Psychoanalysis vs. psychotherapy

What are their main differences?

A very common question I hear from Greek audiences, and I emphasize this because I am a Greek psychologist and each country has its own psychotherapy framework, is the following: Are you a psychologist? That is, a psychoanalyst?

And when I answer no, with a shocked look, they continue: So a psychotherapist? And when I answer no again, they say: So what are you? And I tell them I am a clinical psychologist.

Clinical psychology deals with psychopathology, that is, mental illness and psychoeducation in general. Bipolar disorder, schizophrenia, borderline personality disorder, and others.

But what is the difference between psychoanalysis and psychotherapy, really, and which one should you turn to when you need it? What does it take to become a psychotherapist (in the Greek context) and what does it take to become a psychoanalyst?

Some science

Firstly, psychoanalysis is based on the work of the great Sigmund Freud, who talks about psychoses and neuroses. A psychosis, for example, is when you have hallucinations, while neuroses at that time meant excessive anxiety, etc.

It differs from contemporary psychodynamic approaches to psychotherapy because it is based primarily on his work. And it does not deviate or become outdated. Psychoanalysts are usually trained for many, many years (5-10 years) and want to talk about associations and solve the “why.”

Unlike psychoanalysts, psychotherapists are divided into different schools. For example, the systemic-family school, the cognitive-behavioral school, the Gestalt school, drama therapy, ACT, and other schools of psychotherapy. Their main training lasts four years, although there are shorter training courses, and each school aims at something different.

For example, in cognitive-behavioral therapy, the therapist tries to “change” the person’s dysfunctional beliefs. For example, if they have depression, they will be asked to write down their activities in a diary every day or to note down their thoughts and rate how realistic they are.

In systemic therapy? Through the lens of the family, the individual resolves differences and conflicts and sets boundaries in both the family and personal context. In gestalt therapy? They experience psychotherapy and there is not so much theory involved. As for drama therapy, through writing, art, and theater, the individual expresses themselves and, through the exercises, undergoes therapy.

So what is psychoanalysis?

Let’s dive a little deeper into psychoanalysis and see exactly what it does: First, it explores the unconscious (or subconscious) and focuses on the behavior, thoughts, and emotions that unconscious “forces” influence. It makes associations as we said, and it is a long-term process for the patient (it can last 5-6 years, while the rest last from 10 sessions to 2-3 years).

Its goal? It is the restructuring of the self and the resolution of intrapsychic conflicts. In other words? To resolve cognitive inconsistencies, i.e., parts of ourselves that conflict in order to ultimately make sense.

What is the right form of therapy for me?

It would be pointless to write this article without mentioning which form of therapy is “best.” And the truth is that every professional says it’s their own. Systemic? Systemic. Psychoanalyst? Psychoanalytic.

However, as proper and ethical professionals, we have a duty and obligation to take into account the patient’s request, i.e., the reason they are coming. For example, if it concerns their family, then systemic therapy. If they want something quick for depression, cognitive therapy. Something more long-term, Gestalt therapy. If they want socialization and art therapy. If they like meditation, ACT.

The answer here is not that all forms suit all people. This is because we are unique. As are therapies and therapists. It is important to build a strong therapeutic alliance, i.e., a relationship with our therapist, for the therapy to work well. Problems? They will arise. The key is for there to be understanding and active listening on both sides.

Conclusion

There are other forms of therapy that I have not mentioned here, and the international community may not be particularly in line with the Greek context. To become a psychotherapist, one needs a degree in psychology or social work, and a master’s degree/4 years of recognized training.

However, every therapist’s responsibility weighs heavily on their conscience for their patients. We will never really be ready for everything. That is why psychologists have a psychologist both for individual therapy and for supervision (i.e., to discuss our cases).

Because at the end of the day, the differences are minimal. But the result of the therapies? Maximum..