So, How effective is Psychoanalysis?
What does the research say?
Mark Solms answers this question in the British Journal of Psychiatry in 2017.
Psychoanalysis is a highly effective form of therapy. Research shows effect sizes for psychoanalysis of between 0.73 and 0.85. Anything above 0.8 is statistical lingo for ‘highly effective’. In contrast, antidepressant medication has effect sizes ranging between 0.24 – 0.31 indicating poor efficacy. This is curious when antidepressants remain the most commonly prescribed form of therapy for depression and anxiety in Australia.
“We are profoundly emotional creatures. We register a range of things at a purely emotional level, even before language is learned. We are also deeply relational. From our infancy, we are dependent upon others to satisfy our basic needs”.
Solms argues that we form a range of ‘action plans’ to satisfy these basic needs.
“The main task of early infancy is to learn how to satisfy our needs in a world that changes between harmonious and hostile. Once we begin our therapeutic work, clients often bring descriptions of these early dynamics where action plans were either satisfied or stymied”
Most of our action plans are Unconscious. They take shape in areas of memory other than working memory. Action plans develop in early infancy and are encoded in very old parts of the brain. Emotional memory forms before the more sophisticated cortical layers. These early action plans follow an archaic logic, often taking time to decipher and following a language unique to each individual.
“…only 5% of our action plans are conscious”.
How does Psychoanalysis work?
An effective Psychoanalytic treatment acknowledges that we suffer emotional problems, rather than problems of how we think. Other contemporary therapies such as Cognitive Behavioural Therapy (CBT) suggest that changing our thinking changes how we feel. Psychoanalysis is effective by inviting a change in feeling. Effective treatment returns to difficult relational moments where our needs were unsatisfied. These are experienced in the present moment, but inevitably lead back to early patterns of relationship.
Psychoanalysis is particularly effective in treating trauma. The Unconscious is profoundly situated in trauma. A particular scene, phrase or wording mark a person in singular and unique ways. Echos of these events continue to erupt to the surface of everyday life, inviting resolution. Psychoanalysis is unique in linking language to the body, via the Unconscious. Psychoanalysis has Real effects on traumatic resonances in the body, by treating the unconscious through language.
Psychoanalysis is at least as effective as CBT, and most studies agree that the effects achieved via Psychoanalysis last considerably longer.
Although Psychoanalysis does reduce symptoms, the main aim is not symptom reduction. Rather, effective Psychoanalysis addresses age old automatic patterns of relationship that have ceased to be useful, and in fact in most cases now proves problematic. However, as a byproduct of effective Psychoanalytic treatment symptoms do indeed disappear.
Psychoanalysis is an effective form of treatment. It takes a sustained look at how we uniquely relate to people around us. Psychoanalysis analyses the language we use to describe and explain these interactions and ultimately ourselves.
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