What Is Psychoanalytic Therapy?

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What Is Psychoanalytic Therapy?

Psychoanalytic therapy is a form of talk therapy based on Sigmund Freud's theories of psychoanalysis. The approach explores how the unconscious mind influences your thoughts, feelings, and behaviors. Specifically, it examines how your experiences (often from childhood) may be contributing to your current actions.

Freud described the unconscious as the reservoir of desires, thoughts, and memories that are below the surface of conscious awareness. He believed that these unconscious influences could often lead to psychological distress and disturbances.

Techniques

People undergoing psychoanalytic therapy often meet with their psychoanalyst at least once a week. They can remain in therapy for months or even years.

Psychoanalysts use a variety of techniques to gain insight into your behavior. Some of the more popular techniques include:

  • Dream Interpretation: According to Freud, dream analysis is by far the most important psychoanalytic technique. He often referred to them as "the royal road to the unconscious." Psychoanalysts may interpret dreams to give them insight into the workings of your unconscious mind.
  • Free association: When the psychoanalyst encourages you to freely share your thoughts. They may give you a word (or show you an image) and ask you to say the first thing that pops into your head. Repressed memories often emerge during this process.
  • Freudian Slip: When you say one thing and mean another. Freud believed these 'slips of the tongue' revealed repressed thoughts and desires. Also known as parapraxis.
  • Transference: Occurs when you project your feelings about another person onto the psychoanalyst. You'll then interact with them as if they were that other person. This technique can help your psychoanalyst understand how you interact with others.

Psychoanalysts spend a lot of time listening to people talk about their lives, which is why this method is often referred to as "the talking cure."

What Psychoanalytic Therapy Can Help With

Psychoanalytic therapy may be used to treat a number of different psychological conditions, including:

  • Anxiety
  • Depression
  • Emotion struggles or trauma
  • Identity problems
  • Obsessive-compulsive disorder
  • Phobias
  • Psychosomatic disorders
  • Relationship issues
  • Self-destructive behavior
  • Sexual problems

People who are likely to benefit from this form of therapy are often those who have been experiencing symptoms for some time.

Benefits of Psychoanalytic Therapy

What makes psychoanalytic therapy different from other forms of treatment? A review of the research comparing psychoanalytic approaches to cognitive behavioral therapy (CBT) identified seven features that set the psychoanalytic approach apart.

  • Focuses on emotions. Where CBT is centered on cognition and behaviors, psychoanalytic therapy explores the full range of emotions that a patient is experiencing.
  • Explores avoidance. People often avoid certain feelings, thoughts, and situations they find distressing. Understanding what a client is avoiding can help both the psychoanalyst and the client understand why such avoidance comes into play.
  • Identifies recurring themes. Some people may be aware of their self-destructive behaviors but unable to stop them. Others may not be aware of these patterns and how they influence their behaviors.
  • Experience-oriented. Other therapies often focus more on the here-and-now, or how current thoughts and behaviors influence how a person functions. The psychoanalytic approach helps the people explore their pasts and understand how it affects their present and future.
  • Explores interpersonal relationships. Through the therapy process, people are able to explore their relations with others, both current and past.
  • Emphasizes the therapeutic relationship. Because psychoanalytic therapy is so personal, the relationship between the psychoanalyst and the patient is an important part of the treatment process.
  • Free-flowing. Where other therapies are often highly structured and goal-oriented, psychoanalytic therapy allows the patient to explore freely. Patients are free to talk about fears, desires, and dreams that they have never spoken of before.

Psychoanalytic therapy can also help you learn techniques for coping when future problems arise. Rather than falling back on unhealthy defenses, you may be better able to recognize your feelings and deal with them in a constructive manner.

As with any approach to mental health treatment, psychoanalytic therapy can have its pluses and minuses. Before deciding on this approach, it's important to take these factors into account.

Effectiveness

Success often hinges on the ability to confront potentially stressful or triggering experiences. While some critics have derided the success rates of psychoanalytic therapy, research suggests that both long-term and short-term psychoanalytic therapy can effectively treat a range of conditions.

Long-term psychoanalytic therapy is usually defined as lasting one year or 50 sessions. Short-term psychoanalytic therapy, on the other hand, is defined as less than 40 sessions or less than one year of treatment.

Symptom Reduction

One review of the effectiveness of long-term psychoanalytic therapies found moderate to large success rates for reducing symptoms of a variety of psychopathologies.

A 2021 review of studies found that short-term psychoanalytic therapy led to lasting improvements in somatic symptoms, depressive symptoms, and anxiety symptoms.

Lasting Improvements

People who receive psychoanalytic treatment tend to retain these gains. Most even continue to improve even after therapy ends. On the other hand, the benefits of other evidence-based therapies tend to diminish over time.

A 2010 review published in the American Psychologist suggested that psychoanalytic therapy was as effective as other evidence-based therapies.

Things to Consider

As with all treatment methods, there are also potential downsides that should be considered. This form of therapy tends to require ongoing sessions, often involving three to five sessions a week for several years. Depending on how long your therapy lasts, the costs can mount up quickly.

Psychoanalytic therapy can also be an intense process. It involves provoking emotional responses and overcoming defense mechanisms. While the process can sometimes result in uneasiness, it can also help you understand the unconscious forces that exert an influence over your current behavior.

How to Get Started

If you think you or someone you love would benefit from psychoanalytic therapy, the first step is to seek out a trained professional. To find a qualified psychoanalyst, start by asking your primary care physician for recommendations. You can also use the "Find An Analyst" tool on the American Psychoanalytic Association's website.

Friends who have had a good experience with psychoanalytic treatment can also be another good source of recommendations. If you do not have a good referral from someone you know, there are a number of online psychoanalyst networks and directories that can point you in the right direction.

Once you have identified a potential psychoanalyst, make a call to set up an initial consultation. During this consultation, you can further explore if psychoanalytic therapy is the right approach for you.

Psychoanalytic therapy is just one mental health treatment approach that you may want to consider. Always talk to your doctor or therapist to determine which psychotherapy method might be the most effective for your individual needs.

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