What is a psychoanalyst? Diseases treated by a psychoanalyst

Many people wonder who he is and how he differs from a psychiatrist or psychologist.

A psychoanalyst is a specialist who deals with psychoanalysis. In order to engage in this field of activity, it is necessary to obtain additional higher education.

What does he do?

The main task of his work is to help the individual understand himself. The specialist helps patients reorient their life path and identify hidden factors in psychological behavior.

If you notice any mental disorders that do not allow you to lead a full life, then the first thing you should do is consult a doctor in this category.

This is a kind of psychotherapist who has basic knowledge of psychology and is professionally trained.

How does an appointment with a psychoanalyst go?

A specialist has one medical tool - the word. He only treats them.

Freud called this treatment “truth therapy.”

The result of remembering, realizing and understanding the truth gives the client the opportunity to know the truth of all his past experiences.

Psychoanalysis can last several months with regular long conversations. Treatment will be considered successful if a person can independently look for the causes of his subconscious conflicts and successfully resolve them.

Treatment methods

There are several methods of psychoanalysis that help to get to the depths of the human subconscious. Let's look at them

Free association

To achieve free association, there must be the most comfortable and favorable conditions.

During treatment, the person should be as relaxed as possible. He is asked to sit down on a soft chair with a backrest and say all his thoughts and memories out loud (absolutely everything that comes to mind). These may even be absurd, trivial, illogical thoughts. An important condition for such treatment is the absence of a doctor. The client only needs to hear it. This way the patient can relax as much as possible.

The main goal of free associations is to reach the deepest connection, which is located at the very depths of the human subconscious. In this way, the specialist will be able to find out the reasons that suppress a person so much.

Interpretation of resistance

As scientific research shows, a person usually fails to remember something to which the subconscious has a certain resistance. In his subconscious, the client wants to change something, forget, end his suffering and unconsciously resists. The main task is to rid him of the old, unsatisfactory model of behavior.

It is very important that the specialist knows how to work with resistance correctly. Only then can a positive result be achieved.

There is another interesting method that will reveal all the secrets of the unconscious. To do this we need to analyze dreams. Freud always argued that the content of dreams is the repressed desires of a person. He conducted a lot of research and came to the conclusion that through a dream one can determine a person’s unsatisfied desires and experiences.

Psychoanalysts tend to say: if you work with dreams correctly, you can understand the depth of an individual, his symptoms, and motivational conflicts.

Emotional retraining

This is the process of encouraging patients to use new, intellectual insights into their routine. Each of the methods of psychoanalytic treatment leads to the fact that the patient begins to deeply understand the reasons for his behavior.

This method of therapy is carried out at the final stage, since independent awareness is first necessary.

How to find a good specialist?

A person who received qualified assistance was satisfied with the result will definitely tell his friends and acquaintances about it.

Psychoanalysts are not accepted on the premises of ordinary hospitals. They work on the premises of private clinics, since effective communication requires a favorable, comfortable atmosphere, and a public hospital, unfortunately, does not have such conditions. The psychoanalyst works independently and does not ask for help from other specialists.

Child psychoanalyst

The children's specialist needs to gain favor with him, that is, to make him as interested in the conversation as possible. The moment of conversation can be diluted with role-playing games, communicate, reward for good behavior.

Why does a child need such help?

A pediatrician will help you deal with problems of communication and behavior with peers. It will also help to find the true causes of hyperactivity, lack of perseverance, suspiciousness, attention problems, shyness, stubbornness, absent-mindedness, uncertainty and many more children's problems on a psychological level.

What are the benefits of a qualified psychoanalyst?

A real doctor gives patients more space. Always treats clients in a friendly, respectful, non-directive manner. Listens carefully to all free associations, tries to find out the provoking factors of problems of internal self-knowledge. The doctor will be helped in this by his knowledge, experience, and conscious empathy.

Always listens to the feelings that arise during the process of communication with the patient, and then analyzes everything he hears.

Remember that in the process of work there should be no relationship between the doctor and the patient, just a conversation - that’s all. Moreover, during some treatment methods, the patient does not see a specialist at all. There is a so-called conversation with oneself alone.

The psychoanalyst has no right to disclose all information received. Everything remains only between them.

Mental disorders are often treated by a psychiatrist, who uses specific medications to achieve the desired result. However, in medicine there are softer and more accessible methods of influencing human consciousness. Psychoanalysis was created by the Austrian doctor Sigmund Freud (Austrian neurologist, psychiatrist and psychoanalyst) to eliminate pathological drives, childhood traumas, neuroses and depression. A psychoanalyst treats mental disorders. The doctor uses his verbal skills to establish rapport with the patient.

