Psychoanalysis revolves around the belief you have unconscious thoughts, feelings, desires, and memories that affect how you behave and see the world. It's a type of mental health therapy. It's also a theory that focuses on exploring your unconscious to understand and solve your psychological issues.
It was founded by Sigmund Freud, who started using the word "psychoanalysis" in the late 1800s. He was criticized for his work and theories, but he introduced the important idea that mental illness is treatable. Freud believed that talking about your problems with a trained mental health professional can help you find relief. This idea heavily shapes how mental health problems are understood and treated today.
"Psychoanalysis is probably the earliest form of contemporary psychotherapy," says Joseph Zamaria, a psychologist at University of California, San Francisco.
Development of Psychoanalysis
Psychoanalysis helps you become aware of your unconscious, unhelpful, repeated patterns of emotions and behaviors. This allows previously hidden parts of yourself to come together to promote healing, healthier emotions and behavior, and creative expression.
It may be used to treat mental health conditions or concerns, including:
- Depression
- Anxiety
- Fears
- Panic
- Relationship problems
- Self-criticism
- Eating disorders
- Physical pain
- Lack of direction or purpose
- Any feelings of mental struggle or being unwell
Psychoanalysis vs. psychotherapy
Psychoanalysis is a form of psychotherapy focused on examining your unconscious thoughts, desires, and past experiences. Some other forms of psychotherapy include:
- Cognitive behavioral therapy
- Psychodynamic therapy
- Interpersonal therapy
- Supportive therapy
In practice, psychotherapists may use ideas from different forms of psychotherapy to various degrees. For example, some psychotherapists may not be fully trained in psychoanalysis but still rely on psychoanalytic ideas and approaches, along with other therapy methods
"It's not an on-off switch," Zamaria says.
"It's like a dimmer switch, and every individual practitioner might privilege those [psychoanalytic] ideas more or less. For example, I'm not a psychoanalyst, but when I'm seeing patients in psychotherapy, maybe two-thirds of my mind is gravitating toward how has this person's development affected what is happening for them right now. You might find clinicians that are closer to zero. If you found a bona fide psychoanalyst, it might be a lot less on techniques about what you could do differently right now and more on trying to excavate and decipher the meaning of early life experience," he says.
How is behavior therapy different from psychoanalysis?
Behavior therapy originated in the early 1900s. It focuses on changing your behavior to improve your well-being. The goal is to give you a better understanding of your behaviors and tools for controlling them in desired ways. Compared to psychoanalysis, behavior therapy focuses more on your present behaviors and actions, aiming to find practical solutions to current problems.
"Behavior therapy is really going to be focused much more on actions that somebody can change as opposed to deciphering somebody's life story," Zamaria says.
Behavioral therapy techniques include:
- Reinforcement
- Improving communication
- Shaping
- Modeling
What Does a Psychoanalyst Do?
A psychoanalyst uses many different techniques to help you think about why you're acting and behaving in certain ways. Psychoanalysts also get you to think about the meaning behind your symptoms. In Freud's psychoanalysis, patients look at and interpret inkblots. They also use free association, dream analysis, as well as resistance and transference analysis.
A psychoanalyst may:
- Check how you think and feel (your cognitive and emotional functioning)
- Hold regular sessions, based on what you and your analyst decide
- Focus on boundary issues
- Examine important present and past relationships
- See the symbolic meaning behind emotional and physical symptoms
Traditionally, psychoanalysis could take many years of treatment. This allowed the psychoanalyst to help you understand and change your challenging behaviors and ways to deal with problems. Long-term sessions also aimed to help you recover lost emotional connections, leave unhealthy relationships, and adapt well to your current situation. Psychoanalytic therapists decide on the length of treatment based on your needs. They aim to make sure you understand yourself better, making you able to heal and stop repeating negative behavioral and emotional patterns.
Psychoanalysis Therapy
Psychoanalysis therapy aims to help you uncover and understand why you feel and behave the way you do. Psychoanalysis therapy helps you explore the effects of repressed impulses, internal conflicts, and childhood traumas. You explore how your hidden (unconscious) thoughts and past experiences affect your mental health, relationships, and actions now.
"It's not just about telling a story, it's about engaging with the story meaningfully and applying that meaningful engagement to present life," Zamaria says.
Psychoanalysts look at how the hidden conflicts in your mind have led to feelings of distress or trouble functioning. They spend time listening to you and offering reactions. Ideally, they offer you some guidance.
Psychoanalysis techniques
Psychoanalysis relies on techniques such as:
Free association. You'll speak or write thoughts or words that come to mind. They don't need to make sense. But the idea is that the stream of words or thoughts can help reveal repressed thoughts or feelings.
Dream analysis. In psychoanalysis, dreams may stand for unfulfilled wishes and desires. They may also replay past trauma or conflict. You'll explore your dreams with a therapist to unlock those unconscious elements.
