The Psychoanalytic Lineage
From Freud to contemporary relational and integrative practice
Clinical and evidence statements in this lineage remain under review. The source checks below apply only to their stated treatment, population and outcome.
Guideline sources for approaches in this lineage
Psychoanalysis
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Discussed in the source
NG222 names STPP, not classical long-term psychoanalysis. The distinction in the current text is supported.
Scope: Adults with depression; empirically validated short-term protocols
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives psychodynamic therapy a neutral recommendation for PTSD. The category does not independently establish findings for every psychodynamic protocol.
Scope: The psychodynamic-therapy category for adult PTSD; no separate grade for this specific approach.
Short-Term Psychodynamic
Guidelines and official sources (9)
9 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Recommendation for the stated population
STPP is a named option using empirically validated depression protocols.
Scope: Adults with less or more severe depression
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
The Dutch guideline separately names short-term psychodynamic psychotherapy for avoidant personality disorder.
Scope: Avoidant personality disorder
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives psychodynamic therapy a neutral recommendation for PTSD. The category does not independently establish findings for every psychodynamic protocol.
Scope: The psychodynamic-therapy category for adult PTSD; no separate grade for this specific approach.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests short-term psychodynamic psychotherapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes short-term psychodynamic psychotherapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Clinical Practice Guideline for the Management of Chronic Multisymptom Illness
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against psychodynamic therapies for CMI with IBS symptoms. It discusses brief treatment courses but does not separately grade every psychodynamic protocol.
Scope: Brief psychodynamic treatments studied in IBS within the chronic multisymptom illness guideline.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports insufficient evidence for this category. The statement does not separately evaluate every short-term psychodynamic protocol.
Scope: Adults with PTSD; the psychodynamic-therapy category versus no intervention or usual care.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Discussed in the source
APA lists psychodynamic therapies among comparable models; this does not separately grade every short-term protocol.
Scope: Adults with depressive disorders, excluding psychotic depression; the broad psychodynamic-therapy category.
- mhGAP: brief structured psychological treatment for depression
Recommendation for the stated population
WHO includes brief psychodynamic therapy among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
Mentalization-Based Tx (MBT)
Guidelines and official sources (3)
1 clinical guideline check · 1 research recommendations check · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- CG78: recommendations for research
Research recommendation
MBT is named as an example in a research question about structured psychological programmes. This is not a named recommendation to offer MBT in CG78’s clinical recommendations.
Scope: Comparative research on psychological programmes for people with BPD.
- CG78: 2018 surveillance, Appendix A
Discussed in the source
NICE surveillance explicitly notes that CG78 does not currently recommend MBT by name. Discussion of evidence is not a recommendation to offer it.
Scope: People with BPD
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
MBT is named among recommended specialist BPD treatments.
Scope: BPD; treatment delivered as described and studied
Transference-Focused (TFP)
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Treatment of patients with borderline personality disorder: Guideline Statements and Implementation
Discussed in the source
APA discusses TFP within structured psychotherapy for BPD. Statement 5 gives the structured-psychotherapy class a 1B recommendation; it does not assign TFP a separate grade.
Scope: Patients with BPD receiving literature-supported structured psychotherapy
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
TFP is named among recommended specialist BPD treatments.
Scope: BPD; protocol delivered as described and studied
Schema Therapy
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
Schema therapy is named among recommended specialist BPD treatments.
Scope: BPD; protocol delivered as described and studied
- Borderline personality disorder: recognition and management (CG78)
Discussed in the source
CG78 recommendations do not name schema therapy; general programme guidance does not create a named endorsement.
Scope: Psychological programmes for people with BPD
EFT for Couples
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Emotionally focused couples therapy
Discussed in the source
The archive gives Strong research support under 1998 criteria; it is not a CPG grade.
Scope: Relationship distress with a spouse or intimate partner
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD suggests couples-focused therapy as a category (weak for), without preferring a model. Assess partner involvement and safety; this is not a separate endorsement of this named protocol.
Scope: Adults with mild-to-moderate MDD and significant relationship distress.
IPT
Guidelines and official sources (15)
15 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Recommendation for the stated population
IPT is a named adult depression treatment option.
Scope: Adults with depression
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA does not select one adult psychotherapy monotherapy as superior. It includes IPT and specifically recommends IPT or CBT plus a second-generation antidepressant when combined treatment is chosen.
