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Psychoanalysis in Ilkley, near Bradford, Leeds, Otley, Guisley

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Psychoanalysis as a Clinical Discipline

Psychoanalysis has a creative and constantly developing understanding of human life and experience developed from the initial discoveries made by Sigmund Freud and developed through intensive clinical and theoretical work over a hundred years since by psychoanalysts trained at the standards of the International Psychoanalytical Association.   Theories and clinical practice are constantly developed  through intense work involving continual learning from patients, teaching, supervision and writing. The constant, reliable and non-intrusive frame of psychoanalytic practise with its principles of respect and attention for unconscious process expressed in a developed ability to wait and listen (to unconscious listening) continues to form the structure within which intense emotional content can be safely experienced and understood together.  The subject of analytic attention is the unknown, the unconscious.

The seemingly simple invitation to try to say what comes to mind continues to be the basis of the psychoanalytical method today. The task of the psychoanalyst is not only to listen carefully to the analysand but also to try to understand, from what is being communicated verbally and non-verbally, their underlying emotional conflicts- through listening to the analysts own resonating perceptions of his internal life. Conveying this understanding through interpretations aims to help the person who has come for help gain insight into emotional states, and thereby relief and enrichment in personal and intellectual life.
 
However, such an intellectual description does not really convey how intense an experience an analysis  is as a developing emotional experience between analyst and patient. The safe space for this relationship allows a process to develop in which the unfolding internal world of the patient becomes alive in relation to the analyst. 

This is a complex and difficult process, requiring considerable perseverance and attention by both patient and analyst. Intense feelings and anxieties are aroused in both participants which have to be carefully thought about and worked through. The frequency of the sessions and the unchanging reliability of the analysts presence helps provide the support necessary to allow such difficult work, which then is felt and understood in a very different way from such inter personal and emotional states arising in the 'outside' world. 

Psychoanalysis is different, as a discipline, from Clinical Psychology and Psychiatry. It uses no other form of treatment, such as behavioural techniques or drugs. Psychoanalytical psychotherapy is a less intensive form of psychoanalysis; for example the patient having psychotherapy may have two or three sessions a week; a full psychoanalysis means that the patient attends daily sessions, usually five days a week.

People from all walks of life seek psychoanalytical treatment for many different problems. Some people seek help as they  feel anxious or depressed, or experience feelings of hopelessness or inhibition in their personal and professional life's. They may feel unable to form satisfactory personal or sexual relationships, often involving a repeated pattern, or aware that their life lacks sufficient meaning. Because the commitment in terms of time, cost and emotional involvement is so great in analysis, people seeking analysis have often tried other shorter term or focused therapies but have found that their continued experience is one of suffering to a degree in which the need for such a commitment is understood. The treatment is lengthy and one should think in terms of years - there is no ‘quick fix’.  It is is also true, however,  that many individuals derive considerable help from one or more psychoanalytic consultations. 

A small number of psychoanalytic treatments are available in the NHS in Yorkshire for people with complex, severe mental health difficulties, however resource restrictions make this a rare resource. NHS treatment can be sought through a GP. Low fee  vacancies for psychoanalysis in Yorkshire are available from 2015 through  the Institute of Psychoanalysis Clinical Service North (low fee scheme).

The physical aspects of the psychoanalytical setting aim to allow free expression. While initial meetings will be face to face, using a couch  reliefs the forefront pressure to be in a social persona framework of attention, while allowing freedom to say what is felt; not expected.

The analysand comes to daily sessions at pre-arranged times while the analyst sits in a chair just behind the couch. The analyst does not make notes in the patient’s presence as this would interfere with the analyst’s capacity to give proper attention to what the patient is conveying. It is the analyst’s responsibility to provide a consulting room that is comfortable, quiet, and as free from interruption as possible. Every session lasts 50 minutes and the analyst starts and ends on time. The establishment of this secure setting, together with reliable and predictable adherence to it by the psychoanalyst, is very important as it provides a containing structure within which the patient and analyst are able to explore and think about the patient’s difficulties.

