Most people have heard of Sigmund Freud, the father of psychoanalysis, and many will have heard of some of his more controversial ideas, such as penis envy and the Oedipus complex.
However, psychoanalysis is much more than a quirky approach to understanding the human mind. It’s a specific form of talking therapy, grounded in a complex theory of human development and psychological functioning.
In this article, we’ll introduce the history of psychoanalytic theory, the basic tenets of the psychoanalytic model of the mind, and the clinical approach called psychoanalysis. We’ll explain the differences between psychoanalysis and psychotherapy and consider some criticisms of psychoanalysis.
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What Is Psychoanalysis? A Definition and History of Psychoanalytic Theory
Psychoanalysis is a talking therapy that aims to treat a range of mental health issues by investigating the relationship between the unconscious and conscious elements of psychological experience using clinical techniques like free association and dream interpretation (Pick, 2015).
Contemporary psychoanalysis has evolved a great deal from its roots in the classical Freudian approach, which developed in Vienna during the late 19th century.
Today, there are several psychoanalytic schools that adhere to different models of the mind and clinical approaches. These include the object relations school associated with Klein and Winnicott, Jung’s analytic psychology, and Lacanian psychoanalysis (Gaztambide, 2021).
Many controversies abound between these different approaches today, although all can be classified as an approach to psychoanalysis.
A common thread between them is their focus on the transference and countertransference dynamics between the analyst and analysand as the vehicle of psychological transformation and healing (Pick, 2015). This is explained further below.
Freudian theory: Sigmund Freud & psychoanalysis
The founder of psychoanalysis, Sigmund Freud, was born in Austria and spent most of his childhood and adult life in Vienna (Gay, 2006). He entered medical school and trained as a neurologist, earning a medical degree in 1881.
Soon after his graduation, he set up in private practice and began treating patients with psychological disorders. His colleague Dr. Josef Breuer’s intriguing experience with a patient, “Anna O.,” who experienced a range of physical symptoms with no apparent physical cause (Breuer & Freud, 1895/2001) drew his attention.
Dr. Breuer found that her symptoms abated when he helped her recover memories of traumatic experiences that she had repressed from conscious awareness. This case sparked Freud’s interest in the unconscious mind and spurred the development of some of his most influential ideas.
You can read more about the clinical origins of psychoanalysis in the original text Studies on Hysteria (Breuer & Freud, 1895/2001).
Models of the mind: Ego, id, & superego
Perhaps Freud’s greatest impact on the world was his model of the human mind, which divides the mind into three layers, or regions.
Housing our current thoughts, feelings, and perceptual focus
Preconscious (sometimes called the subconscious)
The home of everything we can recall or retrieve from our memory
At the deepest level of our minds resides a repository of the processes that drive our behavior, including biologically determined instinctual desires (Pick, 2015).
Later, Freud proposed a more structured model of the mind that better depicted his original ideas about conscious and unconscious processes (Gaztambide, 2021).
In this model, there are three components to the mind:
The id operates at an unconscious level as the motor of our two main instinctual drives: Eros, or the survival instinct that drives us to engage in life-sustaining activities, and Thanatos, or the death instinct that drives destructive, aggressive, and violent behavior.
The ego acts as a filter for the id that works as both a conduit for and check on our unconscious drives. The ego ensures our needs are met in a socially appropriate way. It is oriented to navigating reality and begins to develop in infancy.
The superego is the term Freud gives to “conscience” where morality and higher principles reside, encouraging us to act in socially and morally acceptable ways (Pick, 2015).
The image offers a context of this “iceberg” model of the mind, which depicts the greatest psychological influence as the realm of the unconscious.
Freud believed these three components of the mind are in constant conflict because each has a different goal. Sometimes, when psychological conflict threatens psychological functioning, the ego mobilizes an array of defense mechanisms to prevent psychological disintegration (Burgo, 2012).
These defense mechanisms include:
The ego prevents disturbing memories or threatening thoughts from entering consciousness altogether, pushing them into our unconscious.
