You might also ask yourself what feelings you were having while reading this. In particular what were your reactions to my responses to questions 3, 5 and 6?

Thank you, Therese, for sharing your perspective with us today and for educating us about psychoanalysis.

Any thoughts, questions, or feedback? We'd love to hear from you. Reach our team any time at [email protected] or follow us on social @findmywellbeing.