I am a psychoanalyst and still consider there is much of value in that tradition. It is the oldest and original form of psychotherapy and much knowledge and insight has been garnered over the generations since Freud's first explorations of the unconscious mind in the late 19th century. However, many years ago I concluded that psychoanalysis, as commonly practised, was not always as helpful as we might need it to be to resolve the problems our clients and patients present.
There are two key and related factors that led me to move away psychoanalysis as conventionally carried out. First, there is a relative lack of attention to trauma. This is paradoxical, since Freud's original insights were into the long term effects of childhood sexual abuse - but, as Jeffrey Masson showed in his 1985 book The Assault on Truth, Freud soon moved away from his profound discoveries regarding sexual abuse and other childhood trauma, probably partly under immense social pressure in Vienna at the time. Instead, he began to emphasise more essentially internally derived vectors and conflicts, notably the Oedipus complex and the tension between loving and aggressive instincts. Although these are important, the broader field of contemporary psychotherapy now recognises how real (attachment) relationships with caregivers, and all manner of interpersonal trauma (defined as any event that overwhelms the ego's coping capacities) shape the developing personality. Although there are now many psychoanalysts who do recognise and work with the effects of trauma, the legacy of Freud's shift of emphasis is still apparent.
The second, and related, factor is the prevalent assumptions and ways of working with the so-called transference. Freud, in my view correctly, viewed transference as a form of memory. Instead of overtly remembering a developmentally important experience, the patient unconsciously recreates it in the form of a distorted perception of the analyst, or by some other enactment of an early situation. This certainly happens, and when it is identified as a transference memory, the therapeutic effect can be considerable. When viewed in this way, we find that what is going on in the present, for example in relation to the analyst, can throw important light on what happened in the past - and similarly, an examination of recollections of the past can illuminate the present. The crucial task is to keep the focus moving between past and present. In much of contemporary psychoanalysis in the UK, as far as I can understand, this is not done. Instead, there is often a continual focus on what is going on in the present unconscious relationship with the analyst - the crucial movement between present and past is missing (not always, but often). The result is, I suspect, that childhood traumas sometimes do not get explored as much as they need to be because the focus is so much on the present. In part I think this came about through an inappropriate application of methods of child analysis, where the analyst is obviously working in the developmental present, to adult analysis where the personality has arisen from the developmental past. Some analysts take the view that the past is essentially inaccessible, and that exploring it is a waste of time and potentially misleading. They argue that all we have available are the psychodynamic templates, the internal models of the interpersonal world that have arisen from the (now inaccessible) past - and so it is the present dynamics, as played out in the transference that we should address, rather than attempting to reconstruct the past. I disagree. In states of PTSD and its complex developmental forms, memories of the traumatic past are very much present and highly charged, distorting perceptions of the interpersonal present, and need to be processed in some way.
I arrived at this conclusion as long ago as the mid-1980s when I began working as a psychoanalytically trained psychotherapist in a general psychiatric setting, seeing many patients who had suffered extreme trauma and abuse, both during childhood and as adults. This set me on a search for more helpful additional or complementary approaches that could combine with what was still useful within a psychoanalytic perspective. EMDR, emerging in the early 90s, was very helpful and I found it highly psychoanalytic in terms of the content that would emerge regarding early development. From some EMDR practitioners I began to hear of the somewhat related modalities of energy psychology. These mostly involved the targeting of traumatic memories, or constellations of anxiety, with carefully chosen words whilst the client would tap on sequences of acupoints or other components of the subtle energy system. Procedures such as tapping on acupoints appears to break up recurrent dysfunctional patterns, introducing optimum entropy into pathologically excessively ordered mental states - thereby allowing the mind and brain to update and develop responses and initiatives more appropriate to the present.
For the last 25 years I have been immersed in exploring and developing this field of energy psychotherapy, which works at the interface of the mind, body, and subtle energy system. I find it to be, for many clients, profoundly helpful. For me, the work remains psychoanalytic, although its form and style might appear unusual. Like conventional psychoanalysis, it is free-flowing - I think of it in some ways as acupoint-assisted free-association - but the methods allow us repeatedly to make clear links between the past and the present and to target key formative events and their meanings. Although transference does sometimes appear, it is not the focus of the work. The transformative effects are not reparative effects of the therapeutic relationship but derive from work that takes place within the client rather than from playing out the psychodynamic template in the theatre of transference.