The ego blocks upsetting or overwhelming experiences from awareness, leading us to refuse to acknowledge or believe what is happening.
The ego attempts to resolve discomfort by attributing our unacceptable thoughts, feelings, and motives to another person.
The ego satisfies an unconscious impulse by acting on a substitute object or person in a socially unacceptable way (e.g., expressing the anger you feel toward your boss at work with your spouse at home instead).
Ego functioning returns to a former stage of psychological development to cope with stress (e.g., an angry adult having a tantrum like a young child).
Similar to displacement, the ego overcomes conflict by channeling surplus energy into a socially acceptable activity (e.g., channeling anxiety into exercise, work, or other creative pursuits).
The Approach: Psychoanalytic Perspective
The psychoanalytic approach focuses on deciphering how the unconscious mind governs conscious processes in ways that interfere with healthy psychological functioning.
It is built on the foundational idea that biologically determined unconscious forces drive human behavior, often rooted in early experiences of attempting to get our basic needs met. However, these remain out of conscious awareness (Pick, 2015).
Psychoanalysis engages in a process of inquiry into adult defenses against unacceptable unconscious desires rooted in these early experiences and emphasizes their importance as the bedrock of adult psychological functioning (Frosh, 2016).
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Techniques of Psychoanalytic Therapy
A modern psychoanalyst may use a range of different interventions, depending on their school of psychoanalytic thought (e.g., object-relational, Lacanian, Jungian, etc.; Gaztambide, 2021).
However, there are four component techniques specific to psychoanalysis that we explain below.
What are the four ideas of psychoanalysis?
Interpretation refers to the analyst’s hypothesizing of their client’s unconscious conflicts. These hypotheses are communicated verbally to the client.
Generally, the analyst will attempt to make their client more aware of their defense mechanisms and their relational context, including their unconscious conflicts and the client’s motivation for mobilizing a particular defense mechanism (Kernberg, 2016).
There are three stages of interpretation (Kernberg, 2016):
Where the analyst tries to clarify what is going on in the patient’s conscious mind
Gently aims to bring nonverbal aspects of the client’s behavior into their awareness
When the analyst proposes their hypothesis of the unconscious meaning that relates each aspect of the client’s communication with the other
Transference refers to the repetition of unconscious conflicts rooted in the client’s relational past in the relationship with the analyst. Transference analysis involves tracking elements of the client’s verbal and nonverbal communications that aim to influence the analyst’s behavior toward the client (Racker, 1982).
For example, a client with a history of childhood trauma may begin to relate to the analyst as a threatening or predatory authority figure by expressing suspicion of the analyst’s motives, missing sessions, or becoming angry with the analyst.
The analysis of a client’s transference is an essential component of psychoanalysis and is the main driver of change during treatment. It provides the raw material that informs an analyst’s interpretations (Racker, 1982).
Technical neutrality refers to the analyst’s commitment to remain neutral and avoid taking sides in the client’s internal conflicts. The analyst strives to remain neutral and nonjudgmental by maintaining a clinical distance from the client’s external reality.
Additionally, technical neutrality demands that analysts refrain from imposing their value systems on the client (Kernberg, 2016).
Technical neutrality can sometimes seem like indifference or disinterest in the client, but that is not the goal; rather, analysts aim to serve as a mirror for their clients, reflecting clients’ own characteristics, assumptions, and behaviors back at them to develop a client’s self-awareness.
Countertransference refers to the analyst’s responses and reactions to the client and the material they present during sessions, most especially the client’s transference.
Countertransference analysis involves tracking elements of the analyst’s own dispositional transference to the client that is co-determined by the client (Racker, 1982).
Countertransference analysis enables the analyst to maintain clinical boundaries and avoid acting out in the relationship with the client.
Following on from the example given above, an analyst working with a client with a history of childhood trauma may respond to the client’s transference by feeling dismissive or contemptuous of a client that misses sessions or expresses suspicion.
