How Analytic is Psychoanalytic Psychotherapy?

This essay attempts to resolve some of the ambiguities regarding the differentiation of psychoanalytic psychotherapy from psychoanalysis. It argues that they result from a failure to recognize that psychotherapy, although it is grounded in psychoanalytic knowledge, is fundamentally different from psychoanalysis in that it does not have as its goal an uncovering of the unconscious and therefore does not use the psychoanalytic method devised for this purpose. Psychotherapy, in this view, is understood as a reality-oriented process that helps a person understand the present in continuity with a consciously accessible past and that promotes the integration of divergent but alternatively conscious aspects of the self and the object. The conceptual framework for psychotherapy thus understood is to be found in developmental psychology, object relations theory, and the psychology of the self. The essentially analytic aspects of such a process reside in the psychoanalytic knowledge of human development that guides our understanding of the clinical material but also the limits of our therapeutic endeavors; in the analytic attitude of openness to the accessible and individual meaning of a patient's communications that guards against imposing cognitively deduced interpretations of supposedly unconscious meanings; and in the engagement of, and respect for, the patient's observing ego.