I’d never stuck with therapy. Then I tried psychoanalysis

Once in a psychoanalysis session, I cried and laughed at the same time. The energies of each separate, simultaneous outburst seemed to feed each other until I was both cackling in an almost crazed fashion and wailing wretchedly. It was as strange as it sounds. And once it had started, it seemed as if it would never stop. I wondered if they would eventually morph into the same strange, wild thing. But they never did. There was always a discernible separateness. It burnt out after a little while, the way a fit of laughter always does.

My analyst was laughing with me. Then she shook her head and said: “Well, what on earth was that? I have never seen that before.” I laughed too (normal laughter) and told her I didn’t really know, I had never seen or done it before either. I asked her if she thought that laughter and crying could be an outlet for the same emotion, and if maybe that meant I felt something so strongly that I expressed it in both ways. Laughter is associated with joy, but it can also be a release, a coping mechanism, a distraction or many other things. Crying can be a form of relief. Relief sometimes feels close to joy. And joy is often framed by a tinge of sadness, and vice versa.

She told me she agreed that, yes, that was all true. But she suggested I was trying to talk around the fact I had done them both, separately, at the same time (I was). And that I was trying to move the conversation away from what we had been talking about before it started (I was). We were talking about a type of relationship I have often had that I keep separate from everything else I do. A relationship with a kind of person who doesn’t seem to fit with the rest of my life. The quality of separateness, she suggested, was both the striking thing about my emotional response — the separateness of the laughter and the tears — and the interesting aspect of what had caused it.

Except I didn’t start with that clear, simple sentence: “a type of relationship I have often had which I keep separate from everything else I do”. It came up in an offhand way, as interesting things tend to in my experience of analysis. I mentioned someone from my past. My analyst asked how I knew him, and I described our relationship in a universalising way, another trick I use. “Well, he was one of those people, you know, the ones who . . . ” No, she said. She didn’t know people like that. I needed to explain. Again I tried the language of “people” and “you”. She stopped me. “This isn’t something I or everyone else does. This is something you do.”

More questions. Did I like him? Yes, I really liked him. We got on well, I felt like we understood each other. I could have real conversations with him. That was when the laughing that was also crying started. When it stopped, and we talked more about it, my analyst suggested maybe I have two feelings about this that don’t make sense to me together. We talked about the idea of separateness and eventually came to that clean, tight sentence: “a type of relationship I have often had which I keep separate from everything else I do”.

We talked more and arrived at the idea that this kind of separateness has a larger meaning to me too. There are things I do that don’t feel like part of my “real” life. They feel weirder, grottier, darker and more dangerous. The strange thing is, I sometimes wonder if the things that don’t fit are more “real” than the rest of it.

That’s where we left that thought, articulated rather than answered. I don’t know if the question of which is more real is one I’ll ever answer, but I understand myself better for having formed it. That’s where analysis tends to take me. Not to a conclusive end, but to a greater clarity that I can sometimes use for a practical change and sometimes not. I’ve been surprised at how transformative that can be.

I started psychoanalysis last year with low expectations. Before that, counselling had been the most recent in my string of haphazard forays into various kinds of therapy. I hated counselling. I always had the sense my counsellor was trying to provoke an emotional outburst. He managed this in most sessions and, when he did, he would react gravely, comfort me and then we would talk about how bad the thing that had caused the outburst was. I found this unsettling. And his grave manner made me feel freakish. (He never, ever, laughed.) I always left the sessions feeling awful and dreaded going to the next one.

I didn’t get along much better with an earlier attempt at cognitive behavioural therapy (CBT). CBT prioritises learning techniques to manage the symptoms of issues like anxiety and depression, and is typically undertaken for a shorter time period than analysis. The aim is to equip you with practical tools to manage overwhelming emotions. Breathing exercises, say, to dispel the fight or flight response, or learning to recognise negative thought patterns before you spiral.

CBT is considered the form of psychological treatment with the strongest evidence base. It is also the form of treatment to which the most research into effectiveness has been dedicated, compared with other therapies. In the UK, the National Institute for Health and Care Excellence (Nice), which provides independent, evidence-based guidance for the NHS, recommends CBT to treat many different conditions, including anxiety, depression, PTSD and bipolar disorder.

But I didn’t click with it. I felt stupid doing the exercises — things like using an app to keep a “worry journal” of unpleasant thoughts over the course of a week on virtual sheets of paper, and then virtually crumpling them up — so I didn’t really do them properly. I gave up both CBT and counselling within around five sessions. Then there were the intermittent periods I spent trying mindfulness; I would routinely fall asleep in the classes.

I know this doesn’t suggest that my search for mental healthcare was expansive. But I think this is the normal course of action for someone without complex needs, for whom mental healthcare is fairly accessible. (I don’t have a debilitating illness like schizophrenia; and I can afford to pay for treatment, but not spend a fortune.) You feel bad; you try some kind of therapy; it doesn’t go particularly well; you feel frustrated and quit; you avoid it again for a while; you try again a year or two later.

This was how I came to psychoanalysis. I mentioned to a friend that I was thinking of trying therapy again but dreading it. She suggested this might be a better fit; she had been doing it for a while and it had helped her a lot. Actually, she said she loved it. She told me it was essentially about talking, trying to find patterns in the way you form relationships and how these might relate to a role you have learnt to take on, possibly from childhood. Being a person others tend to rely on too much, say. She said it was about figuring out why you seem to find yourself in certain dynamics again and again (overdependent friendships, maybe, or shortlived romantic relationships), as well as figuring out how you might unwittingly be fostering them.