(See more about pyschoanalysis on the website of the Institute of Psychoanalysis in links)

Therapies

There are overlaps between each form of therapy. It can be difficult to distinguish between Counselling, Psychotherapy and Psychoanalysis and the many trainings and levels of qualification allowing safe and good practise. There is no statutory protection of these professional titles and it may therefore be necessary to ensure that practitioners do have relevant serious qualifications for the therapies offered. 

Counselling

Counselling is usually one a week for short term interventions. It provides a space for thinking about emotional difficulties and there is more focus on the present and difficulties on everyday life. Psychodynamic counselling is helpful for difficulties that are not deep seated and can be resolved with shorter term sessions.  There are a wide range of psychodynamic counselling trainings, some requiring specific thorough training and personal experience.

CBT is a form of counselling which works with clients to develop alternative ways of managing emotions and behaviours through a focus on strategies of coping, rather than a relational or exploratory approach and is helpful for specific issues or behavioural, rather than relationship difficulties. The meaning of symptoms or internal work is not usually considered as helpful; with an anxiety state for instance managed by distraction or exercise. CBT therapists usually not have engaged in any personal counselling or therapy. Fully trained CBT therapists may have had  extensive training, while current NHS psychological services increasingly offer telephone or brief counselling with therapist or well being workers with very limited training who may call themselves CBT trained, or  'CBT'. CBT therapists are not trained in understanding and working with long term therapeutic relationships and practitioners who find themselves offering longer term interventions have often moved away from CBT practise but are not fully trained in a further level of understanding.

Psychologists have worked to a doctoral level in human behaviour, often having initial training in a range of behavioural and integrative therapies,  but will require specific further training in psychotherapy to offer psychoanalytic or in-depth work. Their role is often of assessment in diagnostic medical terms, with short term eclectic treatment. Many psychologists, medical doctors, and social workers have gone on to undertake full psychoanalytic training.

Psychotherapy

Psychotherapy is twice to three times a week sessions and usually open ended. This is helpful for long term and more complex difficulties that can be explored with the therapist through the emerge of difficulties in a live way within the therapeutic relationship. It requires a longer term training than counselling and CBT including personal therapy of at least three times a week and there is more focus on linking past and present experiences, with deeper exploration of unconscious factors behind emotional difficulties. The main training for psychoanalytic psychotherapy in the North is the North of England Association of Psychoanalytic Psychotherapy training (NEAPP). Registered and accredited psychotherapists will be registered with the British Psychoanalytic Council

Psychoanalysis

Psychoanalysis is four to five times a week open ended sessions. It provides the most intensive form of treatment helpful for complex difficulties and a full unfolding and development of an analysand's understanding of their self. It can enable depth of understanding and the possibility of more far reaching change, with the intensity of the sessions allowing a very secure basis which allows deeper issues and difficulties to emerge and be understood within the relationship with the psychoanalyst. The intensity of the training and work as a psychoanalyst is held within a secure setting which allows detailed attention to inner life and unconscious representation, allowing deepening self understanding and consequent change. Becoming a psychoanalyst requires further intensive training and personal psychoanalysis usually over many years, and psychoanalysts will usually be engaged in a full creative life of study and learning as well as forms of teaching through their careers. The main training for psychoanalysts in the UK through the Institute of Psychoanalysis, which leads to qualification and membership of the British Psychoanalytical Society.

The title psychoanalyst is not protected, and counsellors can describe their work as psychoanalysis, although this will be a very different experience from seeing a psychoanalyst. A register of psychoanalysts can be found on the website of the  Institute of Psychoanalysis

Consultation and Supervision:

In addition to full psychoanalytic treatment, consultation includes:

  • Supervision to psychotherapists and mental health professionals.
  • Initial consultation including a discussion of appropriate treament
  • Referral advice or recommendation where psychoanalysis or psychoanalytic psychotherapy is not appropriate


Ilkley, Leeds, Otley, Bradford, Silsden, Addingham, Keighley,West Yorkshire psychoanalytic treatment