Midland Psychotherapy

Frequently Asked Questions

What can psychotherapy help with?

Psychotherapy allows us to see that our individual experiences of emotional suffering have a meaning that is specific to us. This emotional suffering can take many different forms and so, psychotherapy can help us to gain understanding of and control over a wide variety of symptoms, including:

  1. Anxiety
  2. Depression
  3. Sleeplessness/Insomnia
  4. Feelings of Emptiness, Guilt, Jealousy, Self-loathing and Dread
  5. Phobias
  6. Addictions
  7. Eating Disorders
  8. Suicidal Thoughts
  9. Obsessive and Compulsive Thoughts and Behaviours
  10. Patters of Repetitive Destructive Behaviour

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How does psychotherapy work?

“ The Unconscious is structured like a language” … Jacques Lacan

Psychotherapy is a caring profession and first and foremost your therapist is there to listen to you and to help you make sense of your life. Throughout his teachings Freud makes the point that in life, what is forgotten or repressed will be repeated or, as he calls it, 'acted out', and what cannot be spoken will find expression in a symptom. This is known as a 'compulsion to repeat', and it explains much of the mental suffering that human beings experience.
Psychotherapy works by facilitating an 'uncovering' of this forgotten or repressed material; experiences from life that it has not been possible to fully process and which, consequently, remain lodged in the unconscious mind, exerting a hidden influence on our day to day lives. Psychotherapy provides an opportunity and a means of expressing something that was not previously possible to express. By finding a way of putting into words, of processing and making sense of something that was previously unconscious, the need to repeat is defused and destructive patterns of behaviour are broken. It is for this reason that the act of speaking is so important to psychotherapy. Above all else, psychotherapy provides a space in which to speak without restraint or inhibition; to speak freely. Freud used the term 'free association' to describe this form of radically free speech, where thoughts are expressed without censorship and allowed to run into each other without any apparent logic.
Free association forms an important part of the psychotherapy process and certain conditions are put in place to help facilitate this type of speech. The therapist and patient usually do not sit and talk face to face as happens in most social situations, not to mention in most other forms of therapy and counselling. Instead, the patient lies on a couch and the therapist sits somewhere out of sight. This is to promote free association and, as far as possible, to remove from the relationship the usual kinds of insecurities and inhibitions that can obstruct the therapeutic relationship.
One further method employed by psychotherapy is that of speaking about dreams. Freud described dreams as 'the royal road to the unconscious' and patients are encouraged to speak about their dreams in session. The reason dreams are afforded such therapeutic importance is that they express a wish fulfillment and, as such, provide access to our deepest desire. All of this is in the interest of facilitating an encounter with an unconscious truth. It is by encountering and, in some way, assimilating this unconscious truth that psychotherapy can help free us from the unconscious residue of our past.

“The problem for human beings is not, ‘are my desires being satisfied or not?’, the problem for human beings is how do I know what to desire in the first place?” « Slavoj Zizek»

This is a process captured in Freud's iconic statement, "Wo Es war, soll Ich werden", sometimes translated as "Where It was, there I shall come into being". In other words, the goal of psychotherapy is to bring into consciousness, to assimilate into my conscious self, that part of me which can otherwise be quite accurately referred to as an 'It', an unconscious desire, which silently goes about exerting its insidious influence on my life expereince.

“The only thing of which one can be guilty is of having given ground relative to one's desire” - Jacques Lacan


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What is the difference between Psychotherapy and Counselling?

“We repeat in action what we are unable to remember in words or images ” - Sigmund Freud

These two terms, psychotherapy and counselling, are sometimes used interchangeably, as if they were the same thing but this gives a somewhat false impression. Both counselling and psychotherapy are processes that aim to ease suffering through personal growth and positive change. They are both processes that emphasise listening to the patient's speech. But they are not the same thing. There is a difference in what is being listened to. The difference is this: counselling addresses what can be spoken about here and now, it takes our experiences at face value and addresses these experiences at a conscious cognitive and behavioural level, seeking to explore the choices we make and the role we play in these choices. In other words, it generally does not address suffering at an unconscious level.
Psychotherapy, on the other hand, believes that it is in the unconscious that the root-cause of emotional suffering and mental ill-health is to be sought.
There are two unique things about psychotherapy that distinguish it from counselling and other forms of therapy. Firstly, after Freud, psychotherapy privileges the role of the unconscious in human experience. And secondly, in accordance with the theoretical position of Jacques Lacan, living in accordance with our individual desire is viewed as the goal of a full and healthy life.
This might sound straight forward but the task is complicated when you realise that the desire that defines each of us individually is often hidden from us. The role of the psychotherapist then is to help elaborate for the patient this unconscious desire. This is done by listening in a very particular way to the speech of the patient. It is listening from a position which is both non-judgemental and non-directive. Only under these conditions will clues to the individual's unconscious desire begin to emerge.