Scope: Adult depressive disorders excluding psychotic depression; bipolar disorder is outside the guideline scope. Initial monotherapy choice or combined treatment.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against IPT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD strongly recommends offering IPT for prevention in this at-risk population. Treatment of an existing depressive episode is addressed separately.
Scope: Pregnant patients at risk of perinatal depression; individual or group delivery.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD strongly recommends IPT for treating perinatal depression.
Scope: Depression during pregnancy or postpartum.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD weakly suggests psychotherapy, naming IPT as an example, or yoga or both for this population.
Scope: Anxiety symptoms during or after pregnancy.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests interpersonal therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes interpersonal therapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests IPT during continuation treatment to reduce relapse or recurrence (weak for). CBT, IPT and MBCT are not ranked against one another.
Scope: Remitted MDD with high risk of relapse or recurrence.
- Management of Bipolar Disorder
Discussed in the source
VA/DoD suggests interpersonal and social rhythm therapy alongside medication (weak for). That combined protocol is distinct from IPT alone.
Scope: Adults with bipolar I or II who are not acutely manic.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against IPT in this comparison.
Scope: Adults with PTSD; IPT versus no intervention or usual care.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA recommends IPT-A as an initial psychotherapy option.
Scope: Adolescents with depressive disorders; the adolescent adaptation IPT-A, excluding psychotic depression.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA recommends combined treatment, favoring a second-generation antidepressant on tolerability grounds.
Scope: Adults aged 60 or older with MDD; combined medication and IPT versus IPT alone.
- mhGAP: brief structured psychological treatment for depression
Recommendation for the stated population
WHO strongly recommends structured psychological interventions including IPT for this population, based on moderate-certainty evidence.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally recommends considering IPT, with low-certainty evidence. The 2023 edition retains the 2015 recommendation because eligible new evidence was insufficient; suitability requires an individual assessment.
Scope: People living with dementia and mild-to-moderate depression.
Supportive Psychotherapy
Guidelines and official sources (5)
5 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Psychosis and schizophrenia in adults: prevention and management (CG178)
Recommendation against the stated use
NICE advises against routinely offering supportive psychotherapy as a specific intervention, while taking preferences and availability of other therapies into account.
Scope: Adults with psychosis or schizophrenia.
- Practice Guideline for the Treatment of Patients With Schizophrenia
Recommendation for the stated population
The American Psychiatric Association suggests supportive psychotherapy (2C). Its recommendation differs from NICE’s advice on routine use; the original statement was checked through the issuer’s indexed text.
Scope: Patients with schizophrenia.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD finds insufficient evidence for or against supportive counseling for PTSD; the recommendation does not individually assess every supportive-psychotherapy model.
Scope: Supportive counseling for adults with PTSD.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests considering non-directive supportive therapy in this defined situation (weak for). The recommendation does not make it the default first-line treatment.
Scope: Mild-to-moderate MDD; medication declined and first-line psychotherapy declined or inaccessible.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Discussed in the source
APA includes supportive therapy among broadly comparable models without selecting a superior monotherapy.
Scope: Adults with depressive disorders, excluding psychotic depression; initial monotherapy selection.
Relational Psychoanalysis
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Discussed in the source
The recommendation concerns a specified treatment format. It does not separately identify relational psychoanalysis.
Scope: Short-term psychodynamic psychotherapy for adults with depression.
Emotion-Focused Therapy
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Emotion-focused therapy for depression
Discussed in the source
The archive rates this treatment Modest under its 1998 criteria, with 2015 re-evaluation pending. This is an evidence-registry rating.
Scope: Emotion-focused therapy for depression
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports insufficient evidence versus no intervention or usual care for this specific variant, rather than every emotion-focused therapy.
Scope: Adults with PTSD; the emotion-focused imaginal-confrontation intervention reviewed by the panel.
Attachment-Focused EMDR
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
The recommendation specifies EMDR delivered using a validated manual. It does not name attachment-focused EMDR or validate automatic transfer to this adaptation.
Scope: EMDR for adult PTSD after non-combat trauma; validated manual required
Child-Parent Psychotherapy
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Child-Parent Psychotherapy: program ratings
Not a treatment recommendation
CEBC rates CPP 1 for infant and early-childhood mental health, and 2 for child/adolescent trauma and domestic-violence services. These are topic-specific registry ratings, not clinical guideline recommendations.
Scope: Children aged 0–5 who have experienced trauma and their caregivers.
