These are *empirically observable* features of psychoanalytic Tx (from coding of session videos/transcripts) that reliably distinguish psychoanalytic therapy from CBT. Not opinion, empirical finding. It’s not that other therapy approaches don’t do these things...
...It’s that psychoanalytic therapists do them more consistently, frequently, and intensely. That’s an empirical finding.
Here we go:
1️⃣Focus on affect (emotional life)
We help patient put words to feelings, including troubling feelings, frightening feelings, contradictory feelings, & feelings that may not initially be acknowledged or even recognized.
2️⃣Focus on avoidance
We attend to wide range of things ppl do by way of avoiding/disavowing aspects of own experience. Not just content of what is avoided, but process of how we go about avoiding. Goal is to help claim, or reclaim, what is ours—the full range of our experience
3️⃣Identify recurring themes
Recognize repetitive patterns that recur across different situations, interactions, & relationships (whether knowingly or unknowingly). Goal is to gain freedom from having to repeat same patterns—in order to live more fully and freely in the present
4️⃣Discussion of past experience
There is a developmental focus, a recognition that present difficulties have developmental trajectory, do not arise in vacuum. OFTEN MISUNDERSTOOD. We're never concerned w past for its own sake, but how it sheds light on *present* difficulties.
5️⃣Focus on interpersonal relations
Experience of self & others is forged in context of attachment relationships & plays out in relationships. Emotional life born of interpersonal experience. Internal models of relationships shape real-world relationships, play out repeatedly
6️⃣Focus on therapy relationship
Repetitive interpersonal patterns necessarily recur in therapy relationship too—where can be recognized, explored, & reworked in vivo. Therapist necessarily becomes participant in patterns. Tx relationship direct window into pt's difficulties.
7️⃣ Exploration fantasy life
EVERYTHING is on table, nothing excluded from discussion. Patients encouraged to say anything/everything on their mind. We then hear wishes, desires, passions, fears, dreads, dreams, daydreams. Nothing in life of mind can be ruled out in advance.
Aim is not *just* to alleviate a symptom or set of Sx. Goal is "weller than well"—to know ourselves more fully, live more freely, connect w others more deeply, live life w greater freedom & possibility, be comfortable in our skins. In short, to become more fully ourselves.