One of the problems for psychoanalysis, at least in the UK today, is that no-one really wants it. This is not necessarily to say that they want CBT, person centred therapy, counselling or some other form of talking therapy either. However, I think there is something especially problematic about psychoanalysis within the context of these other approaches. And this has little to do with the so-called lack of ‘evidence’. Psychoanalysis is the oldest talking treatment of them all and, in fact, has the largest evidence base – if only people were prepared to think of evidence in terms of something other than the pseudo-science of randomised controlled trials (RCTs).
But evidence is not the real issue here at all. The problem for psychoanalysts is that they are offering something which nobody wants. Or, to be more precise perhaps, they are not offering what people do want. People turn to therapy for the same reason that others (or even the same people) might turn to religion, to politics or to philosophy: because they are looking for something. Quite what this ‘something’ might be is another question – which, of course, is what brings them to therapy in the first place. Often, though, there is some vague sense that they has lost something; a sense that before they got ill, got depressed, started feeling anxious, or, in some cases, before they grew up, their life was better, there was more enjoyment in their life. And now……everything has gone wrong, they’ve lost their joie de vivre.
The problem with psychoanalysis, at least for a lot of people, is that it promises nothing; and certainly not the promise of a new life, happiness, or getting back one’s oomph (as one of my patients once put it). The best that psychoanalysis can offer, perhaps, is a recognition that one’s life is structured around the desire for a new life, happiness, and so forth, but that somehow this never seems to happen. This can take a while, and this might be way too long for someone who is still looking for something.
This might not seem like a great marketing pitch for psychoanalysis: after all, who wants to buy something that offers nothing? On the other hand, who really wants to buy something that turns out to be nothing? And this is the crux of the matter: whatever is on offer, for example, the promise of a new life or a happier life, usually turns out to be an empty promise. And does one really want one’s life structured around an empty promise?
But where does the empty promise leave the promise of nothing? Perhaps by offering the promise of nothing, psychoanalysis can open up the possibility of something else.