Psychoanalysis is a form of psychotherapy based on understanding the unconscious mental processes that determine people’s thoughts, actions, and feelings. The therapy then relates those processes to an individual and any psychological or physical suffering they may be experiencing.

Many experts do not see psychoanalysis as a direct cure for depression or any of the other conditions it is used to treat. Instead, psychoanalysis is meant to provide symptom relief, greater self-awareness of actions and decisions, and a broader scope with which a patient can self-observe and correct the problem at hand. It’s also thought that through careful observation of particular patterns, the therapist and patient can trace the source of the behavior or feelings back to a moment of origin and provide the patient with perspective on the current situation. 

How It Works

A trained psychoanalyst works with the premise that human beings are largely unaware of the factors that lead them to a particular behavior or feeling. The analyst uses talk therapy to explore the patient’s thought patterns, reactions, and feelings. Once the unconscious mental material is brought forward in discussion, the hope is that a patient will have better control over the corresponding emotions and behaviors.

Psychoanalysis is one of the most intensive forms of treatment in terms of time and financial commitments. It usually requires years for patient and analyst to reach a point where patterns have been identified and can be observed for treatment. For a traditional psychoanalysis treatment, a patient meets with an analyst three to five times a week for an average of 45 minutes per visit.

Methods of Psychoanalysis

With most traditional psychoanalysis treatments, the patient lies on a couch, and the analyst sits behind the couch, where the two cannot make eye contact. To reach a more intimate level of discussion and discovery, a therapist may use one or more of the following psychoanalytical techniques:

Free Association

The patient talks freely about whatever enters their mind without censoring or editing the flow of thoughts and feelings. This method allows the patient to regress (return to a more childlike emotional state) so that patient and analyst might be able to find the source or sources of problems and forge a better therapeutic relationship.

Interpretation

The analyst may inject himself into the session by commenting on a memory the patient shares or to prod the patient for more in-depth information.

Therapist Neutrality

A neutral therapist serves only to keep the patient focused. The analyst avoids injecting herself into the discussion to prevent distracting the patient with her reaction or feelings.

Transference

If the relationship between analyst and patient is well established, the patient may begin to transfer thoughts or feelings connected with another person (often a parent, sibling, spouse, or other significant figure in the patient’s life) to the therapist. Transference allows the analyst and patient to discuss perceptions and interpretations the patient may have of other people. 

Working Through

This type of psychoanalysis is often a secondary technique. It is used to point awareness on the sources of problems and then “test” the patient with their reaction. Over time, working through allows the patient to make changes in their life to gain control over reactions and conflicts.

Other Disorders Treated by Psychoanalysis

In addition to depression, psychoanalysis may be used to treat:

  • anxiety
  • feelings of isolation
  • interpersonal relationship problems
  • obsessive-compulsive tendencies
  • severe shifts in mood or self-esteem
  • sexual difficulties
  • unhappiness in work, home, or love life

What the Expert Says

“Traditional psychoanalysis would take place several times a week and can be very helpful for some people some of the time,” says Daniel L. Buccino, LCSW-C, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine. “It may be especially helpful for those who may require deeper insight into the repetitive patterns of their problems.”