English French Psychoanalytic Psychotherapy Knot

Citypsychotherapy

Stephane Preteux - MSc MBACP(Accr) English/French Psychoanalytic Psychotherapy
London

Tel: 07921 860498

email: stephane@citypsychotherapy.org.uk

What can Psychoanalytic Psychotherapy Do?

Psychoanalytic Psychotherapy is an analytical process which sees speech as carrying an intentionality that goes beyond what we consciously perceive. Indeed, when addressing someone, are we not always simultaneously sending a message to ourselves? Speech is the only means of access to the truth of this desire. Moreover, it is only a particular kind of speech which leads to this truth, a speech without control known as ‘free association’. The message this speech contains takes its gravitational pull from a Thing (in German ‘Das Ding’) which is almost impossible to grasp but for the desire it generates as a residue or left-over from language.

English French Psychoanalytic Psychotherapy Office 1
Liverpool Street (E1) office

There exists different therapeutic approach guiding the clinic, but none have to-date kept so faithfully close to the scientific rigor first applied to his discoveries by the founder of psychoanalysis Sigmund Freud, than the French psychoanalyst Dr. Jacques Lacan. My approach to Psychoanalytic Psychotherapy is therefore guided in principle by Lacanian tenets and regards questions of ethics as being at the core of the analytical work itself. If guilt is the end result of the conflict between our truest and deepest desires and the societal demands of a ‘civilized morality’ then how does the analyst work with it? it is important to note that psychoanalysis rejects all ideals, including ideals of ‘happiness’ and ‘health’. Its role is one of encouraging patients to explore the relationship between their actions and their desires.

My clinic is specialized in dealing with:

Anxiety designates a whole range of affects and phenomenons. Those include, but are not restricted to, panic attacks, a general sense of worry, incertitude and doubts as to which direction to take in the world. Bodily phenomena include breathlessness, palpitations, muscle tension, fatigue, dizziness, sweating and tremor. If we can never be completely absolutely sure why we are feeling happy or sad – in some instances happiness can cause sadness or guilt – anxiety seems to have an overwhelming certitude attached to it. It is real, something in front of which all words cease and all categories fail. It may materialize itself as a question about our place in life, or inflict us when there is a sudden change in the way we perceive ourselves. It may feel as if suspended between a moment where we no longer know where we are and a future where we will never be able to refind ourselves again. Sometimes anxiety also arise when, confronted by the desire of the Other, we don’t know how to situate ourselves in relation to this desire. In this instance it is often found to be at the origin of obsessive thoughts such as what the other is thinking or what catastrophes are waiting. For the existentialist philosopher Jean-Paul Sartre anxiety was a sign of pure freedom. Psychoanalytic Psychotherapy approaches it from the structural notion of pure loss, the ‘lack of a lack’ with desire as its remedy.

Do you find yourself eating or sleeping too much or too little? That you are pulling away from people and activities because of low or no energy? Some of us may have a reached this point in life where nothing really seem to matter anymore, leaving us instead confused, isolated, angry, upset, worried or scared, perhaps even having suicidal thoughts. When all look well ‘on paper’ this feeling of disillusionment may be quite baffling to understand. The impossibility to re-experience past experiences can plunge us into some forms of clinical helplessness which it may now be urgent for the person to explore. It may be exceptionally difficult for some patients to regard their personal issues as worth investigating, making the relationship with the clinician central to the work. Questions of trust, belief and accepting to reach out for help are often seen as blocks to explore. In Psychoanalytic Psychotherapy I approach this issue with the view of reintroducing meaning through a therapeutic relationship that favours the experience of surprise.

If issues around relationship are usually more visible in private home settings they will eventually burst forth at work, among friends or with strangers. This may lead to the person eventually feeling detached and isolated, caught in endless cycles of arguments and/or going through successive break-ups. Blaming the other or feeling disconnected are the surface symptoms most commonly associated with issues of relationship. Both those responses, passive in nature, may be categorized as different forms of aggressiveness, which it may be useful to view as so many signs of a defence mechanism in overdrive. Those protective thoughts and ideas that the person has built of himself or herself (the ego) is under constant attacks and retaliation has become the last bastion before full blown anxiety. From a Psychoanalytic Psychotherapy perspective the work is mainly viewed as one of ‘un-knotting’ the various threads that have led to this ultimately destructive trend. One of those threads may include the various relationships the patient had with his or her significant others.