However, countertransference analysis enables the analyst to understand that such feelings are a response to the client’s transference rooted in their past relational conflicts. The analyst’s feelings are then observed as material for interpretation rather than expressed (Racker, 1982).
Psychodynamic vs. Psychoanalytic Theory
Psychodynamic theory is an evolutionary offshoot of psychoanalytic theory and keeps key elements of the psychoanalytic theory of human development, psychological functioning, and therapeutic technique (Berzoff et al., 2008).
Psychodynamic theory agrees that clinical problems in adult life often originate in a client’s early relationships. It also considers a client’s current social context and their interactions with the immediate environment.
Both theoretical approaches agree on the following:
The existence of unconscious drives/instincts and defense mechanisms
The impact of the unconscious on human personality and behavior
The impact of internal factors on behavior, meaning behavior is never under a client’s complete control (Berzoff et al., 2008)
It may be helpful to further distinguish between the two by providing some examples of the differences and similarities in clinical approach.
First, both the psychoanalyst and the psychodynamic therapist work with transference and countertransference. In fact, any therapeutic approach that acknowledges and works with transference and/or countertransference may be termed psychodynamic, in part (Shedler, 2010).
Therefore, a psychodynamic therapist attends to their client’s communications to detect how deep-rooted unconscious conflicts may contribute to problematic behaviors, thoughts, and feelings in the present.
However, they also attend to the here-and-now social context of a client’s life to understand how real-world situations such as poverty, grief, abuse, violence, racism, sexism, and so on contribute to a client’s suffering (Berzoff et al., 2008).
A psychoanalyst will see their client (termed a patient, usually) every weekday over an indeterminate period of years. Meanwhile, a psychodynamic therapist will see a client less frequently, perhaps once or twice a week for several months or a few years, depending on the client’s needs. Psychodynamic therapy is more client centered in this respect (Berzoff et al., 2008).
A psychodynamic therapist may include techniques that are not psychoanalytic to work with transference and countertransference. These may include communication skills, such as active listening, empathy, and expressive arts interventions. Psychodynamic therapists are not limited in their approach by the traditional pillars of psychoanalytic technique mentioned above (Shedler, 2010).
A psychoanalyst works with their client on a couch to encourage regression and access unconscious material (Pick, 2015), while a psychodynamic therapist works face to face with a client sitting upright.
Now that we’ve clarified the differences between psychodynamic and psychoanalytic therapy, let’s look at the difference between psychoanalysis and psychotherapy overall.
Psychoanalysis vs. Psychotherapy
A psychoanalyst has a particular set of skills gained from their specific psychoanalytic training. Meanwhile, psychotherapists can train in a range of therapeutic modalities, including psychodynamic, cognitive-behavioral, humanistic, or integrative approaches (Wampold, 2018).
However, both professions focus on helping people via talk therapy. Both use their skills to help their clients gain insight into their inner worlds, address their psychological problems, and heal.
In fact, a psychoanalyst is a type of psychotherapist who specializes in psychoanalysis. Therefore, every psychoanalyst is also a psychotherapist, but not every psychotherapist is a psychoanalyst (Wampold, 2018).
Psychoanalysis Test: The Freudian Personality Test
If you’re interested in taking a quick and easy test to determine your personality type according to classical psychoanalytic theory, then consider taking the Freudian Personality Style Test from the Individual Differences Research Labs.
Although you’ll need to consult a psychoanalyst for a more valid and reliable classification, this test can give you an idea of how psychoanalysts conceptualize personality.
The test is composed of 48 items rated on a five-point scale from Disagree to Agree. The results are in the form of scores ranging from 0% to 100% across eight personality types:
To understand more about Freud’s theory of psychosexual development and how it relates to personality, check out the video below.
Sigmund Freud's Psychoanalytic Theory Explained
Criticisms of Psychoanalytic Theory
Although psychoanalytic theory laid the foundations for much of modern psychology, it is not without flaws. Psychoanalysis is still practiced today, and psychoanalytic theory has since been updated because of our improved understanding of human behavior, neuroscience, and the brain (Frosh, 2016).
