'Give sorrow words; the grief that does not speak
whispers the o'er-fraught heart and bids it break.'
Shakespeare (Macbeth - Act IV Scene III)
WHY? FOR WHOM?
In the course of our lives, we may come across situations, challenges, or behaviors that repeatedly make us feel uneasy, hinder our aspirations and endeavors, and potentially cause suffering to ourselves and those around us.
The objective of psychoanalysis is to embark on an exploration of an individual's personal history, in order to comprehend how it shapes their present life across all its dimensions: family, relationships, career, and love. The ultimate aim is to gradually liberate the person from their symptoms, anxieties, and psychological suffering. Psychoanalysis operates as a "talking cure," where the analyst plays a crucial role by attentively listening to your discourse, creating a safe and privileged space for unrestricted and uncensored expression.
THE INITIAL CONSULTATION
Taking the first step is not always easy, but it enables you to express your needs, acknowledge challenging circumstances (such as separation, multiple break-ups, loss, academic or professional setbacks), or distressing emotions (anxiety, depression, loneliness, low self-esteem, obsessive behaviors, eating disorders) that you wish to address in therapy.
WHAT ARE THE OBJECTIVES?
The goals can vary, from promptly resolving a situation within a short time frame (a few weeks), to embarking on a deeper journey of self-examination and engaging in a more extensive transformative process that unfolds over a longer period (a few months to several years).
WHAT RESULTS TO EXPECT?
A successful psychoanalythic journey brings about a higher quality of life and facilitates personal fulfillment. By gaining a deeper and more nuanced understanding of oneself and one's emotions, it empowers individuals to make choices with increased freedom, unburdened by the weight of the past. It also facilitates the transformation of one's ability to communicate and to love, nurturing the development of psychic freedom and self-esteem.
Psychological distress can be as devastating as physical pain. It obstructs one's existence, complicates relationships with others, and leads to issues in both the emotional and professional spheres.
While people readily visit a doctor when faced with physical symptoms, psychological troubles are often neglected, resulting in seeking professional help only when they become unbearable.
WHICH SYMPTOMS, WHAT ISSUES?
When faced with challenges in areas like family, love, or work, it can be highly beneficial to consult with a specialist. Psychoanalysis can effectively address a wide range of symptoms and issues:
Anxiety and panic attacks
Obsessive-compulsive disorser (OCD)
Post-traumatic stress disorder (PTSD)
Grief and mourning
Difficulties in relationships or parenthood
Stress and burnout
Difficulties in adolescence
Difficulties at work
Issues related to identity, including gender identity
Sexual abuse and other forms of violence
Repetitive patterns of behavior or thoughts
This list is not exhaustive, as psychoanalysis can address a wide variety of psychological and emotional challenges. Each individual's treatment plan is tailored to their specific needs and concerns, as psychoanalysis focuses on exploring the unique history, experiences, and unconscious processes of the person seeking help.
THE COURSE OF A SESSION
The process of psychoanalysis begins with a series of "preliminary interviews" aimed at identifying the patient's problems and assessing their readiness for analysis. Within the Lacanian practice, these interviews can extend over several weeks.
The patient is encouraged to recline on the couch only when visual support for speech is no longer necessary. This shift occurs when the patient perceives the analyst as a "subject supposed to know," someone who holds knowledge about the causes of their suffering. From this moment on, the patient will become an "analysand", a term coined by Lacan to highlight the subject's active role in the analytic setting.
This pivotal moment also marks the inception of transference, wherein the patient transfers their emotions onto the analyst, emotions that were previously directed towards their parents. This mechanism allows the patient to address unresolved issues with parental figures who have exerted influence over their life.
Unlike other psychoanalysts who prioritize a rigid framework, Lacanians embrace surprise as a catalyst. The analyst's demeanor may vary, engaging in conversation or remaining silent, according to the specific necessity in each session, with each analysand.
The duration of a session is variable and is determined by the analyst according to the logic of each specific treatment - for instance, the analyst may end the session when the patient articulates a single word or an idea that shed light on their problem. This unexpected interruption serves to highlight the significance of the newly expressed element and to engage the unconscious during the time that lapses between sessions.
ON THE ANALYST'S SILENCE
"The analyst is called upon to give utmost importance to the word of the analysand, therefore silence is absolutely well-suited to the analyst. It is not easy to remain silent because the most natural thing is to speak, especially when someone asks us something. But the analyst knows, by training, that the word that truly matters is not their own, but that of the analysand's unconscious, which does not emerge if its fertile space is occupied by the word of another. For this reason, the analyst is called to economize their words, so that when they decide to use speech, it has the resonance needed to hit the mark, as happens in every true interpretation."
