Analytical psychotherapy, CBT and
psychological support

The psychoanalysis and psychodynamic psychotherapy are aimed at those who feel caught up in recurring and long-standing psychic problems that hinder their potential for happiness with partners, family and friends, as well as success and fulfillment in their work and the normal tasks of daily life.

Analytical therapy is a talking cure, based on the method of free association. As a fundamental rule, the patient is invited to say whatever comes to mind without restriction, such as considerations of context, decency, feelings of shame or guilt, and other objections. The psychoanalyst does not judge, advise, evaluate or interrupt the flow of thoughts or so-called free associations; rather, he or she intervenes at the appropriate moment to question desire. By adhering to this rule, the patient's thought processes will establish surprising links, reveal connections consciously unavailable to wishes and defenses, and lead to the unconscious roots of hitherto unsolvable conflicts.

Anxiety, inhibitions and depression are often signs of inner conflicts. These lead to difficulties in relationships and, when left untreated, can have a considerable impact on personal and professional choices. The roots of these problems often go deeper than normal consciousness can reach, which is why they prove insoluble without psychotherapy. It is with the help of a psychoanalyst that the patient can gain new insight into the unconscious parts of these disturbances. Talking with a psychoanalyst in a safe atmosphere will lead a patient to become increasingly aware of parts of their hitherto unknown inner world (thoughts and feelings, memories and dreams), giving psychic relief from pain, promoting personality development and offering a self-awareness that will boost the patient's confidence to pursue their goals in life. These positive effects of psychoanalysis will last and lead to new growth long after analysis has ended.

Depending on age, the nature of the difficulties and the person's wishes, we may opt for psychoanalysis or brief psychodynamic psychotherapy.

The psychoanalytic and psychodynamic approaches postulate that discovering and understanding the unconscious causes of the client's problems will free him or her from neurotic blockages. Psychoanalysis and psychodynamic psychotherapy share a common Freudian theory, but it's their aims and methods that vary: psychoanalysis aims to integrate a repressed or dissociated unconscious conflict, while psychodynamic psychotherapy aims to partially reorganize the psychic structure in a context of significant symptomatic change.

Psychoanalysis can be a long and demanding process. The psychodynamic approach is an interesting alternative for patients who respond well to an introspective approach. It uses the same theoretical presuppositions as psychoanalysis, but sessions are generally face-to-face (instead of on the psychoanalyst's couch), held weekly, and can be short or medium-term. Psychodynamic psychotherapy is shorter, and focuses on the patient's central conflicts or problems.

Psychoanalysis and psychodynamic therapy focus on intrapsychic dynamics, i.e. the exploration of affect, desires, dreams and fantasies, and encourage the expression of emotion. The therapist also focuses on exploring patient resistance, i.e. the patient's efforts to avoid certain subjects or engage in activities that delay therapeutic progress. In order to identify and understand thought and feeling patterns, analytic therapy explores the past experiences that gave rise to these patterns, and focuses on interpersonal experiences, emphasizing the therapeutic relationship, transference and the therapeutic alliance. It is both a therapeutic method based on the science of the unconscious, and an ethical conception of the human subject. Going to a psychoanalyst corresponds to a desire to do something to get better, but also to do so in a search for truth with lasting, liberating effects.

The various therapeutic approaches differ in their origins, their conceptions of human nature and the role of psychotherapy, and the techniques they use.

Cognitive-behavioural therapies are techniques based on unlearning erroneous cognitive patterns and modifying dysfunctional behaviours. They aim to eliminate the troublesome symptom, such as panic attacks. CBT focuses specifically on dysfunctional thought patterns and negative emotions. Therapists use techniques to teach new, more appropriate patterns. They proceed by analyzing the dysfunctional schema, then deconditioning it, notably through repeated and prolonged exposure to the anxiety-provoking situation.

CBT is useful for symptomatic treatment and are an interesting alternative to medication. However, these therapies are not aimed at treating the root of the problem, but at modifying thoughts and behaviours through specific exercises. Therapy generally ends with the reduction or disappearance of the symptom that prompted the patient's action.

While cognitive-behavioral therapies target symptomatic changes, the analytic approach favors deeper, more lasting personality changes.

Psychoanalysis or psychodynamic therapy can be recommended in the following situations:

• Repeated difficulties or failures in emotional, social or professional life
• Psychological disturbances such as anxiety, depression, phobias, obsessive thoughts, eating disorders, sexual disorders, etc. 
• Persistent and unexplained existential malaise, personal identity disorders or pathological personality disorders.
• Psychosomatic disorders (somatic manifestations of psychological problems).

In all cases, psychotherapy is based on the patient's own decision. In order to find the causes of their suffering, the origin of an illness, in other words, the origin of what is causing their symptoms, they must commit themselves over a certain period of time. The frequency and regularity of sessions ensure the continuity of the therapeutic process.

Whatever the therapeutic framework chosen, the frequency of sessions is fixed, as this regularity is essential to effectiveness. The discourse must both generate its own dynamic and integrate with the reality experienced by the patient between sessions. A weekly frequency is desirable.

The length of the analysis depends on a number of factors, including the initial problem and the scope of the work to be accomplished, resistance to the work and the analysand's personal objectives. Analysis is considered complete when the analysand "no longer suffers from his symptoms, and has overcome both his anxieties and his inhibitions", and when "the analyst judges that in the patient the repressed has been made conscious, the incomprehensible elucidated, the inner resistance overcome, and that there is no need to fear the repetition of the pathological processes in question" (Freud). So it's understandable that analytical work takes time. When the process is proceeding normally, the end of the analysis - i.e., the end of the joint work of the analysand and the analyst - is decided by mutual agreement between the two protagonists.

The duration of each session is generally 60 minutes, but can be variable, allowing the therapist to make room for subjective time, deciding to stop the session at an essential, revealing formulation, or on the contrary to let a narrative thread come to an end that it would be a pity or too painful to leave in abeyance until the next session.   

The first session is dedicated to getting to know and precisely identifying your problem(s), setting your objectives, the modalities of tailor-made support, and the most suitable type of therapy according to the clinical diagnosis, which may require several sessions. A therapeutic follow-up is first and foremost a human encounter and it is important to feel comfortable and confident with your therapist.

The reimbursement scheme for specialized "psychology" sessions does not cover private psychoanalytic consultations, which do not fall within the institutional context described by the October 2021 decree. As a clinical psychologist, I'm not covered by the French social security system, but my sessions may be reimbursed by certain mutual insurance companies.

Analytical therapies can be carried out in French or English, depending on your mother tongue, as the therapist is perfectly bilingual.

As I explained in an article entitled "Is online psychotherapy beneficial or desirable?"I only carry out online consultations via videoconferencing or teleconferencing if the patient is unable to travel and the treatment has already been underway for some time. I therefore consider this to be an inferior practice, to be used on a case-by-case basis and with due consideration.