The psychoanalytical cure , commonly named Psychoanalysis , is one of the three directions of this word, that is to say the psychotherapeutic practice worked out by Sigmund Freud and its successors.

The patient is called analyzing and the therapeutist analyst . The word analyzing , introduced by Lacan, underlines the central role and credit of the patient.

The indications of the psychoanalysis were and are the object of many theoretical debates. Freud conceived it mainly for the adults neurotics, although, as of its first publications, it gave a case of child ( small Hans , it is true indirect, since it is a conversation with the father of Hans, without direct intervention near the child). The psychoanalysts will explore other indications (Psychose S or children), thus this indication will evolve/move during the Histoire of the psychoanalysis. Certain psychoanalysts consider that beyond forty years the psychoanalysis are not any more one indication first. The psychoanalysts jungiens do not regard this limit as relevant.

The framework

The analytical situation is structured by fundamental rules as by a particular framework.

Fundamental rules

The work of the cure is defined by two fundamental rules. Other rules specify the framework of the cure, but these two rules have a particular status.

free Association

The free association means to aloud say all that comes to mind during the meeting, with the words such as they come. The psychoanalysis is a cure by the word ( talking cure ); only the patient can find or give a direction - or, from a point of view lacanien, the Meaning S (words themselves), which structure its psychic life. This rule came historically, whereas Freud had given up the hypnosis, from a patient which required of him to listen to it and not to stop it by questions.

This free association initially aims at rebuilding the unconscious diagrams and is based firstly on the analysis of dreams. In this case, free association makes it possible to find the elements incorporated by the powerful work of condensation of the dream: many elements tangle up, are dissimulated the ones behind the others and it will be necessary to release them, them recognize, one by one. The question of knowing if analyzing it the true origin of the dream finds or if it rebuilds one of them, is a question of little interest for the cure: in any case in fact associations belong to analyzing and it is him which allots a direction to them.

The first fundamental rule runs up above all against resistance: the Refoulement is maintained (silence of analyzing which does not have " nothing with dire" , of which " the brain is vide") and the psychoanalyst will try to help analyzing it to circumvent it so that he can release himself some. Rule of abstinence

The rule of abstinence comprises two slopes: in the cure and out of the cure.

In the cure this rule prohibits any passage to the act aiming to the instinctual discharge: the desires in love and/or aggressive must be spoken and not acted. This rule applies in fact as well to analyzing as to the analyst who cannot intervene in the reality of the life of analyzing. In particular, any exemption from this rule by the analyst means rupture of the analytical contract.

Out the cure this rule requires to postpone decision making important (changes in the life married, professional, etc) throughout treatment. The length of the current cures involved an adaptation of this rule, requiring of analyzing to work out in the cure any important decision before acting it in external reality. This rule is based on the consecutive instinctual upheavals with the cure and which could involve analyzing it in defensive agirs that he would regret thereafter.

Tally material

Apart from these rules, the material framework is defined:
  • the meetings generally take place two to four times per week, and a missed meeting is due. This is posed because of the need for including/understanding the unconscious reasons which, generally, hide behind the " better reasons of the monde" to miss a meeting (manifestation of resistance, equivalent to silence during the meeting). This point raises question in the Psychanalyse of the children.

  • the payment must be done in liquid for reasons symbolic systems and therapeutic: the concrete aspect of cash enables him to be closely connected to many unconscious reasons that the cure aims at making conscious so that they can be elaborate there. The meeting being paid, at once, analyzing it is free to come or not to return to the following meeting, a check for example would suppose operations after the meeting.

  • the patient lengthens on a Divan (image largely taken again by the Cinéma, often in a comic way) and does not see its analyst. This device, inaugurated by Freud, allows a double effect: it avoids a nonverbal, not controlled communication of the analyst (Contre-transfert), and in addition it develops the verbal expression, privileged means of an awakening and a remote setting of the Affect S.

Analyzes

The psychoanalytical cure proves to be complex since it joins together various objectives, that its course can vary, that it passes by several stages and rests on various methods. It is necessary to review these various aspects.

Objectives

The main objective will be to find unconscious associations of analyzing. The Refoulement must be raised, the past will be rebuilt and put in relation to the present. From this point of view it does not matter the nature of the disorders, since awkward mechanisms of repression are concerned, from where the debates and the hesitations on the field of application of the psychoanalytical cure.