- Children’s attachment (NG26)
Discussed in the source
NICE says to consider parent–child psychotherapy based on the Cicchetti and Toth model. This specified model should not be assumed equivalent to every intervention called CPP.
Scope: Preschool attachment difficulties where parents have maltreated or are at risk of maltreating their child; safeguarding concerns must be addressed.
DBT
Guidelines and official sources (9)
8 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Borderline personality disorder: recognition and management (CG78)
Recommendation for the stated population
NICE says to consider a comprehensive DBT programme for this specified population. This does not establish a recommendation for every personality disorder or every presentation.
Scope: Women with BPD for whom reducing recurrent self-harm is a priority.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
The 2024 guideline finds insufficient evidence for or against DBT for these outcomes. This recommendation is separate from NICE’s BPD recommendation.
Scope: Adults aged 18 and over at risk of suicide; DBT for reducing suicidal ideation, suicide attempts or suicide.
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
DBT is named among recommended specialist BPD treatments.
Scope: BPD; treatment delivered as described and studied
- Dialectical behavior therapy for BPD
Discussed in the source
The archive lists Strong under 1998 criteria, with 2015 re-evaluation pending; this is an evidence listing.
Scope: DBT for BPD
- Self-harm: assessment, management and preventing recurrence (NG225)
Discussed in the source
NICE says to consider the adolescent adaptation, DBT-A, for this specified self-harm population. This does not grade every DBT programme or suicide-related outcome.
Scope: Children and young people with significant emotional dysregulation and frequent self-harm
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against DBT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend one of these treatment arrangements over the other. This does not assess DBT for BPD.
Scope: Adults with PTSD; DBT plus PE versus DBT alone.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
DBT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give DBT a separate recommendation or separate certainty rating here.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO conditionally supports digital interventions based on approaches including DBT, with low-certainty evidence. This is not a recommendation for every full DBT program, and the reviewed trials did not establish benefit for attempts or deaths and were underpowered for those outcomes.
Scope: Digital support for people with suicidal thoughts.
ACT
Guidelines and official sources (18)
16 clinical guideline checks · 2 evidence registry checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Acceptance and commitment therapy for depression
Discussed in the source
The archive lists Modest under 1998 criteria, with 2015 re-evaluation pending. A registry entry does not establish a depression guideline recommendation.
Scope: ACT for depression
- Acceptance and commitment therapy for chronic pain
Discussed in the source
The archive lists Strong under 1998 criteria, with 2015 re-evaluation pending.
Scope: ACT for chronic pain
- Chronic pain (primary and secondary) in over 16s (NG193)
Recommendation for the stated population
NICE says to consider ACT or CBT for pain, delivered by appropriately trained professionals.
Scope: People aged 16 and over with chronic primary pain
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against ACT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Non-Surgical Management of Hip and Knee Osteoarthritis
Discussed in the source
The appendix names ACT as an optional psychosocial or behavioral intervention, guided by availability and patient preference. This is ungraded implementation guidance, not a separately graded osteoarthritis recommendation.
Scope: Conceptual approach to chronic primary (nociplastic) pain when self-management strategies are insufficient.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests acceptance and commitment therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes acceptance and commitment therapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Management of First-Episode Psychosis and Schizophrenia
Discussed in the source
VA/DoD suggests the acceptance/mindfulness therapy category (weak for) and explicitly includes ACT in its evidence discussion. It does not assign ACT a separate recommendation grade.
Scope: Adults with schizophrenia; psychotherapy combined with medication.
- Clinical Practice Guideline for the Management of Substance Use Disorders
Insufficient evidence for or against
The guideline reviews ACT studies and finds insufficient evidence for or against the broader mindfulness-based treatment category. This is a neutral finding for this substance-use scope.
Scope: ACT within the review of mindfulness-based treatments for substance-use disorders.
- Clinical Practice Guideline for Tobacco Use Treatment
Insufficient evidence for or against
The guideline discusses ACT and finds insufficient evidence to recommend a specific behavioral counseling approach over standard CBT. Its description of ACT is not a separate positive recommendation.
Scope: ACT compared with standard CBT for adult tobacco cessation.
- Diagnosis and Treatment of Low Back Pain
Discussed in the source
The review found no eligible ACT studies and identifies comparative ACT research as a priority. The CBT recommendation should not be presented as a separate ACT endorsement.
Scope: ACT evidence considered in the chronic low back pain review.
