Pshychoanalysis anyone?

[Anonymous]

I recently had an appointment with a psychiatrist and was offered some choices at the end – be referred on to a doctor who would most likely diagnose and treat ADHD; be referred on to a doctor for antidepressants and CBT (to treat my anxiety issues); or continue with my current doc and try psychoanalysis.

Supposedly psychoanalysis is the most common treatment in France for the triad of symptoms that makes up ADHD, and stimulants are a last resort part of treatment. Within the psychoanalytic world, disorders don’t exist. So there is no labelling. A person presents with symptoms (anxiety, or distraction, or depression) but they are not categorised into a “disorder” (like ADHD, or GAD, or depressive diorder), and are viewed as simply external symptoms resulting from internal conflict. So I guess all my Googling (trying to find info on the success of psychoanalysis for ADHD) came to nothing mainly because the disorder we know as ADHD is not labelled as such within the psychoanalytic community.

So, I am interested to know if anyone has had any experience with psychoanalysis, and if it helped in any way.

And by psychoanalysis, I am referring to “talk therapy”, where an individual’s life is talked about with the aim of improving understanding of “self”, gaining insight into our behaviours and their origin, and using all of this to grow as a person, which is supposed to have the result of improving outward symptoms (in the same way that relaxation techniques can reduce the occurrence of mouth ulcers and gastric reflux, which both can be outward presentations of stress).

I was really disappointed to not find much about psychoanalysis when I Googled it. I could find out what it is, but not info on how successful it is. So I am asking if anyone has experienced it, and not just for ADHD symptoms. I am curious to know what people think of it. Was it useful? Did it result in symptom improvement or did it just allow for “growth” as a person? How soon did you see results? I am tempted to give it a go, but still ask to be referred on for an ADHD diagnosis and treatment, as I nearly crashed my car again yesterday and I acknowledge that I need some sort of chemical support to deal with those areas of my life, for now at least. If psychoanalysis reduces the need for medications, then that’s great, but I am aware that results can take a while.

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[Anonymous]

I found this article/paper about psychoanalysis, which is quite interesting, if you can get over the length of it – I have been reading it in spurts over the last day or so (with frequent breaks to do other things), and am up to p57 out of 193.

http://gradworks.umi.com/3255212.pdf

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[Anonymous]

Before I was diagnosed with ADHD, I saw legions of doctors who could not make a dent in what was bothering me. Talked about a lot o things, was prescribed all sorts of treatments and I seriously wanted to just call it quits. After the ADHD diagnosis, I could finally make the connections I was missing all of that time. I doesn’t matter if I’m medicated or not (I’m pretty sure I have a low tolerance to these medications so it’s doubtful I’ll ever be able to take them in doses that would make a difference) just knowing the cause of my behavior gives me a chance to work with it – to do an end run around it, so to speak.

Needless to say, in my advanced years, I have developed a whole trunkload of issues that need sorting out. But thanks to the correct diagnosis, things don’t seem quite so desperate.

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[Anonymous]

Hi KrszyK…..yes indeed I am a huge supporter of talk therapy….HUGE. There are a few differences between counseling and psychoanalysis but I can suggest your counselors or therapist’s schooling is one, length of therapy time is another. The separation between the two is primarily (now this is my opinion) is the approach and the the depth, and most important….the skill and ability of the counselor or therapist you chose.

Counselors generally advise and work toward fixing specific issues while a therapist will likely be more focused on a “life span” review and analysis looking for items or “life tasks” or “developmental tasks” that are either missing or skewed in your life, in some manner……and the repair of those life task shortfalls.

So, generally…. you want to work on specific problems rather than uncover deeper issues, counseling might be an appropriate avenue. However….If you are interested in making deeper life changes, changes in your perspective, or the way you think and feel, along with solving problems, psychotherapy is considered the route to go. I might add, a large consideration is the time one commits to therapy. Indications are….if you know a long time commitment to psychotherapy will be difficult, then counseling might be a better avenue, but the changes may not have the life altering magnitude??? I’m just sayin…….