Massimo Cosenza, psychoanalyst
DURATION AND COST
The psychoanalytic treatment does not necessarily require years and is not always associated with high costs as one might think. Critics of psychoanalysis often promote the idea that it is a long-term and expensive therapy, pushing people towards supposedly shorter and more convenient alternatives. However, both short-term therapies and the use of medication do not guarantee definitive solutions in such rapid times, and many patients are disappointed by the short-term results of therapy or the long-term effects of medication.
It is important to emphasize that the duration of the treatment is not predetermined by the analyst, but is adapted to the individual needs of each patient. There are no pressures or obligations regarding the duration of the therapeutic process. Some patients complete the analysis in relatively short times, while for others it may take longer, but in both cases, significant benefits and greater personal satisfaction can be achieved. The analyst commits to being present for the necessary time, without holding the patient beyond the time necessary and without prematurely interrupting the treatment.
Regarding costs, psychoanalysis naturally involves a cost like any other private therapy, but it is not necessarily prohibitive or unsustainable. Many analysts try to accommodate the economic possibilities of patients and adjust fees according to their needs. Patients undergoing analysis usually do not complain about costs but recognize the benefits obtained. It is important to consider that therapy costs become burdensome when they do not correspond to the results achieved. Additionally, short-term therapies or prolonged use of medication can have considerable hidden costs such as side effects or long-term issues.
WHAT IS THE DIFFERENCE BETWEEN A NEUROLOGIST, A PSYCHIATRIST, A PSYCHOTHERAPIST, A PSYCHOLOGIST, AND A PSYCHOANALYST?
These professionals are often confused by the general public, but they have distinct areas of expertise and employ widely different methodologies in their practices, catering to various aspects of mental health and well-being.
The neurologist is a medical specialist who treats diseases and disorders of the nervous system, such as stroke, Parkinson's disease, and multiple sclerosis. Neurologists focus on organic brain and nerve-related conditions but generally lack the training and expertise to address and treat psychological disorders.
The psychiatrist is a medical doctor who specializes in the diagnosis, treatment, and prevention of mental disorders. The traditional psychiatric perspective views the patient's brain as altered in its functions and chemistry. Psychiatrists thus employ a medical approach, primarily prescribing medications to alleviate symptoms, but rarely delving deeply into their underlying psychological causes.
Neurologists and psychiatrists offer specific and useful expertise, but they operate on the "hardware" rather than the "software" of the patient. Therefore, seeking a psychiatrist or a neurologist for anxiety, panic attacks, depression, or any other emotional disturbance that causes distress can be compared to calling a television repair technician when the reported problem is an upsetting TV program or a bad film.
In contrast, psychologists, who are not medical doctors but hold degrees in psychology, focus on understanding the overall functioning of the psyche. They engage in psychological assessments, but in certain cases can go beyond diagnosis to help clients enhance specific functions, making them more effective, productive, and capable in their lives and pursuits.
The term 'psychotherapist' is quite broad and encompasses various professionals who follow different methods of treatment. For example, cognitive-behavioural therapists address symptoms and behaviours through techniques and strategies, focusing on symptom correction without delving into the underlying reasons. Family therapists primarily work with the entire family, observing its dynamics and employing strategies, behaviour prescriptions, and advice; this approach can prove useful in cases involving adolescent issues, early-onset anorexia, and family conflicts where the patient remains closely connected to their family dynamics.
On the other hand, psychoanalysts practice psychoanalysis, a therapeutic method that seeks to understand and resolve problems by exploring their unconscious causes. Psychoanalysis was the first form of modern psychotherapy and the most influential. While it has the longest and broadest case history and encompasses many schools, advancements in its theory and clinical practice are still brought forth through lively and engaging debates in training centers, universities and by practitioners worldwide. We hold psychoanalysis as it was developed by Sigmund Freud and Jacques Lacan to be the most effective form of psychotherapy for treating a wide spectrum of symptoms and conditions.
PSYCHOANALYSIS IS NOT JUST PSYCHOTHERAPY
"Psychoanalysis is a cure through speech invented by Freud (...) in which the central focus is the work of elaboration carried out by the patient themselves, supported by the analyst. However, it is not merely a therapy, because at the core of its functioning lies not only the desire to heal from suffering, but above all, a desire to know the unconscious cause of one's own affliction. The more the patient - whom Lacan calls the 'analysand' to emphasize their active role in the treatment - delves into the root of their suffering and what causes it, the more therapeutic effects emerge. But as Freud puts it, the therapeutic effects appear as a 'surplus', as the consequence resulting from the very process of elaboration. It is one of the core characteristics that distinguishes psychoanalysis from the vast world of psychotherapies."
Domenico Cosenza, psychoanalyst