Psychoanalysis

LegacyUser

Hi,

I've been through a number of counselling based theraphies over the years from CBT to IPT but all with little effect on the root cause. I've learnt a few things about myself along the way, but essentially I've not been able make the changes I want or desire.

My latest counsellor has recommended that I try physcoanalysis which is a longer term treatment rather than short fixed term solutions such as CBT/IPT which really only work for specific problems and not a general problem like mine.

I'm not sure if I'm being given good advice here or being passed on once again. The waiting list for physcoanalysis in my area is +2years. I could go private, but with my experience of other branches of the mental illness profession it feels like I'd be burning money.

Does anyone have any exerpeience of it and would they recommend it? I know what I need to do in my life I just cannot get up/out and do it. It is incredibly frustrating for me and the counsellors just seem to want to talk about my past instead of concentrating on the present/future.

Any advice appreciated.

alias06

Hi there,

I saw your post and I just had to respond as I have been through all this before.

I would strongly advise you to be very cautious about this. There is very little evidence supporting the use of psychoanalysis for any condition and there are no controlled trials for this sort of therapy. In fact it is a model of psychotherapy that is fifty years out of date and is generally known to be ineffective. There are evidence based psychotherapies like CBT and some interpersonal psychotherapies but psychoanalysis is not supported be evidence.

Doctors and psychiatrists generally don't recommend this form of therapy because it takes a huge amount of time and is expensive with little or no return. Nowadays this "therapy" is usually recommended by counsellors when they can't get anywhere but I can tell that you will struggle to find any doctor or psychiartrist who will recommend it.

There are many different types of psychoanalysis but typically it will involve you saying whatever comes into your head and the therapist trying to analyse it or make sense of it.

My personal opinion is it is a total fraud and waste of time. When it is done and has changed nothing you have no way of getting your money back.

There are evidence based psychotherapies. Stick with those.

Greenduck

Hi OP

Psychoanalysis is not for everyone but if applied correctly - can be very beneficial. Most therapists these days work in a certain integrative way. i.e. taking parts from therapies they feel are of value and applying them in the therapy sessions. This can include person centered, psychoanalysis, gestalt, CBT, Body Orientated, Family Systems etc. While some older psychoanalytic theories are out of date, modern approaches have adapted these theories to make it much more suitable for modern therapy.

If you are looking to go deeper into your process I would personally avoid CBT. It has been proven to work but its essentially a short term fix which seeks to make the client feel better instantly, even if it means skimming over the real root of the problems. My suggestion would be to maybe call a few therapists and ask them about the type of therapies they practice and get a feel for how they work. The relationship is key.

LegacyUser

This is what I was afraid of - that I am being pushed to be got rid off by my counsellor.

Is there no positives about pyschoanalysis? My counsellor put great spin on it, but I bit my tongue at the time as after a difficult previous session this came out of the blue. It was similar with my last counsellor.

No one seems able to help me. Am I being pushed out towards the exit?

alias06

If you are going to continue with therapy then you owe it to yourself to make sure that the therapy is evidence based and that the therapist is adequately trained. I feel I have to tell you that there is a lot of poorly trained therapists out there and a lot of what goes on is simply charlatanism. Personally I would stay well clear of psychoanalysis. That sort of long term therapy is in the realm of what can never be measured and therefore never evaluated and therefore the honest truth is that in most cases nobody knows what good or harm is done.

There are reputable institutes that deliver therapy like the Clanwilliam institute: http://www.clanwilliam.ie/

Give them a call and discuss your options.

You should not be investing large amounts of time and money on a treatment that is recommended by a counsellor and not a Doctor or Psychiatrist and that isn't supported by evidence or endorsed by major healthcare providers.

You should also discuss your options with your GP. I've been through it all and I wish I could get back the money I wasted on counsellors and therapists who were happy to keep me coming back even when it was doing no good. It took me a long time to find evidence based professional psychotherapy.

