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Psychoanalysis
A foundational therapeutic method that delves into your unconscious mind to surface thoughts and feelings affecting your behavior.
Introduction
The basics
What is Psychoanalysis?
Psychoanalysis is a form of Insight-Oriented Therapy that delves into your unconscious mind to help surface repressed thoughts and feelings that impact your behavior and relationships. By making the unknown known, Psychoanalysis can help you gain more agency over your life and improve your mental health.
Goal
What is the goal of Psychoanalysis?
The goal of Psychoanalysis is profound and far-reaching: to help you understand the unconscious factors that drive your thoughts, feelings, and behaviors. Think of it like an archaeological dig into your mind — uncovering layer after layer of psychological material that influences one’s life but lies outside one’s awareness.
The aim isn't just symptom relief, but a fundamental restructuring of the personality and an enhanced capacity for work, love, and creativity.
Uses
What conditions does Psychoanalysis treat?
Anyone who has concerns that interfere with the way they want to live their lives could benefit from Psychoanalysis.
Specifically, it can be beneficial for a wide range of mental health conditions, including but not limited to:
- Depression and anxiety (especially when chronic or treatment-resistant)
- Personality disorders
- Phobias
- Self-destructive behaviors
- Relationship difficulties
- Obsessive-compulsive behaviors
- Identity issues
- Trauma concerns
- Existential concerns
Subtypes
What are the subtypes of Psychoanalysis?
Several major subtypes of Psychoanalysis have developed over time, each emphasizing different aspects of human psychology. Classical Freudian Psychoanalysis focuses on unconscious conflicts and drives.
The three main focuses of Freudian Psychoanalysis are:
- Ego psychology, which emphasizes the development of the ego’s functioning and adaptive capacities.
- Object relations theory, which centers on internalized relationships
- Self psychology, which focuses on the development of a cohesive sense of self
Contemporary Psychoanalysis often integrates insights from attachment theory, neuroscience, and other modern approaches.
Effectiveness
Origins
Who developed Psychoanalysis and when?
Psychoanalysis was developed by Sigmund Freud in Vienna, Austria during the 1890s. Freud's insights emerged from his work with patients suffering from what were then called “hysteric” symptoms — physical complaints that seemed to have psychological, rather than medical, causes.
Through careful observation and theoretical development, he created a comprehensive theory of human psychology and a method of treatment that would revolutionize the world’s understanding of the mind.
Evidence Base
Is Psychoanalysis evidence based?
Psychoanalysis has a complex relationship with research. Traditional Psychoanalysis wasn't developed using modern research methods, and for many years, clinicians relied primarily on case studies rather than controlled trials.
However, recent decades have seen increasing research support for psychoanalytic concepts and techniques. Contemporary studies show effectiveness particularly for complex mental health conditions and personality disorders. Modern neuropsychology has also validated some psychoanalytic insights about unconscious processing and the impact of early experiences on brain development.
How it works
Techniques Used
How does Psychoanalysis work?
Psychoanalysis works to uncover and understand the unconscious mind through several key mechanisms like free association, dream analysis, and transference analysis.
The most fundamental aspect of Psychoanalysis is free association, which occurs when you share whatever comes to mind without censorship. As the client is engaged in free association, the therapist may notice patterns in thoughts, memories, and feelings that reveal unconscious conflicts and desires.
Another crucial element is the analysis of transference - the way that a client unconsciously relates to the therapist based on patterns from past relationships. Exploration of transference provides the therapist insight into dynamics of current relationships.
It is through these techniques that repressed thoughts, emotions, and memories residing in the unconscious are brought to light to highlight patterns and conflicts from past experiences. Bringing them to consciousness will then facilitate healing and changes in behavior and relationships.
- Free association: talking freely about anything that comes to mind
- Dream analysis: finding symbolic meaning in dreams
- Transference: recognizing how past relationships and experiences are connected to the therapeutic one
- Interpretation: understanding the deeper meaning of thoughts, feelings, and behaviors
- Working through: finding interpretations in different contexts
- Catharsis: releasing repressed emotions to promote healing
What to expect in a session
What can I expect from sessions in Psychoanalysis?
While lying on a couch has become the iconic symbol of Psychoanalysis, that method is not as widely practiced anymore.
- What a client can expect in a typical session is that they will be encouraged to say whatever comes to mind — thoughts, feelings, memories, dreams, fantasies, experiences, etc.
- The therapist, who maintains a neutral stance, will listen carefully and offer interpretations and patterns that help the client understand the deeper meanings of their life experiences and resolve underlying issues.
