The Analytic Attitude: The Essence of What We Mean by ‘Psychoanalysis’
by R. Roughton;; 3/29/2012

Psychoanalysis is really a strategy of self-discovery mainly because it unfolds within the intense therapeutic relationship. The analytic attitude may be the principle that differentiates psychoanalysis and psychoanalytic psychotherapy off their forms of therapy that aim primarily for symptom relief and behavioral change.

Psychoanalysis has evolved from the changing times once the focus was on sexual and aggressive drives additionally, on conflicts between impulses and defenses from the mind from the patient. Analysts now focus much more about amongst the whole person instead of analyzing conflicts between id, ego, and superego. Instead of instincts, the world thinks about attachments and relationships.

Transference is actually seen throughout the lens of an two-person relationship instead of merely like a projection of past desires and fears; countertransference is certainly not simply inevitable but valuable in the analytic process. The analyst is both an authentic an associate a person's encounter as well as a relatively neutral partner inside an exploratory procedure for discovery.

Psychoanalysis and psychoanalytic psychotherapy resemble inside their underlying theories, they share basic approaches for exploration and understanding, and in addition they go for change that is certainly deeper than symptom reduction. They alter from the other primarily within the intensity and depth on the exploratory process and inside the breadth of understanding and change. Psychoanalytic psychotherapy is a lot more focused and limited in scope, while psychoanalysis is undoubtedly an open -ended investigation of each and every of the person’s life.

There is often a much sharper divide between these analytic modes along with kinds of talk therapy, for example cognitive, behavioral, and supportive therapies. For convenience I talk about the second group as CBS also to the psychoanalytic therapies as PSA. In CBS approaches, the emphasis is on actively accommodating change symptoms and behaviors, whereas inside the PSA therapies the emphasis is on understanding and freeing the affected person’s inner life.

In the CBS group, therapists tend to be active in offering suggestions, clarifications, and supportive comments. Cognitive and behavioral approaches are widely-used to teach better approaches for working with day to day life along with troubling thoughts and emotions. The intent would be to reduce symptoms and improve functioning without deep exploration.

The relationship together with the therapist can be an essential part of such therapies but will not be normally the focus of attention, nor would it be explored due to its roots in past relationships. Transference usually functions as being a supportive bond that's addressed as long as it might be a damaging force upsetting treatment.

In contrast, the PSA approach regards symptoms and problems in daily life as manifestations in the patient’s inner life, reflecting enduring patterns that developed to handle earlier relationships or traumatic experiences. These patterns persist and figure out how the person feels about himself, the best way he attempts to gets his needs met, and the best way he responds in interactions online websites. Current life situations trigger these old patterns and end in feelings and actions based just as much within the past as inside the present.

In the analytic approach, treatments focus surpasses current life events to locate and understand these unconscious patterns, especially because they're revealed from the developing relationship with all the analyst. Thus their bond itself is a fertile field for exploration and analytic work. Analysts will not discount the affected person’s present reality, but an analytic approach explores current reality within the context of enduring patterns. This requires the luxurious of frequent and unhurried sessions, usually 3 to 5 times weekly for psychoanalysis and another to two times each week for psychoanalytic psychotherapy. Insight into past unconscious conflicts, in addition to the expertise in recreating then resolving those conflicts from the analytic relationship, are what make psychoanalytic approach effective and enduring.

Nevertheless, an analytic approach will not be necessarily the most preferred answer to everyone. For some, one from the CBS approaches could possibly be better to the long and arduous journey of psychoanalysis, either because from the nature on the problems or goals for treatment, or because resources are limited.

Nor do I would like to imply CBS therapists never are employed in this exploratory way. But the PSA approach is described as the consistent give attention to discovering and having the patient’s inner life and also on a complete understanding in the analytic relationship because it develops which is then resolved. Whether it is in the greater intensity and depth of psychoanalysis and the more tightly focused and limited psychoanalytic psychotherapy, I think of it as “working analytically.”

Merton Gill advised that any of us simply start to work in the analytic way and do just as much analysis because the patient’s circumstances allow. So how can we do this? The analytic process needs a particular attitude, inside a unique relationship, occurring in a very unusual setting.

First, treatments process have to be guided by an analytic attitude of non-intrusive curiosity and non-judgmental acceptance, a need to get the truth with regards to a person’s emotional life complete, respect to the patient’s individuality and autonomy, to be able to tolerate ambiguity, the patience to have to wait with the unfolding of discovery, plus the humility to revise one’s conjectures when wrong. Being helpful is often a long-range goal, not only a quick solution.

Second, the analyst have to be free enough from her conflicts allowing the affected person to project his needs, desires, idealizations, and hate onto her and also to work non-defensively using these expectations. For extended periods, she needs to be merely a container to the patient’s painful affects, confusion, and hopelessness without succumbing to prospects feelings herself. She has to be receptive to the sufferer’s transference needs and never rush to alter the distortions. Being an analyst requires emotional engagement in a intense human relationship, as well as maintaining appropriate boundaries, refraining from exploiting the person’s vulnerabilities, and keeping one’s own subjectivities and biases under control so as not to distort the individual’s technique of self- discovery.

Third, the analytic approach requires a place of safety, trust, and confidentiality that will the individual’s inner life to unfold. A completely private setting, with consistency and regularity, is significant pertaining to appointment times, frequency, and charges.

The analytic setting becomes the history of stability against which the person’s inner script will have out. The analytic attitude, the intense and profound relationship between two partners, along with the consistency from the setting all foster the unfolding associated with an inner life beyond what the sufferer is consciously conscious of, to discover what he's spent a very long time avoiding — and, within the end, to create life better.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

The Interdisciplinary Team; The Role of the Psychiatrist

by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication