(Note:  Although I am aware that this does not apply to all psychoanalysts, it sure does apply to a lot!)

Patient asks:  What’s the difference between a psychoanalyst and an average therapist?

Psychoanalyst replies:  I have studied the most modern, sophisticated theories of human dynamics, and thus have the tools to understand and unravel the motivating roots of human endeavor…

Translation:  Don’t you know that I spent seventy thousand dollars going to psychoanalytic training after I got my Ph.D.?  Do you deign to suggest that I wasted the money I struggled to earn spending thousands of hours not listening to mere mortals like you?!

Patient asks:  As an analyst do you have higher rates of success than average therapists?

Psychoanalyst replies:  Yes, because I focus on catalyzing permanent, deep change and cure in my patients, which is a long and arduous process that sometimes lasts decades.  Most therapists just effect temporary, surface change – if that.

Translation:  Don’t even try to back me into a corner, peon!  It takes a damn long time to bamboozle you into integrating my denial-laden psychological interpretations into the fabric of your soul, and don’t expect one ounce of my approval until you start making some real headway.  Getting well?  Pfaw!  That’s for the lesser therapists.  I’m here to rework your soul in my image, thank you very much!

Patient asks:  Out of curiosity, do you believe psychoanalysts can help a patient with psychotic issues?

Psychoanalyst replies:  Although Freud would have answered “no,” modern psychoanalytic theoreticians postulate that a patient’s success at utilizing the analytic framework depends on his degree of insight into the nature of his problems, and lack of insight is not necessarily concomitant with psychotic mental process.

Translation:  That would depend on the patient’s ability to pay.  Look, I’m working with you, aren’t I?  Christ!

Patient asks:  Can you explain to me what exactly is the Oedipus complex?

Psychoanalyst replies:  It’s the inherent crux of all the motivating forces that give you a disturbed template for engaging with others in the way you do.  In essence it’s you converting your ambivalent wishes and desires for and about your parents, sexual and otherwise, into the defensive fantasy that those wishes and desires actually manifested in your childhood, and then attempting to replicate those fantasies with others in your present life.  Didn’t you read those articles I suggested?

Translation:  Listen, we all know that little boys inherently want to pork their mothers, and that the more I reject you emotionally (like your sick, beleaguered mother rightfully did) the more you’ll want to pork me, which frankly makes me happy because not only does it gratify my narcissism but it allows me to charge you more.

Patient asks:  Hmm.  I did read those articles, and I found them kind of confusing.  The thing is, I think I really was sexually abused by my parents as a child.  I really remember it.  Do you think that’s possible?

Psychoanalyst replies:  The key is not whether they did abuse you or not, but your fantasy about it.  So let us focus there.  What is your fantasy?

Translation:  Are you deaf, bozo?  I just explained the Oedipus complex in terms a retardate could understand!  Your parents were not the problem.  You were!  Anyone who sits with you for five minutes could figure that out!  You had a DEEP NEED to have sex with them, but they didn’t meet your need, so your memory now manipulates reality into the fantasy that it happened.  Don’t you get it?   This is like a textbook case of Oedipal denial.  God, I can’t wait to share this one in supervision group!  I wish I didn’t have to wait till Thursday.  Crap.  Maybe I should email them all beforehand…

Patient asks:  Hmm, maybe it is my fantasy...  I guess I just keep picturing that sexual abuse really did happen.  I even dream about at night.  It’s so painful.  But I do have a question for you.  Why do you have patients lie on the couch?

Psychoanalyst replies:  Although I will take note of your abrupt changing of the subject, I will answer your query.  Lying on the couch gives patients greater and freer access to explore and express their spontaneous, unconscious thoughts and fantasies – without having to be so focused on projecting their own internalized judgment onto an analyst looking at them.

Translation:  You sniveling ball of defenses!  Clever – switching topics and putting the focus on me!  You’re terrified to lie on the couch and be honest, and so you sabotage the whole process.  Don’t even try to undermine my right to yawn, pick my nose, and doodle in my notepad.  You think it’s easy to sit behind your dandruffed head and tune out your prattle?

