Talking Cures
On How We Listen — and the Subtle Divide Between Talking Therapies
In psychotherapy, I often felt the therapists trying to help me to move forward. In psychoanalysis, during a long stretch of introspection, I once spent weeks circling the same word — unable to say it.
The analytic space didn’t push, didn’t fill the silence. It waited.
It wasn’t comfortable. But something shifted, not in my behaviour, but in how I related to the silence I used to avoid.
That’s what analytic listening does: it holds the unspeakable until we’re ready to risk speaking it.
Having spent time within psychoanalytical studies, and having worked closely with psychiatrists and psychologists over the years, I’ve come to see that while many forms of therapy involve listening, not all listening asks or offers the same thing.
We often use the word ‘therapy’ to describe any conversation that helps. And in many ways, that’s sort of fair.
Both psychotherapy and psychoanalysis involve sitting with someone, speaking openly, and trying to make sense of one’s experience.
But the direction, the depth, and the kind of presence required — are very different.
Where It All Began
‘Psychoanalysis’ came before ‘Psychotherapy’.
It wasn’t created to give people tools or advice. It emerged from something quieter: the ‘realisation’ that symptoms often carry meaning we haven’t yet understood.
Freud and Breuer noticed this while working with Anna O., a patient whose symptoms had no clear medical cause.
Once she found her space to speak freely, without interruption or judgement, her symptoms began to ease. Not because someone told her what to do, but because something in her was finally heard.
That very ‘insight’ became the foundation of the talking cure.
What Psychotherapy Offers
Psychotherapy, in its many forms, tends to focus on what we’re aware of: how we think, how we feel, how we behave, etcetera. It engages with the part of us trying to manage present moments of life, the self that wants to cope better, communicate better, live with more ease.
It often does provide structure/s.
There are strategies, goals, outcomes. And for many people, this can bring relief, clarity, even transformation (!).
It’s an important kind of care. And in moments of crisis or transition, it can be exactly what someone needs.
What Psychoanalysis Asks
Psychoanalysis doesn’t offer such black and white strategies. It doesn’t necessarily aim for behavioural change. Instead, it listens differently.
Rather than focusing on what’s already visible, it turns toward what’s hidden in plain sight, the slips, the silences, the repetitions. Not to decode them quickly, but to stay with them long enough for something meaningful to emerge.
It’s less about adjusting to life, and more about understanding how we came to be shaped by what we couldn’t speak of.
This kind of listening requires patience, and a tolerance for uncertainty. It also asks the ‘analysand’ to remain open to the possibility that what feels familiar may not be fully known. More than that, it requires the analyst to have undergone the process themselves.
The Analyst’s Responsibility
In psychotherapy, ‘personal therapy’ is often encouraged but not always essential.
In psychoanalysis, it’s non-negotiable.
An analyst must have undergone their own analysis, often over years. Not as a checkbox, but as a lived confrontation with the very material they’ll later be helping others explore.
It’s not enough to know about the ‘unconscious’ in theory. One has to encounter it directly, its defences, its discomforts, its strange attachments. Without this, the analyst risks listening only with their training, not with their presence.
This is what sets psychoanalysis apart. The work begins with the analyst, long before it begins with the patient.
Two Movements
Psychotherapy often helps people return to the world with more awareness, stability, or skill.
Psychoanalysis invites people to return to the parts of themselves that never had the chance to speak.
One moves outward, toward functioning; the other inward, toward understanding. Both are movements of care — both aim to heal — but they follow different maps, asking different things of the one who listens.
Sometimes, what brings change isn’t what we say. It’s what someone else is willing to stay with, long enough for us to finally hear it too.