Psychoanalytic Treatment

Psychoanalysis is a method for helping people with symptoms that result from emotional conflict. Common symptoms in the modern era include anxiety (fear that is not realistic), depression (excessive sadness that is not due to a current loss), frequent unhealthy choices in relationships, and trouble getting along well with peers or family members. For example, some people may feel continuously insecure and worried about doing well in school or work despite getting good grades or reviews. Other people may be attracted to sexual and emotional partners who treat them poorly. Others may experience loneliness and isolation because of fears about close relationships. Others may sabotage their success by always changing direction before reaching their goals. Children may have tantrums beyond the age when these are normal or be afraid of going to sleep every night or feel unhappy with their maleness or femaleness.

The same symptom can have several different causes, an etiology Freud termed overdetermination. For example, depression may be caused by inner emotional constraints that prevent success, by biological vulnerability, or by upsetting events (such as the death of a loved one), or it may result from a combination ofthese. Therefore, most psychoanalysts believe in meeting with a person several times before deciding upon the best treatment. Psychoanalysis is not for everyone who has a symptom. Sometimes psychoanalysis is not needed because the problems can be easily helped using other, less intensive forms of therapy. Sometimes biological problems or early childhood experiences leave a person too vulnerable to undertake the hard work of psychoanalysis. When psychoanalysis is not necessary, or not the best treatment for a particular person, a psychoanalyst may recommend psychoanalytic psychotherapy, a treatment that is based on the same principles as psychoanalysis but with less ambitious goals and, usually, less frequent sessions.

Psychoanalysis can treat specific emotional disorders, as described in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (rev. 4th ed., 2000) and can also help with multiple sets of problematic symptoms, behaviors, and personality traits (such as being too perfectionistic or rigid). Because psychoanalysis affects the whole person rather than just treating symptoms, it has the potential to promote personal growth and development. For adults, this can mean better relationships or marriages, jobs that feel more satisfying, or the ability to enjoy free time when this was difficult before. Children may do better in school after fears about competition and success diminish, or they may have more friends and get along better with parents after they begin to feel better about themselves.

Because psychoanalysis is a very individual treatment, the best way to determine whether it would be beneficial for an individual is through consulting an experienced psychoanalyst. In general, people who benefit from psychoanalysis have some emotional sturdiness. They tend to be capable of understanding themselves and learning how to help themselves. Usually, they have had important accomplishments in one or more areas of their life before seeking psychoanalytic treatment. Often, they have tried other forms of treatment that may have been helpful but have not been sufficient to deal with all their difficulties. Sometimes they are people who work with others (therapists, rabbis, teachers) whose emotions have been interfering with their ability to do their jobs as well as possible. Psychoanalysts understand such problems in the context of each individual's strengths, vulnerabilities, and life situation.

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