Psychotherapy and Psychoanalysis in Cleveland
Janet L. Sharp, M.A., LPCC-S

Psychotherapy and Psychoanalysis

These the two types of therapy in which I specialize. The following are common questions about these approaches. Clicking on the links below will take you to a discussion of each question. In order to determine whether therapy might be helpful to you, you may contact me to request further information or request an appointment.

Q.
Who can benefit from psychodynamic psychotherapy and psychoanalysis?
Q.
Who do you generally see in your practice?
Q.
What does psychodynamic mean?
Q.
What is psychodynamic therapy?
Q.
What is psychoanalysis?
Q.
What are the similarities between psychotherapy and psychoanalysis?
Q.
How do psychotherapy and psychoanalysis differ?
Q.
Who is a psychoanalyst?

Q.
Who can benefit from psychodynamic psychotherapy and psychoanalysis?

A.
Psychotherapy or psychoanalysis is typically recommended for the person who is:
  • Inquisitive about his or her own mind and behavior;
  • Experiencing frustration with his or her own efforts, sometimes including previous therapy, to overcome personal problems;
  • Interested in talking confidentially with an experienced therapist, either instead of, or in addition to receiving psychoactive medication from his or her physician.

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Q.
Who do you generally see in your practice?

A.
People contact me for many reasons. Because the identity of the people I see is confidential, I am unable to describe actual clients. However, examples of the many individuals who may respond well to psychodynamic therapy include:
  • A promising young attorney is unable to overcome his procrastination and avoidance of work, ever since joining a large, prestigious firm.
  • A psychologist is encountering strong reactions to a patient that he suspects relate to present or past problems of his own. When he realized he was behaving unusually towards the patient, he decided to explore the situation with an analyst.
  • A woman of fifty remains irritable and depressed long after her youngest child has left for college, driving an emotional wedge between herself and the husband she loves.
  • A successful professional woman suffers from unrelenting self-doubt and nagging headaches that prevent her from going to the next level in her career.
  • A single accountant in his thirties who feels better since starting an anti-depressant medication, but needs more time to talk through his social anxiety and loneliness than his psychiatrist can provide.
  • A college student who has lost weight rapidly since moving away from home. At times, she finds that hurting herself is strangely comforting.

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Q.
What does psychodynamic mean?

A.
Psychodynamic refers to the idea that the human mind, or psyche, is complex and active. Some of the factors or forces in play in the mind include:

  • Intellect, thinking and knowledge
  • Talents, skills and abilities
  • Sense of right and wrong
  • Goals, wishes, desires and fears
  • Dreams and fantasies
  • Feelings of all kinds, such as:
    • Anxiety and feeling good or safe
    • Pleasure and pain
    • Sadness, happiness, mourning and joy
    • Guilt and shame.

These factors can be in conflict with one another, creating problems for the personality to resolve. Simple examples of this type of conflict are:

  • Your best friend is attracted to a married man and fantasizes about an affair. Although she is tempted, getting involved would make her feel guilty, as well as jeopardizing his marriage and family life. She decides that living with a clear conscience is more important to her then fulfilling her desire.
  • Another friend chooses the affair and is now dealing with the consequences to herself and others.
  • A public speaker wishes to deliver his lecture effectively but has a panic attack when an unconscious sense of shame about “showing off” arises just before his most prestigious engagement.

As in the latter case, conflicts become more difficult to resolve when the individual is unaware of what motivates the conflict. This is commonly the situation when people feel helpless to understand their own feelings or behavior. In other cases, they keep making the same mistakes or re-living the same old problems and are unable to get control. Psychoanalysts specialize in understanding connections between past experience and present feelings, thoughts, and behavior.

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Q.
What is psychodynamic therapy?

A.
Psychodynamic therapy is a conversation between therapist and patient or client that is based on the assumptions that:

  • Much of our behavior and many of our thoughts and feelings are outside our awareness
  • Talking with an experienced professional can help people understand how they think, feel, and behave
  • Understanding one’s own mind can lead to greater freedom to live one’s life well.

The thoughts and feelings that arise in psychotherapy provide keys to understanding oneself with the help of an experienced therapist.

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Q.
What is psychoanalysis?

A.
"Psychoanalysis" refers to a theory of the mind as well as a therapeutic method, both of which originated with Sigmund Freud. An Austrian neurologist, Freud observed that troubled human behavior, relationships, emotions, and thoughts tended to improve when his patients became aware of previously “unconscious” feelings, conflicts, beliefs, and motives that lay behind their problems. When these could be addressed in the context of the analytic situation, his patients obtained relief from emotional pain and found new solutions to their personal difficulties.

More than century since Freud's early discoveries, psychoanalysts continue to study how people think, feel, love, hate, learn, develop, and cope – using a method of listening and thinking that is similar to that of Freud. It involves getting to know one unique individual at a time.

Early psychoanalytic theory and practice have undergone many revisions, but some of the major principles of psychoanalysis remain intact. For example:

  • Each individual develops uniquely, based on a complex inter-weaving of mental and physical endowment, upbringing, and experiences.
  • Our actions and reactions, thoughts, and dreams have meaning. Their meanings can be explored through psychoanalysis.
  • Our lives and behavior are governed not only by rational choices but also thoughts and feelings outside our current awareness.

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Q.
What are the similarities between psychotherapy and psychoanalysis?

A.
Both are methods of personal therapy derived from psychoanalytic theory.

  • Both entail speaking as frankly as possible with a trained professional in order to reach a deeper understanding of the complexities of one’s feelings, behavior, and mind.
  • Typically, people participating in either one of these therapies report feeling enriched by the insights and understanding they achieve.
  • Both types of therapy, as practiced by a psychoanalyst, are unique to each individual patient. Cookie-cutter solutions and managed care constraints never dictate the treatment approach. Rather, the analyst discusses his or her clinical judgment and recommendations with the individual and together they plan how best to address the presenting problems.
  • In every case, confidentiality is a necessary condition for treatment to occur.

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Q.
How do psychotherapy and psychoanalysis differ?

A.
One of the differences between the two methods is frequency of visits.
Psychotherapy is less frequent, with sessions occurring once a week on average. It may be brief or long-term, depending on the patient’s needs and goals.

Psychoanalysis is conducted four or five times per week over an extended period of time. This more intensive therapy is often recommended for individuals with difficult, longstanding symptoms and those who desire a more in-depth approach after working in psychotherapy for awhile.

Another difference pertains to the use of the couch. In psychoanalysis, the patient reclines on a couch with the analyst out of his or her line of vision. This practice tends to facilitate a more relaxed state in which the individual may be more open to his or herown thoughts, or associations, and speak as freely as possible.

Q.
Who is a psychoanalyst?

A.
A psychoanalyst is a professional therapist who first obtains an advanced degree (for example, a Masters in counseling or social work Ph.D. in psychology, or M.D.) before studying psychoanalytic practice and thought at an institute dedicated to psychoanalysis.

In addition to at least four years of course work and extensive, supervised clinical experience, each analyst-in-training is required to undergo psychoanalysis herself. In this way, she has an opportunity to become as thoroughly acquainted with his or her own character and mental life as possible.

This rigorous and multi-faceted preparation to work as a psychoanalyst is designed to ensure his or her ability to practice at the highest level of personal and professional integrity. If your physician or other trusted person suggests that therapy may be helpful to you, you may wish to consider seeing a psychoanalyst.

For more information about psychoanalysis, follow this link to a publication by the American Psychoanalytic Association, "About Psychoanalysis."

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