Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions.
Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist.
The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day.
Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.
Not to be confused with Psychodynamic Psychotherapy – a similar, yet different – form of talking therapy. You can read about their differences here.
The Science Behind Psychoanalytical Psychotherapy
Psychoanalytical Psychotherapy is based on Sigmund Freud’s theory of psychoanalysis. Freud suggested that negative thoughts and experiences from childhood are suppressed, and are subsequently pushed to the back of the mind – known as the unconscious mind.
Despite this, these thoughts and experiences have a big influence on an individual, including as an adult. Therefore, by processing these thoughts and experiences in a positive way, a person will normally see an improvement in their mental health. They will also increase their awareness of the mind, and see how it continues to affect their current life.
Psychoanalytical Psychotherapy is particularly useful for trauma-based cases, as a person will often be able to recall a trauma that had previously been repressed. To achieve the goals of this treatment, a trained therapist will use a range of techniques.
How Does Psychoanalytical Psychotherapy Work?
Psychoanalytical Psychotherapy is generally seen as a long-term therapy. The sessions generally start with a therapist waiting for an individual to talk – based on their mindset.
The patient is encouraged to state whatever is going through their mind, and the therapist will attempt to notice patterns (“read between the lines”) or common themes in a person’s thoughts, and try and identify any past event which seem to be having an effect on a person’s difficulties.
In cases where the aim is to recover memories of a past trauma, the therapist will use some techniques to try and get an individual to recall their past.
In any case of Psychoanalytical Psychotherapy, the aim is to help a patient understand how their unconscious mind has an impact on their current behaviour, thoughts and feelings.
Psychoanalytical Psychotherapy is the classic form of therapy that is often seen in the media – a person will normally lie on a couch when speaking to a therapist.
Psychoanalytical Psychotherapy can run for an indefinite period of time. If using the NHS, a person will rarely be able to have more than 50 sessions – with sessions normally being held once a week.
A usual course is around six months – therefore over 30 sessions. For someone who uses the private sector, they can have Psychoanalytical Psychotherapy for years. Once a patient and therapist agree that there has been positive change, the therapy may be terminated.
Some people may use Psychoanalytical Psychotherapy for many years, especially if they find it helpful. In any case, a good ending point is commonly when a person has got to the point where they have strong insight into how their unconscious mind contributes to their thoughts, emotions and behaviour.
Most people leave Psychoanalytical Psychotherapy with a vast improvement in their symptoms. Psychoanalytical Psychotherapy commonly has long-term benefits, and the techniques and knowledge taught should result in a person being well-protected from a relapse.
When is Psychoanalytical Psychotherapy Useful?
Psychoanalytical Psychotherapy can be useful in multiple mental health conditions. In general, any case where a person is struggling emotionally, aiming to explore their mind, or where any psychological disturbance is present, can find this treatment helps.
Cases involving any unprocessed trauma can be helped too by Psychoanalytical Psychotherapy. It is normally used for treating Depression, Anxiety (e.g. phobias), post-traumatic stress disorder and other trauma-related conditions, personality disorders, obsessive-compulsive disorders, somatic disorders (e.g. conversion disorder) and eating disorders.
As seen – Psychoanalytical Psychotherapy can be used to help treat a plethora of conditions. Outside of mental health – someone looking to explore their thoughts or learn more about their mind may find Psychoanalytical Psychotherapy to be useful.
In theory, anyone with a mental health condition may benefit from Psychoanalytical Psychotherapy – it is dependent on the circumstances of each person.
How effective is Psychoanalytical Psychotherapy?
Psychoanalytical Psychotherapy appears to be effective in most cases – especially when taking long-term effects into account. For Depression, the evidence is mainly positive.
One study found that in cases of treatment-resistant depression, that Psychoanalytical Psychotherapy was more effective than cognitive-behavioural therapy, with CBT normally the first line of treatment for Depression in the UK .
Generally, studies suggest Depression is well-treated by Psychoanalytical Psychotherapy . However, not all studies suggest Psychoanalytical Psychotherapy produces positive results, it has been suggested that its evidence of success is ‘limited’ .
As mentioned earlier, Psychoanalytical Psychotherapy appears to be very effective for Anxiety disorders . One study looking at the treatment of the eating disorder bulimia nervosa found that CBT actually produced more positive results than psychoanalytical psychotherapy .
But despite this, Psychoanalytical Psychotherapy continues to be seen as effective for many mental health conditions, and is commonly used as a treatment in many cases.
Something that does seem important is that the client and therapist have a good relationship, where trust is evident. While many people will find their symptoms lessen as a result of this treatment, Psychoanalytical Psychotherapy is not for everyone. Everyone is unique.
How to find a therapist?
It is recommended that you contact your GP and inform them of your problems. They will refer you to the relevant mental health team.
If you are aiming to use the private sector, you could ask your GP or someone you know for a recommendation. You can also look online – the British Association for Counselling and Psychotherapy have a therapist directory on their site.
- Everything You Need to Know About Psychoanalytical Psychotherapy
- Advantages and Disadvantages of Psychoanalytical Psychotherapy
- 8 Things You Should Know About Psychoanalytical Psychotherapy
- What is the Difference Between Psychoanalytical and Psychodynamic Therapy?
- List of Therapy Types
- Overview of Sigmund Freud and His Theories
If talking therapy alone hasn’t worked, then your Doctor may suggest adding a medication.
There are many other types of therapy, you can see an exhaustive list of them here.
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 Fonagy, P., Rost, F., Carlyle, J.‐a., McPherson, S., Thomas, R., Pasco Fearon, R., Goldberg, D. & Taylor, D. (2015), Pragmatic randomized controlled trial of long‐term psychoanalytic psychotherapy for treatment‐resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry, 14 (3) p312-321.
 Leichsenring, F (2005) Are psychodynamic and psychoanalytic therapies effective? A review of empirical data, The International Journal of Psychoanalysis, 86 (3), p841-868,
 Smit, Y., Huibers, M., Ioannidis, J., van Dyck, R., van Tilburg, W. & Arntz, A. (2012). The effectiveness of long-term psychoanalytic psychotherapy—A meta-analysis of randomized controlled trials. Clinical Psychology Review. 32 (2), P81-92.
 Milrod, B., Leon, A., Busch, F., Rudden, M., Schwalberg, M., Clarkin, J., Aronson, A., Singer, M., Turchin, W., Klass, T., Graf, E., Teres, B. & Shear, K. (2007). A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder. The American Journal of Psychiatry. 164 (2), p265-272.
 Poulsen, S., Lunn, S., Daniel, S., Folke, S., Mathiesen, B. Katznelson, H. & Fairburn, G. (2014). A Randomized Controlled Trial of Psychoanalytic Psychotherapy or Cognitive-Behavioral Therapy for Bulimia Nervosa. The American Journal of Psychiatry. 171 (1), p109-116.