While many APPI members are involved in teaching psychoanalysis, psychoanalytic psychotherapy and other related subjects in universities and colleges, the main focus of all APPI members is that of clinical work.

Such clinical involvement extends across a wide area of Irish life and a variety of settings ranging from the Health Service (psychiatric hospitals, primary care services, maternity hospitals, counselling services, addiction services, etc.) to prisons and probation services, schools and, of course, to private practice as psychoanalysts and psychoanalytic psychotherapists.

Psychoanalysis and psychoanalytic psychotherapy are ‘talk therapies’. The person who is troubled or who has encountered some difficulties attends sessions once or twice per week, depending on circumstances. At these sessions, the client or patient is invited to speak – to say whatever comes into mind, without trying to organise the material, or sanitise it or censor it for the analyst’s ears. There is no insistence from the analyst on the sort of thing to be spoken about. Sometimes a person will begin with what is immediately troubling them, sometimes with what has led to them seeking out a psychotherapist or psychoanalyst. Sometimes the person will begin with some other issue and only gradually reach the main reason for attending. Sometimes people want to speak about their inner thoughts and about their dreams, but all of that is left up to the individual. All that is asked is that the person speaks, and speaks the truth.

The way a person responds to such freedom can vary hugely. Sometimes there is relief, sometimes exhilaration, or anxiety, or fear. In our everyday lives, we are mindful of what we say, and to whom we speak – often with good reason. It is not an easy task allow ourselves the freedom to speak without restraint.

The psychoanalytic space is a free space, and the relation to the analyst is not like any other of our relationships in life. We do, however, bring to psychoanalysis or psychotherapy a set of attitudes and ingrained ways of relating to others and of thinking about ourselves. Because the analyst remains rather opaque to the patient, since she or he does not disclose personal information, the patient will tend to attribute to the therapist all sorts of attitudes and beliefs. In this way, the patient transfers habitual responses to the analytic relation, which allows the psychotherapist to facilitate the patient in discovering how much her/his imagination is framing the world she/he inhabits. A successful psychoanalysis or psychoanalytic psychotherapy allows the patient to create new and less painful ways of thinking about her or his existence.