What is psychoanalysis?
Who is a psychoanalyst?
What qualifications and experience will my analyst have?
How does psychoanalysis differ from other mental-health therapies?
What code of ethics do IPA analysts operate under?
How do I find an IPA psychoanalyst?
How can I find out if an analyst is a Member of the IPA or not?
How did the IPA begin?
What can psychoanalysis offer me?
Is psychoanalysis appropriate for children?
What will undergoing analysis involve for me, or my child?
To whom should I complain about or comment on the treatment my analyst is giving me?
How much will a course of psychoanalysis cost?
What is the outcome of psychoanalytic treatment?
What do we know?
What is Psychoanalysis?
Psychoanalysis is a treatment approach based on the observation that individuals are often unaware of many of the factors that determine their emotions and behaviour. These unconscious factors may be the source of considerable distress and unhappiness, sometimes in the form of recognizable symptoms and at other times as troubling personality traits, difficulties in work and/or in love relationships, or disturbances in mood and self-esteem. Because these forces are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts of will, often fail to provide relief.
Psychoanalysis, as a treatment method, is based on concepts concerning unconscious mental processes originally developed by Sigmund Freud and further developed by a considerable number of experienced psychoanalysts who have followed.
Psychoanalytic treatment can reveal how these unconscious factors affect current relationships and patterns of behaviour, trace them back to their historical origins, show how they have changed and developed over time, and help the individual to deal better with the realities of adult life.
In the course of intensive psychoanalytic treatment, the nature of the relationship which inevitably develops will have significant features deriving from the “internal world” of the analysand and become available for experience and exploration by the analysand and analyst together. It will become possible to understand many of these aspects more deeply and to work upon making meaningful desirable changes.
A person does not need to feel that they are in need of “treatment” in order to derive benefit from a psychoanalytic exploration of their own “inner world” and ways of coping with the world of people around them. A desire to “know oneself better” and – perhaps – to function better in the world may be sufficient motivation to engage in psychoanalytic exploration with a qualified psychoanalyst.
The most intensive form of psychoanalytic treatment is Psychoanalysis itself. This involves scheduling regular “sessions” of 45 or 50 minutes (depending from the country), from three to five times each week for a number of years (there are differences in frequency between different psychoanalytical cultures).
Psychoanalytic Psychotherapy, involves in general (but not necessarily) less sessions per week. Some patients start with one session a week, come to feel the need for more frequent sessions and will “build up” from a lesser number of sessions per week to a higher frequency.
The commitment to these arrangements is seriously made by both patient and analyst, and involves a commitment to pay also for missed sessions, when these may occur.
Psychoanalysis can be applied to psychoanalytically based therapies that take place in individual, group family and even organisational contexts.
Another slightly different definition can be found on the website of the Paris Psychoanalytical Society. To read this other text (available in French and English) please click here !
All members of the IPA are psychoanalysts. However, legislation regarding who may call himself or herself a "psychoanalyst" varies from country to country and sometimes between regions within a country; so that in some places: anyone, even an untrained person, may use the title. It is therefore important to know the practitioner's credentials before beginning treatment.
Graduate psychoanalysts trained under the auspices of the IPA have had very rigorous and extensive clinical education. Candidates accepted for training at an accredited psychoanalytic institute must meet high ethical, psychological, and professional standards. These candidates are either physicians who have completed a residency programme in psychiatry, psychologists or social workers who have completed a doctoral program in their fields or hold a clinical masters degree in a mental health field where such a degree is generally recognized as the highest clinical degree; all must have had extensive clinical experience.
We recommend that you work with an analyst who is a member of the IPA. As a graduate of a psychoanalytic society or association and the IPA, your psychoanalyst is connected to a tradition of training, treatment, scholarship and research that meets exacting standards recognized around the world. You can therefore be sure that you are receiving the highest standards of modern professional psychoanalysis in the Freudian tradition.
IPA analysts are graduates of one of its Constituent Organisations in over 30 countries that together comprise the IPA.
