People decide to go into psychoanalysis for lots of different reasons. It may be that they’re having difficulties with work, study or family life or are having problems around love, sex, gender & relationships. It may be that they have worries about their identity or are struggling with difficult choices in their life. They might have had some sort of mental health problem or perhaps have had issues with drug & alcohol use. They may simply have a sense that there are patterns in their life that limit their freedom and seem beyond their power to change.
How was psychoanalysis created?
In 1882, an Austrian woman called Bertha Pappenheim – later a well-known social worker, feminist and writer – made a treatment suggestion to her doctor, Josef Breuer. Calling it the ‘talking cure’, she asked him if he would agree to simply listen to her while she spoke to him at length about her life and the problems that she was experiencing. Breuer accepted her request and later discussed this method of treatment with a close colleague of his, the neurologist and psychopathologist Dr. Sigmund Freud. Freud adopted and greatly developed this technique in his own work and all of what later became the talking treatments found their beginning here. Freud gave the rest of his life to developing the practice and theory of psychoanalysis. Forced to flee the Nazi persecution of the Jews, he left Vienna in 1938 to live in London and worked there until his death in 1939. Freud’s creation, psychoanalysis, has always held that human suffering finds a unique expression, treatment and transformation through the work of speech in the analytic setting.
In 1951, the French psychiatrist and psychoanalyst Jacques Lacan started to hold a regular teaching seminar in Paris in which he developed what he described as his ‘return to Freud’. Hugely influential in Parisian cultural life as well as in psychoanalytic theory and clinical practice, the seminars drew great crowds and carried on for thirty years until his death in 1981. His work has had lasting effect on psychoanalysis worldwide and it’s estimated that about half the world’s analyst are now trained in Lacanian frameworks. Interest in Lacanian practice has been growing in the UK since its introduction in the 1980’s and there are now two UK-based training and research organisations: The Centre for Freudian Analysis and Research and The London Society of the New Lacanian School.
Lacan’s written work has a reputation for being difficult and complicated but his ‘return to Freud’ was – in part – simply an effort to remind his fellow analysts that the speech of the client was the centre of the treatment, not the supposed knowledge, technique or ‘expertise’ of the analyst. The talking treatment has its effects, said Lacan, because human life is woven through with speech and language.
Are sessions always fifty minutes long?
One of Lacan’s innovations in analytic practice was the variable length session and so there’s no set ‘fifty minute hour’ in a Lacanian psychoanalytic treatment. In much the same way that someone writing a sentence doesn’t have to put in a full stop or a comma a certain set number of seconds after they start to write, an analytic session doesn’t necessarily end a certain set number of minutes after it starts. Sessions then will often come to a close at a point relative to the speech of the person rather than the hands of a clock. One consequence of this is that Lacanian work is quite focused, the sessions are shorter and tend not to involve long periods of silence. Shorter sessions are also perhaps a bit easier for people to fit into busy, modern lives.
Do people really lie on a couch when they talk?
Each treatment is built around the individual. Some people may work better while lying on a couch and some will be better off in some variety of a face-to-face setting. All analyses start with a series of sessions which are called ‘preliminary discussions’ and which may go on for some time.
How many sessions are there in a week?
Once a week seems to be the minimum if a treatment is to gain and keep a useful working momentum and it can often be helpful to speak more than once a week – but there’s no ‘norm’ for this. The conditions of the work are discussed in the first sessions but this can be revisited at any time. Sessions can be spread across the week or can happen in the same day.
How long will the treatment go on?
It is entirely up to the person concerned – the ‘analysand’ – to decide this for themselves: one session may be enough or a treatment may continue for months or indeed years.
How much does it cost? Is there a fee for the first meeting?
In the same way that there’s no standard treatment in psychoanalysis – since there aren’t any standard people seeking treatment – there’s no standard fee either. It’s important that fees are appropriate, affordable and sustainable for each person and so fees – including those for the initial session – are agreed only after a discussion of individual circumstances.