Shrap

tesco_bag wrote: »

It is incredibly frustrating for me and the counsellors just seem to want to talk about my past instead of concentrating on the present/future.

This is interesting to me OP. If you're looking for the root of a problem (or even the root of how you are stopping yourself from looking at it or going about fixing it), it is often found in your past/upbringing and not in your present/future. I would have thought anyway. Certainly has been my experience. Are you maybe rejecting this approach by your previous and present counsellors, and finding no solutions as a result?

alias06

Shrap wrote: »

This is interesting to me OP. If you're looking for the root of a problem (or even the root of how you are stopping yourself from looking at it or going about fixing it), it is often found in your past/upbringing and not in your present/future. I would have thought anyway. Certainly has been my experience. Are you maybe rejecting this approach by your previous and present counsellors, and finding no solutions as a result?

Yes but sometimes going over negative experiences in the past leaves the person feeling miserable and stuck. We have all had negative experiences but endlessly rehashing and going over them is not helpful in most cases. If someone has had genuinely traumatic experiences then that can be helped with psychotherapy but it needs to done properly and there are very specific techniques and methods for doing this.

All some counsellors want to do is dig into the past because they want to believe there is always some root cause to a clients problems and in many cases there is not.

I think the OP is fed up going over the past but the counsellor wants to keep banging on about it even when it isn't helping.

Time to move on.

Molecule

Analysis is a fairly unusual thing to recommend these days but perhaps something that you've said or done while in your counselling sessions suggested to him/her that you might benefit from it. It might be a valuable experience for you but if you're looking for something directive or something that doesn't focus on the past, then I wouldn't imagine that psychoanalysis would be suitable. In traditional analysis a lot of time would pass with very little feedback from the analyst, although newer forms of psychodynamic therapy would provide a bit more in that regard.

Have you actually told your counsellor or previous therapists that you are dissatisfied and why? If not then it might be worth trying that. It's ok to tell them "I don't feel I'm getting anything from discussing X, I'd rather look more into Y." Or you could even get them to explain to you why they're taking a certain approach or concentrating on a particular thing. A very important part of therapy can be examining how and why you react to certain people or things, and how and why they react to you. It can be very enlightening though not always pleasant to hear.

Finally, you mention that the changes that you want haven't happened. With the best will in the world, no counsellor or therapist, no matter how gifted, can change things for you. You have to make the changes yourself, based on what you learn in sessions or elsewhere. Their job is to help you to understand why you think or do certain things (or what might be stopping you from thinking or doing certain things), but when it comes to using that information to make changes in your day to day life then only you can do that. Attending any sort of therapy is an active, collaborative process.

It's also worth remembering that sometimes while we may really want to change, we might not be ready to actually go through with it at this time. Within psychology it's known as the cycle or circle of change. Sometimes you can be at the contemplation or planning stage, but not yet at the 'doing' stage. A good therapist should recognise that but it might also be worth having a think about that yourself before you spend a lot of money on going private. Maybe you just need a little more time?

LegacyUser

Molecule wrote: »

Have you actually told your counsellor or previous therapists that you are dissatisfied and why? If not then it might be worth trying that. It's ok to tell them "I don't feel I'm getting anything from discussing X, I'd rather look more into Y."

The last time I tried that, the treatment was ended.

Finally, you mention that the changes that you want haven't happened. With the best will in the world, no counsellor or therapist, no matter how gifted, can change things for you. You have to make the changes yourself, based on what you learn in sessions or elsewhere. Their job is to help you to understand why you think or do certain things (or what might be stopping you from thinking or doing certain things), but when it comes to using that information to make changes in your day to day life then only you can do that. Attending any sort of therapy is an active, collaborative process.

Yes, this is what I keep telling them. I am not happy, I know what I need to do, but for seom reason I can't/won't do it. Yet, they seem to want to continually delve into my past and not actively help me figure out my present issues and inability to change things. I know what I need to do - I just can't do it.

