Picture a therapist. Who do you see? If you’ve read one too many New Yorker cartoons like me, it might be something close to the classical psychoanalyst. This figure, we might call them the Freudian, is culturally associated with all the frustrations of therapy: A dispassionate suit-wearing (and cigar-smoking) professional who returns your statements to you as enigmatic questions, conducting a survey of your pain with seemingly no end in sight. The most comfort we can expect from the Freudian is for them to point you to the box of tissues on your way out the door.

“The use of touch alongside talk therapy is on the rise, tracking with other somatic therapies that aim to address the body directly.”

Many who are experiencing loneliness or isolation, recovering from trauma, or dealing with any number of life’s difficulties — physical, psychological, or both — opt for someone friendlier, less cold than the psychoanalyst appears to be. In particular, the use of touch alongside talk therapy is on the rise, tracking with other somatic therapies that aim to address the body directly. But the complicated truth is that psychoanalysis was invented to relieve somatic symptoms. Through a series of discoveries from working in the clinic, Sigmund Freud, the founder of psychoanalysis, developed a method to address physical ailments relying only on…talking.

“The complicated truth is that psychoanalysis was invented to relieve somatic symptoms.”

Freud founded psychoanalysis in his quest to treat what at the time was called hysteria (we can compare this to psychosomatic illness). Freud’s patients presented him with physical ailments that had no traceable, organic cause, and it was around this problem that he invented a new field.

I should briefly pause here to explain two things: 

1. Psychoanalysis is both a theory of how the mind works and a practice of talk therapy that focuses on the interplay between conscious and unconscious thought (the latter of which arises within speech in the recounting of dreams, and in jokes and slips). But, at this point, Freud was only beginning to figure this out. 

2. Hysteria/hysterical/hysteric are words that have since garnered a disparaging connotation especially towards women. Here, it refers to a psychological condition (of both men and women) that has bodily symptoms.

Okay, back to our story! At first, Freud followed the very famous French physician Jean-Martin Charcot in using certain kinds of touch and bodily stimulation to treat their patients. Their interventions were not unlike the somatic therapies of today. Charcot and Freud both used the application of pressure and recommended visits to the sanatorium, a sort of health spa where techniques like massage and hydrotherapy would be used. (Sounds nice!)

“If there was no bodily cause, then it must be psychic, and if the cause was psychic, then wouldn’t it need to be treated accordingly?”

But as Freud’s thoughts on his patient’s ailments evolved, he began to understand the mental underpinning of these symptoms. If there was no bodily cause, then it must be psychic, and if the cause was psychic, then wouldn’t it need to be treated accordingly?

Freud found a common thread in his cases, a traumatic event that went unincorporated into everyday thoughts, and thus showed up within the body as a physical symptom. And these were not just any old symptoms, but ones that was laced with meaning. The purpose of Freud’s talk therapy was to speak the symptom in order to reconnect its bodily expression to the regular memories and thoughts of the patient. Poof! The symptom would disappear. (Well, not exactly poof! — as it turns out, this often takes many years of psychoanalysis.)

It so happens that two other elements are at play when we rely solely on speech in therapy.

The first helps to explain how Freudians became so identified with frustration. Integral to psychoanalytic treatment is, ironically, the resistance on the part of the patient to the treatment itself.

“The symptom is the way we figured out how to deal with something painful or unspeakable — we often can’t imagine living without it, even if it causes us suffering.”

Maybe it sounds strange, but we hang on tight to our symptoms. The symptom is the way we figured out how to deal with something painful or unspeakable — we often can’t imagine living without it, even if it causes us suffering. While a therapist could certainly find ways of evading a patient’s resistance by using relaxing techniques like certain kinds of touch or hypnosis — which might even allow for advances in the treatment — resistances are bound to spring back up again. Psychoanalysis works with these resistances in order to address and abate them, even though they can make the therapy slow going at times.

The second element to consider is the upside of what has become known as the prohibition on touch in psychoanalysis is that it allows for the unfolding of the transference. The transference is why we keep coming back to analysis (because we believe the therapist has something to tell us about ourselves) and how a picture of our worldview enters the treatment (because the way we treat our therapist showcases how we are in other relationships).

“Psychoanalysts resist gratifying patient’s desires because it can keep the treatment locked in a pattern of seeking and receiving satisfaction, inhibiting the exploration of one’s psychic landscape.”

Transference is the main tool of the psychoanalyst to get to the root of psychic difficulties. Psychoanalysts resist gratifying patient’s desires because it can keep the treatment locked in a pattern of seeking and receiving satisfaction, inhibiting the exploration of one’s psychic landscape. In many cases, having gotten what they want, patients leave treatment before their symptoms are truly addressed. So there’s a reason why these therapists seem inhospitable! Through this lens, the relationship between patient and therapist is founded on a different principle than any other relationship in our life.

In “Are You My Mother?,” Alison Bechdel recounts her experience in psychotherapy. (I love this book a lot and, especially if you’re interested in what it is like to be in psychoanalysis, I highly recommend it!) In it there is a scene where her therapist, Jocelyn, hugs her. The hug concludes a session that takes place just days before Christmas where Bechdel had “cried quite freely for the first time in Jocelyn’s presence.” Years later, following a Christmas visit to her mother’s home, Bechdel returns to Jocelyn’s office wanting a hug. She asks at the end of a session, after silently working up the courage to do so throughout the hour. This time, Jocelyn says they would need to discuss it. Now Jocelyn is no longer only a psychotherapist, she’s undergoing training in psychoanalytic work, and she’s not sure that offering a hug would be beneficial to the treatment.

“Talk therapy can provide a way out and through our difficulties — even traumatization and somatic symptoms — but all of this hinges on the withholding of touch in order to carve out a space to explore our vast psychic lives.”

Bechdel later realizes, “For Jocelyn to actually hug me at this time…would have been to drop me analytically.” In the absence of the hug, Bechdel is eventually able to conclude her therapeutic work with a stronger sense of conviction, less inhibited by difficulties in her relationships, and with a new lease on her life’s work and passions.

Talk therapy can provide a way out and through our difficulties — even traumatization and somatic symptoms — but all of this hinges on the withholding of touch in order to carve out a space to explore our vast psychic lives. While there’s no question that we need touch and we’re starved for truly restorative relaxation in our contemporary moment, finding it in the psychotherapeutic setting might hinder our attempts to recover.

Getting comfortable with being uncomfortable — and, if you’re up for it, settling in for the long haul — in therapy can offer a durable, lasting alternative to our suffering. There’s a reason why psychoanalysts (and other psychoanalytically informed therapists) aren’t giving you hugs: It’s because they want you to heal.

Ashley D’Arcy is Senior Editor at The Good Trade. She is also a psychoanalyst-in-training and holds a Master’s in philosophy from the New School for Social Research. She lives in Brooklyn with her wife and their Miniature Australian Shepherd, Rocky.