I am often asked to explain what psychotherapy is. Or more particularly : what does one talk about in therapy?

The simple answer is that the client talks about whatever comes into his mind during the session. It is nature of the talk, or discussion,  in therapy that distinguishes it fundamentally from everyday discourse.

Sometimes the emotional distress that is being experienced is woven deeply into the person’s life. In many cases it is only through therapy that this distress can be accessed and explored.

Psychoanalytic Psychotherapy focuses on a number of areas to help the client access the areas in his life that are causing difficulties.  I have outlined these areas below.

Focus on Feelings

The therapist helps the client describe and put into words feelings that may be troubling, threatening or feelings that he may not have been aware of. Psychoanalytic Psychotherapy resonates at a deep level and gives an experience that is different from an intellectual understanding. Many intelligent people can explain the reasons for their difficulties yet their understanding does not help them overcome these difficulties.

Exploring distressing thoughts and feelings

The client may avoid certain aspects of experience that are troubling or painful. The therapist may draw the client’s awareness to the way he describes a troubling event. In many cases the client may do this without talking of how the event affected him.

The therapist may also explore why a client comes late or misses sessions.  Sometimes therapy can bring up subjects that the client wishes to avoid.  The client may not be aware that he is doing this and acts out by coming late or missing sessions.

Recurring Themes

The therapist helps the client to identify recurring themes in a person’s thoughts, feelings, self-concepts or life experiences. In some cases the client may be acutely aware of these but may feel drawn into situations and feel unable to do anything about them. E.g. a man is consistently drawn romantically to women who are unavailable.

Discussion of Past Experience

Past experience of major figures in our lives affects our relationships. The therapist highlights how the past lives on in the present. The goal is to help the client live more fully in the present.

Focus on interpersonal relationship

Psychotherapy places a heavy emphasis on the client’s relatonship and interpersonal experience. Aspects of our personality are forged in the context of interpersonal relationships.

Focus on the therapy relationship

This relationship can become deeply meaningful. If there are repetitive themes in the person’s way of interacting then these will emerge in the therapy sessions. For example, a person prone to distrust others will also distrust the therapist. This can be brought alive and examined in the safe confines of the relationship. The goal is greater flexibility in relationships and enhanced capacity to meet emotional needs.

Exploration of Fantasy Life

From the beginning of therapy the client is invited to say whatever comes to mind regardless of how silly, embarrassing, Irrelevant or random it may seem. Daydreams, desires and fantasies are also explored. In many cases these may not have been put into words. This area is a rich source of information about how a person sees himself and others and how he makes sense of experience.

What are the benefits?

Psychoanalytic Psychotherapy is not just about symptom remission. It is about developing one’s own psychological capacities. These may include:

• more fulfilling relationships
• better use of one’s talents and abilities
• better relationships with others
• a realistically based sense of self esteem.

Self development, self reflection and self-discovery continue between sessions and long after the therapy has ended. In short, the client can acquire a higher degree of self-knowledge.