This piece was originally featured on Psychology Today, and was written by WILA’s blog countess for the American Psychoanalytic Association’s unplugged blogging platform.
We are all born with needs that are felt and expressed as emotions. Although we all experience feelings of desire, fear, attachment, and despair, new research shows how these feelings are connected to our basic needs.
- We need to engage with the world. This is felt as a curiosity.
- We need sexual partners. This is felt as lust.
- We need to escape dangerous situations. This is fear.
- We need to destroy those people and things that come between us and satisfaction. This is rage.
- We need to attach to those who look after us. Separation from those who look after us can feel like panic and despair.
Developing healthy ways to meet these needs results in a feeling of well-being. When these are unmet it can result in attempts to meet them in out-moded ways that worked when we were children but are now faulty and unproductive as adults. This can lead to suffering in our current lives, relationships, and at work.
Research demonstrates that psychoanalytic psychotherapy can help achieve better control over our emotions, more successful relationships, and a more fruitful professional life. In other words, psychoanalytic psychotherapy allows us to unlearn reactions that negatively affect our lives and to learn productive ones.
Unbearable emotions are caused by unmet needs
Imagine a baby. When his parents step out of the room the baby doesn’t have the capacity to know that they will be back. All he knows is that he needs them. This need is expressed through a feeling of love when they are present and through the feeling of despair when they are gone. He has not yet acquired the capacity to understand that they will be back or the ability to self-soothe. When all goes well developmentally, the baby eventually learns that when his parents leave the room they always come back. But if the parents remain unreliable or neglectful the fear that they won’t come back is reinforced.
As this boy becomes a toddler and a teenager his parents continue to be unreliable, and he copes with this rejection by distancing and convincing himself that he does not need them.
Now let’s fast-forward. The boy is 40-years-old and finds that he cannot sustain a romantic relationship which brings him into therapy. As the therapy progresses, it emerges that whenever he starts to feel dependent on a significant other, he experiences intense panic and distances himself. This distancing behavior, designed to protect him from the despair, eventually leads to a break-up.
The challenge is to unlearn that default reaction with the mind of an adult. The adult mind does have the capacity to understand things that a small child can’t grasp. This is where psychoanalytic psychotherapy comes in. It is designed to address and help patients learn to tolerate painful feelings as they arise. The therapist and patient follow these feelings to their beginnings, where they were originally learned.
In this example, the need to distance from an important person goes back to the need for and the fear of losing his parents. To avoid that happening, he leaves the relationship before any real dependency can take place. Gradually, the patient unlearns the automatic response of flight from dependency. This is achieved through repetition.
How does psychoanalytic therapy work?
Research has established that psychoanalytic psychotherapy is just as effective as cognitive behavior therapy (CBT) in the short term. However, psychoanalytic psychotherapy shows an increase in its effects after termination of treatment. In other words, people who go through psychoanalytic psychotherapy continue to benefit and grow from the treatment long after it has ended.
In the above example, the therapist encourages the patient to share his pain and recognize its origins. He reviews with the therapist his usual coping mechanism of distancing and detachment. The therapist addresses both the underlying feelings and the patient’s attempts to avoid them.
Unlike other psychotherapeutic methods that seek to lessen the intensity of the feelings, the psychoanalytic therapist helps the patient to stay with and tolerate these feelings over and over again. Eventually, this repetition allows the patient to let go of the original reaction and to practice new options of feeling and coping.
Psychoanalytic psychotherapy allows the patient to gain access to unmet needs which are experienced as painful emotions and to learn to regulate them and become increasingly liberated from their oppressive and demanding grasp on our lives. This leads to an increased capacity to live a richer, fuller life.
Solms, M. (2018). The scientific standing of psychoanalysis. BJPPsych International, (15) 1, 5-8.
Steinart C., Munder T., Rabung S., Hoyer J. & Leichsenring F. (2017). Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. Am J Psychiatr, doi: 10.1176/appi.ajp.2017.17010057
Abbas A. A., Kisley S. R., Town J. M., et al (2014). Short-term psychodynamic psychotherapies for common mental disorders (update). Cochrane Database Syst Rev, 7, CD004687.