Contemporary Freudian analysis

Domain I · Psychodynamic & depth psychology · Joseph Sandler, Anne-Marie Sandler · Britain

What it is

An intensive, open-ended psychoanalytic treatment. It keeps Freud's structural conflict model (drive/wish, defence, superego, compromise formation) and integrates object relations through Sandler's concept of the representational world: wishes are wishes for particular self–object role…

Format

• The Contemporary Freudian tradition has no phase manual. The phases below follow the clinical-process chapters of The Patient and the Analyst (clinical situation → treatment alliance → transference/resistance → working through → termination) and standard BPS practice.
• Phase 1 – Consultation/assessment (1–4 sessions).

Who practises it, and how they are trained or regulated

• Format. Psychoanalysis is 4–5 sessions/week of about 50 minutes on the couch, open-ended, typically several years. BPS training analyses and training cases run at 5x weekly. Psychoanalytic psychotherapy versions use 1–3x weekly, often face-to-face, and apply the same principles with more emphasis on the alliance and on here-and-now work.

Evidence status, as the guide reports it

• Move on when: there is a shared understanding of why treatment, an agreed frame (times, fees, holidays, missed sessions), and evidence that the patient can use a trial interpretation.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Impatience or reproach. It is working when time between enactment and recognition shortens.
• Accusatory tone. It is working when the patient becomes curious about the pattern rather than ashamed of it.
• It is working if the patient becomes curious. If clarifications pile up into interrogation, the alliance thins.
• Reliance on countertransference without checking it. It is working when affect becomes more modulated and more available.
• Premature flight, or extending the date to avoid loss. It is working when the patient mourns rather than denies the ending.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.