What does a psychoanalyst do, how does he work ?
The psychoanalyst listens, and talks when he thinks it’s necessary.
He could occupy the position of the specialist with loads of expertise, whose counseling always brings about the desired results. However, he prefers to adopt an attitude of learned ignorance, and to be attentive to how a particular person has settled in life. He encourages people to reposition themselves, in their own measure. He can help by exploring possibilities and proposing this or that practical solution, but in the end it is the person who consults the professional who decides, and does what he wants, can, and must for himself.
What characterizes the psychoanalyst is not primarily that he deals with depression and stress, for example, or with other more technical and uncommon things like psychosomatic disorders or personality disorders. What characterizes him or her is the way he or she goes about it. What characterizes the psychoanalyst is the desire to meet a person, and to work with him, regardless of the starting point.
He knows what a compulsive neurosis or schizophrenic psychosis is, for example, so he could make diagnoses and decide from there to adopt one or the other ‘obligatory’ therapeutic strategy. He could do so, but he doesn’t. He prefers to build the relationship with every person who consults him carefully, patiently. He certainly hears the immediate request of those who consult him, but he usually refrains from answering immediately. He waits to see if one obvious problem maybe hides another one, or is more complex than what appears at first sight. He listens. He does not neglect the symptoms but he doesn't want to eliminate them immediately without knowing what's at stake. He realises they may be crucial in a person's life and cannot be abandoned before something else can replace them, something that still needs to be built. He tries to grasp the meaning of these symptoms in the context of a whole life, that of a particular being with all of his personal, individual history.
The psychoanalyst and the person who consults both work with words : words exchanged in the context of a human relationship full of emotions. All these words matter, even more so where silence may reign and one is allowed not to speak the whole time. Words and silences count, they can have as much effect as deeds. We all know how praise and insult affect people. But it is no less meaningful when a person finally allows himself to talk about certain things that are otherwise repressed, inaudible, socially inappropriate, or deemed contradictory, absurd. Likewise, an interpretation can transform false and destructive evidences or dreadful confusion into promising new leads. And it can also help to stop life’s treadmill from time to time, to record what is actually being felt and said and done and to start exploring how to feel otherwise than before, how to think and act differently.
All that is easy to say, but difficult to do, both for the patient and for the psychoanalyst. For one should not believe that the consultant and the psychoanalyst simply resemble each other. The suffering of the former needs and deserves the empathy, patience and recognition of the latter. But we must not conclude from this that the consultant and the psychoanalyst are each other’s doubles, twins echoing each other. They are not. And they don't need to be.
It is always tempting to make oneself loved by one's counterpart by always agreeing with him, by practising an all too easy seduction that makes the other person believe that one has understood him, that one feels things in exactly the same way as he does, that one agrees with what he says, and that one would act in the same way as he does. I will not pretend that this is never the case, but if we stop there, if we can’t ever wake up from this far too imaginary and far too simple belief, we're not going anywhere : we are bound to live in a binary world. A world where unquestionable loyalty towards some people, or even submission to deception and manipulation by these same people is completed with fierce and total enmity towards all the other people. I believe common life and relationships to be far more complex than that, and I believe that they deserve to be cultivated as such. That’s hard work, but that’s what human life is, full of uncertainties, a good recipe for laughs and tears.
It is precisely to avoid falling into this kind of imaginary trap and to be able to realize the differences that separate the psychoanalyst and his consultant that every psychoanalyst does a personal analysis before practising his profession, before listening to other people and before starting to work with them to try and surmount what inevitably separates all people who do not yet know each other. And it is for the very same reasons that many analysts regularly talk about their work to colleagues, even after many years of professional activity, just to make sure that their initial safeguards are maintained all down the road.