Psychoanalysis
Core Mechanism
Insight into unconscious conflicts + transference interpretation + corrective emotional experience reorganizes relational patterns
Ontology
Unconscious conflict between drives, defenses, and internalized relationships
Therapeutic Voice
"What comes to mind when you notice that feeling?"
View of the Person
A divided subject driven by unconscious forces it cannot directly access
Evidence
NICE: long-term PDT considered for complex depression
Limited RCTs (treatment length); naturalistic studies
Leichsenring & Rabung (2008) meta-analysis of LTPP
Difficult to study via RCT. Umbrella review (Leichsenring et al., 2023) found moderate evidence for PDT broadly.
Conditions
Epistemology
Blind Spots
May neglect behavioral activation and symptom stabilization while pursuing insight; long timeframes can delay relief
Contraindications
Active psychosis, acute suicidality, active substance dependence requiring stabilization, severe cognitive impairment, clients needing immediate symptom relief or crisis intervention
Training
Psychoanalytic institute training (4-7 years), personal analysis required
APsaA; IPA member institutes
2,000+ hrs didactic + 300+ supervision + personal analysis
$40K-100K+
Philosophical Roots
Freud; Nietzsche (drives beneath reason); Schopenhauer (will as unconscious force); Ricoeur (hermeneutics of suspicion); Klein, Bion, Winnicott (object relations)
Related Modalities
Clinical Vignettes
See how Psychoanalysis formulates these cases:
Test Yourself
What is the fundamental rule of psychoanalysis?
Show answer
Free association — say whatever comes to mind without censoring.