Editing Psychoanalysis (section)

===Techniques===
The foundation of psychoanalysis is an interpretation of the patient's unconscious conflicts that are interfering with current-day functioning – conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions. [[James Strachey|Strachey]] (1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten.<ref group="lower-roman">also see Freud's paper "Repeating, Remembering, and Working Through"</ref> In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what [[Robert Langs]] later called the "frame" of the therapy<ref>[[Robert Langs|Langs, Robert]]. 1998. ''Ground Rules in Psychotherapy and Counselling''. London: Karnac.</ref>—the setup that included times of the sessions, payment of fees, and the necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts (aka [[free association (psychology)|free association]]).

When the patient reclines on a couch with the analyst out of view, the patient tends to remember more experiences, more resistance and transference, and is able to reorganize thoughts after the development of insight through the interpretive work of the analyst. Although fantasy life can be understood through the examination of [[dream]]s, masturbation fantasies<ref group="lower-roman">[[cf.]] Marcus, I. and J. Francis. 1975. ''Masturbation from Infancy to Senescence''.</ref> are also important. The analyst is interested in how the patient reacts to and avoids such fantasies.<ref>Gray, Paul. 1994. ''The Ego and Analysis of Defense''. J. Aronson.</ref> Various memories of early life are generally distorted—what Freud called ''[[Screen Memories (Freud)|screen memories]]''—and in any case, very early experiences (before age two)—cannot be remembered.<ref group="lower-roman">see the child studies of Eleanor Galenson on "evocative memory"</ref>

====Variations in technique====
There is what is known among psychoanalysts as ''classical technique'', although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient.

''Classical technique'' was summarized by Allan Compton as comprising:<ref>{{cite web |title=Psychoanalytic Techniques |url=https://psynso.com/psychoanalytic-techniques/ |publisher=Psynso |access-date=24 December 2022}}</ref>

* Instructions: telling the patient to try to say what's on their mind, including interferences;
* Exploration: asking questions; and
* Clarification: rephrasing and summarizing what the patient has been describing.

As well, the analyst can also use confrontation to bring an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as:

* Dynamic interpretation: explaining how being too nice guards against guilt (e.g. defense vs. affect);
* Genetic interpretation: explaining how a past event is influencing the present;
* Resistance interpretation: showing the patient how they are avoiding their problems;
* [[Transference]] interpretation: showing the patient ways old conflicts arise in current relationships, including that with the analyst; or
* Dream interpretation: obtaining the patient's thoughts about their dreams and connecting this with their current problems.

Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue. These techniques are primarily based on [[Conflict theories|''conflict theory'']] (see above). As ''object relations theory'' evolved, supplemented by the work of [[John Bowlby]] and [[Mary Ainsworth]], techniques with patients who had more severe problems with basic trust ([[Erik Erikson|Erikson]], 1950) and a history of [[maternal deprivation]] (see the works of Augusta Alpert) led to new techniques with adults. These have sometimes been called interpersonal, intersubjective (cf. [[Robert Stolorow|Stolorow]]), relational, or corrective object relations techniques.

Ego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic (cf., Eric Marcus, "Psychosis and Near-psychosis") patients. These supportive therapy techniques include discussions of reality; encouragement to stay alive (including hospitalization); psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies (hallucinations and delusions); and advice about the meanings of things (to counter abstraction failures).

The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation", using active intervention to interpret resistances, defenses, creating pathology, and fantasies. Silence is not a technique of psychoanalysis (see also the studies and opinion papers of Owen Renik). "[[Neutrality (psychoanalysis)|Analytic neutrality]]" is a concept that does not mean the analyst is silent. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.<ref>{{Cite journal |last=Leider |first=Robert J. |date=1983-01-01 |title=Analytic neutrality—a historical review |url=https://doi.org/10.1080/07351698309533520 |journal=Psychoanalytic Inquiry |volume=3 |issue=4 |pages=665–674 |doi=10.1080/07351698309533520 |issn=0735-1690|url-access=subscription }}</ref><ref>Greenberg, J. (1986) [https://www.wawhite.org/uploads/PDF/E1f_10%20Greenberg_J_Analytic_Neutrality.pdf The Problem of Analytic Neutrality] {{Webarchive|url=https://web.archive.org/web/20220608093724/https://www.wawhite.org/uploads/PDF/E1f_10%20Greenberg_J_Analytic_Neutrality.pdf |date=2022-06-08 }}. Contemp. Psychoanal., 22:76-86</ref>

Interpersonal–relational psychoanalysts emphasize the notion that it is impossible to be neutral. [[Harry Stack Sullivan|Sullivan]] introduced the term ''[[Participant observation|participant-observer]]'' to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue.<ref>{{Cite journal |last=Green |first=Maurice R. |date=1977-07-01 |title=Sullivan's Participant Observation |url=https://doi.org/10.1080/00107530.1977.10745493 |journal=Contemporary Psychoanalysis |volume=13 |issue=3 |pages=358–360 |doi=10.1080/00107530.1977.10745493 |issn=0010-7530|url-access=subscription }}</ref>