Here are some characteristics that help differentiate this treatment from other forms of psychotherapy:
* Psychoanalysis is not short-term treatment but its results are often lasting with positive effects that are usually realized in the years following the completion of treatment.
* Patients often use the couch which fosters thinking, emotional experience and self reflection and allows for privacy and connection in equal measure.
* It is the power of self understanding in the context of a facilitating therapeutic relationship that allows psychoanalysis to be effective.
* Patients are encouraged to attend frequent sessions during the work week. This allows for continuity and intensity of focus and is not a measure of the severity of the problem. Psychoanalysts are specifically trained to work in this intensive, dedicated manner in a close partnership with each patient. A wealth of experience and research has confirmed that this is the best way to help patients evolve and change in meaningful ways.
As a member of an IPA Constituent Organisation and the IPA itself, your analyst adheres to a strict code of ethics at both the national and international level. To see this code click here.
Your analyst may also be a member of another health discipline, professional body or educational institution as well as being qualified to practice psychoanalysis.
To find a psychoanalyst, you can use the search function on the homepage of this website. The IPA does not recommend individual analysts, but please feel free to contact a local Constituent Organization about finding a suitable analyst. A number of these analysts are capable of conducting analysis in a language other than the principal one of the Constituent Organization.
You can use the search function on the homepage of this website by introducing the full name of the analyst. If he or she will be displayed with name and address, he/she is an IPA member. But you can also email the IPA with the full name of the analyst - and the IPA Membership Services team will be able to tell you.
In 1902 Sigmund Freud invited four men (Stekel, Adler, Kahane and Reitler) to meet him in order to discuss his work, and they formed what they called the Psychological Wednesday Society, since they met every week on that day. By 1908 there were 14 members and the name was changed to the Vienna Psychoanalytical Society; it was in this year that Ferenczi joined it. Besides the members, there were some guests who later became important for psychoanalysis; these included Eitingon, Jung, Abraham and Jones, each of whom later became President of the IPA.
In 1907 Jones visited Jung in Zurich. It was Jones who suggested to Jung that an international meeting should be arranged to bring together colleagues from various countries in order to discuss their common interest in psychoanalysis. Freud welcomed the proposal, and it was he who chose Salzburg as the best place for the projected meeting. Jung called this meeting the "First Congress for Freudian Psychology". This very informal meeting is now reckoned to be the first International Psychoanalytical Congress, although the IPA had not yet been founded.
It was during this meeting in Salzburg, on 27 April 1908, that the idea of an international association was discussed and agreed upon. The next Congress was held at Nuremberg in March 1910, and it was at this Congress that the IPA was founded. Sigmund Freud believed an international organisation was essential to advance and safeguard his thinking and ideas.
Today the IPA is the world’s primary psychoanalytic accrediting and regulatory body. It has members in about 50 countries, mostly in Europe, North America and Latin America.
While psychoanalytic theories are of great value in understanding “human nature” itself and its cultural products in the fields of literature, theatre and, especially, cinema, they are also invaluable to individual people who are troubled by their own distressing feelings and behaviour.
People who may be severely and chronically anxious or depressed, people who may have repeated difficulties in relationships, people who may have difficulty forming any relationships at all, or people who feel an unexplained emptiness in their lives, can benefit significantly from psychoanalytic treatment.
Psychoanalysis occupies a very complicated place in the modern world: it has a great deal to offer in helping to understand one’s own “self”, and how one’s own mind operates – as well as helping to understand much of how other peoples’ minds work!
Yet, by its very nature it leads us into often quite threatening and unwelcome territory.
When “Psychoanalysis” as a treatment technique was discovered by Sigmund Freud in the very early 1900s, he quite quickly understood that his findings – through his clinical work with patients – would “disturb the world”. This has proved to be true and nowadays even the mention of the word “psychoanalysis” attracts a hostile response from many people.
