The method of free associations, in Paris

Psychotherapy with a psychoanalyst and psychoanalysis are distinguished by the method which is both the driving force and the guarantee, both of their success and of their failure.

Also called the fundamental rule, this method which will revolutionise the effectiveness of psychotherapies will be named by Freud: the method of free associations.

The origins of the free association method

Before defining in more detail what it consists of, let us return to the Freudian discovery. At the end of the 19th century, Freud attended Charcot's presentations at the Pitié-Salpetrière hospital in Paris. The Parisian master, in front of an audience of doctors captivated by his experiments, then hypnotises patients to sometimes create a symptom, sometimes to relieve it.

Assured by the experience of his colleague Joseph Breuer, Freud saw in hypnotic suggestion the possibility of treating nervous disorders but above all, of deducing a functioning of the psychic apparatus taking into account the unconscious.

This discovery is a real revolution in the psychotherapeutic and medical fields: most of our nervous symptoms (physical or psychological) are determined by thoughts and representations of which we are not conscious but which act without our knowledge and result in our troubles.

Freud's excitement is equal to the effects that hypnosis produces on the patients he sees: their disorders dissipate as they relive under hypnosis the traumatic scenes and the fantasies that they had forgotten and repressed.

Where the doctors of the time remained without answers in the face of the nervous suffering of patients which they could not explain and even less treat, a path is thus opened in the understanding of nervous disorders and their connection with speech.

Gradually, however, Freud will realise the limits of the hypnotic method. Not only do the symptoms end up returning once the transference link with the psychotherapist is broken, but some people resist the effects of suggestion and hypnosis.

If a new continent is accessible to Freud on a theoretical level, he finds himself in a therapeutic impasse. Emmy, a famous patient of Freud, will rescue the latter from the clinical embarrassment into which the hypnotic method plunged him.

Indeed, this patient, who is ultimately at the origin of the method of free associations, asks Freud, rather than submitting to his suggestions, to be silent and listen to him.

Emmy then begins to freely associate her thoughts without being directed by the recommendations or suggestions of the psychotherapist. It is then on her own, by freely associating her thoughts out loud, that she gradually manages to say the repressed elements at the origin of her symptoms.

Freud then realises that the patient acquires on her own, by respecting the method of free associations, knowledge about herself which produces lasting effects in the alleviation of her pain.

As the practice progresses, the method will be refined: the patient says each of the thoughts that cross his mind during the session, even if they seem shameful, harmless or unpleasant. If the patient respects saying each of his thoughts out loud, without censoring them (which he normally does in social relationships), he will access new knowledge about himself and his desire. In doing so, the patient frees himself from his symptoms by discovering what was the unacknowledged source.

The lasting results that Freud obtained with the method of free associations contrast radically with those he obtained with the method of suggestion.

A new method is born and Freud will be able, in the light of his experience, to refine his theorization to improve its effectiveness. Since then, many psychoanalysts in Paris and everywhere else have continued to confirm, through their clinics, the relevance and effectiveness of the free association method. Thanks in particular to the contributions of Jacques Lacan, the method was also adapted to the treatment of psychosis so that to this day, the method of free associations is effective for any suffering person wishing to treat themselves.

With the abandonment of suggestion and the use of the method of free associations , psychoanalysis or psychotherapy with a psychoanalyst will allow an unprecedented quality of care which affects both psychological symptoms and bodily symptoms.

It is therefore a real revolution in the field of psychotherapy that Emmy endorsed and that Freud was able to support.

The method of free associations thus constitutes the cornerstone of psychoanalysis and psychotherapy with a psychoanalyst.

For the patient, once he is settled, it is a matter of saying each thought that crosses his mind, without omitting any. Regardless of the content, the patient says the thoughts that cross his mind without judging or censoring his words. He thus speaks his thoughts, his body, his dreams as images come to his mind without trying to master what he is saying or what he wants to say.

It is an exercise that can prove difficult to the extent that we are accustomed since our childhood to censor certain of our thoughts, so as not to hurt others, not to displease and multiple reasons entering into the play of our social relations. It is therefore a question of letting go of the restraints of current discourse in order to be able to access, session after session, a new word, an unspoken word which propels the patient and his treatment forward.

By respecting the method of free associations, the patient will discover a whole part of himself that he was unaware of, memories that he forced himself to keep in oblivion and fantasies that were previously unacknowledged. Thanks to this knowledge that he gradually acquires about his psychic functioning, about himself, the being in the position of patient or psychoanalyst unravels all the symptoms that made him suffer and thus develops a new subjective positioning: gradually emerges from his alienation to emerge, at the end of his psychoanalysis, as a subject.

It is therefore the psychotherapeutic contract based on respect for free associations which is the guarantor of the smooth running of the treatment.

The fundamental rule is so important that its consideration literally determines the success of the cure. If you wish, you will find an intervention during a psychoanalysis conference entitled, free associations, a surgical method.

The method of free associations