Transference analysis. Transference refers to a tendency to repeat unresolved conflicts from the past in the present. You'll analyze those patterns to understand them and make changes.
Countertransference. Your psychoanalyst will emotionally respond to what you've shared about your thoughts and past experiences.
Interpretation. The psychoanalyst will seek to clarify what you've shared. They may also help you uncover unconscious thoughts or behaviors and explain how they're connected to what's happening for you now.
Limitations of Psychoanalysis
Like all forms of psychotherapy, psychoanalysis may help you work through your unconscious mind and past experiences to address your mental health issues or emotional challenges. But it's not for everyone, and it has limitations. Only you can decide if a psychoanalytic approach is best for you.
Some limitations include:
Limited scientific support
Psychoanalysis is rooted in theory but doesn't revolve around science. Experts are working to support its success with better data-gathering methods and a systematic outlook.
The idea of the unconscious mind was hard to grasp by philosophers during Freud's time. Many didn't believe in an unconscious state. The new challenge is that Freud's theory of psychoanalysis is a concept that doesn't fit our current understanding of the brain.
Long-term process
Psychoanalysis takes time. It won't offer any immediate help or relief for your mental health concerns. It may take several years or last throughout your life. As a result, the cost of psychoanalysis may also be a concern for many people, especially if insurance doesn't cover it.
May not offer quick relief
Given the time involved in psychoanalysis, you can't expect it to offer immediate relief for your depression, anxiety, or other mental health conditions or concerns.
"If people are wanting something to change very quickly, they might not be as satisfied with psychoanalysis," Zamaria says.
Can't treat all mental health conditions
Psychoanalysis may not offer relief for every mental health condition, especially on its own. You may need medication to treat your emotional disorders and psychiatric conditions. You may benefit more from other forms of psychotherapy. For example, psychoanalysis isn't the best way to get immediate help or tools for dealing with specific concerns, such as panic attacks or angry outbursts.
"If you're wanting to focus very specifically on one aspect of your life, you may not find psychoanalysis as satisfying," Zamaria says. "Some of the more behavioral therapies might be a little better at just laser-focusing on one particular issue and not really considering other issues, even if they might be related. More broadly, if people are wanting direction and planning and techniques and tools and strategies, they may not get as much of that from psychoanalysis as they might from other modalities."
But it doesn't mean the end of psychoanalysis or that it doesn't have benefits. Over the long term, there's evidence that psychoanalysis can help treat many conditions, including major depression. Talk with your doctor and mental health care team about the best treatment plan for you.
Success depends on individual psychoanalysts
As with any mental health professional or care provider, it's important to find one who's a good fit for you. Some psychoanalysts may offer more guidance, while others may keep sessions more open-ended. Zamaria suggests looking for a therapist willing to adjust their technique based on your feedback. For example, you may prefer more or less validation from them or more or less direction about what to do during your sessions.
"Psychoanalysis can be tremendously helpful to people as long as they find a configuration that works for them," Zamaria says. "If meetings are frequent and you're seeing someone who's very good, it could be extremely helpful."
Finding a Psychoanalyst
To find a psychoanalyst, you can go to the American Psychoanalytic Association. They have a list of analysts who can start helping you with your mental health. Depending on your needs, you could be referred to a graduate analyst, an analyst in training, or a qualified psychoanalytic psychotherapist.
Many other mental health professionals may use psychoanalysis techniques as well, even if they aren't fully trained as psychoanalysts. If you're interested in psychoanalysis, look for a psychologist or other provider who uses these techniques.
Takeaways
Psychoanalysis is a type of mental health theory and therapy focused on uncovering unconscious feelings, desires, and conflicts that affect your life and may be the root of mental health problems. Many psychotherapists use aspects of psychoanalysis even if they aren't strictly psychoanalysts. You should expect psychoanalysis to last several years. Behavioral or other forms of therapy may be better options depending on your concerns and goals.
Psychoanalysis FAQs
How long does psychoanalysis take?
Psychoanalysis typically requires frequent sessions held once or more per week, over several years. The amount of time you need depends on your goals. Some other forms of therapy, such as psychodynamic therapy, also use psychoanalysis, but they have fewer and shorter sessions.
What is Sigmund Freud's psychosexual theory?
Freud believed personality develops through five stages as you grow up. Each one focuses on a different part of your body where pleasure is focused. These stages are oral, anal, phallic, latency, and genital. Freud believed that if you don't get enough gratification or you have too much frustration at any stage, you may have fixations later in life.
Is psychoanalysis used today?
Yes, some practicing therapists are trained in psychoanalysis. Others may use psychoanalytic approaches along with other techniques. For example, psychodynamic therapy is based on psychoanalytic theory. Some other forms of psychotherapy, such as cognitive behavioral therapy (CBT), are more popular today.