For me, I chose counseling, but my counselor was more like a psychotherapist, and we went at my problems from the “whole life” perspective. It took years (5) and was really a relearning process from my very foundations. It was the best thing I ever ever did, it has changed me forever. My life has changed so dramatically it would take pages to describe it, and then I would fall short, and fail miserably!!! We never discussed ADD or ADHD, ever. How my brain process(s) never entered into the discussions. We dealt with my perspective, my beliefs how I processed that information , how I acted on it and why……..and if it positively reinforced my life or negatively affected my life. Sounds simple, it’s is kind of, but it took about five years of hard hard work on my part. I could not have done it on my own, I know that….it took the “right guide or therapist” for me to get it done!!! Actually it never stops, although I don’t go to counseling and haven’t for 15 years now…..I own the learnings and the process and it is part of who I am now and will be forever.

I will state again……it was the best thing I have ever done in my life…..for me for my family for everything I do and am. I have no regrets, I live the life I want….I am content beyond words. I am not suggesting I don’t have all the life challenges we all have….I do…..it’s just that now I see them different….I react different. It’s just life….and that is cool with me.

How my brain works or doesn’t is a given…..like my height. What I do with it, and my heart is critical, and I must care for them both!!! I don’t take meds anymore, of coarse I’m retired so life is more relaxed, and I’m not sayin or advocating any of this anybody. This is just “MY” story and “MY” life… if there is something here for you……help yourself….if not, I am enrichened by it’s retelling. Thanks for this opportunity.

Toofat

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[Anonymous]

Thank you both for your input

@toofat – I greatly appreciate you sharing your experiences and thoughts. My proposed therapy is the long term variety, based on a psychoanalytical model as opposed to a behavioural/biological model (such as CBT). I studied psychology at uni, and we touched on many different forms of therapy, and I can understand the basic principles behind psychoanalysis. I just didn’t know much about it’s effectiveness. It is good to hear from somebody who has been through it and feels it was worthwhile. I can’t imagine going through the process of psychoanalysis and NOT growing/improving in some way, but there is always some doubt, because people are in “therapy” for years and years, and I guess we figure that it therefore cannot be any good, probably because we are used to the “quick fix” effects of medication and surgery. The flip side of the coin is that nobody would continue to put themselves through the emotional wringer of psychoanalysis for years at a time if there wasn’t some benefit to be had.

I am extremely nervous about the whole thing. It’s anxiety provoking to know you’ll be poking around at things you’d rather not remember, or behaviours you’d rather not admit to. But I also need some change in my life, because if I keep going like I am, I can see the self-destructive behaviour patterns spiralling out of control.

I am still contemplating requesting a stimulant for intermittent use. A near miss on the road the other day (one of many) has scared me into thinking about the medication side of things once again. Especially for driving in busy traffic or for long distances, as in both circumstances I am particularly vulnerable to distraction. I don’t know if therapy and medication will be a suitable combination of treatments though, and I must admit to being a little scared of the dependence/addiction side of stimulants. Been there, done that, but with pain killers not stimulants, and it wasn’t fun. I’d hate to go down the same path with stimulants, though many people here seem to have started and stopped stimulant therapy without any problems. I am really longing for relief from some of my symptoms while I wait for therapy to have some results, but I wonder if stimulants will do me more damage than good in the long run.

Aaaahhh…the agony of it all

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[billd]

wow toofat, well said

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[Anonymous]

Look at it this way – you can set a broken bone and it will heal properly in time. Physical therapy will help you regain the use of your broken limb. Medication will not affect either, but they can make the process more bearable and if there’s the possibility of an infection from your injury then medication can do what setting the broken bone cannot. However, medication alone cannot take the place of setting the broken bone and physical therapy.

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[Anonymous]

Too true. Everything has it’s place, and multi-modal therapy works very well in many circumstances. I see a lot of it in my rehab nurse work. A good example is that failure to take adequate pain relief can actually hold up a patient’s progress, unless they are particularly strong willed and positive in their outlook.

I have plowed my way through more of the very long paper about psychoanalysis and found the study of a boy, with ADHD symptoms that fit the DSM criteria for diagnosis, who attended therapy for two years, with the result that he no longer fit the DSM criteria for ADHD by the conclusion of therapy. It’s very encouraging, but also confronting, because it makes me look to my children (my daughter with anxiety and my son with ADHD) and wonder how much of their issues have been caused by my own unresolved conflicts – has it all paid forward and affected them? Quite probably, if you use a psychoanalytical model. But it also means they are treatable too, under the same model. So it’s a double edged sword.

