psychoanalysis

Psychoanalysis is an intensive form of therapeutic process.  Often I find that people have stereotypes of psychoanalysis as a cliché taken from the cartoons about it in the New Yorker or in the wider media of television and film. In my experience of my own psychoanalysis and from working with my patients in this modality, psychoanalysis can enrich one’s life both during and after treatment is completed, for years to come.  Long held patterns and difficulties may be explored in an in-depth way, often providing relief and fulfillment in ways that were unimaginable before.  Some patients seek an analytic treatment after other attempts at psychotherapy have not yielded the relief and change they desire.  Both psychotherapy and psychoanalysis are beneficial to a patient, but they are different in some respects.

The premise is fairly simple: when you embark on an analysis, you commit to typically between 3-5 weekly sessions.  Either sitting up face to face with the analyst or lying on the couch are options, however, the couch is the more traditional route and for good reasons.  The couch is simply a tool: it is used by a patient as a way to free up the social conventions and proprieties of face-to-face contact, and relaxing the body thereby allowing one to become fully immersed in their inner world: thoughts, feelings, dreams and bodily sensations create a playing field where the analyst and patient have the chance to fully explore the inner workings of the patient’s mind.  The use of the couch allows a process of self-reflection and self-inquiry that is different from sitting across from the therapist/analyst, in that face to face contact often has the issue of what to say, what to reveal, how the therapist will receive this, and how facial expressions will convey things. The couch provides a freedom to say what comes to mind, without the added pressure of wondering whether to look at your therapist, what eye contact may reveal, what your therapist says or doesn’t and anxieties of coming up with things to say to keep your therapist’s attention or some kind of performance anxiety to “keep things moving.”  Face-to-face therapy is an extremely valuable treatment experience; psychoanalysis is just another modality to access deeper layers of experience without social pressures inherent in face-to-face contact.

The frequency of sessions creates a momentum and rhythm allowing patients not to feel so pressured to “get everything in” a typical single weekly session.  The ability to have this kind of intensive conversation, combined with the lack of pressure to “get everything in” in a weekly session allows both the patient and the analyst the chance to explore more in depth the various fantasies, memories, and dreams we all have as thinking, feeling human beings.  It also allows whatever occurs or is stirred up by a session to be brought back into a following session, thereby increasing the efficacy and flow of treatment by allowing the freshness of discovery to not get lost by waiting many days to see the analyst.

By allowing a trained psychoanalyst to have access to the inner workings of your mind, a partnership is formed for the sole purpose of further understanding and experiencing the vast landscape of your mind.  We are all human; we live in a body, in a society with pressures to find fulfillment, more satisfaction in intimate sexual and romantic relationships.  We have work and professional pressures and aspirations.  Generally we have families with spouses and children and relationships with important friends who enhance our lives. Some patients feel isolated, alone, disconnected and lonely without fully understanding why.  In an analytic treatment, many patients discover how they have come to develop beliefs about themselves and the world that don’t often serve them in finding a fulfilling and enlivened experience of life.  Conflicts and “knots” have a chance to breathe and become disentangled in an analytic exploratory process.

I practice and have extensive training in contemporary psychoanalysis.  I am a graduate and Member of the Psychoanalytic Institute of Northern California, a full member constituency of the IPA (International Psychoanalytical Association). The world of psychoanalysis has changed a lot since the days of its creator, Sigmund Freud.  Psychoanalysis celebrated its 100th birthday last year, and over time many great thinkers and practitioners have used psychoanalytic theories to enhance and develop a greater understanding of the original theories of the mind created by Freud and his colleagues.  Psychoanalysis is practiced and taught all around the world now.  I believe that contemporary practice is enlivened and enriched by the profession’s continual improvement of techniques and theories to help our patients’ lives in many ways, intimately, sexually, professionally and bodily.

If you are interested in this kind of treatment, feel free to contact me for a consultation where we may together assess your situation.  The time and financial commitment may feel daunting, but the investment in yourself and your life may be worth the experience.  Better relationships, more fulfilling sexual satisfaction, better and more gratifying employment and relief from psychological distress, distraction and impairment are often the results of psychoanalysis.


Drew Tillotson, PsyD.   l   1730 Divisadero St., San Francisco, CA, 94115   l   (415) 551-7970   l   drew@drewtillotson.com