The cure can lead to several modifications, of which most desirable according to Freud is the improvement of the capacity of sublimation. The objective of the analysis is not inevitably the suppression of Symptôme S, which distinguishes the analysis, for example, of the Psychiatrie. See low fine analysis.

This question of the objective of the psychoanalysis lends to debate. Discusses outside the analysis, dispute of its effectiveness: to see Critical psychoanalysis. But critical also within the psychoanalysis, as for the true goal :

  • Freud is based largely on the model of the " régression". For him, the lifting of repression puts an end to the regression. Thus, the analysis makes the individual able to reach a more elaborate psychic sexuality. Analyzing of choice in love will become capable and professional choices leading to a real satisfaction, in the long run, where the symptom proposes only one immediate and diverted satisfaction. Freud says that the analysis is finished when the patient is taken again by the life, i.e. it can have an opened out sexuality and work .
  • the Ego-psychology takes again this model to make an adaptive ideal of it. The Me must be reinforced, to become able to compose with the situation in which it is, as well in reality as in the psychical reality.
  • For Jacques Lacan, the cure must lead to a full word. It must remove the lure of a relation of me with other me, and allow a relation of prone to Other.

Interpretation of the dreams

See also: Interpretation of the dreams

If such an interpretation constitutes royal roads carrying out towards the unconscious one, it should be heard here like clinical investigation. The cure is thus based partly on the analysis of the dreams, the freely associating patient. The analyst proposes interpretations, whose nature and frequency vary according to the school, since these interpretations are opposed to the to let go of a transfer which must be established so that the cure progresses.

Development, perlaboration

The development is a spontaneous psychic work: the excitations which the psychic Appareil receives are only undergone, but worked out and thus not associated with representations. The development appears an imaginary work and symbolic system. It indicates finally a spontaneous tendency, tendency to psychic construction.

If Rome, sheltering recent monuments (appearing the conscience) and of the monuments of the Antiquité (appearing the Inconscient in its infantile dimension), the development compares with construction monuments, that they are infantile or not.

In the cure, the Perlaboration is an extension; it is this time about a development going against the symptom - one could simply say an addition of development. The mental health disorder is due to a lack of development and the cure must bring a surface adapted to a renewal of psychic work, associative work, rebuilding work: the patient establishes bonds , it reminds, gives direction to the events of his life.

Transfer and Counter-transference

Transfer

The transfer is the republication of infantile relations, tested this time towards the analyst. The analyzing ready one with the analyst of the characteristics which it does not have, which is those of people of its infantile entourage.

The analyst is invested, like instinctual Objet. The Analyzing lends a value to him, it idealizes it, the sacring. The analyst sees himself thus promoted with the statute of parental figure. For the analyst, it will precisely be a question of not adhering to this image.

The transfer is not only positive (transfer of love or admiration): when the analyst refuses to adhere to this image and to behave in the manner that waits analyzing it, this one turns over its positive feeling in negative feeling, in a negative transfer, even heinous, in will to destroy the analyst. Some critical of the psychoanalysis confuse the analyzes which are carried by the psychoanalysts within the cure towards the negative transfer as well as towards the positive one, with the refusal of a theoretical criticism of the psychoanalysis, its possible refutation. Confusion enters the psychoanalytical theory and its rational criticism and the practical control of the cure which often requires many efforts to untie the traps of repression and the transfer.

Freud distinguishes the moderate positive transfer, that which is appropriate, from the excessive positive transfers and the hostile transfers. But these deux-là is inevitable, the cure cannot be held without them. The transfer, like repetition, is opposed, by masking the past, with the recollection.

Counter-transference

The Contre-transfert indicates the tested tranferential one of the analyst towards analyzing. To be usable in the cure, the counter-transference must be a consequence of the transfer. (One can also define as against-tranferential the only psychic movements resulting from the transfer.)

From the counter-transference, the analyst includes/understands what is played in the transfer, which enables him to interpret it, this interpretation of the transfer being posed like essential point of the analytical cure.

For Lacan, the comprehension of the counter-transference is essential: personal resistances of the psychoanalyst block the work of analyzing.

End of the analysis

The question of the end of the analysis is complex. One generally considers a core of driven back, and analyzes it will not go until raising any repression. In Analysis with end and analyzes without end , Freud puts this question by noting several points:

  • the analysis finishes when there is no risk of relapse - losrque repression was sufficiently raised to guarantee that the neurosis does not take again its rights. But, it, this note applies to normal conditions, a traumatic situation being able all the same to compromise the mental health.

