Psychoanalysis is based on the observation that individuals are often unaware of the factors that determine their emotions and behavior. Because these factors are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts will often fail to provide enough relief. Psychoanalytic treatment explores how these unconscious factors affect current relationships and patterns of thought, emotion and behavior. Treatment traces theses patterns back to their historical origins, considers how they have changed and developed over time, and helps the individual to cope better with the realities of their current life situation. Analysis can be viewed as an intimate partnership, in the course of which the patient becomes aware of the underlying sources of his or her difficulties, not simply intellectually but emotionally as well – in part by re-experiencing them with the analyst. From the beginning of therapy, patient and analyst work together to build up a safe and trusting relationship that enables the patient to experience aspects of his or her inner life that have been hidden because they are painful, embarrassing, or guilt-provoking.
In psychoanalysis, the patient typically comes four times a week, lies on a couch, and attempts to communicate as openly and freely as possible, saying whatever comes to mind. These conditions create the analytic setting, which enables you to become more aware of aspects of your internal experience previously hidden. As you speak, hints of the roots of current difficulties that have been out of your awareness gradually begin to appear – in certain repetitive patterns of behavior, thought and emotion, in the subjects which you find hard to talk about, in the ways you relate to the analyst. The analyst helps to identify these patterns, and together you and the analyst refine your understanding of the patterns that limit you or cause you pain, and help you elaborate new and more productive ways of feeling, thinking and behaving. During the years that an analysis takes place, you wrestle with these insights, going over them again and again with the analyst and experiencing them in your daily life, fantasies, and dreams.