Competence of a psychoanalyst

A psychoanalyst is a doctor who has completed higher medical education and completed an internship in the specialty “Psychiatry”. A specialist can explain to a person the reasons for the appearance of internal problems, the psychology of decisions made, actions and actions. To confirm the qualifications of a psychoanalyst, the doctor is required to undergo training with a more experienced colleague and receive a certificate of completion of the courses.

The doctor examines the following points from the patient’s life:

problems that arose in childhood;
pleasant and unpleasant memories from the past;
fantasies and forbidden desires;
vivid dreams or nightmares;
various positive or negative thoughts;
experienced tragedies and stress.

A psychoanalyst, using his methods, “penetrates” a person’s consciousness, assesses the complexity of the situation and directs the patient to the right path to solving the problem. The doctor makes it clear to the patient how to get out of the current situation.

The specialist in practice uses the following methods of psychoanalysis:

The personality method studies a person’s relationship with people, society, and life in general.
The free association method is based on the ability of a person to reason about anything, regardless of the topic of conversation. A person can safely “open his soul” knowing that everything said will not leave the room. The doctor learns a lot about the patient, including bad deeds, complexes, tragedies and desires.

Using one of the methods, the psychoanalyst gains confidence in the person, penetrates the consciousness and mind. This is required to conduct a deep analysis of the individual's inner world.

What complaints do people turn to a psychoanalyst for?

Physically healthy people come to see a psychoanalyst who want to understand their inner world and get rid of pressing problems. Such clients may make the following complaints:

a state when life is not interesting, work does not bring pleasure;
a sudden jump in ideas, when a person jumps from one thought to another;
anxiety and uncertainty in close relationships with a woman or man;
emotional instability;
sometimes there is a desire to commit a crime;
a feeling of anger and aggression occurs after a minor quarrel with a stranger;
panic, fear;
obsessions with persecution;
frequent conflict situations that do not have a serious background;
frequent fantasies based on vulgar thoughts of a sexual nature;
sudden changes in mood and behavior;
severe experiences associated with stress;
touchiness and tearfulness.

Such symptoms are not associated with damage to the brain structure. The reason lies deeper in the recesses of the soul. The psychoanalyst listens carefully to the patient, directs the patient’s thoughts to the right path and receives the necessary information.

How does an appointment with a psychoanalyst work?

A person with mental problems often withdraws into himself. To reveal the essence of the patient, the psychoanalyst uses a number of specific techniques:

the session lasts no more than 50 minutes. This is one of the rules of psychoanalysis. It is during this time that you need to turn the client’s soul inside out and delve properly into the problems;
the doctor can sit on a nearby chair or walk around the room while the patient expresses his thoughts;
The main rule of psychoanalysis is the theory of free associations. The bottom line is that a person is given complete carte blanche. You can talk about whatever you want. They often remember stories from childhood, youth, and especially pleasant moments. As a rule, a person approaches fears or conflict situations with caution until he understands that the doctor can be trusted. This can happen in one session, and sometimes after several months of active visits to a specialist;
the ability to talk about everything is known in psychoanalysis as the “passenger effect.” After the information received, the doctor evaluates all the data and selects the main concept according to which he will offer the person a way out of the current situation.

At first, it is very difficult to talk about your problems openly and “without a mask”. Gradually, confidence in the doctor comes, stiffness goes away and a feeling of lightness and trust appears.

Diseases treated by a psychoanalyst

A psychoanalyst primarily treats mental disorders that do not require drug therapy. A specialist can relieve a client from the following disorders:

Psychosis. At the same time, the person inadequately assesses the current situation, perceives the environment distortedly and behaves strangely. Patients suffer from split personality, aggression, persecution mania, and delusional ideas. Often these problems appear after suffering stress, sexual abuse in childhood, with a fast pace of life, absence of parents, relatives and poor social conditions.
Phobias or fears. Fear of heights, darkness, crowds, and various animals affects a person’s nerves. At the same time, patients fear for their lives, become arrogant, and overly cautious. The doctor can “pull” the phobia out of the head through a conversation, during which the person opens up and gives the opportunity to release his fear.
Neurosis. Mental illnesses are reversible and have a long course. A person's performance and mental activity decreases. Emotional instability, fear, tearfulness, attacks of aggression and anger, weakness, and mood swings appear.

Also, a psychoanalyst can help get rid of hesitation in making important conclusions necessary for work. The doctor analyzes so that the patient believes in himself, breaks boundaries and crosses the threshold of self-doubt.

Psychoanalyst Research Methods

The psychoanalyst does not prescribe the usual blood tests, etc. This is not necessary when the problem does not concern the physical body. In psychoanalysis, the mental aspects of human activity, his behavior and fears are important.

During the entire work cycle, the following analysis methods pass through the patient:

Accumulation of received material. In this part of the study, the doctor forces the patient to talk about his life and important moments. A person also needs to tell a specialist about his dreams.
Interpretation. This is where the psychoanalyst comes into play. The doctor talks to the person about his life decisions, right or wrong choices and dreams. He sorts out “to the bones” all the flaws of the inner world and consciousness.
Elaboration. This is the final stage of psychoanalysis, when a person begins to understand himself independently. Gradually, a chain of events develops that leads to the only correct exit.

With the help of these methods of psychoanalysis, a person’s consciousness changes. Patients receive satisfaction from the work done and the results obtained.

Psychoanalysis is necessary to overcome those problems that are difficult for a person to deal with on their own. A specialist in this field of psychiatry advises the following:

You can overcome fear even before the onset of this feeling. You need to convince yourself that the problem is inside your head, it doesn’t exist externally;
You should increase your level of self-esteem for yourself, and then for those around you. Self-confidence helps strengthen authority;
It is sometimes difficult to avoid doubts when making an important decision. To prevent this from happening again, you need to stop changing conclusions to suit the situation. If a person has decided that he will do this and not otherwise, he needs to act. Even a negative result will teach you to avoid similar situations in the future;
Neuroses do not appear in people who have a strong family. Love for loved ones extends to all areas of a person’s activity and protects him from troubles.

Psychoanalysts advise maintaining humanity in any difficult situations. This will help further protect your “inner self” from frustration and friction.

The psychotherapist's task is to help the patient remember, identify, and reintegrate unconscious contents so that the patient's ordinary life can be more satisfying.

Freud says:

“We take an oath from him to obey the fundamental rule of psychoanalysis, which is that from now on we have to regulate his behavior. He must tell us not only what he can communicate intentionally and readily, which gives him a feeling of relief, as in confession, but everything else that comes to mind, even if he is unpleasant to talk about it, even if it seems unimportant to him or virtually meaningless” (1940, p. 31).

The psychoanalyst relies on these discoveries without criticizing or approving them in their essence. The psychoanalyst does not take a moral position, but serves as a blank screen, reflecting the views of his patients. The therapist tries not to show his personal attitude towards the patient. This gives the patient the freedom to relate to the psychoanalyst in a variety of ways, transferring onto the therapist attitudes, attitudes, even physical characteristics that actually belonged to people with whom the patient interacted in the past. This transference is crucial in the psychotherapeutic process, since it transfers past events into a new context that is conducive to their understanding.

For example, if a female patient begins to treat a male therapist as her father, in an outwardly submissive and respectful manner but in a covertly hostile and disrespectful manner, the psychoanalyst can clarify these feelings to the patient. He may point out that it is not he, the therapist, who is causing these feelings, but that they arise within the patient herself and may reflect aspects of her relationship with her father that she once repressed.

“To resist this all-round attack from the patient, the psychoanalyst needs to analyze himself completely and completely... The psychoanalyst, on whom the fate of many people depends, must know and keep under control even the most difficult to eradicate defects of his own character; and this is impossible without a complete psychoanalysis” (Ferenczi, 1955).

“The concept of transference... states that observing, understanding and discussing the patient's emotional reactions to the psychoanalytic situation establishes the most direct ways of achieving an understanding of his character structure, and therefore his problems. It becomes the most powerful and indeed necessary instrument of psychoanalytic therapy" (Horney, 1939, pp. 33-34).

Transference makes psychotherapy a living process. Instead of just talking about life, the patient forms a critical relationship with the therapist. To help the patient make these connections, the psychoanalyst interprets some of what the patient says, suggesting links that may or may not have been previously recognized by the patient. This process of interpretation is a product of intuition and clinical experience.

In the psychoanalytic procedure, the patient is encouraged to never repress unconscious content. Freud saw psychoanalysis as a natural process; the energy which has been repressed slowly passes into the realm of consciousness, where it can be used by the improving ego: “Whenever we succeed in analyzing a symptom at its root, freeing the drive from one dependence, it does not remain isolated, but immediately enters into a new one.” addiction". The task of the psychotherapist is to identify, explain and separate the constituent elements of drives that are denied or distorted by the patient. “Psychosynthesis is thus achieved during the analytic treatment without our intervention, automatically and invariably” (1919, p. 161). The transformation of old, unhealthy habits and the establishment of new, healthier ones occurs without the intervention of a psychotherapist.

