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Psychoanalysis

What it is

Psychoanalysis is a therapeutic technique developed by Sigmund Freud in the early 20th century. The goal is to uncover the patients’ unconscious parts of their emotional rhythms to resolve their present conflicts.

Who needs it

Psychoanalysis works best with patients whose issues center on their self-esteem. Through this exhaustive process, the patient can integrate formerly repressed memories into the present, with the goal of reducing troublesome symptoms.

How it works

The patient reclines on a couch in a quiet office setting, and the analyst sits to the side and behind, outside the patient’s field of view, enabling his or her thoughts to flow uninterrupted. Once recalled, the patient’s memories are replayed within the analyst-patient relationship. In a process known as transference, the analyst becomes the target of the emotions that the patient had originally experienced in their early-life traumatic events. The analyst then interprets these interactions in the context of the patient’s current life issues. Sessions typically last an hour, occur several times a week, and last for several years.

Where to go

Analysts can be physicians, psychologists, or anyone with a master’s degree in mental health (such as social workers or psychiatric nurses). These clinicians must undergo several years of training at a facility accredited by the American Psychoanalytic Association.

What to expect

A lack of sound scientific evidence supporting psychoanalysis has plagued this field in comparison to other therapies. The current medical and insurance system favors treatments that target specific disorders and have defined beginnings and ends. Psychoanalysis takes a more open-ended approach time-wise and does not usually focus on specific disorders.

What could happen

Like with Psychodynamic Therapy, the possibility of exploring unpleasant past events is not painless. Furthermore, as a result of the lack of evidence and the numerous sessions inherent in the therapy, it has fallen out of favor in recent decades. Insurance companies that do cover it will only pay for a finite number of sessions, likely fewer than recommended by the analyst.

Types of Treatment Options

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References
  1. Sadock B, Sadock V, Ruiz P. (2009) Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed. Philadelphia, PA; LWW.
  2. Doidge N. (1997) Empirical evidence for the efficacy of psychoanalytic psychotherapies and psychoanalysis: An overview. Psychoanalytic Inquiry, 17:S1,102-150.
  3. Parsons M. (2014) Living Psychoanalysis: From theory to experience. New York, NY: Routledge.
  4. Moore BE, Fine BD. (1990) Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.
  5. American Psychoanalytic Association. (2015) Standards for Education and Training in Psychoanalysis. Retrieved on 6/2/2016 from http://www.apsa.org/content/educational-standards
  6. Fonagy, P. (2003). Psychoanalysis today. World Psychiatry, 2(2), 73.