- Management of Headache
Discussed in the source
The recommendation is neutral for the mindfulness-based therapy category; the discussion includes ACT. It does not assign ACT a separate recommendation grade.
Scope: Mindfulness-based interventions for headache treatment or prevention.
- Tinnitus
Insufficient evidence for or against
VA/DoD names ACT among the interventions for which evidence is insufficient to recommend for or against treatment. The list is explicitly unranked.
Scope: Adults with bothersome tinnitus receiving ACT from a trained provider.
- Management of Adult Overweight and Obesity
Discussed in the source
ACT studies inform the weak recommendation for the cognitive behavioral intervention category. ACT receives no separate grade here; this is not an eating-disorder treatment recommendation.
Scope: Internalized weight bias and stigma in adult overweight/obesity care.
- Primary Care Management of Chronic Kidney Disease
Discussed in the source
The appendix names ACT among behavioral pain-management options, selected by availability and preference. This is ungraded guidance; much supporting evidence comes from people without kidney disease.
Scope: Adults with chronic kidney disease and chronic pain; self-management insufficient.
- Management of Type 2 Diabetes Mellitus
Discussed in the source
The review includes ACT within mindfulness/acceptance interventions. The graded recommendation concerns a stress-reduction programme category, without a separate ACT grade or established long-term benefit.
Scope: Adults with stress related to type 2 diabetes.
- Clinical Practice Guideline for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults
Insufficient evidence for or against
APA finds the evidence insufficient for a recommendation in these comparisons. This is not a finding of ineffectiveness.
Scope: Adults with chronic musculoskeletal pain; ACT versus active control or usual care.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
ACT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give ACT a separate recommendation or separate certainty rating here.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
Sigmund Freud (1856–1939) created the first systematic theory of the unconscious mind and the first "talking cure." His ideas — the unconscious, transference, defense mechanisms, the centrality of early experience — became the foundation for virtually every subsequent psychotherapy. But psychoanalysis did not remain a single school. Freud's students and their students diverged sharply, producing rival traditions that emphasize different mechanisms of suffering and change. Understanding these branches is essential for any therapist working with psychodynamic concepts.
Full Contents
Read all 21 entries as a single page
-
Sigmund Freud
Created psychoanalysis: free association, dream interpretation, transference analysis, the structural model (id/ego/superego). Proposed that unconscious conflict — especially around sexuality and aggression — drives psychopathology.
Concepts: The unconscious · Transference/countertransference · Free association · Defense mechanisms · Id/ego/superego · Oedipus complex · Repetition compulsion
-
Jungian / Analytical Psychology
Freud's earliest major defector. Proposed a collective unconscious populated by archetypes. Individuation — the integration of conscious and unconscious — as the central developmental task. Embraced mythology, symbolism, and spirituality.
Concepts: Collective unconscious · Archetypes (Shadow, Anima/Animus, Self) · Individuation · Active imagination · Psychological types · Complexes
Relation: Broke with Freud in 1913 over the nature of libido and the role of spirituality. Freud saw Jung's interests as mystical regression; Jung saw Freud's theory as reductively sexual.
-
Adlerian / Individual Psychology
First major defection from Freud. Replaced sexuality with social interest and inferiority/superiority as core motivations. Emphasized lifestyle, birth order, early recollections, and the creative self. Proto-cognitive and proto-systemic.
Concepts: Inferiority complex · Striving for superiority · Social interest (Gemeinschaftsgefühl) · Lifestyle · Birth order · Fictional finalism
Relation: Left Freud's circle in 1911. Anticipated cognitive therapy (private logic), family systems (birth order), and humanistic psychology (creative self). Underrecognized influence.
-
Ego Psychology
Shifted focus from the id to the ego's adaptive functions. Emphasized defense analysis, adaptation, and autonomous ego functioning. Dominated American psychoanalysis from 1940s–1980s.
Concepts: Defense mechanisms (systematic) · Adaptive ego functions · Conflict-free sphere · Developmental lines · Neutralization
Relation: Freud's structural model taken to its logical conclusion — the ego as mediator, adapter, synthesizer. More systematic and 'scientific' than Freud, but criticized as too cognitive and detached.
-
Object Relations (British)
Shifted from drives to relationships as primary. We are shaped not by instincts but by internalized patterns of relating — "internal objects." Klein emphasized early phantasy; Fairbairn argued libido is object-seeking, not pleasure-seeking; Winnicott gave us the good-enough mother, transitional space, true/false self.
