From the outside, everything looks fine. And yet it doesn’t feel that way.
Psychoanalytic psychotherapy · Online · English · Russian · German
Psychoanalytic psychotherapy · Online · English · Russian · German
Most people expect to be told what to do. Here you talk freely. If that sounds like talking to a friend, it is not. What you do not see is the other half.
I notice the pause before your father’s name, the joke that arrives on schedule, the way you are with me. A century of clinical theory helps me read it. We start there.
You got the promotion and felt nothing. You and your partner live like flatmates. One call from your mother and the week is gone. You say the same things to your child that your father said to you, though you promised yourself you wouldn’t.
People wait for a crisis to make it official. It rarely comes. The years go instead.
Each week I answer one letter about something that got under someone’s skin. No names, nothing that could identify you.
“My promotion came through in March. I rang my mother, we booked a dinner, and on the drive home I felt nothing at all. I’m forty-one. I have everything I was working for. Why does it feel like I’m waiting for something?”Fine on paper, Zurich
Nothing is broken in you. But I don’t think the next promotion is what you are waiting for.
Read my answerOne letter and my answer, once a week. Nothing else.
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Want to write your own? letters@siabartrum.com
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This is psychoanalytic psychotherapy: you talk, and I listen for what the talking is doing. Not advice, not techniques, not homework. The things that run your life show up sideways, in the story you tell twice with a different villain each time.
What the work gives back: you notice the pattern sooner. There is more room between what happens to you and what you do about it. The people close to you become easier to read. None of this can be promised on a schedule, but it is what the time is for.
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Psychoanalytic work runs on regularity. When the day and the hour stay the same, you stop thinking about them, and the whole session goes on what you bring. Difficult things come up when they have a reliable place, week after week.
I was a management consultant. Client work, deadlines, reorganised teams, the particular fatigue of being competent at something that has stopped meaning anything. I understood the terms of that life and I met the people who were paying its price, often without saying so.
What interested me in the end was not strategy. It was what people did not say in the room, and what kept happening to them regardless of how well the plan was written.
Trained in the French psychoanalytic tradition, under faculty of the International Psychoanalytical Association, the Paris Psychoanalytic Society and the British Psychoanalytical Society, with academic supervision by Alain Gibeault, Secretary General of the IPA 1999-2003.
Every case is taken to clinical supervision with Jorge Ulnik, a psychoanalyst in Buenos Aires and winner of the 2021 Sigourney Award, the field’s principal international prize.
Sia Bartrum · Psychoanalytic psychotherapist
Sia Bartrum · Psychoanalytic psychotherapist
A newsletter about public stories that get under private skin: each essay starts from an event everyone is arguing about, and follows the reaction, not the event, to somewhere less comfortable.
The first three to five sessions are for getting to know each other. In the first, I will ask what brings you. After that, I ask you to say whatever comes to mind, in whatever order it comes. This is how every session works from then on.
This gives you a first taste of what psychoanalytic psychotherapy feels like from the inside, and whether it suits you. You are under no obligation to continue. It gives me a first understanding of your inner workings, and of how the work should be set up to help you most.
At the end of these sessions we agree how often we meet. We do not agree how long for: the work is open-ended, and we decide together, as we go, when it feels right to stop.
People often ask this a few sessions in, once the most pressing things have been said. Come anyway. These often turn out to be the most useful sessions.
When nothing urgent is pulling at you, there is room to look underneath. Instead of reporting on the week, you can start to see what keeps producing it, and the connections that are hard to notice while you are busy coping. There is no need to prepare a topic. Start with whatever is there, even if it is “I don’t know what to say”.
No. The session is where the seed is planted: something gets noticed, or said out loud for the first time. Most of the growing happens after you leave. A thought comes back on the way home. A familiar situation looks slightly different on Thursday.
That is why the time between sessions matters as much as the hour itself, and why regular sessions help: each one picks up what has been moving in the meantime.
In psychoanalysis this is called the frame: the same day, the same time and the same length, every week. A session runs for exactly fifty minutes, not five minutes less and not five minutes more.
The frame gives the work firm edges. When you know exactly when and how the next session will happen, nothing about the arrangement needs your attention, and outside disturbances are kept to a minimum. That predictability lets the mind settle, and it is what allows the unconscious to come into the work.
This is why I hold firmly to the agreed day and time. The steadiness is not a formality. It is what makes the work inside it possible.
Sometimes, yes. Meeting every other week is better than not meeting at all, but the work moves more slowly and takes longer, because more of each hour goes on catching up.
How often we meet is not a rule applied to everyone. It depends on what you want to work through, and we decide it together in the first few sessions: for some people that is once a week, for others twice. As the work goes on, there will be times to review it, including whether to meet more or less often.
Psychoanalytic psychotherapy is long-term work. For most people that means somewhere between one and three years, sometimes longer. I cannot give you a date at the start, and I would be wary of anyone who could.
Nothing is imposed. There is no contract for six months or five years, and you are free to stop whenever you choose. I ask one thing: if the wish to stop comes up, bring it to a session. It often means something difficult and important is at work, and it is worth talking about before you decide.
When we both feel the work is done, we take a few sessions to prepare for the ending, and then we part.
Coaching works towards stated goals. CBT works on identified thoughts and behaviours with defined protocols. Both are bounded and both can be useful.
Psychoanalytic psychotherapy does not begin from a goal or a protocol. It attends to what you did not intend to say, what repeats, and what you have arranged your life to avoid knowing. There are no exercises and no plan.
A warm manner is not enough. Ask whether they are in their own therapy and whether their work is supervised. I do both.
My own therapy means I know this work from the patient’s chair, and my blind spots are dealt with there rather than brought into your sessions. Supervision means every case is regularly reviewed with a senior psychoanalyst, so your treatment never rests on one person’s view. Without either, a therapist’s own unresolved reactions can quietly shape the work, and no one is in a position to notice.
On analysis
Therapy won’t spare you hard feelings. It gives them a name.
A feeling you can name is a feeling you can live with.
Sia Bartrum
I read every enquiry myself and reply within a few working days. Nothing is scheduled automatically; there is no booking calendar. Times are agreed by email.
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This practice does not provide crisis or emergency care. If you are at immediate risk, contact your local emergency service.