The market of available treatments for psychological problems is shrinking, which is why it is extremely important to know what exactly is on offer and what kind of specialist one wants to see. First of all, let’s talk about the differences between psychiatrists, psychotherapists, and psychoanalysts. These are completely different professions, and you will get radically different treatments from their representatives.
Psychiatrist – this is a person who doesn’t know how to do absolutely anything but choose a diagnostic label to attach to you and prescribe you medication. You will be hard-pressed to get a psychiatrist to remember your name, let alone retain the memory of what actually bothers you. A steady stream of patients flows into a psychiatrist’s office where they get their scrips and are sent away within minutes.
Psychotherapist – this is a person who doesn’t solve any problems either, but at least s/he will listen to you and not shut you up with zombifying medications. Psychotherapists have access to an enormous array of non-medicinal therapeutic practices that help make your problems manageable. The problems never go away because psychotherapy doesn’t touch their roots. Imagine having a lawn that keeps getting overgrown with weeds. You can use a lawn-mower on it but that will require weekly rounds of mowing since the seeds of the weeds will never go away. This is what psychotherapy is like. People end up visiting a therapist for years because life becomes tolerable as a result. However, without those visits, the problems quickly reappear in full bloom.
Many people choose this option, and I think it’s very respectable and has a right to exist. If one doesn’t feel like changing one’s life dramatically and simply wants to enjoy what s/he has better, that is perfectly fine.
Sessions with a therapist are usually pleasant. The support and acceptance one gets during them often make one feel euphoric after a session. One problem with psychotherapy is that you never know when you are visiting a quack who will not provide even this modest kind of support and will end up hurting you.
Psychoanalyst – this is a person who will also treat you non-medicinally and will never attach any diagnostic labels to you. Insanity, depression, bipolar disorder, anxiety disorder, schizophrenia – none of those exist in a psychoanalyst’s world. For an analyst, you are neither sick nor abnormal. You are simply a human being who exists in a certain way and who is not better or worse than anybody else because of this. If you want to bug an analyst, just say something like, “I know this sounds completely crazy but. . .”
The goal of psychoanalysis is not to make life tolerable by mowing the lawn of your problems but to eradicate them altogether. This is why analysis will not last for many years (granted that both the patient and the analyst work and not pretend to work.) This is a finite process, at the end of which you are supposed to let go of your problems for good. For instance, if you have an alcohol addiction, as a result of psychoanalysis you will not need to spend the rest of your life going to meetings, confessing your alcoholism, and struggling “one day at a time” with the temptation. Because there will be no more temptation. Alcohol will simply stop being of any interest to you without any effort of will-power.
The downside of the process is that the sessions can be very painful and the time between them can be even worse. This is like removing facial hair with pincers one hair at a time as opposed to shaving. I believe that the degree of pain depends on how well one is prepared for the process and how aware one is of what the process will entail. (More on this later.)
One good thing about psychoanalysis is that an analyst (a real one, that is) always works with a supervisor. This is a person who is there to make absolutely sure that the analyst never projects his or her own problems onto you and doesn’t use you to advance any personal agenda.