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psychoanalytic psychotherapy english french citypsychotherapy book session here london e1, sw18, kt17 07921 860 498 [email protected] share on facebook share on google share on twitter share on linkedin stephane preteux - msc mbacp(accr) english/french psychoanalytic psychotherapy london e1 - sw18 - kt17 tel: 07921 860 498 [email protected] home about me fees location contact me confidentiality publications faq links menu home about me fees location contact me confidentiality publications faq links what is psychoanalytic psychotherapy? psychoanalytic psychotherapy is a once-and-for-all process dealing directly with what causes suffering. at a practical level psychoanalytic psychotherapy listens out for two distinct messages from the patient: one is directed at the interlocutor or audience, the other is addressed unconsciously to the speaker himself. in other words ‘ what are we really telling ourselves when we speak to others? ‘ the gap between what we tell each other and what we ideally want to convey constitutes our desire. when frustrated this desire turns into anxiety before producing symptoms such as those listed below; they are ‘substitutes’ for something else that did not happen ( freud, 1916:280 ). crucially for psychoanalytic psychotherapy this desire guides the clinic – see ethics . in this unique arrangement the patient’s speech is the only available means of access to the truth of this desire, a speech known as ‘ free association ‘. why do i feel anxious? anxiety denotes a whole range of affects and phenomenon. those include panic attacks, vertigo, a general sense of worry, uncertainty and doubts regarding which direction to take in life. bodily phenomena may include breathlessness, palpitations, muscle tension, fatigue, dizziness, sweating and tremor. if we can never be sure of the reasons behind our feeling, say, happy or sad (happiness can cause sadness or guilt) anxiety has an overwhelming certitude attached to it – it is real, something in front of which all words and categories fail. anxiety can be felt when there is a sudden change of our place in the world and how we used to see ourselves in it; we can no longer rely on the desire of the other as a compass to situate ourselves. instead, we exist in suspension between a moment where we no longer know where our place is and a future where we will never be able to refind ourselves. anxiety is often found at the origin of obsessive thoughts. for the existentialist philosopher jean-paul sartre, anxiety is evidence of our freedom. psychoanalytic psychotherapy approaches it from the fundamental notion of an absolute loss, a ‘lack of a lack’ , thus putting desire as its ultimate remedy. am i depressed? do you find yourself eating or sleeping too much or too little? that you are pulling away from people and activities because of low or no energy? some of us may feel like nothing matters anymore. we are left confused, isolated, angry, worried or scared, perhaps even having suicidal thoughts. in those cases where all seems well and ‘perfect’ this feeling of disillusionment is quite baffling to understand. one way of looking at depression is as a force or movement driving our lives. like a heart that has stopped beating, depression marks a stop to this vital movement. given the set of circumstances and how long things have been kept this way unaddressed, it may be challenging for some to regard this issue as worth investigating. often placated by feelings of shame we tend to fall back on the basic assumption that us alone can change our situation. unsurprisingly, questions of anger, frustration and isolation are often central to the experience of depression. in psychoanalytic psychotherapy, i approach this issue with the view to reintroducing a movement using the element of surprise. relationship issues relationship fall-outs are expressions of a toxic form of aggressivity between partners. typical signs include living in tension and mutual rejection, jealousy, passive aggressivity, denial and in some instances verbal or even physical abuse. for example in the act of blaming the other personal criticism is expelled by projecting it onto the other. referring himself to the master-slave dialectic by the german philosopher hegel (1807) lacan argues that a fraught relationship is ‘ imaginary ‘ in nature, a life and death struggle for ‘ pure prestige ‘. in this context the other is seen as a rival, whose elimination seems to be the safest option. generally speaking, aggressive attacks are a form of response indicating that one’s defense mechanism is somehow stuck in overdrive. the ego is felt to be under constant attacks and threatens to collapse. those are moment of great vulnerability and risk in which retaliation is seen as an attempt to protect oneself against the anxiety that the threat of disintegration immediately poses. jealousy is experienced when the ego concludes that the other with whom one is competing has the advantage. feelings of jealousy reflect the desire to have this advantageous position for oneself, and the wish to eradicate this frustrating other. psychoanalytic psychotherapy sees working with issues in relationships as one of ‘un-knotting’ the multiple threads that have led to this situation. its goal is to try and dislodge the frozen and stereotyped perceptions and evaluations at play. one avenue of exploration may for instance include exploring those significant previous relationships in the patient’s life. why am i angry? anger may be categorised as any forms of violence expressed towards others or oneself in self-harm. in the former, symptoms of anger include bullying, threatening people, persecuting, insulting, pushing or shoving, using power to oppress, shouting or playing on people’s weaknesses. psychoanalysis regards anger as a ‘ passage à l’acte ’: a form of ‘acting out’ with no control. we become violent when the real has come to possess such a grip on us that the fictional character we had created of ourselves to contain it breaks down. however paradoxical this may sound, psychoanalysis psychotherapy understands anger as a form of ‘ deadly enjoyment ‘ which, in its final analysis, expresses nothing other than a rejection of what is felt to be a threat to one’s sense of integrity. for freud, hate and anger are more ancient feelings than love. in this context, the clinical work consists of using language as a way to make something of this anger. the exercise of symbolisation realised in therapy may well be initially experienced as somehow exacerbating this feeling further, but should in due time transform itself into some useful and creative productions. why do i feel i can't act? in certain situations we may find it almost impossible to act, and instead react as if feeling self-conscious and unable to act in a natural way. symptoms of inhibition include reticence, procrastination (delaying), reserve, wariness, reluctance, discomfort, hesitancy, nerves, nervousness. the experience of inhibition can be transitory, for instance in a surprise accident from which we eventually recover, or last some extended period of time while bringing with it feelings of isolation and anger. from another person’s perspective, it may look as if nothing is really going on. in fact, being quiet may even be encouraged and seen as a positive personality trait (especially for men), that is, until eventually some violence is done and personal ties are cut. symptoms of inhibition include fear; being hyper sensitive to the other’s reactions; feelings of being disconnected or dissociation. in therapy, it may be useful to invoke the place and presence of the other with its omnipotence. in psychoanalytic psychotherapy it is essential to help patients try to remember anything that could have been felt as particularly traumatic. it may also be useful to explore the various relationships the patient had with this so-called ‘omnipotent other’. i don' feel confident i

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