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It began, of course, with Freud. Psychoanalysis refers both to a theory of how the mind works and a treatment modality. In recent years, both have yielded to more research-driven approaches, but psychoanalysis is still a thriving field and deals with subjective experience in ways that other therapies sometimes do not.

Belief in such hallmarks of Freudian thinking as the primacy of the unconscious fantasy, sexual desires (libido, penis envy, Oedipal complex), and dreams has wavered. But Freud also identified such basic mental maneuvers as transference, projection, and defensiveness, and demonstrated how they distort functioning. As a treatment based on extended self-exploration, psychoanalysis has evolved beyond the silent-shrink stereotype.

For more, see Psychoanalytic Therapy.

The Fundamentals of Psychoanalysis

Freud pioneered the idea that unconscious forces influence overt behavior and personality. He believed that childhood events and unconscious conflict, often pertaining to sexual urges and aggression, shape a person’s experience in adulthood.

Freud’s theory of psychoanalysis created the framework for psychoanalytic therapy, a deep, individualized form of talk therapy. Psychoanalytic therapy encompasses an open conversation that aims to uncover ideas and memories long buried in the unconscious mind.

Psychoanalysts employ specific techniques, such as spontaneous word association, dream analysis, and transference analysis. Identifying patterns in the client’s speech and reactions can help the individual better understand their thoughts, behaviors, and relationships as a prelude to changing what is dysfunctional.

What is the id?

The id holds primitive desires and urges. Freud conceived of it as an unconscious, instinctual, dark component of the psyche that seeks pleasure. It isn’t rational or accessible, and primarily possesses sexual and aggressive urges—although some contemporary psychologists believe that Freud overemphasized these tendencies.

What is the superego?

The superego embodies a person’s higher moral code. This moral compass is responsible for self-control, decision-making, and sacrifice, abilities that allow an individual to live well with others in society. The superego is thought to arise from parental authority, according to Freud’s view. It has absolute and inflexible standards, which leads to conflicts with the impulsive id.

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How Psychoanalysis Has Influenced Therapy

Freud’s ideas have been contested and criticized—yet his influence is also hard to overstate. Freud’s realization that much of mental life operates outside of awareness was a groundbreaking insight that propelled psychology forward. Establishing psychoanalysis—and the idea that talking about oneself and one’s troubles could alleviate mental illness and enhance well-being—has paved the way for the many forms of therapy available to help individuals today.

How did psychoanalysis influence psychiatry?

Psychiatry became a medical specialty in the 1800s, and it served people with severe conditions, such as psychosis, bipolar disorder, and depression, who lived in hospitals or psychiatric institutions. Freud began to study milder disorders, and their unconscious roots, which he termed neuroses. This led psychiatry to treat individuals who were not severely impaired but faced challenges regarding emotions, relationships, or work. This shift contributed to the development of numerous forms of therapy, as well as an ongoing debate about the classification and medicalization of mental illnesses.

How has the prominence of psychoanalysis changed over time?

A widespread and widely respected specialty in psychiatry in the 1960s, psychoanalysis has fallen in popularity since then. The reasons may include that analysis broadened to treat more personal and societal ills than it intended to, drug discovery and excitement around psychopharmacology, philosophy and art adopting psychoanalytic concepts, and insurance companies standardizing medical and psychological care.

Psychoanalysis in Practice

Psychoanalysis has evolved and modernized since Freud’s conception of the practice, and many people engage in it today; It can be a powerful treatment for those wishing to delve into deep self-reflection.

Psychoanalysis involves meeting with a trained psychoanalyst a few to several times per week, where patients talk about themselves, their challenges, and whatever else prompted them to seek therapy. Patients aim to speak freely without censoring themselves, and explore subconscious beliefs, emotions, or desires with the analyst.

Psychoanalysis is open-ended and lacks predefined goals, in contrast to other therapies such as cognitive behavioral therapy. The process often lasts years, or even decades.

Is psychoanalysis right for me?

The experience of psychoanalysis is well-suited to some personalities, but not everyone’s. It’s an intense process of self-examination and feedback from the analyst; patients may have to confront painful and undesirable feelings, thoughts, and impulses.

Psychoanalysis is a good fit for those who want to develop a deeper understanding of themselves—how the pieces of their story fit together, as well as their interior and exterior lives. It’s the right approach for people whose challenges are serious and longstanding; psychoanalysis can expose the core dynamics that may be leading them to feel trapped in a destructive cycle.

How does psychoanalysis address resistance to change?

Various forms of psychotherapy help patients recognize their fears or distress and provide the support and tools for patients to overcome those challenges. But even with those resources, some clients still can’t change—they have conflicting desires and motivations. Psychoanalysis is well-suited to address the psyche’s unconscious resistance to change, as it aims to unearth the hidden forces that explain why the unconscious may benefit from maintaining existing patterns.

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