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What can I expect from psychotherapy sessions?

“The interpretation of dreams is the royal road to a knowledge of the unconscious activities of the mind” - Sigmund Freud

New clients sometimes find psychotherapy to be something different to what they were expecting. People sometimes come to psychotherapy with an expectation of receiving great wisdom and advice that will help solve all their problems. Because psychotherapy challenges the conventional tendency to satisfy our every demand, the reality of a psychoanalytically informed process can take a little getting used to.
We live in a society that often demands that answers are provided immediately, if not sooner. There is no shortage of so-called experts willing to tell you what is wrong with you and how you can be restored to your rightful state of total happiness. In this respect psychoanalytic psychotherapy resists the modern preoccupation with the quick fix in favour of a deeper and more considered approach to the complex question of what causes emotional suffering. Psychoanalytic psychotherapy will not rush to understand you but will, instead, afford you the time and space to understand yourself.
Contrary to a popular stereotype, your therapist is not there to give you advice, to tell you what you should do or feel. Patients are sometimes surprised or even disappointed by this reticence on the part of the therapist, but in fact, it is precisely because of this reluctance to advise, that psychoanalytic psychotherapy opens up the space needed for the patient to discover their own desire. This is why the silence that can at first seem strange or uncomfortable to a patient, is actually an important part of the therapeutic process.
Patients who come to psychotherapy having had previous experience with psychiatry and/or counselling may particularly find that the experience contradicts their expectations. Unlike some other approaches to mental health, psychotherapy will not ask a lot of questions, will not rush to sympathise nor attempt empathy; a psychotherapist will not prioritise taking notes, keeping files or diagnosing disorders; nor will a psychotherapist work to a generalised formula for recovery. Instead, psychotherapy will respect the uniqueness of your subjective experience and allow you to make sense of this experience as your discourse unfolds. In short, the emphasis is on what you have to say, not what the therapist has to say.


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How long will it take?

“There is no golden rule which applies to everyone: every man must find out for himself in what particular fashion he can be saved ” - Sigmund Freud

Naturally, this is a question that many clients ask of their therapists. However it is difficult to give a satisfactory answer. The length of treatment varies from one client to the next and there is really no way of generalizing on this point. For some people there can be a significant break-through within a relatively short period while other people stay in therapy for many years, gradually overcoming resistances and uncovering ever-deeper levels of personal truth.
It is important when entering therapy that the subject is prepared to allow the process to take its natural course, however long that will take. Perhaps, as a rule of thumb, we could say that therapy lasts as long as the subject feels they have something to say or feels that they have a question to answer. This means that it is always the client and not the therapist who will decide when the treatment has achieved its objective and can come to an end.


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How much will it cost?

One reason why, with the exception of certain parts of Dublin, psychoanalytic psychotherapy has not establised itself as an integral part of mental health services in Ireland is due to the expense traditionally associated with this therapeutic option. Historically this has lead to a reluctance on the part of state funded health services to adopt a psychoanalytic approach, resulting in psychoanalytic psychotherapy becoming the preserve of the rich. In my view, this is not an acceptable situation. Mental health suffering is too serious an issue in our society to permit purely financial considerations dictate who has access to the most in-depth and therapeutically efficacious treatment options. For these reasons, at Midland Psychotherapy there is a committment to providing a quality psychoanalytic service at affordable prices. With this in mind, it is my policy to set a fee on a case by case basis, respecting both the individual client's financial situation and the value of the service being provided. This is known as a sliding scale and allows me to provide a psychotherapy service at a rate that is affordable to each individual client.
I invite anyone who is interested in psychotherapy to make contact and I am happy to negotiate a fee that you find manageable. Although some fee will always be charged, I am committed to the principle that financial circumstances should not preclude access to psychotherapy.


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How to make an appointment?

You can make an appointment either by e-mailing me at info@midlandpsychotherapy.ie or by telephoning me on 086 2032384. You'll find all the contact details and directions for finding the clinic on my Contact page.


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