Nevertheless, for those with the courage to persist – either as patients, or students of the human mind – in trying to understand what psychoanalysis has to offer, there will be considerable reward.
Psychoanalysis, by its very nature, delves into the world of the unconscious mind. It operates on the basis that our early experiences – of whatever nature – strongly influence how our minds develop and how we interact with the other people around us.
Many significant psychoanalysts have contributed to our understanding of mental development and the operation of mental processes – especially the so-called defence mechanisms – and how these help us to deal with the world around us. While “psychoanalysis” is still almost automatically connected to “Freud”, this does not acknowledge the very many advances in both theory and technique which have resulted from psychoanalytic therapeutic work and research over the past 100 years.
Psychoanalysts have also worked with very highly disturbed patients, who would otherwise be diagnosed as “psychotic” by many psychiatrists. But if both the patient and the psychoanalyst have the required motivation and courage, good results can be obtained. Nowadays, medication is sometimes used alongside the psychoanalytic treatment, although reliance is heavily on the part of the treatment which is the relationship formed with the analyst.
Further information about psychoanalysis and what it has to offer will be found in other “pages” on this website.
Some psychoanalysts specialise in the analysis of children. Child psychoanalysis – an offshoot of adult psychoanalysis - shares with it a common theoretical framework for understanding psychological life, while also using additional techniques and measures to deal with the special capacities and vulnerabilities of children. For instance, the young patient is helped to reveal his or her inner feelings and worries not only through words, but also through drawings and fantasy play. In the treatment of all but late adolescents, parents are usually consulted to round out the picture of the child's life. The goal of child and adolescent analysis is the removal of symptoms and of the psychological blocks that interfere with normal development.
Analysis is a partnership between patient and analyst, in the course of which the patient becomes aware of the underlying sources of his or her difficulties not simply intellectually, but emotionally - by re-experiencing them with the analyst. Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind. This situation, called ‘the analytic setting’, permits the emergence of aspects of the mind not accessible to other methods of observation.
As the patient speaks, hints of the unconscious sources of current difficulties gradually begin to appear - in certain repetitive patterns of behaviour, in the subjects which the patient finds hard to talk about, in the ways the patient relates to the analyst.
The analyst helps elucidate these for the patient, who refines, corrects, rejects, and adds further thoughts and feelings. During the months or years that an analysis takes place, the patient wrestles with these insights, going over them again and again with the analyst and experiencing them in daily life, in fantasies, and in dreams. Patient and analyst join in efforts not only to modify life patterns and remove incapacitating symptoms, but also to expand the freedom to work and to love. Eventually the patient's life - his or her behaviour, relationships, sense of self - changes in deep and abiding ways.
Psychoanalysis originally began as a method of treating psychological problems in adults through the so-called “talking cure”. Very soon, two leading early psychoanalysts – both women as it happened! – began to try to treat young children who were showing problem behaviours by play therapy. It was found that just as adults could express themselves with words, children would express themselves in the way they played in the presence of their analytic therapist.
Nowadays, there is separate “career path” for child psychoanalysts and psychoanalytically-oriented child psychotherapists. These professionals are especially trained to assess and treat problems in children.
Parents – or other relatives, teachers, neighbours or friends - who become concerned that a child is showing evidence of being seriously troubled should seek assessment for that child with a well qualified professional, who may recommend referral to a child analyst.
Many behaviour disorders such as inappropriate aggression, panic and anxiety disorders, inappropriate sexualized behaviours, depression-like symptoms, phobias, school refusal, eating disorders and many others can be treated by psychoanalytic methods.
If, after suitable assessment of the child with the co-operation of the parents and even other siblings, psychoanalytic treatment is recommended, then the parents will need to support the child being seen, perhaps for several sessions each week, by the therapist. The sessions will consist of play with the child in a suitably set-up play room.
Somewhat older children or adolescents may be able to undergo a modified form of the “talking therapy” without relying so heavily on play itself.
