Panel on What is Psychoanalysis?

Peter Zimmermann: Psychoanalysis – The Talking Cure

Anna O, one of the early psychoanalytic patients, famously referred to psychoanalysis as the “talking cure”.

I am using this statement as the starting point for my reflections on what defines psychoanalysis.

There are 2 components to the above definition: “talking” and “cure”.

1. Psychoanalysis seeks to CURE human beings of their emotional pain and suffering. This speaks to our responsibility as analysts and the goal of our work. Patients entrust their lives with us with the expectation that our work together will relieve their pain and suffering.

2. Psychoanalysis seeks to achieve this goal through TALKING.

Talking can be thought of in two different ways:

Talking, as in: talking ABOUT something, and talking as in: talking WITH someone.

‘Talking ABOUT’ pertains to finding words for one’s experience or articulating one’s feelings and thoughts. This idea is at play when the objective of our work is to make unconscious determinants of our patients’ emotional life conscious, which is a central goal of psychoanalysis.

The role of analyst, in this case, is that of the observant listener who comments on the verbalizations of the patient in an effort to facilitate the articulation and understanding of the patient’s emotional world and its unconscious determinants.

This is essentially a one-person psychology.

In ‘talking WITH’ someone, the emphasis is on communication, on being engaged in a dialogue with another human being and having a receiver for one’s verbalizations.

The goal of the patient being in dialogue with the analyst is to enable the patient to arrive at a deep understanding of his or her unconscious modes of relating as they are enacted in the relationship with the analyst. This entails both, finding words for the unconscious experience as it is enacted with the analyst AND having a receiver for that experience. The articulation of the patient’s inner experience occurs in the context of a relationship.

It is this context, the therapeutic situation, and the connection between patient and analyst, that either facilitates or obstructs the patient’s articulation of his or her experience and the unconscious organizing principles that shape it.

In this formulation, the analyst is actively engaged in the analytic process and his engagement with the patient inevitably and inextricably codetermines the dialogue.

Psychoanalysis, defined in this way, is a two-person psychology. It is a dialogue between patient and analyst that is in the service of relieving the emotional suffering of the patient through an in-depth exploration of the relationship that patient and analyst are engaged in and the unconscious meanings this relationship assumes for the patient.

Since a central claim and discovery of psychoanalysis is that all of the patient’s unconscious experience is awakened and enacted in the relationship with the analyst, we can say that the analysis of the unconscious relationship between patient and analyst is at the heart of psychoanalysis.

This unconsciously determined relationship between patient and therapist constitutes the TRANSFERENCE.

Therefore, psychoanalysis, defined in this way, is TRANSFERENCE ANALYSIS.

Psychoanalysis seeks to bring about a cure by engaging in an in-depth exploration and analysis of the patient’s transference relationship with the analyst.

From this perspective, all analytic tools, like free association, the couch, frequency of sessions, and the analyst as blank screen, are incidental to psychoanalysis. They are a means to an end, the end being the analysis of transference.

Experience teaches us that there are good reasons for some of these tools, but in any particular situation it may be that one or the other tool is not conducive to the analysis of transference and, if imposed, is creating an obstacle rather than facilitating the work of transference analysis. Therefore, I believe that all our decisions regarding psychoanalytic practice – our so-called technique – and how we work as analysts, should be clinical ones, in the service of facilitating the analysis of transference, and not a priori decisions on what we deem to be psychoanalytic technique.

This also means that I consider the differentiation between psychoanalytic therapy and psychoanalysis to be obsolete. Any therapy that has at its heart the analysis of transference IS psychoanalysis, whether this occurs on a once a week or 5 times a week basis, lying on the couch, sitting face to face or pacing in the room, Skyping or in person sessions. What to my mind defines psychoanalysis and sets it apart from all other forms of therapy is the analysis of transference.