Anger, as expressed in any kinds of violence turned towards the others or towards oneself in self-harm, is regarded in psychoanalysis as a ‘Passage à l’acte’: a form of acting out with no control. We become violent, that is, when the Real has such a grip on us that this fictional character that we have created of ourselves to contain it literally breaks down. However paradoxical this may sound, anger is understood to be some kind of deadly enjoyment which, when all is said and done, expresses nothing less than an absolute rejection of what is perceived as an attack from the outside. Freud claimed that hate and anger is older than love. In this instance the clinical work consists in using language as a way to construct something of this anger. The exercise of symbolisation realised in Psychoanalytic Psychotherapy may at first be perceived as somehow exacerbating this negative feeling, but should in due time eventually transform itself into creative productions.

Depending on the situation we can find it almost impossible to act and react instead as if frozen by fear. Inhibitions can be transitory, such as in a surprise accident from which we eventually somehow recover, or lasting long periods of time with deep feelings of isolation and a simmering anger. From somebody else’s perspective it may seem as if nothing wrong is going-on. In fact staying quiet may even be encouraged and regarded as a positive personality trait, that is, until eventually some kind of violence is done and ties are cut. Symptoms of inhibition include fear, being extra sensitive to the other’s reactions, feelings of being disconnected and/or sometimes even dissociated. In this specific case it is useful to invoke the place and presence of the Other with its omnipotence. In Psychoanalytic Psychotherapy it is important to help patients remember anything that may have been felt as particularly traumatic, but also explore the various relationships the patient is likely to have had with this so-called ‘omnipotent Other’.

As a derivative of the experience of inhibition issues of self-confidence can be usefully viewed as revolving around the notion of power, the perceived lack of which is based on an image (the ego) which, by its very nature, is deceptive. This is certainly not to say that the feeling of low self-confidence is not real; this ‘hole in the mirror’ can eventually have a significant impact in one’s life if left unattended. The society we live in demands that we constantly show self-confidence, short of being arrogant (which is just another form of lack in self-confidence). The work undertaken in Psychoanalytic Psychotherapy includes encouraging patients to describe their significant relationships with the view to identify those specific master signifiers with their alienating influence.

Moods can oscillate more or less suddenly and radically between extreme euphoria and a sense of invulnerability (in some cases with spending habits getting out of control) and morbid, self-deprecating or even suicidal thoughts at its opposite end. In the clinic the work is primarily to try and achieve some form of stability, then to reduce or average the gulf between the highs and the lows. Explorations to this effect are encouraged by helping patients with providing detailed descriptions of their actual experience, but also to help them remember if there were any significant events that had occurred in their past and the type of things they used to hear being said within the family structure. The desire or willingness to become curious about those moods swings; the time at which they appear, what makes them suddenly turn into their opposites, what, if anything, could be associated when those are at their peaks, is also key ingredients in Psychoanalytic Psychotherapy.

Perhaps ironically enough, from the psychoanalytical perspective, drug or alcohol addictions could be usefully seen as a type of self-cure. They are pain killers that have taken such a prominent place in the patients life that one may even postulate that some kind of relationship has formed with it: at least the patient is never completely left alone with his anxiety. The looming danger with addictions of this sort, beside the obvious risks to one’s health, is the potentially long lasting alterations to the person’s view of himself or herself. “I would no longer be ‘me’ without it”, “I am expected to achieve and couldn’t do this without it” are what we can hear in the clinic. The combination of use as a pain killer and/or as a means to sustain a certain lifestyle in which one is trapped makes it a formidable symptom to treat. The work may seem arduous, if not impossible, but this would be to gravely underestimate the power of words. The patient’s understanding of the notion of ‘belief’, as well as what used to be seen and heard in the past, would be an important avenue to start with in Psychoanalytic Psychotherapy.

Impotency or obsessive thoughts of a sexual nature that distract from an intimate relationship between partners can wreck havoc in a couple. Some of the interpretations that can be heard as an effort to make sense of this situation include the firm belief that one is no longer attractive, that some extra marital affairs must surely be taking place, or that one has fallen out of love with the other. In all cases the result may be devastating due to the emotional distance it can eventually create (in its reverse, sex may be going on not because of any sexual desire as such, but only to nurture this emotional bond). In Psychoanalytic Psychotherapy the French psychoanalyst Jacques Lacan claimed that there actually is no such thing as a sexual relationship. If each person has his or her own specific ways and fantasies to reach sexual gratification then it becomes automatically easy to realise that we can never be exactly ‘on the same page’ with each other regarding our sexual desires. In the clinic what may be at play for men is a deep form of anxiety about being ‘swallowed up’, the stress of being each time tested for one’s performances, or for something somehow felt to be too close for comfort. Desire bursting forth can express itself in obsessively thinking about sex minus issues of intimacy, or its opposite: disgust.

