Anyone who has undergone traditional psychoanalysis will know that it is not about finding a cure for an illness, or even relieving the symptoms of one. In this occasionally marvellous, often painful, and sometimes absurd enterprise, the analyst—whether Freudian, Jungian, Kleinian, or Lacanian—does not tell you what it is that you’ve got, nor does he or she explain how you will get over it. Instead, you embark on a personal exploration during which you find that you don’t only suffer from the symptoms you thought you did, but also a range of other conflicts underlying them. The process is classically driven by two mechanisms, and these are essentially all there is to the technique (though not, of course, the theory) pioneered by Freud.

The first is “free association,” which means that you say whatever comes into your head during regular, 50-minute sessions—taking place two to five times a week over a period of months and years—revealing themes, links and patterns in your psychology of which you were previously unaware. The second is the “transference,” which is what takes place between you and the analyst as you become embroiled in an intimate relationship that is unlike any other you might have outside the consulting room (though it may substitute for an inadequate or absent one). The principle that the relationship is what does the therapeutic work is fundamental to all the so-called “psychodynamic” therapies to have grown out of the Freudian tradition. If the analysis is successful, the outcome of that relationship will change something in your life for the better. Your symptoms will retreat back into deeper conflicts, which you come to accept as the price of being alive.

Psychoanalysis is hardly redemptive, and never promised to be. When early patients of Freud’s complained to him that nothing could change the original circumstances which made them unhappy, he agreed—with a caveat: “Much will be gained if we succeed in transforming your hysterical misery into common unhappiness.” This is one of Freud’s most celebrated remarks, though it appears in Studies in Hysteria, which was published in 1895, before he had developed the full psychoanalytic method. But it captures the pessimism—or realism—which threads its way through all Freudian practice. It is one of the peculiar fascinations of psychoanalysis that a method seized upon by so many in the search for self-transcendence should have sprung from a man so captivated by the irredeemability of human nature.

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