The training of a psychologist consists of obtaining a higher psychological education, possibly additional courses and seminars. In addition to higher psychological education, a psychotherapist undergoes training in some type of psychotherapy; sometimes, when preparing a psychotherapist, it is necessary to undergo personal training psychotherapy. A psychiatrist is a doctor who has received medical education. Some psychiatrists receive additional training in psychology, in which case they may also provide psychological counseling or psychotherapy.

The psychoanalyst has a higher education, as well as additional psychoanalytic education. Also, during professional training, a psychoanalyst must undergo personal training psychoanalysis (at least 3 years) in order to work through his own internal conflicts, learn to understand his unconscious, in order to better understand the unconscious of his patients. A good psychoanalyst continues his training throughout his life, attending psychoanalytic conferences, seminars, and supervision.

2) Working methods.

A psychologist can work within one of the areas: cognitive psychology, Gestalt psychology, existential approach, etc. He can work with adults, children or families. Psychologists often practice an eclectic approach, combining different theories, approaches, and methods. Consulting psychologists can give advice, instructions, develop a “life plan,” give their clients homework, and practice various behavioral and communication skills with them. The work is aimed directly at changing behavior, thoughts, emotions. The work is carried out on a conscious level, with visible manifestations of problems.

Usually adheres to one or more areas of psychotherapy in which he has received training. This could be hypnotherapy, psychoanalytic psychotherapy, existential psychotherapy, etc. The work of a psychotherapist is more systematic and deeper than the help of a consulting psychologist. Meetings are held regularly, there is a certain course of psychotherapy.

A psychiatrist administers medication, diagnoses and, based on this, prescribes the necessary medications to the patient.

A psychoanalyst works with a patient in only one direction - psychoanalytic. He may offer psychoanalytic psychotherapy or psychoanalysis, depending on the problems and capabilities of the patient. The work is carried out at the deepest level - the unconscious. Psychoanalytic treatment is a long-term process with a fairly high frequency of regular meetings with a psychoanalyst. The psychoanalyst does not give homework, does not impose his opinion or values, and does not teach the patient how to live correctly.

3) Treatment results.

Successfully works with situational problems that have appeared recently and are not characteristics of a person’s character. In this case, the results of working with a psychologist usually appear quite quickly in the form of changes in behavior, communication, and decision-making on an issue of concern. But if the problems are located in a deeper layer of the personality, then over time they return and require more in-depth study - with the help of psychotherapy or psychoanalysis.

Psychotherapy treats a wider range of problems, from neuroses, addictions to psychosomatic personality problems. The results of psychotherapeutic treatment are more stable; changes affect a person’s character, behavior, thinking and feelings.

Drug treatment administered by a psychiatrist usually produces quick results, but while it often improves some aspects of a patient's life, it worsens others. For example, anxiety decreases, fears decrease, but at the same time indifference and emotional insensitivity appear. Medicines provide only a temporary effect; as soon as the medication is finished, all symptoms return. Therefore, for complex problems, drug treatment must necessarily be accompanied by psychotherapy or psychoanalysis.

Psychoanalysis and psychoanalytic psychotherapy successfully work with deep-seated problems, with the unconscious level. This is especially effective when the causes of nervous disorders and depression are unclear. Psychoanalysis is aimed at a person’s greater understanding of himself, his unconscious feelings, conflicts, and fears. Psychoanalysis is aimed not so much at getting rid of symptoms (during psychoanalysis they go away quite quickly on their own), but at exploring one’s inner world, one’s feelings. The main results of successful psychoanalysis are personal maturity, awareness of life, a feeling of greater freedom, independence and the discovery of the ability to be creative and enjoy life. Of course, these goals require deep personal changes, which take more time. Therefore, psychoanalysis and psychoanalytic psychotherapy can take from six months to several years.

II. What should a good psychoanalyst be like?

In our country, a psychoanalyst is not a doctor, as is customary in the West. For us, this is a specialist with a higher education, usually psychological or medical, who has received additional professional education in psychoanalysis.

So, a good psychoanalyst has additional specialized education in psychoanalysis (lasting at least 2-3 years), has undergone personal psychoanalysis, i.e. visited his own psychoanalyst for at least 3 years with a frequency of 3-4 times a week, as a rule, is a member of some professional community, continues his professional development. A professional psychoanalyst cannot combine psychoanalysis with anything else. If a psychoanalyst tells you that, in addition to psychoanalysis, he also practices hypnosis or combines it with Gestalt therapy, then you should think about whether to contact such a specialist. Since it takes a lot of time to master psychoanalysis at a professional deep level, there is no time left to study other types of psychotherapy. Such a multidisciplinary psychoanalyst speaks only of his superficiality. In addition, psychoanalysis is a specific technique that is not compatible with other methods. It is impossible to conduct psychoanalysis and then simultaneously engage in hypnosis or use any other method with the same patient. But these are formal aspects of the choice of a psychoanalyst. In addition, there are other aspects that manifest themselves directly in interaction.

