Does psychoanalysis work?

alias141282

I'm starting psychoanalysis shortly. I have depression which I know has its routes in my childhood. I have tried medication and CBT to no avail and now my psychiatrist has recommended psychoanalysis.

Some psychiatrists are very sceptical about it but mine has recommended it and he is a very well respected psychiartist.

Has anyone here tried it or seen it work in practice?

Odysseus

I'm a psychoanalyst and have been working in an analytic position for over a decade, within the HSE and private practice so yeah imo yes, but only if you are suitable to it. Is there any thing you would like to ask as it is totally different to CBT? Do you know what type of analyst you will be seeing as there are different schools of psychoanalysis.

alias141282

I don't know what school this analyst practices. I am just hoping its not the type where the analyst stays almost totally silent and I have to say whatever comes into my head. I presume that is quite dated now. I presume it will be more of a conversation around the routes of my problems.

Can I ask Odysseus what type of analysis you practice and how it works and how long it typically takes just so I get an idea.

hotspur

alias141282 wrote: »

Does psychoanalysis work?

alias141282 wrote: »

Has anyone here tried it or seen it work in practice?

The latter really shouldn't be considered worthy evidence of the former. You could ask the same of angel therapy for depression and get a couple of people saying it worked miracles for them.

Evidence that you can trust can only come about from scientific research. Notwithstanding the fact that there are large contentious issues of methodology, here is the American Psychological Association's division on clinical psychology position on the research on different therapies for depression:
http://www.psychology.sunysb.edu/eklonsky-/division12/disorders/depression_main.php
And specifically on short term psychodynamic therapy for depression:
http://www.psychology.sunysb.edu/eklonsky-/division12/treatments/depression_psychodynamic.html

Psychoanalysts usually have less interest in scientific research on the effectiveness of therapy than, for example, CBT'ers. When they do try their hand at such research it is often poor. Psychoanalysis and science are not friendly bedfellows.

Even the key references from the APA for psychodynamic therapy having modest research support contain people like Leichsenring who does bad science. I recommend reading this article about one of his papers and its subsequent inclusion in a meta-analysis that got a lot of attention last year:
http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2010/05/wading-through-a-sea-of-bad-science-a-closer-look-at-a-metaanalysis-comparing-longterm-and-shortterm.html

The organisation in the UK which provides guidlines for treating health problems based on good evidence - NICE - have this to say in their guidlines on treating depression:

"Psychotherapy based on psychodynamic principles has historically been provided in the NHS but provision is patchy and a good evidence base is lacking. It is therefore important to establish whether short-term psychodynamic psychotherapy is an effective alternative to CBT and one that should be provided."

None of this should be taken to mean that psychoanalysis or psychodynamic therapy (and as Odysseus pointed out there are innumerable types of these therapies) is not effective for depression in general or will be for you in particular. It should be taken to mean that they haven't as yet established a good evidence base that they are effective. But then less studies testing it have been done than CBT. Also we tend to compare the effectiveness of a therapy for depression to the effectiveness rates of other treatments. You've already tried the 2 most commonly used ones.

I felt that it is important to include that last paragraph as your post cuts along the lines of being both a quest for personal recommendation about your future treatment and a general question about whether a therapy has been found to work well for a particular problem.

I would be inclined to take the advice of a psychiatrist familiar with you and your history of previous treatment seriously in considering this matter.

alias141282

Thanks hotspur. I'm definitely going to give it a go anyway as I figure I have nothing to lose.

Odysseus

alias141282 wrote: »

I don't know what school this analyst practices. I am just hoping its not the type where the analyst stays almost totally silent and I have to say whatever comes into my head. I presume that is quite dated now. I presume it will be more of a conversation around the routes of my problems.

Can I ask Odysseus what type of analysis you practice and how it works and how long it typically takes just so I get an idea.

What you described it pstchoanalysis based upon the rule of free association, so yes that is what it is. People don't come to me to have conversations, that is not to say I don't speak but only when needed. Your words are more important than my as they speak your personal story.

We are not there to problem solve or give you advise, we are there to listen. Finally it is far from being out dated, and I would not still be working that way if I thought it didn't. Give it a try but undertaking analysis is a big committment. In my own practice I only see people weekly, I did 5 years of analysis during my training. I have just started back but I go 3 times a week.

Sorry last edit: I trained as a Lacanian therapist which is the most common psychoanalytic training in Ireland at the moment. Do you know for definite it is a psychoanalyst you will be seeing as there is often a lot of confusion around that.

It will vary if you are seeing a psychoanalytic psychotherapist or going the whole hog.

At the end of the day your paying good money to speak about yourself, so use every minute of it. Best of luck with it.

Sorry your question of time, I'm not being funny but it will tak as long as needed, that is one of those questions that can't be answered. As I noted I just started back I have no idea when it will end, I will know that when I no longer need to go. It's quite common for analysts to be in analysis at varying times during their career.