Who Can Benefit from Psychoanalysis?

The best way to discover if psychoanalysis would be of benefit is to seek a consultation with a psychoanalyst. Psychoanalysis is a highly individualized treatment that optimistically relies on the person's innate potential for self healing and growth. To undergo psychoanalysis, a person must have a sufficiently stable lifestyle to meet the requirements of the treatment process. This person may have already achieved important satisfactions -with friends, in marriage, in work, or through special interests and hobbies.

Despite such achievements, a person seeking psychoanalysis can have significant symptoms, which may include: depression or anxiety, sexual incapacities, or physical symptoms without any demonstrable underlying physical cause. The person may be plagued by private rituals or compulsions or repetitive thoughts of which no one else is aware. Another may live a constricted life of isolation and loneliness, incapable of feeling close to anyone. A victim of childhood sexual abuse might suffer from an inability to trust others. Some people come to analysis because of repeated failures in work or in love, brought about not by chance but by self-destructive patterns of behaviour. Others seek analysis because their way of being restricts choices and the opportunity for pleasures (obsessive behaviour). Some people seek psychoanalytic treatment because other approaches have not resolved psychological problems, or only temporarily so.

Whatever the problem a thorough evaluation is required to determine if psychoanalysis is properly indicated. Sometimes, the evaluation takes place over a short series of interviews thereby permitting the person and the analyst some experience of each other within the therapeutic setting.

In their work however, psychoanalysts will be more interested and focused on the truths and meaning in a person's difficulty. If one were nevertheless to try to classify the many issues that bring people to analytic therapy, say using DSM classificatory systems, then one would be confronted with a wide and diverse range of problems.

Specific Disorders

Specific illnesses then, that may be amenable to psychoanalytic treatment include (but are not limited to) the following categories:

Depression - This mood symptom, which is often recurrent or prolonged, might affect some 20% of the population at some stage of life. Women are affected more often than men, though men tend to mask such symptoms by using alcohol or excessive work to avoid acknowledging such problems. Depression is often associated with suicidal thoughts, disturbed sleep, weight loss, poor appetite and decreased concentration. On occasion a tragic outcome may result unless it is diagnosed and adequately treated. Ongoing difficulties related to one's personality may play a more important role in the course of symptoms than the "trigger" which brings a person to seek help. This is why psychoanalysis can be of great help, given its emphasis on the totality of a person's life experiences when assessing treatment options, and in treatment itself.

Anxiety - This common disorder is often overlooked as a treatable problem. Often though it markedly reduces a person's activities and the ability to deal with life in general. It can start at an early age and can be associated with depressive symptoms or substance abuse as a coping strategy. The severity and range of symptoms may vary from seemingly "mild" problems such as various phobias (eg social phobia), to more generalised anxiety symptoms that may lead to difficulties in leaving one's house (agoraphobia) or in severe cases lead to panic attacks (feelings of great panic connected with feeling as if one is dying, sweating, rapid breathing, tremors and stomach disturbances). Post traumatic stress disorders too are a variant, which in chronically unresolved cases may require psychoanalytic treatment to clarify the underlying causes that hinder recovery.

Eating Disorders - This problem, which often affects young women (but men on occasion also) is associated with distortions in the perception of one's body. One sees oneself as being too fat, too ugly or in other disparaging ways. Deep seated psychological conflicts, which may take extended periods of treatment to resolve, may on occasion need to be secondary to more immediate medical concerns if the illness endangers one's health. Nevertheless in selected cases an ongoing psychoanalytic treatment may not only support the person in their quest for recovery, with or without medical help, but also lead to greater understanding about the emotional origins of such symptoms.

Somatoform Disorders - This term refers to a collection of disorders which have in common the feature of physical symptoms becoming the way a person (unconsciously) expresses psychological conflict or pain. Such people then, may be diagnosed as having Pain Disorder (where as the name suggests pain that is not otherwise explainable is the prominent feature), or Conversion Disorder (where there is a seeming loss of function eg of a limb following a stress) or Hypochondriasis (a preoccupation with illness).

Personality Problems - The way a person has developed and been shaped by internal and external forces has a profound bearing on how one can, or cannot, cope with life. A person's coping style may be as much of a problem as the stress that provokes initial symptoms. Great attention is therefore paid to this aspect of people who seek psychoanalytic help, given the intense and extended nature of the work required to resolve emotional difficulty. Nevertheless understanding and addressing personality issues may in many cases be the key to sustained recovery from emotional conflict.

Other - The above list is intended as a guide only to what may be amenable to psychoanalytic treatment. It is by no means exhaustive. Many disorders do not neatly fit the above, and many overlap with each other as well. For example victims of sexual, emotional or physical abuse often have diffuse symptoms that are recurrent and disabling but not necessarily easily categorised; this does not mean treatment is unwarranted. Indeed, psychoanalytic treatment which offers a secure and safe setting in which to explore early experiences may be the only way some people are able to approach the emotional reality of such trauma, and then start to recover. This may be more so in Child and Adolescent psychoanalysis which is a highly specialised field in itself, limited only by the availability of suitably trained psychoanalysts.

One can appreciate from the above the diverse nature of problems that may be able to be resolved over time by psychoanalysis. Treatment, being necessarily focused on uncovering hidden truth and meaning behind symptoms, may well take an extended period of time. Generally this is viewed by patients as an investment in their and their family's future, despite the time and commitment required. Critics will point out that the extended time required to resolve issues of itself means that psychoanalysis is not efficient or effective. Such criticism is in fact not supported by local and international research. While it may be true some people with certain problems may seek (and be helped by) shorter and more focused treatment options, with or without medication, only individual assessment that takes a holistic view can help people decide which treatment option best suits their needs.