Julie Sale, LCC Director, sets the record straight on the difference between psychotherapy and psychoanalysis.

I am not normally one to stand on a soap-box and shout out my thoughts and feelings on a subject. I am usually content to work within my values in my client, teaching and writing work, sharing my position on subjects through my way of being in the world. Today though, I’m feeling the need for a bit of a shout!

The issue that is animating me is the confusion between the words ‘psychotherapy’ and ‘psychoanalysis’. Now, I can forgive the general public for not knowing the difference between these terms. Why would they? But I find it more difficult to accept when people within the profession use these words interchangeably. They are not the same thing!

‘Psychotherapy’ is the generic term for talking therapy, the process of addressing emotional concerns with a trained professional. If it is to be used interchangeably with another word, the closest would be ‘counselling’, (although there can be some training differences between counsellors and psychotherapists).

‘Psychoanalysis’ is a type of psychotherapy, one of many, many different approaches, (referred to as modalities), to the work of resolving emotional difficulties.

As the British Association for Counselling and Psychotherapy explains.

‘Counselling and psychotherapy are umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing.’

‘there are different ways of working with people, usually referred to as ‘approaches’, ‘techniques’ or ‘modalities’.

So, if psychotherapy is ‘fruit’, psychoanalysis is ‘a banana’.

The reason this is bothering me is the contexts in which these words are used to mean the same thing. I sat through an Improving Access to Psychological Therapies, (IAPT), training recently and the presenter confidently announced that ‘psychotherapy does not work with OCD’. I was bemused. If psychotherapy does not work with OCD then OCD is not treatable. CBT works with OCD, which is the point the presenter was trying to make, and CBT is a modality of psychotherapy. What the presenter meant was that, in her opinion, psychoanalysis doesn’t work with OCD. Over 100 IAPT trainees left that course thinking that psychotherapy means psychoanalysis. It doesn’t! More worryingly, they left thinking that psychotherapy doesn’t work. And this is only one of several occasions recently where I’ve heard the terms used to mean the same thing.

‘So what?’ you might ask. My fear is that if this mix up of the terms isn’t addressed the idea will filter out to GP’s, commissioning bodies, employers, students and the general public that psychotherapy does not work and those of us who have trained as psychotherapists and achieve evidenced change in our clients will be overlooked or maligned.

I’m not entering into a debate here as to whether or not psychoanalysis works. I am a believer in ‘horses for courses’ in therapy. Humans are varied and a variety of approaches is needed to help them. I am just calling for clarity.

So, can we please remember that psychotherapy is the job of supporting people through a change and psychoanalysis is just one approach to that job?

Thank you. I have now stepped off my soap box!

If you would like to learn more about the various approaches to therapy or if you are looking for support with an emotional issue please visit www.localcounsellingcentre.co.uk 


Jo Coker Clinical Director at LCC starts our blog series on long term relationships

As a relationship therapist I am often asked questions about relationships. The top two must be; ‘what does a great relationship look like?’ and ‘what is love?’. I have often wished that I had an easy answers for these questions, but they are, as you might expect, complex issues and so hard to define. When we start our relationships we often do not think of what the future will hold, and concentrate on the rather more immediate aspects of relationships, how attractive we are to each other, sex, weddings, setting up home and so on. We rarely think how we will support each other, perform and love together under the stress and pressure that a long-term relationship brings.

Dr Sue Johnson, author of The Love Secret, tells us that in relationships couples get bogged down in the minutia of events and attribute false meaning to them, which often disturbs the balance of the relationship. In fact, what really is disturbing us is the threat to our ‘safe haven of secure love’ i.e. our adult attachments.  Love and being in a great relationship she argues is about being there for our partner no matter what, and creating a safe dependable space that we can return to when the going in life gets tough. It is a ‘seeking, comforting connection’ that is innate in all of us and is the predictor of a solid relationship. It is the solid foundation that all the other great benefits of being in a relationship flow from.

I saw this modeled recently by my friends Kate and Fred. This year just after Christmas, my lovely friend, Kate, lost her 3-year battle with terminal breast cancer. We had known each other since being students, our husbands are best friends and our children grew up together. Over the last three years we all watched cancer ravaged my friend and as the disease took hold of this once Catherine Zeta Jones ‘look alike’, she physically diminished before our eyes.

However, this dreadful situation did not dampen Kate’s lust for life, love and humour, and over this period we had some sidesplitting moments as we relived our past scrapes and adventures. As Kate became weaker we were privileged to watch the incredible care and tenderness that her husband Fred demonstrated. In every action love and care glowed, whether it was carrying her when she could not walk, cleaning her when she was sick from the maintaining treatment or feeding her when she could not eat. Naturally, he did not always get it right. I vividly remember Kate complaining bitterly that she was wearing red Christmas tights in August when she could no longer dress herself. Fred, unlike Kate, has never been a fashion icon! But that aside he was there with her every step of the way providing a safe and comforting space through her journey, until she died surrounded by Fred and her children. In her actions Kate too was Fred’s safe haven, giving him a space where he could share his concerns and fears about the future without her. Together they demonstrated how unselfish and thoughtful true love and relationships can be, and how rich.