Maybe you just need a little more time?

The clocks been ticking for over a decade now. How much more time do I need?

Are you maybe rejecting this approach by your previous and present counsellors, and finding no solutions as a result?

We know what the cause is. It was an upbringing where there was little social interaction or conversation which resulted in me not learning how to integrate socially. I'm fine at work, but socially I am inept. Especially with opposite sex. I have no likes/interests which means I don't go out. It has now got to the point where socialising is scary for me and totally out of my comfort zone. I manage to do it at times, but I normally take 'prefer' to remain in my comfort zone.

LegacyUser

I've just been reading through the other threads since I posted my previous reply.

Out of curiosity I clicked on this one: http://www.boards.ie/vbulletin/showthread.php?t=2057317255

Reply #9 interested me, so I toddled off to You Tube and found the video. About half way through it started saying things which I could relate to. And it has got me wondering...

Has there been any follow up to this? Any more research?

From a quick google there are people reporting an increase in intensity etc, but I'm sturggling to find anything related to mood, depression and ability to get out and on with life.

ahnow

I'd highly recommend the Clanwilliam Institute as well, fantastic help.
Psychoanalysis has been updated in their methods also and would be quite similar in a lot of ways to any psychodynamic therapy. An earlier poster mentioned that all they do is get you to mention random words that pop into your head...this is not true!
CBT is good for short term solutions and helping to ease of symptoms but it dont tackle any underlying issues.
Some sort of psychodynamic or psychotherapy might be more helpful, but it might take a few tries to find a therapist that suits you, OP.

LegacyUser

I can't use the Clanwillian Inst. as I'm not near it.
I'm a bit fed up with the whole thing to be honest.

From my previous reply, porn might have had an effect on me (or made a problem worse) but I think that there are other issues too that need addressing. I@m just really wary of an approach that has been slated in the majority of articles I've read.

Semele

Psychoanalysis is a complicated theory that is hard to explain simply, unfortunately! You understand it more through experience of it than you can from having an overview in advance. It was the earliest formal type of psychotherapy and has been subject to a huge (and often deserved) amount of criticism. But do keep in mind that modern psychoanalysis is a very different beast to the classic Freudian model and has adapted to take into account much of our current understanding of attachment theory (http://en.m.wikipedia.org/wiki/Attachment_theory), which actually fits very well within a psychodynamic framework.

You will often find that CBT has supposedly the greatest effectiveness of all therapeutic models. I both agree and disagree with that. I think it does a brilliant job with what its for, but it by no means suits every person or every problem. It's a complicated issue to get into, but there are a lot of critical debates within the field of psychotherapy research about what constitutes "evidence" when talking about personal meaning and experience. CBT performs better than other therapies in randomised-controlled trials (RCTs), commonly understood to be the highest form of evidence. But this is a model from physical health research, where one works on the assumption that apriori defined symptom reduction equals improvement. However, I have known many client who actually worsen on standardised measures of depression, social functioning etc during the course of therapy and who at the same time report great benefit in terms of insight and meaning. They may objectively be more "depressed" for a time, but subjectively find that they are evaluating and living their lives in an increasingly more authentic manner. I don't think an outcome measure intended to capture hard, replicable data such as the outcome of physical tests can account for such personal events.

Evidence that what we do works is essential in psychotherapy. I just don't always believe that our current medical model of judging this is applicable to meaning-filled issues. So don't be overly put off by criticisms of psychotherapy. Try it, with a therapist you connect with, and see what you think is working for you. It looks like CBT hasn't, despite its apparent evidence base. So start to question that, rather than think you have failed!

I'd recommend you read Irvin Yalom's book- The Gift of Therapy. He's a famous existential psychotherapist and the book is a series of short essays on aspects of psychotherapy. If you feel it connects with your experience and feelings then that might be an indication that psychoanalytic psychotherapy might have something to offer you.