There are many standard cartoon situations: desert island cartoons, man on a ledge cartoons, middle aged man and nubile girl cartoons, furious wives waiting - rolling pin in hand - for their husband cartoons. One of the most common shows two men in a room with certain essential props. There is always an armchair, a couch, usually a carpet, and on the wall a framed certificate. These are jokes about psychoanalysts. A man lying upside down on the couch. The analyst: "Can't you do ANYTHING right?" An analyst shown wearing a Napoleon hat and with one arm thrust into the breast of his jacket asks his patient, "When did you first begin to feel omnipotent?".

People like jokes about how daft psychoanalysts are, and many think that they should be placed somewhere between charlatans and down-right con-men. Yet very few people who have not had first hand experience of psychoanalysis, or who have not read about it, have any idea of what a psychoanalyst does. Indeed, many members of the otherwise sophisticated public share the opinion that "Anyone who goes to a psychoanalyst needs his head examined."

And yet in any of the recent millennium lists of the greatest thinkers of the 20th Century, Sigmund Freud, the Viennese medical doctor who was the discoverer and founding father of psychoanalysis, is always among the top few. And these same, sceptical, no-nonsense citizens entirely accept and are often guided by ideas and attitudes that come directly from Freud, or from later psychoanalytic writing. For instance, everyone knows what a Freudian slip is, i.e. the sudden "accidental" betrayal of a person's true thoughts, unthinkingly blurted out from his or her unconscious. Indeed, the very idea of an unconscious from which such personal truths might spring is a psychoanalytic concept. As are "ambivalence" (as in "I have ambivalent feelings about him"), "sibling rivalry", "neurosis", and "Oedipus complex". At the end of the twentieth century, we all speak Freud.

No one disputes the fact that a person's behaviour could be open to different interpretations, some of which might amaze and disconcert him. We all interpret other people's behaviour: as we struggle to get on comfortably with our families and colleagues and friends we all make (psychoanalytically derived) shots at interpreting their and our own actions and attitudes. "She was behaving peculiarly because she was nervous"; or "He's too competitive to delegate any responsibility to anyone else".

What Freud did was to assume that human behaviour was ultimately understandable, that it followed rational laws, but that those laws could only be seen to be rational if we understand the principles that guide them. Crucially, he added to rational explanations for human behaviour, the element of the unconscious; he said, that is, that some of the most important things which influence our behaviour and our character are feelings and experiences of which we are not aware.

Freud was certainly not the first to recognize the unconscious in human mental life, but he was the first to study it in such depth and to explore and elaborate a way of making it accessible to conscious thought. One hundred years ago, in 1899, Freud's Interpretation of Dreams, his first and perhaps most revolutionary work, shone a light on the unconscious by showing how it manifests itself in anxieties, physical symptoms or dreams. This no longer feels like such a revolutionary idea; we are all aware of a reservoir of experiences and memories felt to be located somewhere deep within our minds, which we glimpse when we remember our dreams. We are struck by the feeling that in the middle of the night we were a child again, in our parents house, having a temper tantrum; or an actor on a stage, waiting for the curtain to go up and realising that we have forgotten to learn our lines. At moments like these, we become aware that there is a whole world within us, a world full of powerful emotions and complicated relationships, a world to which we have very limited access.

In the years following the publication of The Interpretation of Dreams, psychoanalysts have been engaged in a broad study of those aspects of the human condition that do not fall directly into the physiological. They study the human mind - how it works and how it falls ill - and they simultaneously treat individuals by applying the knowledge and experience they have gained about the way people feel and think and behave.

The only mystery is why this is ever considered such a crackpot thing to do. Who, after all, has not come across someone who is failing to prosper, and seems doomed to repeat endlessly some self-destructive pattern in life, but who maintains nevertheless that there is nothing wrong with him? It is into this territory that the psychoanalyst steps. He comes from a theoretical and professional tradition that attempts to understand in a general way what makes people tick, and he scrutinises and analyses his relationship with a particular patient in minute detail, often over a long period time.

Psychoanalysis is not like physical medicine. It is not pure science, as Freud , in the beginning of his studies, hoped it would be. Psychoanalysts use a combination of scientifically confirmable data, philosophical observations about human nature and very real and painstakingly acquired therapeutic skills to understand their patients. They are not primarily interested in changing specific behaviours and not at all interested in molding their patients to some pre-conceived idea of "normal". Rather, practising psychoanalysis can be likened, as the British psychoanalyst Paul Williams put it, to restoring a painting. "Patient and analyst attempt together to lift the grime and wear of the years without damaging the original underneath. Where damage appears, repair is carefully undertaken in accordance with, as far as is possible, the intentions of the creator - the Self of the patient. The process is a science and an art". Such a process is about discovering, experiencing and assimilating what is authentic and emotionally true in the patient's self.

Long before Freud, authors and poets addressed this side of life. Paulina, in A Winter's Tale, suggests that Leontes' son has died because the child has tried to contain the agony of his parents quarrel, and the attempt had overwhelmed him. In Macbeth, Macduff's comrades implore him to express his grief when he hears of the deaths of his wife and children, "Give sorrow words; the grief that does not speak, Whispers the o'er fraught heart and bids it break" . Like Shakespeare, Freud understood how children and adults may get ill from carrying pains they cannot speak about and cannot make sense of. It was from this understanding, and his painstaking attempts to study such states and to find ways to relieve them, that, in the face of general scepticism from the medical establishment, psychoanalysis, "the talking cure", was developed.

There is nothing prurient about this and nothing destructive. It is not messing with people's minds; it is about easing suffering and clarifying mental confusion. Contrary to another popular myth, it is not "all about sex", although sexuality - fantasies, difficulties, experiences - are often part of a much more far reaching exploration of the patient's whole emotional life.

It is also the case that psychoanalysis is constantly developing. Some of Freud's own ideas have been set aside and new formulations have been found. Not just time, but geography and culture create changes. Psychoanalysis in Great Britain is not exactly the same, though it is closely related to, that practised in France, the U.S. A. and so on.

Sometimes people are nervous about going to see a psychoanalyst because they feel they will betray aspects of themselves that feel deeply private. They think that analysts, like witch doctors perhaps, will look into their souls, or make impertinent trespassing sorties into their private thoughts or desires. And yes, it is sometimes frightening to get to know yourself, to confront your demons. But the analytic relationship allows this to take place in an atmosphere of developing trust, an atmosphere in which difficult, painful experiences can be safely explored and understood. It is in such situations of closeness and dependency that people have a chance to grow. For many people the home of their childhood provides such a setting, but for many others (and for many different reasons) it does not, or not sufficiently. It is then that people need further help in order for their lives to become more rewarding.

One familiar argument against going to talk to a psychoanalyst is that it would be "self indulgent". "How could I spend so much time talking about myself?" But in fact it could be argued that nothing is more self indulgent than allowing one's uncontrollable patterns of behaviour to make life difficult for one's family and friends. The perennially dissatisfied wife, the workaholic husband, the boyfriend who is an incipient alcoholic, all place intolerable pressures and burdens on people who care about them. In such circumstances, to take responsibility for one's own life, for one's own problems, however difficult and even painful it might be, is a grown-up, unselfish thing to do.

Priscilla Roth. May 1999

Copyright © 1999 Priscilla Roth