When people ask what psychoanalysis is, they usually want to know about treatment. As a therapy, psychoanalysis is based on the observation that individuals are often unaware of many of the factors that determine their emotions and behavior. These unconscious factors may create unhappiness, sometimes in the form of recognizable symptoms and at other times as troubling personality traits, difficulties in work or in love relationships, or disturbances in mood and self-esteem. Because these forces are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts of will, often fail to provide relief.

Psychoanalytic treatment explores the way in which these unconscious factors affect current relationships and patterns of behavior, traces them back to their historical origins, examines their development over time, and seeks to enable the individual to deal better with the realities of adult life. Analysis is 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 by re-experiencing them with the analyst. Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind. These conditions create the analytic setting, which permits the emergence of aspects of the mind not accessible to other methods of observation. As the patient speaks, hints of the unconscious sources of current difficulties gradually begin to appear - in certain repetitive patterns of behavior, in the subjects which the patient finds hard to talk about, in the ways the patient relates to the analyst.

The analyst helps elucidate these for the patient, who refines, corrects, rejects, and adds further thoughts and feelings. During the years that an analysis takes place, the patient wrestles with these insights, going over them again and again with the analyst and experiencing them in daily life, in fantasies, and in dreams. Patient and analyst join in efforts not only to modify crippling life patterns and remove incapacitating symptoms, but also to expand the freedom to work and to love. Eventually the patient’s life –his or her behavior, relationships, sense of self—changes in deep and abiding ways.

Psychoanalysts strive very hard to LISTEN to their patients-- and to understand. This focus on listening and understanding is one of the dynamics that separates psychoanalysts from those mental health practitioners who see their prime goal as PRESCRIBING either behavior or medications.