Me and Psychoanalytic Psychotherapy

After graduating in Applied Mathematics from the university of Paris (X) in France followed by a brief incursion in film 3D special effects in Soho (UK) I certified in Transactional Analysis from the Metanoia Institute and received a diploma in Psychodynamic Psychotherapy from WPF in London. I then graduated with a Master of Science (MSc) in Psychotherapy from Roehampton university, London. I am today a fully accredited member of the British Association in Counselling and Psychotherapy

Establishing my clinical practice in the UK has provided me with a unique experiential understanding of language allowing me to conduct Psychoanalytic Psychotherapy with equal analytical efficiency in English and or in French.

English French Psychoanalytic Psychotherapy Stephane Preteux

Fees - Budget Conscious Help

The initial assessment of £50 will be an opportunity for us to clarify the issues that have led you to consider psychotherapy, and your expectations as to its outcome. It may also be a chance for you to ask questions about me, my background, clinical work and qualifications as well as make your mind as to whether you feel confident that we can work together.


By the end of this session I aim to discuss therapy options with you, including other services if for any reason therapy seems impracticable with me. If we agree to continue, we will discuss availability and fees as based on a sliding-scale ranging from £55.00 for individuals who meet certain financial criteria to £65.00.

All other details regarding the work will be discussed during the initial session.

Location

It is possible to meet at the three locations below. Click on the button for more details of the address.

Liverpool Street - London E1 7NJ

Disabled Access - Front Parking Available

Southfields - London SW18 5UJ

Disabled Access - Parking Available

London Road - Epsom KT17 2BP

Front Free Parking Available

Contact Me

To book an initial appointment you can contact me directly by phone: 07921 860498, by email: stephane@citypsychotherapy.org.uk or by filling up the secured form below and I will get back to you within 24h.

Psychoanalytic Psychotherapy and Confidentiality

Confidentiality in therapy is paramount and may be of significant concern for some clients. For my part the handling of confidential materials between sessions is rigorously as well as constantly bound to the Ethical Framework for Good Practice in Counselling & Psychotherapy as elaborated by the BACP (British Association for Counselling & Psychotherapy). Issues of confidentiality, as encapsulated in the list below, is for my pracice a matter of:

  1. Being trustworthy: honouring the trust placed in the practitioner (also referred to as fidelity): Practitioners who adopt the fundamental principle of being trustworthy regard confidentiality as an obligation arising from the client’s trust.
  2. Autonomy: respect for the client’s right to be self-governing: Practitioners who respect their clients’ autonomy protect privacy; protect confidentiality; normally make any disclosures of confidential information conditional on the consent of the person concerned; and inform the client in advance of foreseeable conflicts of interest or as soon as possible after such conflicts become apparent.

  3. Providing a good standard of practice and care: All clients are entitled to good standards of practice and care from their practitioners in counselling and psychotherapy. Good standards of practice and care require professional competence; good relationships with clients and colleagues; and commitment to being ethically mindful through observance of professional ethics.

  4. Keeping trust: The practice of counselling and psychotherapy depends on gaining and honouring the trust of clients. Keeping trust requires careful attention to client consent and confidentiality.

  5. Respecting privacy and confidentiality:

    – Respecting clients’ privacy and confidentiality are fundamental requirements for keeping trust and respecting client autonomy. The professional management of confidentiality concerns the protection of personally identifiable and sensitive information from unauthorised disclosure. Disclosure may be authorised by client consent or the law. Any disclosures of client confidences should be undertaken in ways that best protect the client’s trust and respect client autonomy.

    – Communications made on the basis of client consent do not constitute a breach of confidentiality. Client consent is the ethically preferred way of resolving any dilemmas over confidentiality.

    – Exceptional circumstances may prevent the practitioner from seeking client consent to a breach of confidence due to the urgency and seriousness of the situation, for example, preventing the client causing serious harm to self or others. In such circumstances the practitioner has an ethical responsibility to act in ways which balance the client’s right to confidentiality against the need to communicate with others. Practitioners should expect to be ethically accountable for any breach of confidentiality.

    – Confidential information about clients may be shared within teams where the client has consented or knowingly accepted a service on this basis; the information can be adequately protected from unauthorised further disclosures; and the disclosure enhances the quality of service available to clients or improves service delivery.

    – Practitioners should be willing to be accountable to their clients and to their profession for their management of confidentiality in general and particularly for any disclosures made without their client’s consent. Good records of existing policy and practice and of situations where the practitioner has breached confidentiality without client consent, greatly assist ethical accountability. In some situations the law forbids the practitioner informing the client that confidential information has been passed to the authorities, nonetheless the practitioner remains ethically accountable to colleagues and the profession.

I will do my best to answer any questions you may have regarding this particular code of ethics during the preliminary session.

Frequently Asked Questions

If help is available it may not remain an easy process to go about deciding to find the right person to talk to. Below is a list of the most frequently asked questions around starting therapy 'on the right foot'.