Concepts: Internal objects · Splitting · Projective identification · Good-enough mother · Transitional space · True self / false self · Paranoid-schizoid / depressive positions
Relation: The most radical departure from Freud within the British tradition. Replaced drive theory with relational theory decades before the Americans. Klein stayed close to Freud's timeline but transformed the content; Fairbairn and Winnicott broke more decisively.
-
Interpersonal Psychoanalysis
Psychiatry is the study of interpersonal relations. Sullivan replaced intrapsychic with interpersonal — personality is the pattern of one's relations with others. Emphasized anxiety as the core signal of interpersonal threat.
Concepts: Participant-observation · Parataxic distortion · Security operations · Self-system · Interpersonal anxiety · Detailed inquiry
Relation: American alternative to ego psychology. Sullivan was influenced by social science and pragmatism, not Freud's metapsychology. Bridge between psychoanalysis and interpersonal/relational thinking.
-
Lacanian Psychoanalysis
"Return to Freud" through structural linguistics. The unconscious is structured like a language. Desire is constituted by lack. The subject is split between conscious speech and unconscious truth. Dominated French and Latin American psychoanalysis.
Concepts: The Imaginary / Symbolic / Real · Desire as lack · The Name-of-the-Father · Jouissance · The mirror stage · Objet petit a · Variable-length session
Relation: Lacan claimed fidelity to Freud while radically reinterpreting him through Saussure, Hegel, and topology. Rejected ego psychology as an American betrayal of psychoanalysis.
-
Attachment Theory
Bowlby integrated psychoanalytic object relations with ethology and systems theory. Attachment is a primary biological system. Internal working models of self-and-other formed in early relationships shape all subsequent relating.
Concepts: Secure base / safe haven · Internal working models · Attachment styles (secure, anxious, avoidant, disorganized) · Proximity seeking · Separation anxiety · Strange Situation
Relation: Bowlby was a British psychoanalyst who was effectively expelled by the Kleinians for bringing in biology. Attachment theory was initially rejected by analysts but eventually became foundational across modalities.
-
Self Psychology
Proposed that the self — not the ego — is the center of psychological life. Pathology arises from failures of empathic attunement (selfobject failures) rather than intrapsychic conflict. The therapist's empathic immersion is curative.
Concepts: Selfobject needs (mirroring, idealizing, twinship) · Narcissistic injuries · Empathic attunement · Transmuting internalization · Optimal frustration / optimal responsiveness · Selfobject transference
Relation: Kohut initially presented his ideas as extending Freud but eventually proposed self psychology as a replacement for conflict theory. Controversial because it seemed to eliminate the unconscious and aggression as central.
-
Short-Term Psychodynamic Therapies
Psychoanalytic concepts applied in time-limited formats. Focus on a central conflict, active interpretation, attention to the triangle of conflict (defense–feeling–anxiety) and triangle of persons (current–past–therapist).
Concepts: Core Conflictual Relationship Theme · Triangle of conflict · Triangle of persons · Central focus · Time limit as activating
Relation: Response to criticisms that analysis was too long and too expensive. Demonstrated that psychodynamic principles could work in briefer formats with comparable outcomes.
-
ISTDP
Intensive Short-Term Dynamic Psychotherapy. Extremely active, confrontational approach that pressures defenses to access underlying feeling. Works with the "unconscious therapeutic alliance" and aims for emotional breakthroughs.
Concepts: Triangle of conflict · Unconscious therapeutic alliance · Defense restructuring · Breakthrough to the unconscious · Graded pressure · Unlocking the unconscious
Relation: Direct descendent of short-term psychodynamic. Davanloo radicalized the active, confrontational stance. Most technique-driven of the psychodynamic therapies.
-
Interpersonal Therapy (IPT)
Time-limited therapy focused on interpersonal problems: grief, role disputes, role transitions, interpersonal deficits. Explicitly avoids transference interpretation and intrapsychic focus. Highly manualized and researched.
Concepts: Four interpersonal problem areas · Sick role · Communication analysis · Interpersonal inventory · Role playing
Relation: Descended from Sullivan's interpersonal psychiatry via Adolf Meyer. Deliberately stripped psychodynamic depth to create a researchable, manualized treatment. Ironic that it became one of the best-evidenced 'psychodynamic' approaches.
-
Ego State Therapy
Works directly with dissociated or semi-autonomous ego states using hypnotic and experiential methods. Bridged psychoanalytic structural theory with dissociation research.