Wow. This has turned into quite an interesting week!! My mind has really been stretched and challenged. I have already started reflecting back on my life and allowing my thoughts to really roam through my life without stopping the minute I feel anxiety creeping in. Come what may, this week has already had a positive effect on my life by making me question the way I think about behaviours and their origins. Conflict is necessary for us to grow, as I was told at a recent conference, and how true is that!!

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[dspicelady]

@Toofat-When I first joined this site, I would read your posts and think….what the heck is this guy talking about? How can anyone be so calm and laid back? (Think of an squirrel on caffeine trying to understand the pace and focus of a tortoise). After a few months in therapy, I started seeing your posts as some kind of utopian view, if you will. You know, “nice place to visit”, but seriously I could never live like that. Even though I would seek out your thoughts on any given topic, and wish like crazy that I truly felt what you felt.

It’s been almost a year in therapy, and unbelievably, it’s starting to click for me. I do see that calmness in my life. I didn’t think it would ever be possible to follow my heart, as you often relay, but I am doing just that and the world is not collapsing around me.

I find myself reading your posts now with a knowing smile. It may sound “stalker-esk”? but you really have inspired me all this time. I so desperately wanted to see the world as you do, and I am getting there.

Thanks for hanging around.

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[Anonymous]

KK wrote: “It’s anxiety provoking to know you’ll be poking around at things you’d rather not remember, or behaviours you’d rather not admit to.”

Yes, but it’s a lot more anxiety provoking to not deal with these things and end up living your life in an increasingly smaller box, editing out most of it.

Am seeing a therapist, finding it very useful. But my guy deliberately pokes at stuff I don’t want to look at, we’re also doing meditation training and it’s part of dealing with personal material. Sometimes I really hate him for it, but it’s what I really need so I forgive him.

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[Anonymous]

i don’t see why you couldn’t do both. I’m a big fan of CBT for generalized anxiety and intrusive negative thinking. I think I need to read back over the generalized anxiety stuff. I’m pretty good at recognizing negative thinking now, but I am still getting so worked up and procrastinating horribly by constant worrying. ADHD treatment is helpful for not thinking about all my worries at the same time, some motivation, and doing one thing at a time, and avoiding distractions. but I am still a worrier by nature!!!!

long-term vs short term therapy is really important for deep seated emotional issues ie. trauma and etc.

also, an ADHD specialist could work with you on your fears of addiction.

i was in therapy for years. I’m not sure what I got out of it except for mindfulness about how emotionally reactive I was and how distorted much of my thinking was. I don’t think I ever found the right therapist match. I’m stubborn and it had to be my way. I got the most out of using these concepts in a professional setting. such a perfectionist that if a grade or work performance review was coming, i was on it.

this website was so helpful for me.

especially this module: http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=46

although best results do come from face to face rather than self-learning. i need to go back over that packet in a bad way lol.

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[Anonymous]

From all of my recent research, I have realised that CBT and psychoanalysis come from two VERY different worlds of thought that are not compatible with one another.

CBT is based on the biological model of the mind – that the processes of the mind are expressed in behaviour, and by studying behaviour, we learn more about the mind. The biological model assumes that mind and brain are one, and that biological processes account for our thoughts and emotions. The biological model proposes that ADHD, anxiety disorder, depression etc are all based on a biological disorder, that is, some form of brain dysfunction that is the same in every person with the particular disorder.

The psychoanalytical view of things is that the mind and brain are separate and every mind is unique. There is the basic premise that nobody can possibly understand how another person thinks because there is no way to examine another’s subjective experiences. The psychoanalytic view is that every experience a person undergoes will have an effect on them, and sometimes cause conflicts in their mind – such as a baby feeling positive about their mother because she is the source of comfort and food, and then feeling negative about their mother when food does not come immediately. The positive vs negative must be worked through in an individual’s mind, and external factors can influence this – so a normal baby will work through the negative mother feelings with the help of the mother’s ongoing comfort and positive influence, but if the mother is absent for some reason (even emotionally) then the baby may have more difficulty reconciling the conflicting feelings of love and hate and the conflict will continue.

