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How Psychoanalysis Works
The overview on the home page describes what psychoanalytic treatment does. This page tries to explain how — and why it works the way it does.
You don't need to understand psychoanalysis to benefit from it. The experience of treatment is quite different from grasping its conceptual underpinnings. What follows is for the curious. If you have questions as you read through, shoot me an email. I'm happy to dialogue a bit with you.
The Mind Creates Meaning
Every experience you have, in each and every moment, is a product of work that the mind is doing behind the scenes. The mind's job is to take in raw experience and organize it into something meaningful. It does this constantly, efficiently, and automatically. You don't passively receive experience; the mind constructs it.
Think of it this way: imagine an old film projector, and imagine that the movie it throws onto the screen is your conscious experience — everything that passes through your awareness, moment by moment. The film running through that projector stands for the internal structures and processes the mind has built up over time — out of early relationships, formative experiences, and the particular way you've come to make sense of things. The world doesn't come to you directly. It comes to you through the film.
This means that to some degree, we find in the world what we already expect to be there. We take in pieces of reality and arrange them according to models we've already built. But the fit between the experience we construct and the reality it's meant to represent is never perfect — and it's in that gap, between what's actually there and what the mind makes of it, that the mind's construction processes can be detected and examined. The analyst is trained to see these processes, and to help you see them too.
Patterns Take Root
When the construction process works well, it keeps updating. New experiences revise old expectations. Relationships are able to evolve and deepen. The mind stays flexible, and the personality keeps growing. In the projector analogy, the film changes — new experiences leave their mark on it, and the movie shifts accordingly.
But sometimes a part of the film stops changing. A meaning that formed early — about who you are, what others are like, what you can expect from the world — gets fixed in place. Experience stops revising it. Instead, the mind begins bending new situations into familiar shapes. We become more and more absorbed in our film and less and less in the world.
This is what symptoms are. Not random malfunctions, and not signs of weakness — but signs that some part of the mind is working very hard to keep an old film running. The rigidity itself is meaningful.
We become more and more absorbed in our film and less and less in the world.
Patterns Surface in Treatment
The mind doesn't leave its patterns at the door when you walk into a therapy session. It brings them in. The same construction process that shapes how you experience your relationships, your work, and yourself shapes how the treatment feels — how you experience the therapy and the analyst. It's the same film that rolls.
This is not a problem to be managed. It's the whole point. The analytic setting functions as a screen onto which these patterns can be projected, and the analyst's training allows them to create the conditions necessary for this to happen. What emerges is not just the repeating pattern itself, but the unconscious processes responsible for it.
This is a powerful way of working because it circumvents the mind's tendency to fit new information to old understandings. Rather than talking about your patterns from a distance, the treatment brings you into direct contact with them — as they're happening, in real time, in the room.
There's a temptation to think of what happens next as a separate step — that once a pattern is visible, you then work on changing it. But that's not quite how it goes. The seeing and the changing are not sequential. They're the same moment.
We don't talk about your patterns from the outside. We live through them, and practice waking up in the midst of them — again and again, iteratively, each time with a little more recognition. It's this repeated contact that does the work.
Understanding Brings Change
When a pattern is truly contacted — not just recognized intellectually, but encountered directly in the middle of it happening — something shifts. The constructed experience and the reality it's meant to represent come briefly into focus together. Perception clarifies. It's not that the analyst is telling you that your perceptions of reality are wrong or distorted, it's that you're put back in touch with your own sense that there's a mismatch between your lived experience and the world as it is (in this case, the analyst and the session). This strengthens the mind's natural capacity to update itself and to think more generally.
This is what gives the treatment its sense of coherence and forward movement. As patterns are identified and grappled with, as the analyst brings attention and puts words to one's constructed experience, the reasons behind the patterns come into focus. Those reasons, once understood, free the mind from the work of pushing old film. You come to know your reasons as opposed to being them. This orients you to a fuller and more meaningful sense of past, present, and future. The treatment deepens and things begin to change outside the room as well. Both happen simultaneously.
What to Expect
Psychoanalytic treatment is a significant commitment. Meeting frequently — at least twice weekly — is not incidental to how it works. Frequency is what allows the patterns we've been describing to emerge, be contacted, and gradually shift. Without it, the process loses much of its depth and momentum.
The treatment doesn't have a fixed endpoint. It tends to find its own natural conclusion — a point at which the work feels genuinely complete rather than arbitrarily stopped. For most people this takes years, not months. That's worth knowing going in.
The financial side of things needs to be discussed in person. Though I do still accept some insurances, I'm increasingly shifting my practice to a fee-for-service model. If cost is a barrier, it's worth a conversation — there may be more flexibility than you'd expect. And if it turns out we're not the right fit, referrals to other clinicians are always available.
The process starts with a phone call. From there, if it feels right, we can arrange an initial consultation — at least two meetings within a week — to get a sense of one another. There's no obligation beyond that. The only way to really know if this kind of work is for you is to get a feel for it.