Concepts: Ego states · Internal dialogue · Energy-based bridging · Executive ego state · Hidden observer
Relation: Drew on Federn's ego psychology and Janet's dissociation theory. Anticipated IFS and structural dissociation models. Bridge between psychoanalytic and hypnotic traditions.
-
Relational Psychoanalysis
Synthesized object relations, self psychology, interpersonal, and feminist theory into a new paradigm. Mutual influence between analyst and patient. The analyst's subjectivity is not an obstacle but a resource. Two-person psychology.
Concepts: Two-person psychology · Mutual recognition · Enactment · Intersubjectivity · Relational matrix · Analytic third · Negotiation
Relation: Mitchell's relational turn was an explicit break from both classical drive theory and ego psychology. Drew on nearly every post-Freudian tradition while rejecting one-person psychology.
-
Transference-Focused Psychotherapy (TFP)
Object relations-based treatment for borderline personality. Works with the split internal object relations that emerge in the transference. Systematic interpretation of primitive defenses (splitting, projective identification).
Concepts: Object relations dyads · Identity diffusion · Primitive defenses · Transference interpretation · Splitting · Treatment contract
Relation: Kernberg synthesized ego psychology with Kleinian object relations — his developmental model maps how internalized object relations become personality structure. TFP is the clinical application.
-
EFT / Emotionally Focused Therapy
Johnson's couples therapy integrates attachment theory with experiential and systemic approaches. Greenberg's individual EFT integrates process-experiential and emotion theory. Both focus on accessing and restructuring core emotional experience.
Concepts: Attachment injury · Negative interaction cycle · Primary/secondary emotion · Softening · Emotion schemes · Two-chair / empty-chair
Relation: Johnson applied Bowlby's attachment theory directly to couples distress. Greenberg integrated emotion-focused technique with psychodynamic understanding of emotional processing.
-
Mentalization-Based Treatment (MBT)
Focuses on developing the capacity to understand behavior in terms of mental states — one's own and others'. Designed for borderline personality. Integrates attachment theory, developmental psychology, and psychoanalytic thinking.
Concepts: Mentalization · Psychic equivalence · Pretend mode · Teleological stance · Epistemic trust · Alien self
Relation: Fonagy began as a psychoanalytic researcher who demonstrated that attachment security predicts mentalizing capacity. MBT operationalizes this into a manualized treatment.
-
Schema Therapy
Integrates cognitive therapy with object relations and attachment theory. Identifies "early maladaptive schemas" (stable, self-defeating patterns from childhood) and "schema modes" (moment-to-moment emotional states).
Concepts: 18 early maladaptive schemas · Schema modes · Limited reparenting · Schema domains · Healthy Adult mode · Schema perpetuation
Relation: Young was trained by Beck in CBT but found it insufficient for personality disorders. Schema therapy explicitly brings psychoanalytic developmental thinking into cognitive-behavioral framework.
-
IFS
Internal Family Systems. The mind naturally subdivides into "parts" — managers, firefighters, exiles — organized around a core Self. Therapy involves accessing Self-energy and unburdening wounded exile parts.
Concepts: Self · Parts (managers, firefighters, exiles) · Unburdening · Blending · Self-energy · Protective system
Relation: Schwartz came from family systems, not psychoanalysis, but IFS recapitulates object relations and ego state theory in accessible language. The 'parts' map onto internal objects; Self maps onto Winnicott's true self.
-
Attachment-Based Therapies
Clinical applications of Bowlby/Ainsworth: Circle of Security, Child-Parent Psychotherapy, attachment-focused EMDR. Focus on creating earned security through the therapeutic relationship or parent-child repair.
Concepts: Earned security · Reflective functioning · Rupture and repair · Shark music · Being with vs. fixing
Relation: Direct clinical applications of attachment theory. Represent the convergence of psychoanalytic, developmental, and neuroscience research into specific interventions.
-
AEDP
Accelerated Experiential Dynamic Psychotherapy. Integrates attachment theory, affective neuroscience, and transformational studies. Explicitly warm, affirming stance. Works with core affect and "transformational experience."
Concepts: Core affect · Transformance · Metaprocessing · Undoing aloneness · Healing affects · State transformation
Relation: Fosha drew on Davanloo's ISTDP but inverted the stance from confrontational to explicitly warm and affirming. Integrates attachment theory and positive psychology with experiential technique.