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What is Psychoanalysis?

Medically Reviewed and Edited by 
Olga Kyrychenko, Psychologist

The definition of psychoanalysis is hallmarked by its consideration of the unconscious as the primary drive for overt behavior. To answer the question of how psychoanalysis works, we must examine its core foundations: defense mechanisms, the psyche, and past experiences.

In a separate article, I mentioned that psychoanalysis should not be treated as synonymous with psychodynamic therapy. Although both are Freudian approaches, classical psychoanalysis mainly concerns “unconscious forces”. That said, I’ll focus more on contemporary psychoanalysis in this discussion and how it has shifted to an empirical treatment approach over the years.

Freud’s psychoanalysis definition may be simplified as understanding how our psyche interprets our past experiences and what defense mechanisms we manifest due to such. Therefore, the goal of psychoanalysis is to investigate how your trauma (primarily, childhood trauma) impacts your current behavioral patterns.

I have written this article in hopes that you may be able to answer the query, “Is psychoanalysis right for me?”. To do that, I will discuss different psychoanalysis types and the techniques that separate them from other therapeutic approaches. Once you have a clearer understanding of the process of psychoanalysis, I will provide you with the details of the use of psychoanalysis as well as its benefits and limitations.

Different Types of Psychoanalysis

I focused on researchers regarding contemporary psychoanalysis since the principles of those newer psychoanalytic approaches are what therapists practice nowadays. These psychoanalysis treatment types deviate from classical psychoanalysis mainly by introducing new foundations that are as equally important as defense mechanisms and past experiences.

Object Relations Therapy

Based on Melanie Klein’s theory of object relations, object relations therapy focuses on your relational experiences most especially, with those who are considered significant: parents, immediate family, and partners. As a therapeutic approach, it is centered on your “position”: paranoid-schizoid and depressive. 

Manifesting characteristics that are connected to those positions is not enough to account for undergoing distress. It is normal to display behaviors and experience the feelings associated with the positions.

However, if you dwell on a certain position or consistently manifest the maladaptive mechanisms linked with the positions, that is when you will be considered to be experiencing mental distress or even a mental disorder.

The goal of object relations therapy then is to help you move away from the position you are fixated on. For example, if you are manifesting too many characteristics of a person in the paranoid-schizoid position you may continuously feel helpless, shameful, fearful, and may act ruthlessly towards others. Your therapist, using psychoanalytic techniques, will help you realize that these feelings and actions are not “you” but rather, a part of you that you can change and control.

Self Psychology

Concepts of self psychology applied in psychoanalytic therapy mainly focus on regulating self-esteem. We all tend to either overestimate ourselves or fixate on our flaws or problems, and thus, feel inferior. With self psychology, you and your therapist collaborate and work toward the goal of having a more positive and accurate view of your “true self”. 

The “true self” pertained in this therapeutic approach is you minus your negative perception of yourself. It is important to take note that negative perception does not mean your view of yourself is bad, negative perception also pertains to viewing yourself as too good (i.e. if you are suffering from narcissistic disorder).

Guided by your therapist, through self psychology you will be able to recognize irrational thoughts, dysfunctional behavior patterns, and volatile relationships (especially in people with BPD). After recognizing such, the therapeutic process will then be streamlined to improve your perception of yourself: recognizing flaws, discarding unhealthy routines, and crafting a more optimistic mindset, among many others.

Relational Psychoanalytic Therapy

Since many modern therapy approaches focus on symptom reduction, a contemporary psychoanalysis therapy type emerged. Relational psychoanalytic therapy challenges the common pattern in psychoanalysis wherein the therapist lets you discover for yourself the root cause of the problem and act on that rather than the symptoms you are manifesting.

Through this treatment type, therapists suggest healthy coping strategies after understanding your unique experiences and collaborating with you to give more meaning to those experiences. Also, as its name suggests, relational psychoanalytic therapy sets enhancing and improving interpersonal relationships as one of its main goals.

Psychoanalysis Techniques

More than simply “techniques”, the following are key concepts psychoanalysts consider or act upon to reach the therapeutic goals they have constructed with you. They are treated as psychoanalysis techniques because they have been utilized in both therapeutic and clinical settings and therefore, apply to different cases and contexts.

Projective Identification

The psychological phenomenon wherein you project thoughts, emotions, or qualities onto another person is called projective identification. Through subtle verbal and non-verbal cues, you are unconsciously conveying your “fantasies”. In the context of psychoanalysis, these fantasies are your unrecognized desires that stem from the distress you are experiencing or from your past experiences.

In psychoanalytic therapy, the instances where you manifest projective identification are used as a basis for your empathy with another person. You are expected to demonstrate this psychological process when you are feeling depressed. The therapist will then help you in “withdrawing” such projections which are considered maladaptive.

Countertransference

This is a technique that is considered the “response” of your therapist to your projective identification. An effective therapist can recognize which thoughts and feelings are theirs and which are the ones you have projected onto them. 