Other than her recommendation, I didn’t have any reason to expect psychoanalysis would go much better than my other attempts at therapy. Really, the impression I had of it, based on vague prejudices, was worse. I thought of it as “the weird one”, which is the way people often respond when I tell them I’m doing it. And I had an idea that it was elitist, the preserve of a rarefied intellectual and cultural elite. (For some reason, this didn’t include me, a novelist and essayist with a masters degree in maths and physics.) Also that it mostly involved digging up old memories of your family for the sole purpose of blaming everything on your parents, and that this had been disproven as a method. The analyst, too, I presumed to be stern and argumentative.

My preconceptions could be summarised by the way one friend reacted when I arrived at the pub after a session: “Isn’t that the one that Woody Allen does with a man who frowns, and he does it five times a week, and it’s all about his dreams and his parents?” I remembered an episode of Mad Men in which Betty Draper’s analyst telephones Don after her sessions to report her private confessions and describes her as “consumed by petty jealousies”. So there was misogyny too.

And yet I trusted the friend who told me about it. I was interested in the idea of repeating patterns. And really, I felt like I did need to find something that worked for me, because I have bad spells of depression and I don’t know what causes them. Spells when I stop sleeping and start having frequent nightmares about (and during the day seeing images of) myself coming to physical harm, being crushed or strangled. It’s a frightening state of mind to be in. Usually, I don’t even recognise it as a state of mind until it starts to pass and I see it in hindsight. At the time, it just feels like the way things are. But it has happened enough times now that I can see it as a pattern. So the idea of patterns struck me.

My friend also told me that psychoanalysis wouldn’t be a quick solution to anything. Strangely, that made it more appealing. It didn’t seem to be promising a way to briskly make me feel better, but rather a longer route to understanding myself better. A smaller promise, maybe, but one that seemed more realistic. In a world that often feels full of purported easy solutions, there is something reassuring about anything that doesn’t claim to be.

I don’t think I’m the only person who feels like this. Since I started analysis, I’ve noticed that more and more friends and friends-of-friends seem to be trying it too, like when you learn a new word and suddenly see it everywhere. Recently, at lunch with a group of people aged between 25 and 35, we discovered that not only were multiple people in psychoanalysis, but two were seeing the same therapist. The New York Times reported recently that, in the US, applications to train in psychoanalysis have increased considerably. Parapraxis, a magazine that launched at the end of last year and is pitched as “a venue for theoretical debate about the meaning and role of psychoanalysis today”, has amassed a Twitter following of more than 6,000 people, not insignificant in the world of niche literary magazines.

Its founder, Hannah Zeavin, an academic who teaches at University of California at Berkeley and is a former fellow at the Columbia University Center for the Study of Social Difference, told me the magazine seems to have sparked an interest in the treatment too. “The other day I got the best text message of my life. There’s a clinic in New York where they have patients showing up in droves trying to get into analysis because of Parapraxis,” she said. She qualified this. “Well, when I say ‘droves’, I’m sure they’re talking about five weirdos in New York who came to our magazine party or saw a tweet from us.”

Perhaps what I have noticed is nothing more than a microtrend. But I think a word-of-mouth buzz, even a small one, can suggest people are frustrated with the dominant options and curious about what else might be out there. As we emerge from the pandemic seeking to make sense of how our lives have changed since it began, I think a recommendation for something that might help with this, outside the mainstream advice, can feel powerful. When CBT is touted as a relatively quick, measurably effective “one size fits all” answer, it can be alienating if you don’t personally find that to be true. A treatment positioned almost as the opposite of this is oddly appealing.

Six months into psychoanalysis, I am no authority on it. But this is the longest I’ve stuck with any form of mental healthcare by some way. And although it didn’t promise this, it is the only one which has improved the way I feel and my relationships. “For all of psychoanalysis’s faults, both real and imagined, it is not a condescending treatment, it’s as complicated as the individual in question. That’s very relieving to people,” said Zeavin. I smiled at the word condescending, it reminded me of how stupid I felt working through the steps of CBT.

Still, I found this article hard to write. I’m aware that there is a long-running, often ferociously argued, debate about whether psychoanalysis works at all. A central, early criticism is that it presents itself as a science but doesn’t conform to the standard of evidence demanded of scientific research (that any claims can be verified independently by repeatable experiments, and so on). Beyond this, it is argued that, since the theory of psychoanalysis was developed via subjective personal reports, the claims it makes can’t be scientifically tested. Not only is there no evidence, there is no way to produce any. When I think back to my preconceptions before trying it for myself, that’s basically all I knew about it. I’d never thought to check the details; when we are aware that a practice has been marginalised on the grounds of expert opinion, it becomes standard to regard it not only incuriously but also with suspicion.

I felt weighed down by that perception. While writing this, I tied myself in knots constructing arguments about how studies as they apply to the general population can, but do not necessarily, relate to the individual. I wondered: am I even allowed to write an essay on psychoanalysis without once quoting Freud? It became easier when I realised I wasn’t really writing about evidence, but experience. Not yours or other people’s, but mine.

Rachel Connolly is a writer in London. Her first novel “Lazy City” will be published by Canongate on August 24

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