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Psychoanalytic therapy is a form of in-depth talk therapy that aims to bring unconscious or deeply buried thoughts and feelings to the conscious mind so that repressed experiences and emotions, often from childhood, can be brought to the surface and examined. Working together, the therapist and client look at how these early hidden and stifled memories have affected the client’s thinking, behavior, and relationships in adulthood. This therapy is based on Sigmund Freud’s theories about psychoanalysis.

The ideas of Freud found purchase in Vienna, Austria, in the early twentieth century. Freud and other well-known analysts, including Alfred Adler, Carl Jung, and Otto Rank, came together as an organized group, the Wednesday Psychological Society, later known as The Vienna Psychoanalytic Society. The nascent group met in the evenings at the home of Freud to discuss case studies or scientific presentations.

According to Freud, we can deal with our conflicts when we bring our unconscious thoughts to the forefront. If the buried conflict is not brought to consciousness, we will continue to suffer neurosis and internal strife.

When It's Used

Psychoanalytic therapy delves into a client’s past to better inform them of the present. Themes also do recur during therapy, and the analyst works toward highlighting and connecting these themes along with past experiences and current behaviors. Patients can be unaware of their behavior patterns, even if they may be evident and self-destructive.

Research that appeared in the Clinical Psychology and Psychotherapy Journal showed that psychoanalytic techniques were effective in the treatment of mood disorders. In a study follow-up, participants who received psychoanalytic therapy had fewer interpersonal problems and improvement in depressive symptoms when compared with participants who received other therapies.

One small study found that 77 percent of patients reported significant improvement in symptoms, interpersonal problems, quality of life, and well-being upon completing psychoanalytic therapy. At a one-year follow-up, 80 percent reportedly experienced improvements. Psychoanalytic therapy can help people with mental health problems such as:

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What to Expect

Some very specific techniques are used in psychoanalytic therapy:

  • Free association uses spontaneous word association. The client says whatever first comes to mind when the therapist says a word. The therapist then looks for and interprets patterns in the client’s responses so they can explore the meaning of these patterns together.
  • Dream analysis uncovers repressed feelings that may be hidden in symbols that appear in the client’s dreams. The therapist helps the client discover the meaning and significance of those symbols.
  • Transference analysis explores the transfer of the client’s feelings and emotions from one person to another. For instance, the client’s repressed childhood feelings toward a parent may be transferred to a partner in an adult relationship later in life, or to the therapist during the psychoanalytic process.
How It Works

Psychoanalytic therapy uses analytic techniques to help release repressed thoughts, experiences, and emotions, but it is a modified, generally briefer, and less intense version of early Freudian analysis. Here are key elements of psychoanalytic therapy:

  • The therapist-patient relationship is central to the healing process, as are the original theories of attachment, which focus on the quality of bonding between infant and parent.
  • Transference, or the transfer of earlier emotions and needs to people and events in the present time.
  • Resistance is the stage of therapy when the client becomes overwhelmed by the release of painful, repressed feelings and tries to avoid dealing with them.
  • Eventually, as patients become more comfortable and less resistant to facing their issues and are able to understand their own motives and behavior, healing can begin.

The traditional method of psychoanalysis normally entailed about five sessions a week. Modern-day psychoanalysis calls for one or two sessions a week. Engaging in frequent and intense sessions may well allow deeper treatment overall. Depending on the extent of the difficulties a client may have, this type of therapy can last for years.

What to Look for in a Psychoanalytic Therapist

It’s a good idea to screen your potential therapist either in person or over video or phone. During this initial introduction, ask the therapist:
How they may help with your particular concerns
Have they dealt with this type of problem before
What is their process
What is the treatment timeline

A psychoanalytic therapist is a licensed, experienced social worker, psychotherapist, or other mental health or medical professional with training in psychoanalysis; there are psychoanalysis certification programs available. In addition to finding someone with the appropriate educational background and relevant experience, look for a psychoanalytic therapist with whom you feel comfortable discussing personal matters. Note that not all types of therapy are covered by insurance, call your carrier for information.

  Psychoanalytic Theory & Approaches American Psychoanalytic Association
  Careers in Psychoanalysis American Psychoanalytic Association
Leichsenring, F., Biskup, J., Kreische, R., Staats, H. The Guttingen study of psychoanalytic therapy: First results. The International Journal of Psychoanalysis April 2005;86(2):433–55.
Last updated: 05/10/2022