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What is psychotherapy?

 

 

The aim of psychotherapy is to create the space and opportunity for change and improvement by giving voice to aspects of a subject’s life that have remained otherwise silent. The most crucial concern of any psychotherapy is to respect the uniqueness of the subject in treatment. Thus, as a psychoanalytic psychotherapist, I consider the singular life history of every subject that I work with. The aim here is to provide possibilities of transformation commensurate with the individual’s subjective past experiencesand his/her interpretation of these. As a result, psychotherapy is not the place for ready-made prefabricated answers allegedly suitable for all subjects.

 

The psychotherapeutic process aims to uncover a subject’s unconscious knowledge. This is done through a slow process of free associative speech accompanied by the therapist’s interventions and interpretations. Ultimately, every human being knows the most about his/her own life. The problem is that such knowledge tends to be buried under layers of repression caused by social taboos, personal inhibitions or the pressures of unrealistic ideals. Through therapy, it is hoped that such obstacles can be lifted so that a more enriched manner of relating to one’s life can emerge.

 

As a psychotherapist working with the tools provided by psychoanalytic theory (Freud, Lacan, Laplanche to name a few of the theorists informing my practice), my work focuses on the importance of language. I thus tend to focus on patients’ words in an effort to help them reach a better formulation of their suffering. By putting their suffering into speech and by verbally expressing the psychic conflicts to which they are at mercy, subjects in therapy can find ways of relating differently to the various affects, sorrows and losses they confront in their lives. The psychotherapeutic relationship, built over time with the therapist, addresses the subject’s behaviors, memories, affects, fantasies and dreams. The most essential thing to remember when deciding to undertake psychotherapy is that time is essential as making sense of loss, anxiety and/or trauma requires patient introspection and reflection. Psychotherapy seeks to make life meaningful. This process, however, takes time but the rewards of one’s patience will become eventually evident as things slowly start to make sense. According to psychoanalytic theory, there is no way of properly living in the present with a clearly directed gaze towards the future if one does not, first of all, address one’s past. Without a proper working-through of one’s past through an in-depth exploration of dreams, memories, fantasies and traumas, the past will continue to haunt us in persecutory ways. As Milan Kundera put it most eloquently, the “past is full of life, eager to irritate us, provoke and insult us, tempt us to destroy or repaint it”. As we try to attune ourselves to the present moment and pave the way for a more fruitful and meaningful future it is central that we address the past so as to disable it from provoking us into sabotaging our present and our future through compulsions to repeat. Thus, psychoanalytic psychotherapy focuses on the whole life rather than an isolated problem. It has a wide focus and addresses the whole gamut of human suffering ranging from anxiety to depression to mania and even psychosis.

   

Before deciding to begin psychotherapy with a given individual, a number of issues need to be covered in the crucial preliminary sessions. These may be as few as one session or as many as four or five sessions. The aim of these sessions is to assess whether or not the two individuals involved (potential therapist and patient) are ready to enter into a therapeutic relationship. In these sessions, I provide interested individuals with an understanding of what psychoanalytic psychotherapy involves. Moreover, I try to ascertain what previous notions potential patients may have regarding psychotherapy. I ask them what they expect from therapy and why they chose to come and see me at this particular point in their lives. The preliminary sessions are crucial for establishing the frame of the therapeutic work to be done in the months or years to come. The frequency of sessions per week as well as the costs and fees will also be determined.

 

Beyond the possibility of undertaking long-term individual psychotherapy, I offer brief psychotherapy as well. The aim here is to focus on a particular problem over the course of a well-defined period of time (from a few weeks to a number of months). The details of the therapy are also determined in the preliminary sessions. Sometimes the aim of a shorter therapy may consist of providing a subject in emotional distress with some stabilization in order to appease and mitigate suffering. However, such an effect may eventually trigger curiosity and a desire to know more leading to the decision to undertake long-term work where the aim will consist of uncovering as much of the unconscious mechanisms guiding an individual’s life.

 

A oommon aim of therapy is to appease suffering caused by difficulties confronted in sexual relationships. Psychoanalytic theory is very aware of the problems plaguing the sexual relation between two subjects regardless of gender and sexual orientation (Lacan expressed this difficulty with his famous adage concerning the so-called impossibility of the sexual rapport). As a result, more than anywhere else in human interactions, it is absolutely crucial that people engaged in a sexual relation take the time to communicate and listen to each other. As a psychotherapist versed in the Lacanian tradition, I am very aware of the misunderstandings that such communication can bring about. One aim of therapy is to reduce the risk of such misunderstanding and to thereby help reduce feelings of alienation a subject may feel with respect to his/her partner. By providing the subject with the space to explore the emotions involved in an intimate relationship, psychotherapy can help the subject enjoy the richness of his/her emotional life without becoming victim to its intensity.

 

 

Finally, whether one seeks therapy in order to shed light on the ambiguities and ambivalences inherent to the complexities of an intimate relationship or whether one seeks to address questions related to other aspects of life (profession, social life, frienship, trauma, fear, loss), the psychotherapeutic process will always take the subject on a path of exploration that takes the whole of life into consideration rather than looking simply at an isolated symptom as though it were separable from everything else.  

 

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