Therapy is an opportunity for you to talk safely in a confidential place about your life and all that may be confusing, painful or uncomfortable. The therapist is someone who is academically trained to listen attentively so as to help you cope better.

Therapy is a process which is personal. Going through painful experiences may feel as if things are worse than when you started. In the long-run however therapy should help you feeling better. If it doesn’t after a while you should let your therapist know that things are not improving.

Apart from rare occasions where a single session is enough it usually takes a number of sessions before therapy starts to make a difference.

No. Because everyone is different (therapist included) everyone will feel the therapeutic process differently. Some therapy are successful, others are less. The relationship with the therapist is central to any progress.

It is important that you find a therapist you find yourself comfortable with, which could mean that you want to search for someone who is aware of your cultural background. Having said this it should not matter for the therapist.

No. There exists different methods and approaches in therapy and you might want to discuss the various modalities with your therapist so as to be sure his or her way of working will be all right with you.

Many different types of therapy are available. However it is often found that your relationship with the therapist is central to the progress of therapy.

Sometimes only one session is enough to feel better. However, as the therapy progress it may be the case that sessions continue over several weeks or months. It is common practice after 6 or 12 sessions to review how therapy is going for you, and discuss whether you feel it is important for you to continue or not.

Sessions usually last fifty minutes to one hour. However it is also the case that some modalities extend or shorten this time

Usually people see their therapist once a week. However this frequency can change if you wish a more intense therapy. This should be made clear from the start in the initial session with your therapist.

he following are a list of recommended questions, however do also ask your therapist any others that you think of:

  • How many sessions will I have?
  • What type of therapy do you offer?
  • How much will it cost?
  • What happens if I miss a session?
  • What happens if I want to take a holiday, will I still have to pay?
  • Will the counselling be confidential?
  • Will you make notes during the session, and if so, what happens to these?
  • Can I contact my therapist in between sessions?

The initial assessment is a chance for you to ask about the qualifications the therapist has and whether he or she is a member of a professional body such as:

You might also want to check whether the therapist has any experience and/or training in any particular area of concern important to you.

Trust your first impressions. If might just be that after a few minutes you feel you can trust the therapist and that you are comfortable talking. If on the other hand you feel not quite at ease, you may want to reconsider your choice of therapist.

If after several sessions you don’t like your therapist you may want to address the matter with him or her. This might just be part of the therapeutic process iself (transference). If after a while there is still a real and long lasting discomfort then you may wish to consider seeking another therapist.

If you feel that after a while there doesn’t seem to be any difference for you, it is important that you discuss this with your therapist. If then nothing changes then you may wish to go to another therapist.

400-450 hours college-based therapy training is the number of hours BACP recommends as a minimum. You may want to ask your therapist for the details of their qualifications. Don’t hesitate to ask questions. If you still feel unsure, do contact the therapist’s professional body in order to verify their qualifications.

Currently there is no legal requirement for therapists to be licensed. However, it is wise to choose a therapist who is a member of a professional body and who is insured to practice.

If after a while you would like to end therapy it is preferable that you first discuss it with your therapist in order to bring things to a clean end. If this seems too difficult to do face to face, you may want to give notice of wishing to end therapy in writing. Please do bear in mind any agreement you made at the beginning of therapy with regards to ending sessions.

It is important that you discuss this when you make your agreement with your therapist at the start of therapy. Because the rooms I am using require me to be charged on an ongoing basis unless in exceptional circumstances I am charging for missed sessions.

This is important to clarify this at your initial session with your chosen therapist. For reasons related to hiring the rooms I personally expect payment for missed sessions including holidays.

What is being shared in therapy is confidential to the extent that it will not be reported to anyone except a supervisor who, for the protection of the client also offers his or her own interpretations and make sure no harm is being done. In other circumstances however, if there appears to be a serious risk of harm to you or to others the therapist should inform you of his or her intention in dealing with this situation. This is usually done with your permission. These circumstances should be explained to you at the beginning of your therapy.

What you tell your therapist is entirely up to you.

Therapists usually ask to have your doctor’s contact details in case they feel there is a serious risk of harm to you.

This is not encouraged. The therapy is for you and is safe because what you talk about is explored in depth between you and your therapist. If there are communication difficulties, it would of course be understandable to have an interpreter in the room. If you feel you would rather be with other people in therapy you may consider group therapy.

Useful Links

Professional Organizations

  • UKCP – United Kingdom Council for Psychotherapy – www.ukcp.org.uk – Tel. 020 7014 99 55
  • BACP – British Association of Counselling & Psychotherapy – www.bacp.co.uk – Tel. 01455 883 300
  • BPS – British Psychological Society – www.bps.org.uk – Tel. 0116 254 956

Other Useful Websites

Psychotherapy Training Organizations and Services

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