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Understanding therapist titles: What is a psychoanalyst?

by Sarah Graham
Tuesday 25 November 2014
4717 6390

When you're searching for a therapist on, you'll come across various different professional titles. It can be difficult to know what each title means - Do I need a psychologist or a counsellor? A psychoanalyst or a psychotherapist? - so, to clear things up, we asked a number of RSCPP therapists to explain what their title means and what you can expect from that type of therapist.

So what is a psychoanalyst? Registered Psychotherapist Christos Tombras explains:

Psychoanalysis is based on the work of Sigmund Freud. Freud observed that we know very little about the factors determining our emotions and behaviour, however we tend to believe that we know all that there is to know. He understood that there is a conflict between what we know and what we actually don't know, and saw that this conflict makes us suffer and fall ill.

Freud invented psychoanalysis as a tool to investigate the psyche. Psychoanalysts do not deal with objective, measurable phenomena, in the way psychiatrists or clinical psychologists do. Psychiatrists are medical doctors, and clinical psychologists often share the same medical point of view.


How do psychoanalysts work?

Rather than the "objective" aspects of human suffering, psychoanalysts are interested in its subjective ones. An analyst will invite you to reflect on the difficulty you are facing. How do you understand it? What does it mean for you? What was it in your own personal history that makes it so difficult to do such and such? Why do you find yourself unable to choose what is good for you?

They focus, in other words, on the whys and hows of your suffering, and not just on the symptoms that make things difficult for you. Of course, a symptom can and will change; it may be transformed, and suppressed, it may even disappear; the underlying conflicting forces of your mental life, however, will still be there.

Psychoanalysts focus on the whys and hows of your suffering, not just the symptoms.

Nevertheless, psychoanalysts do indeed share some psychiatric terminology. This is because they try to form some kind of theoretical understanding of what is at stake by drawing on their experience in the consulting room. So they might speak of schizoid personalities, paranoid psychoses, hysterical conversions, psychotic episodes and what have you. However, they will not do that in the consulting room. Medical terminologies and theories inform their practice but only indirectly.

Importantly, when a client worriedly asks them, "What's wrong with me, doctor, am I mad?", psychoanalysts will refrain from giving an answer. They do so because they recognise that attaching a medical label to a suffering is not going to help in this exploratory journey of reflection and understanding. They are not doctors, and they believe that suffering and distress is not necessarily a sign of madness.


What training does a psychoanalyst have?

There are many schools of psychoanalysis, and it is almost impossible to draw any clear dividing lines which would leave everyone satisfied. What most schools of psychoanalysis share, however, is their recognition of hidden conflicts in one's mental and emotional life, and their commitments to working with them. For this reason, one of the most important aspects of a psychoanalytic training is the personal analysis that the trainee has to undertake. This can take years and years, and is designed to give to the future psychoanalyst a first-hand knowledge of the forces they will be dealing with in their own practice.

All psychoanalysts follow a professional body's confidentiality guidelines and code of ethics.

Finding support

If you are concerned about the issues raised in this article then you may like to read about finding the right therapist for you. If this route is not appropriate for you, your GP can assess you and direct you towards support.

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Updated 07 January 2015