Treatment length & structure
How long does Psychoanalysis typically take? Is there any set structure?
Traditional Psychoanalysis is one of the longest forms of therapy, typically lasting several years with sessions 3-5 times per week. This frequency allows for deep exploration of unconscious material and the development of what therapists call the “analytic process.”
While there's no rigid structure, the treatment typically moves through phases:
- Beginning with building trust and exploring surface issues
- Gradually delving into deeper material
- Working through core conflicts and preparing for termination.
Due to its depth and intensity, Psychoanalysis may not be suitable for all individuals or situations.
Getting care
Finding a therapist
How do I find a therapist who uses Psychoanalysis?
Alma’s directory has many therapists who specialize in Psychoanalysis, including:
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Similar types of therapy
Besides Psychoanalysis, what other types of therapy might be right for me?
If after reading this, you’re not sure if Psychoanalysis is quite the right fit, here are some other types that might be worth looking into:
Psychodynamic Therapy: if past patterns feel important
Psychodynamic therapy examines how past experiences and unconscious patterns shape current emotions, relationships, and coping styles.
Attachment-Focused Psychotherapy: if relational safety feels central
Attachment-focused psychotherapy explores how early caregiving and relational patterns shape trust, safety, intimacy, and emotional regulation.
Hypnotherapy: if focused relaxation interests you
Hypnotherapy uses guided relaxation, focused attention, and suggestion to help people access patterns, beliefs, or habits that may be harder to shift in ordinary conversation.
Narrative Therapy: if you want to reframe your story
Narrative therapy helps people separate themselves from problems and re-author stories in ways that reflect values, strengths, and meaning.
This article was written and medically validated by Drs. Jill Krahwinkel-Bower and Jamie Bower.
FAQs
Psychoanalysis is one of the most intensive and far-reaching therapeutic commitments available, typically involving several sessions per week over a period of years. It tends to be the right choice for people who are seeking profound self-understanding, who have complex and long-standing difficulties that haven't responded to shorter-term approaches, and who have the time, financial resources, and genuine curiosity to sustain a deep exploratory process. People drawn to psychoanalysis often feel that their struggles have roots that go very deep, and they want to understand and transform those roots rather than simply manage symptoms.
Yes. It has been proven that this therapeutic approach can be delivered effectively online through secure video platforms. Outcomes are comparable to in-person care across a wide range of approaches and conditions, according to consistent research. If you're looking for this type of therapy online, you can use this link to find a therapist who specializes in psychoanalysis and takes your insurance.
Whether psychoanalysis is covered depends on your individual insurance plan. Most major insurance plans cover therapy when it's provided by a licensed mental health professional, regardless of the type of therapy you choose. What matters more is whether therapy is considered medically necessary given your diagnosis. The best way to find out what you'll pay is to check your plan's explanation of benefits, call the member services number on your insurance card, or use Alma's free cost estimator tool before booking.
Psychoanalysis is the origin point from which psychodynamic therapy evolved. Classical psychoanalysis typically involves three to five sessions per week, uses the couch, and emphasizes a more neutral therapeutic stance. Psychodynamic therapy adapted those principles into a more flexible, accessible format — typically one to two sessions per week, face-to-face, and less formally structured. Both approaches work with the unconscious, past experiences, and relational patterns, but psychodynamic therapy generally allows for more tailoring to specific goals and presents a lower time and financial barrier than traditional psychoanalysis.
Psychoanalysis aims for something more thoroughgoing than symptom reduction — it aspires to a fundamental restructuring of personality and a deeper understanding of the self. The goal, as Freud articulated it, involves transforming what is unconscious into what is conscious, and that work requires time. Layers of defense, ingrained relational patterns, and deeply held beliefs don't shift quickly; they need to be encountered repeatedly in different contexts, examined from multiple angles, and worked through rather than simply understood intellectually. The frequency of sessions — typically three to five times per week — also matters, because it sustains an immersive process that maintains the analytical work across the full arc of daily life.
Free association is the foundational technique of psychoanalysis. The idea is simple: you say whatever comes to mind, without filtering, editing, or trying to make it coherent or logical. What you include, what you leave out, the way one thought follows another, the places where the flow suddenly stops — all of these become windows into the unconscious material that may be shaping your behavior and emotional life. The analyst listens carefully not just to the content but to the patterns and gaps, occasionally offering an interpretation. It sounds simple but is often surprisingly difficult, because the mind's natural impulse is to self-censor and present a coherent, socially acceptable version of itself.
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