Patient asks:  And free association?  What exactly is that?

Psychoanalyst replies:  It’s a way to get you to speak about what’s really happening in your unconscious, and not get lost in the mundane, defensive talk that characterizes most human interchange – and can easily derail good analysis.

Translation:  Actually there’s nothing free about free association at all, nitwit.  I’m charging you four dollars a minute to go off on pointless tangents that heighten your sense of powerlessness and inferiority, which render you optimally marinated to accept my speculative interpretations…  Pucker up, ’cause I got more where this is coming from.

Patient asks:  Can you explain to me the difference between transference and countertransference?  They confuse me.

Psychoanalyst replies:  The mechanism of transference involves all the things from your past that you unconsciously project onto me in an attempt to avoid the recognition of your core issues – like a lens clouding reality.  Countertransference, on the other hand, is a theoretical construct that considers the possibility that the psychoanalyst might be projecting unconscious material onto his patient in return.

Translation:  God, wasn’t my reply brilliant?!  That little rat tried to trap me in his cage, but I gave him a good flick in the snoot!

Patient asks:  Have you been in psychoanalysis yourself?

Psychoanalyst replies:  What is your fantasy about that?

Translation:  Screw you, buddy.  Don’t even try to suggest I don’t know what I’m doing.  You’re the one who’s dumb enough to come here four times a week and pay the king’s ransom to have me do to you what my prick of an analyst did to me.

Patient asks:  Are you still in analytic training?

Psychoanalyst replies:  It seems you are questioning whether or not I can be of psychoanalytic use to you to help you resolve your neurotic complexes.  The key here, again, is that we explore your fantasy about my degree of training.

Translation:  Being halfway through analytic training is none of your damn business, blowhard, but trust me, when I get that institute certificate your fees are going up, up, and up, and if you can’t pay, well, tough luck, ’cause I got a waiting list!  Hopefully by then I’ll have some supervisees of my own who I can pawn you off onto…  Kill two birds with one stone!

Patient asks:  Do you love me?

Psychoanalyst replies:  What is your fantasy about me loving you?

Translation:  Jesus Christ, I should have been a banker.  At least then I would have gotten to spend my days hanging around normal, healthy people, not whining psychological cripples.

Patient asks:  Well, I don’t know, it just seems odd to me that you, as a psychoanalyst, would suggest I go on anti-depressants.  May I ask why you suggested that?

Psychoanalyst replies:  What is your fantasy about why I suggested that?

Translation:  Oh, don’t start that crap with me!  We both know this whole process is a sham and that no one really changes.  Listen, I took the meds.  You can too.  Grow up, sniveler.

Patient asks:  [taking deep breath]  I have to admit, I am considering quitting analysis.  It’s very expensive and it’s making me feel worse.  And it doesn’t seem to be helping me at all.  What is your opinion on this?

Psychoanalyst replies:  [silence]

Translation:  Don’t even try to manipulate me into begging you to stay, Weasel.  We’ve been through this like forty times over the past nine years.  You know you need me and you know you’re not going anywhere, so there’s no point in me engaging in this discussion.  Besides, my supervising analyst always tells me that I talk too much in session.  For that reason I will avoid rushing to say anything, and let you do the analytic work – for a damn change.

Patient asks:  I just feel so lonely and anxious when I come here.  Is that normal?

Psychoanalyst replies:  [silence]

Translation:  Don’t try to put your feelings onto me, freak.  If you only knew how absolutely boring you were you would be better able to relate to the deep pleasure I get in watching you squirm in discomfort…

Patient asks:  Hmm….I guess it is normal…  Well, did you think this was a good session?

Psychoanalyst replies:  How do you feel it went?

Translation:  God, only two minutes to go – and then three more sessions before the day is done!  I wonder if I should pick up a bottle of Chablis on the way home – or maybe Sauvignon Blanc?