As a therapeutic technique, countertransference is used by the therapist to communicate your feelings to you clearly. It aids with the whole “meaning building” which is the core of psychoanalysis. You are then expected to be able to develop the capacity to tolerate and understand the feelings you have projected onto your therapist.

The Destructive Superego

Based on Freud’s theory about the provinces of the mind, the superego is considered the conscience and the “seat of morality”. It may seem like the “good part” of your unconscious opposing the impulsive id. It may also be considered superior to the realistic ego.

However, due to distress and poor coping strategies, this superego of yours may morph into a destructive superego. The development of such hinders recovery by instilling guilt and moral condemnation in you regarding your emotional struggles. 

Your therapist will guide you to “battle” this destructive ego by strengthening your ego to take control of your cognition and eventually, your behaviors. Although you may feel depressive guilt, that guilt will lead to remorse and a desire to make amends which, in this case, is shifting towards healthier thought processes and behavioral patterns.

Psychoanalysis Uses

Evidence shows psychoanalysis and other therapies that highlight the unconscious are mostly used to treat internalizing disorders. Based on research, here are the most common psychological disorders psychoanalysis is employed on:

Additionally, since psychoanalysis highlights subjectivity, by recognizing that your thoughts, feelings, and actions are all part of your “individual experience”, you can actively collaborate with your therapist in realigning your maladaptive mindset.

Is Psychoanalysis Effective?

The short answer to the question regarding the effectiveness of psychoanalysis is that it depends, since psychoanalysis is contextual. If you do not prefer dwelling on past experiences or believe there is no hidden meaning behind your distress, then psychoanalysis should not be your first choice in choosing a treatment option.

However, if you are open to discussing your dreams, fantasies, feelings, and wishes – your unconscious as a whole – then the question of whether psychoanalysis works or not can be quickly answered by data presented in numerous studies.

One of those studies was published in the journal, The Lancet Psychiatry, where the practice of psychoanalysis in the present years was assessed. The research found that the effectiveness of psychoanalysis is as backed by empirical data as CBT, the most evidence-based therapeutic approach.

Based on studies, psychoanalysis sessions are almost impossible to conduct online in the same way as in person. There is a review of how psychoanalysis is applied in an online setting and it mainly criticized the “safety” of applying psychoanalytic techniques with you not being in a conducive environment like a clinic or your therapist not being in the vicinity should there be potentially triggering situations that may arise during the sessions.

What are the Benefits of Psychoanalysis?

In the previous section, I have cited a study that examined modern psychoanalysis. The researcher also mentioned the following benefits of psychoanalysis:
  • Better therapeutic relationship = better prognosis
  • Person-centered but not overly directive; allows you to feel more in control
  • Reduces the likelihood of being triggered by daily stressors
  • Cost-effective;  easier to conduct in under-resourced environments
  • Promotes hopefulness; permits you to fully discuss ambiguous experiences
Unlike other therapies which somehow constraints you in simply talking about present problems or analyzing just overt behavior, psychoanalysis does not restrict you. All in all, if you are someone who considers yourself an insightful individual, psychoanalysis allows you to, in an almost literal sense, speak your mind.

What are the Drawbacks of Psychoanalysis?

The main criticism regarding psychoanalysis is its empirical soundness but even though I have provided materials regarding psychoanalytic therapy being an equally evidence-based therapy as other forms of therapy, other limitations of this treatment option still exist.

  • Some therapists may still adhere to outdated perspectives
  • Investigating repressed memories may bring you discomfort
  • Long-term psychoanalytic therapy is expensive and too intensive

Even with these limitations, psychoanalytic therapy remains a valuable and viable option if you are seeking therapeutic support. I mainly want to help you manage your expectations and make an informed decision about whether or not to choose to undergo psychoanalysis.

Getting Started With Psychoanalysis

Directories that provide lists of therapists like Psychology Today may aid you in finding a psychoanalyst that may be able to accommodate you. As I previously mentioned, psychoanalysis is not a viable option for online therapy thus, most online therapy providers only offer other psychotherapy options. Therefore, it is best to inquire at your local community mental health center or locate the nearest private clinic to undergo psychoanalysis.

The American Board of Psychoanalysis has a page dedicated to helping you find a certified psychoanalyst based in the US. Some cities and states also have their therapist catalog you may browse through like Chicago and Massachusetts

Is Psychoanalysis Right For You?

In choosing the right therapy option, you are expected to have a clear and solid understanding of the main goals of the treatment. With psychoanalysis, the goal is to unravel your unconscious as a way to explain present behaviors and consequently, serve as a guide to alleviate symptoms and reduce distress.

To have a glimpse of the therapeutic process, I have discussed the different techniques associated with psychoanalytic therapy as well as the most common clinical populations wherein such treatment methods are used. 

If you think that psychoanalysis fits your needs after reading through its efficacy and its strength and limitations, I have also provided you with a guide on how to get in touch with a psychoanalyst.