  • Sándor Ferenczi being felt sorry for that the analysis of the transfer was not until its term, the negative transfer not having been treated, Freud answers (without mentioning that it is of him and Ferenczi), that this conflict was not then in force. The analysis can treat only the conflicts with the present, consequences of the development of a last traumatism. It cannot pre-empt future conflicts which had not then arised. If the analyst evokes them, analyzing it will not hear it. If the analyst wanted to cause this conflict, which would pose a broad problem deontologic, then the conflict would not be manageable, since not elaborate - and it me would spend all its energy to rather work this new conflict than with the analysis. Freud thus recommends to stick to with the second fundamental rule, free not analyzing what cannot the being.
  • does the analysis aim the mental health, analyzed reaching, by the analysis, so that the others worked out without assistance, or the analysis aims it at forming one analyzed with the capacity of Introspection higher than the normal? There still it would be about an insoluble question.
  • Any neurosis also has a core psychotic, supposed inanalysable. The analysis will thus be limited to that of the neurosis, question since largely discussed: for example Jacques Lacan or Wilfred Bion, wishing to treat the psychosis. But especially this question is raised by a Nouvel analyzing typical, suffering Personality disorder traditional neurosis and borderline either.

Didactic analysis

The training of an analyst poses problem. For Freud, it is not no need for a medical formation - but several analysts will see marked illegal practice of the Médecine, for example in the United States (the Analyze profanes). Especially, this question is that of the didactic Analyze, training the analyst to listen to the desire of the other: the future psychoanalyst must initially follow his own psychoanalysis. But this cure is more thorough than a psychoanalysis " ordinary " , it is especially accompanied by a thorough theoretical study of the concepts of the psychoanalysis.

Freud takes part initially in the foundation of the International Psychoanalytical Association (IPA), which will have to consider practices in order to guarantee a serious analysis. Its first President, Carl Gustav Jung poses the need for a didactic analysis for the future psychoanalyst. Thereafter, of many schools will propose a formation with the analysis and will be recognized or not by the IPA.

Jacques Lacan, with the catches with the IPA which he criticizes, will propose for example the procedure of the Passe. It will give up it thereafter, regarding it as a failure.

For the Psychoanalytical Organization of French language, there is " quatrième" analyzes; : initially analyzing it an analysis follows - two people are thus concerned. Then the new analyst takes its first patient, third nobody implied. Lastly, the practician beginning is made supervise by another analyst and it is the fourth protagonist there, from where the name of analysis fourth.

Evolutions

The psychoanalysis evolved/moved initially of the time of Freud. She initially recognized the transfer like being opposed to the progression of the cure. Moreover, this one seemed restricted with the neuroses. Then, the transfer will be recognized like flux an analyzable and useful transference neurosis. The counter-transference, in the same way, appears initially an obstacle and appears more and more like a tool available to the analyst.

The evolutions of the analysis depend in particular on analysts other than Freud.

Analysis activates and analyzes mutual

Ferenczi, Otto Rank, Wilhelm Stekel propose the technique of the Psychanalyse activates. Benevolent neutrality is forsaken there in favor of an activity in the objective to shorten the cure. Rank and Steckel suggest fixing time limits of the cure. Ferenczi, as for him, does not move back in front of the injunctions and prohibitions which the psychoanalyst should give to analyzing.

Sandor Ferenczi is precursory psychanlyse of child in what it causes the regression; it will go until trying out a mutual Analyze, but will give up it. The mutual analysis consists of the inversion of roles between therapeutist and patient: the therapeutist can go to analyzing, or lie on the couch.

Analyzes children

Anna Freud and Melanie Klein founds the Psychanalyse of the children. There is debate: is it necessary to simply modify its methods or the objectives of the analysis while making it educational?

Scansion and passes

Jacques Lacan proposes the scansion of the meetings, as well as the master key.

Psychoses psychoanalyze and new analyzing

Many analysts try to found an analysis of the psychosis. Nowadays, of many news diseases are dealt with, which poses the figure of a Nouvel analyzing, suffering for example disorders Psychosomatique S.

Other psychotherapies

See too

Related articles

External bonds

References

  • Roger Perron: " A psychoanalysis, why? " , Interedition, 2006, ISBN 2100493809

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