A good psychoanalyst will not promise you quick results; he will not say that all your problems will be solved in a few meetings or a few months. Moreover, these should be regular meetings at least 2 times a week.

Psychoanalysis is perhaps the most non-directive method of psychotherapeutic assistance. Therefore, the psychoanalyst does not give advice, does not convince the patient, does not insist on his vision, does not hypnotize, does not engage in suggestion.

The psychoanalyst provides the patient with a “space” where he can feel safe and where he can think, feel what is happening to him, where the patient’s own thoughts and associations can appear. This space is created by the fact that the psychoanalyst interferes minimally and is silent a lot. When a patient finds the analyst's silence difficult to bear, then the psychoanalyst adapts to him, becoming a more active participant in the interaction in order to reduce anxiety and discomfort. Here it is important to mention the main rule of psychoanalysis - the rule of “free associations”. It means that the patient can talk about whatever comes into his head, no matter how stupid or irrelevant it may seem to be.

In general, a good psychoanalyst, in addition to knowledge, must have developed empathy in order to understand the patient’s feelings. He listens carefully to the patient in a certain, psychoanalytic manner, which helps him deeply understand the patient's inner world. The psychoanalyst's feelings are his main tool for understanding. You can say that he works through his feelings, using them. But, the psychoanalyst usually does not reveal his feelings, does not speak directly to the patient about them, but, based on them, makes interpretations about what is happening with the patient or in their interaction.

What happens in the relationship between the patient and the psychoanalyst is one of the focuses of the psychoanalyst's work. Through the analysis of these relationships, the patient’s feelings, conflicts, and fears are understood and processed and changed. Psychoanalysts call this “transference analysis”, i.e. analysis of the feelings that the patient has towards the psychoanalyst. Therefore, it is so important that the patient understands his feelings towards the psychoanalyst and can talk to him about them.

A good psychoanalyst is always friendly and respectful, trying to give interpretations as empathetically and gently as possible so as not to hurt the patient, since discovering something inside oneself can be unpleasant.

It is difficult for us to face our shortcomings, our aggression, envy, fears, emptiness. Confronting these feelings may cause resistance to further psychoanalysis. On the one hand, we consciously want to change our lives, to change ourselves. On the other hand, we are used to living this way and have become very rigid; unconsciously we do not want to change, we want to leave “everything as it is,” any changes (even good ones) are perceived as undesirable.

The psychoanalyst also works with this part of the personality, which is already accustomed to problems and symptoms and does not want to part with them. Of course, such work can cause anger, irritation, dissatisfaction in the patient, and a desire to escape from it. Therefore, the so-called “resistance analysis” in psychoanalysis is the second important focus of psychoanalytic work. Knowing this, the psychoanalyst listens carefully to the patient and helps him see such moments of his “resistance”, analyze them in order to overcome them together and continue the analysis. It is precisely in order to be able to overcome such resistances that always arise during psychoanalysis that the psychoanalyst enters into an oral contract with the patient. It stipulates such a condition that when the patient has resistance to analysis, which is often expressed in the desire to leave the psychoanalyst and complete psychoanalysis, then he must come to several more meetings (usually about 4) in order to have the opportunity to talk about the resistance that has arisen and overcome it.

Also, the psychoanalyst does not reveal personal information about himself to the patient, and does not enter into any other relationship with the patient other than psychotherapeutic (friendship, partnership, love, etc.). The less the patient knows about the psychoanalyst, the more freely he will fantasize about him, which will help to quickly understand the patient’s unconscious conflicts and resolve them.

The psychoanalyst does not violate the terms of the oral contract with the patient. If possible, he informs in advance about breaks, rescheduling of meetings, and changes in payment. All these conditions are included in the concept of “psychoanalytic setting”, which is discussed in this article.

So, let's summarize.

A good psychoanalyst:

gives enough space to the patient;
friendly and respectful, non-directive;
listens to the patient's free associations;
tries to understand the patient’s inner world using his knowledge and experience, empathy;
makes interpretations about what is happening in the patient's unconscious;
uses his feelings that arise in communication with the patient as the main tool,
analyzes what is happening between him and the patient, the patient’s feelings towards him;
analyzes resistance to psychoanalysis when it appears;
does not enter into any other relationship with the patient, does not disclose information about the patient.