How exactly do psychoanalysis and psychotherapy work

Back to childhood: this is what you can expect from psychoanalysis

You may notice that in certain situations you cannot react the way you would like. That one simply fails completely due to certain problems and suffers from certain compulsions that make everyday life difficult or even impossible.

In these cases, psychoanalysis, which is part of psychotherapy, can help to find answers to the 'why' and to develop possible solutions. It sheds light on what happens in our subconscious, i.e. unconsciously.

Freudian psychoanalysis:

Psychoanalysis, more precisely analytical psychotherapy, is a form of therapy that is used in psychotherapy.

Most of them certainly think of Freud when they think of psychoanalysis. And then directly the couch that you lie on. Both sounds like cliché, but they are not that wrong.

Let's start with Freud: Siegmund Freud (1856 to 1939) was an important Austrian neurologist and depth psychologist. He is the founder of psychoanalysis. This procedure is based on the assumption that early childhood imprints and experiences in adolescence shape us for our lives. Injuries from this period can therefore trigger psychological problems in adulthood.

Imprints in childhood

Let's take an example: the separation of parents there. If this negative experience remains unprocessed, it can lead to psychological abnormalities or problems. Even in adulthood, affected people still fall back into their childhood behavior, so to speak.

And even if there may not always have been an apparent reason in childhood, whether it be neglect or a separation, many adults face stressful fears or compulsions that they cannot explain, but whose causes lie in the past.

Indeed, many childhood experiences become lodged deep in our subconscious. They determine our behavior without our being aware of it. Such trauma can sometimes severely reduce the quality of life. Here psychoanalysis can be a helpful method to explore the reasons.

When does psychoanalysis help?

Many problems are buried so deep in the soul that they need the help of a professional to figure them out and to understand one's own actions or certain physical complaints. It is a strenuous and usually painful process, but at the end of which there is usually an enormous improvement in the quality of life.

To solve deep family problems or to combat anxiety, psychoanalysis is the right method. The "normal" lovesickness or a spider phobia is certainly not one of them. Even a long-lasting emotional upset or even depression cannot be brought under control with the process of psychoanalysis.

The couch, symbol of psychoanalysis

The famous couch that was already in Sigmund Freud's treatment room still plays a role in psychoanalysis today. It may seem strange at first, but the couch has proven itself: In a lying position, patients are actually more relaxed and able to open up better. It is not so difficult to reveal memories, experiences and thoughts to the psychoanalyst.

So if you sit across from the therapist in psychotherapy, you are lying on the couch in psychoanalysis.

Laying down on the couch with a stranger and talking about your own state of mind naturally requires a great deal of trust. The psychoanalyst and patient must of course first build such a basis.

The job of the psychoanalyst

The psychoanalyst leads the way into the subconscious, but tries to exert as little influence as possible so as not to cloud the memory. First he listens a lot and lets the patient talk. Usually the patient tells what is on his mind. That is why the meetings take place several times a week. In this way, behavior patterns become recognizable over time.

If you are worried that you will reveal too much: There is no such thing as "too much". A psychoanalyst is a professional who is trained to guide and protect the patient along the way. And: Of course, he is subject to medical confidentiality.

How long does a psychoanalysis take?

Depending on the severity of the disorder and the accessibility of the patient, a psychoanalysis can take years - with several sessions per week. This is extremely time-consuming and requires the patient to be really willing to deal with his or her story.

What training does a psychoanalyst have?

There are many ways to become a psychoanalyst, but a university degree, ideally medical or psychological, is a prerequisite.

Anyone who has completed a relevant degree and would like to receive further training as a psychoanalyst can, for example, seek advice from the German Psychoanalytical Society (DPG) or the German Psychoanalytical Association (DPV).

An important part of the training is self-awareness in training analysis. That means: you lay yourself down on the couch again.

Psychotherapist, psychologist and psychiatrist: what is what?

As a layperson, one is often confused and wondering whether the job titles psychotherapist, psychologist and psychiatrist mean the same thing. Here is a brief overview:

A psychologist can only be called someone who has a degree in psychology, be it a bachelor's or master's degree. However, this does not justify treating the mentally ill. To do this, the psychologist still has to complete training as a therapist. Psychologists also often work in business or in marketing in the health or legal system or as school psychologists if they have a corresponding educational focus.

To become a psychotherapist, you have to study psychology or medicine and then complete a qualified, multi-year training course. Only that is entitled to psychotherapy and to apply for a license to practice medicine in order to be able to treat patients.

Psychotherapists treat compulsions, complexes, addictive behavior and depressive moods. A distinction is made between child and adolescent psychologists and therapists for adults. It is treated with therapies such as psychoanalysis, behavioral therapy or therapies based on depth psychology.

A psychiatrist must have completed a medical degree and have trained as a specialist in psychiatry or psychotherapy. As a doctor, he researches mental illnesses and is responsible for the physical and medical diagnostics of the mentally ill. That means: It detects disorders, determines the physical and medical causes and treats them with medication.

Are you in a difficult situation yourself and don't know what to do next? Then these offers of help could help you:

Contact person for those affected:

A point of contact in an emergency is the psychiatric outpatient clinic or the psychiatric department of a clinic, your own family doctor, a resident psychiatrist or psychotherapist, the medical on-call service (116117), the police (110) or the ambulance service (112).

Telephone counseling can also be reached anonymously, free of charge and around the clock (08001110111). However, it is more suitable for smaller crises.

You can also find important addresses here:

You can also find help on the website of German Depression Aid Foundation.

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