Older children and adolescents may have a form of what in adults is diagnosed as “depression” and may in fact be significantly depressed and suicidal. It is very important that such children and adolescents be given the opportunity to have their distress listened to and, hopefully, its causes understood.
Psychoanalytically trained therapists are especially equipped to listen to their young patients and to hear what is underlying the surface of the disturbing and disturbed behaviour.
Seeking suitable therapy for a child or adolescent in need of help – who is generally hardly in a position to seek out help for themselves – can avert many years of psychological disturbance and even may turn out to be life saving.
If you have a complaint about or would like to comment on the treatment you or your child has been receiving from your IPA analyst, you should first contact the IPA Constituent Organization of which he/she is a Member. The IPA can tell you if necessary the name of the Constituent Organization and its contact details.
The IPA does not set fee levels and psychoanalysts’ fees vary greatly. For those who cannot afford private fees, treatment is available through some institutes at lower cost. Psychoanalysts in training - physicians, psychologists, or social workers who are already experienced therapists - will often adjust their fees to the financial needs of the patient. In addition, because of their commitment to analysis and to community service, many graduate analysts also make an effort to treat patients at reduced rates.
Let us begin with a summary of current knowledge about outcomes of psychoanalytic treatments – and proceed to explain how this knowledge has come about later.
By combining and comparing the many past studies of a variety of treatment methods, it is now appreciated that Psychoanalytic Treatments do at least as well as – and, very often, better than - the other treatment approaches in achieving AND maintaining treatment gains - as well as continuing to show improvements long after treatment has been concluded.
Psychoanalytic treatments have been regularly “compared” to other treatment methods in recent decades. The other treatments are generally briefer, more “focussed”, talking therapies (e.g. Cognitive Behaviour Therapy [CBT], Dialectical Behaviour Therapy, [DBT], Interpersonal Therapy [IPT]) or medication with anti-depressants, or major and minor tranquilisers for anxiety symptoms.
For anyone considering entering a psychoanalytic treatment, the question about a beneficial outcome is a highly legitimate one, because entering such treatment requires investment of considerable time and – usually – financial outlay.
In the past, one often could only ask the analyst or psychoanalytic therapist themselves. Of course, these clinicians had confidence in their work – and why wouldn’t they, if psychoanalytic ideas were the very concepts which guided their understanding of the relevant disorders?
Regrettably, there has been considerable controversy over past decades about the question of outcome in psychoanalytic treatment, due to two things: firstly, an inherent difficulty in conducting the required studies into what is first and foremost a private and confidential form of therapy; and secondly, the existence of a form of hostility to the concepts and theories which inform the conduct of psychoanalytic treatments. In addition, in recent decades, the advent of increasing numbers of medications aimed at anxiety and depression, as well as at obsessive-compulsive behaviours, has offered more “short-cut” and “less deep” approaches to treatment of many disorders.
As explained in many of the sections on this part of our website the focus of attention in a psychoanalytic treatment is the relationship between the analyst and the patient as it evolves over the considerable time taken to explore the relevant problems.
In more recent years, a number of research groups have developed increasingly sophisticated studies of treatment outcome which have, to a significant degree, overcome many of the criticisms of past studies – as well as allaying the objections (in the past) of many treating analysts themselves about the intrusion into the private therapy “space” which “research methods” could involve. [You can be assured that any psychoanalytic treatment which you undertake will be absolutely confidential].
In addition, modern statistical measures have permitted undertaking of more valid comparisons between studies of outcome in different treatment methods.
In summary then, if you enter a long-term, intensive psychoanalytic treatment with a well qualified, psychoanalytically-trained clinician, you have a very good chance of achieving the goals of relieving the problems which may have caused you to seek treatment in the first place. It will take time and commitment on your part – as well as on the part of your therapist.
Thanks to the American Psychoanalytic Association (http://www.apsa.org/) for the use of "Facts about APsaA and Psychoanalysis" as a model for some of the FAQs. ‘How did the IPA begin?’ is adapted from an article by William H. Gillespie.