Psychoanalytic Therapy

Psychoanalytic therapy involves working closely with a therapist to resolve concerns stemming from the unconscious mind and develop healthier, more effective habits. Different techniques may be used to achieve these goals, such as: 

Free association

One of the most notable techniques is free association, in which clients are encouraged to verbalize their thoughts, no matter how random or disconnected they may seem. Free association may help reveal underlying challenges—such as certain defense mechanisms—that are not immediately apparent. 

Analysis of transference

Another technique is the analysis of transference, in which clients project and transfer unconscious feelings onto the therapist, which can show in their behavior and responses during sessions. By analyzing these interactions, the therapist can help clients identify parts of their lives that need attention and ultimately provide a strategy to address them.

Dream interpretation 

With this technique, clients can discuss and dissect their dreams. Dreams can sometimes offer insights into unresolved emotions. Dream symbols and narratives may help improve self-awareness and personal growth during the therapeutic process.

Throughout psychoanalytic therapy, clients may attend multiple sessions per week over an extended period. While this form of treatment may not be suitable for everyone, it has been shown to help individuals struggling with various emotional, personal, or relationship concerns. With time and effort, it may lead to real positive change in one's life.

During the first sessions, you'll build a connection with your therapist by discussing your thoughts, feelings, and concerns. Psychoanalytic therapy is a form of in-depth talk therapy. Instead of offering quick solutions, the therapist may help you express and understand hidden emotions or experiences affecting your behavior over time. You might talk about dreams, memories, and feelings, which reveal insights into your unconscious mind.

Although the process can be challenging at times, the aim is to help you learn about patterns that may be causing emotional distress while learning how to heal emotionally. For optimal results, it’s recommended to approach this type of therapy with an open mind and a willingness to explore your deepest thoughts and feelings. 

Patience, trust, and dedication are key to progressing and achieving positive outcomes. In addition, maintaining a solid working relationship with your therapist can help improve the overall experience and success of psychoanalytic therapy.

Psychoanalytic therapy may be helpful for individuals experiencing a wide range of emotional and psychological concerns. This form of therapy can help identify negative patterns of thinking and support overcoming past traumas. Psychoanalytic therapy can be particularly beneficial for people living with certain mental health conditions, such as the following:

• Depression: Individuals experiencing prolonged feelings of sadness, hopelessness, or lack of interest in daily activities.
• Anxiety disorders: People facing excessive worries, fears, or specific phobias that affect daily life.
• Post-traumatic stress disorder (PTSD):² Those who've experienced traumatic events and experience symptoms like flashbacks or severe anxiety.
• Obsessive-compulsive disorder (OCD): Individuals with recurrent, unwanted thoughts or repetitive behaviors.
• Personality disorders: People with long-term patterns of behavior that differ from what is expected in their culture.
• Eating disorders: Individuals with unhealthy attitudes and behaviors related to food and body image, such as anorexia or bulimia.*
• Dissociative disorders: Those experiencing disruptions in memory, consciousness, or identity, often as a result of trauma.

Through exploring unconscious thoughts and emotions, individuals can identify the underlying causes of their symptoms. Psychoanalytic therapy may help uncover unprocessed emotions, leading to improved symptoms and a more stable mood.

In addition, psychoanalytic therapy may be helpful for individuals grappling with addictions like alcohol use disorder, drug dependence, or compulsive gambling. By working through underlying emotional and psychological concerns, psychoanalytic therapy may help people overcome addictive patterns.

For those struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Psychoanalytic therapy aims to help individuals recover from past traumas and recognize patterns of thinking and behavior that cause emotional distress. It may ultimately help individuals understand more about themselves and their inner conflicts.

During therapy sessions, individuals work with therapists to explore how the unconscious mind affects their thoughts, feelings, and behaviors. Some key goals of psychoanalytic therapy can include:

• Gaining insight into unconscious processes and exploring how they affect daily life
• Cultivating self-awareness by understanding the origins of thoughts and feelings
• Developing healthier ways to cope with emotional troubles
• Resolving emotional challenges that stem from childhood experiences
• Building strong interpersonal relationships

Therapists might help individuals achieve these goals by creating a comfortable and supportive space for revisiting past traumas and examining thoughts and feelings. As the therapy progresses, individuals may become more self-aware, potentially resulting in improved emotional and mental well-being. As a result, psychoanalytic treatment may help individuals lead more fulfilling lives.

Psychoanalytic therapy is often compared to other widely utilized modalities, such as cognitive behavioral therapy (CBT). A more short-term form of treatment than psychoanalytic therapy, cognitive behavioral therapy focuses on how one’s thoughts, feelings, and behaviors are connected in the present. Cognitive behavioral therapy is currently considered the gold standard of therapeutic methods. However, as discussed in the next section, research shows that psychoanalytic therapy may be more effective than cognitive behavioral therapy in the long term. 

There are several different therapeutic modalities that have grown out of the psychoanalytic approach to therapy developed by Sigmund Freud. One of the most prominent is psychodynamic psychotherapy. Unlike many forms of therapy—CBT, DBT, etc.—psychodynamic therapy focuses on exploring a participant’s past to provide insights into their present challenges. 

Often taking place over the short term, psychodynamic therapy is a less intensive modality than psychoanalysis. Sessions usually occur once a week for 15-25 weeks, rather than several times a week for multiple years. Alternatively, long-term psychodynamic psychotherapy, which typically lasts for at least two years, is available for participants with complex conditions, like certain personality disorders. 

Various studies support the effectiveness of psychoanalytic therapy. A systematic review found that people who underwent long-term psychoanalytic therapy or psychoanalysis experienced significant improvements in their symptoms and changes in their personality. In addition, these positive changes appeared to last for years after the therapy sessions were over.

Another systematic review evaluated psychodynamic therapy as an empirically supported treatment (EST) for common mental disorders in adults. The review examined data from other studies in the past two years to assess its effectiveness, affordability, and workings. The results showed that psychodynamic therapy is effective in reducing symptoms of depression, anxiety, and personality disorders. The benefits of PDT outweigh its costs and harms, proving its long-term effects.

One study that included 70 patients with PTSD treated with psychoanalytic psychotherapy showed promising results. The patients, assessed over one year, experienced an improvement in their recovery as the number of therapy sessions increased. Although the research had limitations, it sheds light on the potential effectiveness of psychoanalytic therapy for those diagnosed with PTSD related to trauma, such as torture and human rights abuses.

In a study comparing long-term psychodynamic and psychoanalytic therapy with cognitive behavioral therapy (CBT) for individuals with depression, researchers found that psychoanalytic therapy produced greater long-term improvements in depressive symptoms. 

There is also evidence that psychoanalytic approaches can be helpful for young people experiencing mental health disorders. In a meta-analysis that included 11 studies, researchers concluded that short-term psychodynamic psychotherapy can effectively treat a range of mental health conditions experienced by children and adolescents.