The term "treatment" designates the practice of psychoanalysis -- as opposed to the theory of psychoanalysis.
The term has a specific meaning in psychoanalytic theory which is quite different from the way it is understood in medicine.
In particular, the aim of psychoanalytic treatment is not to "heal" or "cure" the analysand, in the sense of developing a perfectly healthy psyche.
Clinical structures, such as neurosis, psychosis and perversion are essentially "incurable."
The aim of psychoanalytic treatment is to lead the analysand to articulate this truth.
The treatment is a process with a definite direction, a structural progression with a beginning, middle, and end.
The beginning, or "point of entry into the analytic situation", is a contract, or "pact", between the analyst and the analysand which includes the analysand's agreement to abide by the Fundamental Rule.
Following the initial consultation, a series of face-to-face preliminary interviews take place.
These preliminary interviews have several aims.
- They enable a properly psychoanalytic symptom to be constituted in place of the vague collection of complaints often brought by the patient.
- They allow time for the transference to develop.
- They permit the analyst to ascertain whether or not there is really a demand for psychoanalysis, and also to hypothesize about the clinical structure of the analysand.
After the preliminary interviews, the treatment is no longer conducted face to face, but with the analysand reclining on a couch while the analyst sits behind him, out of the analysand's field of vision (the couch is not used in the treatment of psychotic patients).
As he free associates, the analysand works through the signifiers that have determined him in his history, and is driven by the very process of speech itself to articulate something of his desire.
This is a dynamic process which involves a conflict between a force which drives the treatment on (see transference, desire of the analyst) and an opposing force which blocks the process (see resistance).
The analyst's task is to direct this process (not to direct the patient), and to get the process going again when it gets stuck.