Some individuals work through their conflicts in such a manner, or have so many conflicts to deal with, that their “mind torment” (for want of a better phrase) expresses itself in biological symptoms (eg anxiety, altered mood, inability to focus, headaches). Much the same way that stress causes mouth ulcers and reflux in one person, dermatitis in another, and headaches in another. Each outward expression is completely normal, but the mouth ulcers and dermatitis linger past the time of stress, and the reflux has the potential for causing damage well beyond the time of stress if it has been prolonged.

So the psychoanalytic view is that each mind has a reaction to events that have occurred, and in some people, these reactions persist well beyond the time of conflict and affect behavioural/biological processes. By going back and revisiting past events, the feelings and thoughts associated with these can be examined, and an awareness reached, which in turn can allow the person to work through the conflict in a manner that allows them to leave it behind and move on (it’s really a lot more complicated than this, but I can’t even grasp some of the concepts involved, as they are pretty convoluted).

Psychoanalysists aim to keep themselves isolated from outside influences (such as negotiating with schools, labelling a disorder, etc) because they believe it will bias them in their interactions with their patients. For example, if they label a disorder as ADHD, there is the risk of bringing preconceived ideas along with it based on their previous experience with others with the same label, as well as if they believe that there is a biological basis for some behaviours/symptoms, then this may also adversely influence their own behaviour with the patient. So they begin with an empty slate and examine the behaviours/symptoms with no preconceived ideas about the underlying causes of those behaviours/symptoms.

@sugargremlin – the right therapist match is absolutely crucial to success, regardless of the type of therapy. And to complicate matters, some people are simply not the right sort of people for undergoing a particular type of therapy. I am pretty sure I would suck at CBT!

Whew! Sorry for the long post people.

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[Anonymous]

I just thought I would mention that I broached the subject of psychoanalysis with my son today. He was diagnosed with ADHD earlier this year, and we decided to trial stimulants. But he has been reluctant to take his medication recently, and has been very angry at times, so I thought I would offer him another treatment option. It is his life, after all, so he should be able to have some choice in the matter.

Anyway, I explained a bit about what psychoanalysis was, and included the fact that it could be challenging, confronting, and hard work, but that it also had the potential to greatly improve his life. I explained the confidentiality of the sessions, and the possible frequency and length of treatment. He asked a few questions, and I answered the best I could, and then suddenly, out of nowhere, he started venting a heap of frustrations. It seemed like our discussion about therapy prompted him to let fly with all this emotional baggage he has been holding onto. Some of his friends have left his school to go elsewhere (for varying reasons), and others have “changed”, so he is feeling abandoned by them. His teachers have been frustrating him for many reasons, and he feels like leaving the school. Boy, was that a surprise!! I knew he had his frustrations, but not that they were so many and so depressing for him.

The upshot of it was that my son is willing to try therapy (psychoanalysis), so I will ask around to find somebody suitable. I think he will be a good “patient”. He has strength of character and is quite articulate with his speech. I would love to get my daughter into therapy, as anxiety plagues her daily, but she is more fragile and has difficulty expressing herself at times. I would really have to dig around to find a good therapist match for her. We went down the CBT route, but she intensely disliked going. She happily went to a social skills group, but she stubbornly stuck to her belief that she had no problems with her behaviours and did not need to change! She believes that it is the other people in her life who need to change, not her. She was the only one in the group who did not show any improvement 🙄 Her teacher this year has had more of a beneficial effect on her than her psychologist!!

Ooops, I did not mean to ramble on so much!! I always seem to have so much to say 😳

@dspicelady – thank you for your post, by the way. It was invaluable to see how your thoughts on therapy changed as your treatment progressed. I hope I have the same progress!

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[Anonymous]

Krazykat- your son is awesome! very very few adolescents will agree to trying therapy!

very interesting how different types of therapy connect with people. many therapists are trained to perform multiple types in order to meet clients’ needs.

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[Anonymous]

A very good friend of mine who just finished her PhD in social work (mindfulness) also sees the therapist my husband and I see, and she says ‘there’s no end to therapy”. It can go on forever

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[Author]

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