At Kate’s funeral many stories were told and laughed at, many about her wonderful and maddening ways. I was interested to observe that the maddening ones were loved and laughed at most, perhaps because perfectionism is unreal. Perhaps the most poignant was by her son who recalled how she was not the best packed lunch maker when he was at school and that the peanut butter would always spread over everything else in the pack, which he found exasperating. He then recalled that while on a recent skiing trip his travel has been disrupted by snow. As he settled in for the long cold night at the station in his ski bag, he felt a Tupperware box in the bottom of the bag. There was the inevitable packed lunch with peanut butter everywhere! It was, he said, like a beacon of love across the miles.

So maybe this is a reminder that it is not the small irritants that cause emotional noise in our relationships that we should attend to, it is the solid safe haven of love behind them that defines our relationships and makes them unique and so special. As Fred said to me at Kate’s funeral ‘see the irritating quirks for what they are, laugh and embrace them, they are the small detail in the wider picture of love’. What a wise man!

If you are having relationship difficulties, why no speak to one of our specialist therapists. Sessions are available from just £15.00. Contact LCC on 01462-674671 or visit www.localcounsellingcentre.co.uk

Authenticity in Relationships

Krystal Woodbridge, Psychosexual Therapist & Relationship Counsellor at LCC continues our series on relationships

The presence or absence of authenticity in a relationship can mean the difference between a happy, fulfilling and loving relationship, or a relationship fraught with insecurities, conflict and disappointment. Authenticity means not being afraid to show your partner who you really are, warts and all. It is true that early on in a relationship, when everything is new and exciting, we are often on our best behaviour, hoping not only to attract our new or potential partner, but also to keep them from being scared off by the reality of our “less than perfect” selves. This honeymoon period can be wonderful, exciting and all-consuming. But what happens once the relationship is more established? Can our partner live up to the same high standards that they set for themselves to woo us with, and which we have come to expect of them? And can we live up to our own? If we try to maintain a facade, it is inevitable that at some point we will begin to crack under the pressure of expectation that we place on ourselves, or the pressure that we perceive our partners place on us. In fact, the word perception is key to understanding what stops us from being truly authentic in our relationships. For example, if we perceive that our partner expects us to be an idealised version of ourselves, we make the assumption that they will not accept our imperfections, which can range from bad habits to our deepest needs and desires. However our perception is just that – a perception, an assumption that we know exactly what our partner will think if we let them in.  These assumptions often come from the belief that others, particularly our partners, view the world, others, even themselves, in exactly the way we do. After all, we are “as one”, as two halves of a whole – aren’t we? Well, no, I don’t believe we are. We each have our own, unique way of viewing ourselves, the world, other people, which is influenced by our own individual values and experiences. We cannot possibly know what our partner is thinking or feeling, and they cannot possibly know the same for us. Once we truly realise this, we can accept that our assumptions of how our partner will receive our deepest needs, desires, imperfections and foibles are more a reflection of our own view of ourselves. This highlights the importance of developing a healthy relationship with ourselves well as with our partner. It means that just because we might view the fact that we have issues with trust, or a need for reassurance as “needy”, it doesn’t mean that our partner will view it as a negative thing. It also means that as we cannot assume that our partner knows how we feel or what we want, we have to tell them! When we were infants, if we wanted something we would cry and our parents would either instinctively know what we wanted, or they would work it out. Whilst this works in a parent/child relationship, it cannot work in an adult/adult, romantic relationship. So why would we expect our romantic partners to know what we want or need? Sometimes we even worry that if our partner doesn’t guess correctly, that they must not love us!  Just by asking yourself the following questions, you can start to think about how fulfilled you are in your relationship:-

  • What are the things I like about my partner/relationship?
  • What are the things that I don’t like?
  • Am I being honest with myself?
  • What are the things that I want from my partner but do not get?

If there are things that you feel need improvement, ask yourself what you think you need to do to to make this happen. What stops you? Are you making assumptions about your partner? Try to write a list of all the potential positive and negative consequences of saying how you feel and the likelihood of each consequence.

Being brave and telling your partner how you feel might be risky, but the payoff can be the growth of a happy and fulfilling relationship, where both parties are genuine and have permission to make mistakes, freedom to be themselves, and a secure base from which to explore the wide world and return to for comfort.

If you are having relationship difficulties, why no speak to one of our specialist therapists. Sessions are available from just £15.00. Contact Kathy Freeman on 01462-674671 option 2 or visit www.localcounsellingcentre.co.uk