However, serious criticisms of the theory and its applications remain (Eagle, 2007).
The major criticisms include the following:
Many of the hypotheses and assumptions of psychoanalytic theory cannot be tested empirically, making it almost impossible to falsify or validate.
It emphasizes the deterministic roles of biology and the unconscious and neglects environmental influences on the conscious mind.
Psychoanalytic theory was deeply rooted in Freud’s sexist ideas, and traces of this sexism still remain in the theory and practice today.
It is deeply Eurocentric and unsupported cross-culturally and may only apply to clients from Western Judeo–Christian and secular cultures.
Freud emphasized pathology and neglected to study optimal psychological functioning.
The theory was not developed through the application of the scientific method, but from Freud’s subjective interpretations of a small group of patients from a specific cultural background and historical period (Eagle, 2007).
Given these valid criticisms of psychoanalytic theory, it is wise to approach Freud and his theories with skepticism.
Although his work formed the foundations of modern psychology, it did not develop from a scientifically validated evidence base and is not falsifiable. Therefore, Freud’s students and followers have borne the burden of attempting to provide evidence to support the scientific and clinical validity of psychoanalysis.
A Take-Home Message
While Freud’s classical psychoanalytic theory and traditional clinical technique have earned widespread criticism for their lack of a scientific evidence base or testability, the explanatory power of psychoanalytic theory has become part of popular culture in the West.
For example, we all know about the Freudian slip and generally accept that people often remain “unconscious” of certain aspects of themselves, their motives, behavior, and the impact they have on others.
Various defense mechanisms have become part of the everyday language of popular psychology, such as denial, repression, and projection.
There is also no denying that Freud’s interpretation of dreams has led to the widespread belief that our dreams actually mean something, rather than just being a series of random events that occur when we’re sleeping.
Meanwhile, the central therapeutic concepts of transference and countertransference have informed a widely accepted psychodynamic understanding of relationships, especially in health and social care settings. These ideas have also informed the development of safeguarding practices that uphold professional boundaries.
Some of Freud’s ideas may seem eccentric and of their time, but his legacy is far reaching and has influenced areas of thought far beyond the clinical practice of psychoanalysis.
Berzoff, J., Flanagan, L. M., & Hertz, P. (2008). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts. Jason Aronson.
Breuer, J., & Freud, S. (2001). Studies on hysteria. In J. Strachey (Trans., Ed.), Complete psychological works of Sigmund Freud, Vol. II (1893–95). Vintage. (Original work published 1895)
Burgo, J. (2012). Why do I do that? Psychological defense mechanisms and the hidden ways they shape our lives. New Rise Press.
Eagle, M. N. (2007). Psychoanalysis and its critics. Psychoanalytic Psychology, 24(1), 10–24.
Frosh, S. (2016). For and against psychoanalysis. Routledge.
Gay, P. (2006). Freud: A life for our time. W. W. Norton.
Gaztambide, D. J. (2021). A people’s history of psychoanalysis: From Freud to liberation psychology. Lexington Books.
Kernberg, O. (2016). The four basic components of psychoanalytic technique and derived psychoanalytic psychotherapies. World Psychiatry, 15(3), 287–288.
Racker, H. (1982). Transference and countertransference. Routledge.
Pick, D. (2015). Psychoanalysis: A very short introduction. Oxford University Press.
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109.
Wampold, B. E. (2018). The basics of psychotherapy: An introduction to theory and practice. American Psychological Association.
About the author
Jo Nash, Ph.D., is a writer, editor, and writing coach. Jo obtained her Ph.D. in Psychotherapy Studies from the University of Sheffield, where she was a Lecturer in Mental Health at the Faculty of Medicine for over a decade.
Today, Jo combines her passion for language with mindfulness skills when coaching writers to help them cultivate flow and optimize productivity. She is the creator of the ‘focused flow’ approach to writing coaching.