Psychoanalysis: What Is It and How Is It Different from Other Types of Psychotherapy?

by Alison Cabell

The image of a patient lying on an analyst's couch in which the patient is talking and the analyst is silent, has been the invariable stereotype for psychoanalysis. Contrary to widely-held beliefs, contemporary psychoanalysis and psychotherapy have a lot in common, but also important differences. Since relatively few therapists are psychoanalysts, what are the differences between psychoanalysis and psychotherapy?

Psychoanalysis: An Overview

Modern psychoanalysis has been developing ever since the late 19th and early 20th centuries when Austrian neurologist Sigmund Freud first wrote about the unconscious. Before Freud there was no psychotherapy or psychoanalysis for the treatment of "mental disorders." In fact, those individuals were often imprisoned or banished, rather than helped, if they displayed symptoms that we would now understand as psychological.

Today the main psychoanalytic theories work from the assumption that we all have internal, unconscious beliefs that shape how we think and feel. These unconscious beliefs function like a "blueprint" and enormously influence how we behave in the world and how we conduct our relationships, and they can persist throughout our lives. Our fears and unconscious ways of protecting ourselves tend to make it extremely difficult for us to even recognize these beliefs, let alone work on resolving them.

In psychoanalysis, an analyst helps a patient discover and interpret the unconscious beliefs that are interfering with their current day-to-day functioning — and which can cause painful symptoms such as anxiety, depression, phobias or compulsions. For psychoanalysis to be most beneficial, a patient is encouraged to gradually talk as openly and freely as possible about his or her life, including thoughts, feelings, experiences, beliefs, memories, as well as current and long-standing problems, fantasies, and dreams.

Modern psychoanalysis is actually quite different from the stereotype of the analyst never speaking. Analysts now are likely to actively engage with and help their patients become comfortable with the psychoanalytic process. And analysts take a strong interest in the relationship that develops between the two people, analyst and patient, who are working together for the same purpose — to help the patient better know and understand his or her own mind.

People seeking psychoanalysis often are looking for a treatment that addresses the underlying causes of their problems and want help that will have a lasting benefit. Psychoanalysis aims at addressing the earliest unconscious issues which tend to hold in place long standing patterns in which people can feel stuck.

While psychoanalysis is often considered the most intensive form of psychotherapy, there is a perception that seeking analysis means you must be prepared to lie on a therapist's couch daily for years without end. Most analysts do recommend more than once per week sessions and may or may not recommend using the couch, but this is worked out between the patient and the analyst. Because psychoanalysts view treatment as a developmental process (meaning the patient is learning on a deep emotional level new ways of defining oneself and others in his/her life), analysis takes time and should not be rushed in order to be most effective. Therefore psychoanalysis tends to be a longer process than other types of treatment.

The insights and understanding that result from psychoanalysis can ultimately help individuals feel less inhibited, more comfortable in their own skin and freer to live the life they desire.

How is Psychoanalysis Different from Psychotherapy?

The primary difference between psychoanalysis and psychotherapy is the strong emphasis in psychoanalysis on uncovering unconscious processes which are viewed as playing a primary role in an individual's difficulties.

There are many forms of psychotherapy that are quite different from psychoanalysis and, in contrast, many emphasize current behaviors and beliefs without as deep an examination of their roots. A treatment approach such as cognitive behavioral therapy may be quite appropriate for someone with difficulties that originated within a recent period of time rather than for someone with problems which have persisted for years. In addition, therapists who are not analysts may practice psychoanalytic or psychodynamic psychotherapy and these are therapy treatments which also deal with unconscious processes and address a patient's long standing issues.

Psychotherapy — often known as simply personal counseling or therapy — is an intentional, professional, interpersonal relationship in which a trained counselor or therapist works with an individual, couple, family, or group to help them improve their mental health and sense of well-being. The following is a short list of some of those treatment approaches:

• Cognitive Behavioral Therapy
• Gestalt Therapy
• Humanistic Therapy
• Psychodynamic Therapy
• Expressive Therapy

These approaches may also use other forms of communication besides spoken language such as art, drama, music, play, narrative stories, and the written word.

Additionally, many forms of psychotherapy are designed to help clients cope with and overcome specific issues, such as stress or anger management, assertive awareness, or a fear or phobia. The type of treatment you receive will primarily depend on the problems you are facing and how you wish to address them.

Another notable difference between psychoanalysis and many other forms of therapy is the training required. Most jurisdictions require marriage and family therapists, clinical social workers, and clinical psychologists to have graduate-level training and a minimum number of supervised hours providing psychotherapy prior to becoming licensed counselors or therapists.

In addition to these requirements, psychoanalysts are required to complete several years of additional coursework, go through personal analysis which may be multiple times per week for some years, and analyze several patients multiple times per week for two to three years with weekly supervision. This comprehensive training provides psychoanalysts with additional professional skills to identify and listen carefully for unconscious beliefs in their patients and to interpret those beliefs. The objective, then, is for patients to have more understanding of and capacity to regulate their own thoughts and feelings.

Whether you would be better served by seeking a short-term treatment such as cognitive behavioral therapy or the type of in-depth treatment provided by psychodynamic psychotherapy or psychoanalysis depends largely on the types of problems you are facing and on your particular needs.

No one type of psychotherapy is effective for everyone. However, regardless of the type, all forms of psychotherapy encourage open and honest communication between the client and the therapist in order to be most effective. In addition, recent studies in neuroscience have shown that while undergoing psychotherapy, a patient's brain actually changes and forms new neuropathways. Such research demonstrates that psychotherapy produces benefits for individuals which can endure over time.

So, if you are considering seeking therapy or analysis, the best thing you can do is speak to several therapists in your area, ask them questions, discuss your concerns, and pick the professional who feels right for you.

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