What Is Psychotherapy And How Does It Work?

What Is Psychotherapy?

Commonly termed ‘Psychoanalytic Therapy’, this ‘talking’ therapy is used in the treatment of mental disorders. Psychoanalytic therapy is based on Sigmund Freud’s principles of psychoanalysis, introduced and developed in the early twentieth century. According to Freud, much of our behavior is influenced by unconscious motives, and the key to understanding our current actions can be found by exploring our childhood experiences. Freud’s theory asserts that mental disorders originate from unconscious, and unresolved, conflicts arising during this critical period of development. Those receiving psychoanalytic therapy usually have weekly therapy sessions, sometimes over an extended period.


Freud believed neuroses, such as anxiety disorders, occur because three parts of the mind are in conflict – the ego (rational mind); the id (sexual and basic instincts); and the superego (conscience). Mostly rooted in early childhood experience, these feelings are forced from the conscious to the unconscious mind via a process of repression. In Freud’s view, adults with major personal problems tend to exhibit regression – moving backwards to child-like states of fixation. In such cases, Freud argued that the adult must be helped to access and face up to whatever emerged from the unconscious in a process he termed insight. The three principal methods used to discover repressed ideas, and thus gain insight, are: hypnosis, free association and analysis of dreams.


This was the first psychoanalytic method used by Freud. Working with his colleague, Breuer, Freud treated a woman (Anna O) with symptoms of hysteria. Under hypnosis, a repressed memory emerged concerning guilt about her wish to be dancing instead of nursing her dying father. After discovering this repressed memory, Anna O’s symptoms were relieved.

Sigmund FreudLicense: Creative Commons image source

Over time, Freud came to rely less on hypnosis, in part because some people were difficult to hypnotize; and because those undergoing hypnosis became ultra-suggestible, and thus recalled memories could be unreliable.

Free association

In this simple method, the subject is repeatedly prompted by the therapist to say the first thing that comes to mind. During this exchange, it is hoped such free association will reveal emerging fragmentary elements of repressed memories. Where the subject resists such prompting and refuses to freely disclose thoughts, it could be argued the technique is proving ineffective. However, such resistance (e.g., long pauses) can indicate the subject’s thinking is focused on important repressed ideas, in turn suggesting the therapist should prompt further.

Dream analysis

Freud’s theory of dreams made a distinction between the manifest content (the actual dream) and the latent content (the deeper, repressed ideas). He believed the mind normally censors repressed material but is less inclined to do so during sleep – an idea supported by later theorists who think dreams symbolize and express underlying ideas.

Dream analysis is conducted by the therapist. According to Freud, each dream interpretation is one small piece of a larger jigsaw puzzle. Interpretations from multiple free association and dream analysis sessions will gradually converge to form a coherent picture which, like a jigsaw puzzle, can only fit together one way.


To be effective, therapy must enable a subject to both access repressed ideas and re-experience the feelings associated with unresolved problems. In this process, the subject transfers onto the therapist powerful emotions previously directed towards his/her own parents (or highly significant others). Crucially, the therapist provides an empathetic, non-judgmental environment, allowing the subject freedom to reveal and express repressed feelings. For the subject, the therapist’s neutrality signals that these emotions arise from repressed memories, and not from the therapy. This sharing of burdens helps the subject come to terms with repressed ideas and conflict.

Lacanian Psychoanalysis

Not all psychoanalysts practice Freud’s psychoanalytical theories, for example, Lacanian Psychoanalysis follows the theories of Jacques Lacan, a French psychoanalyst who argued that some of Freud’s theories were incorrect. Lacan created his own school of Psychoanalysis, and although Lacanian psychoanalysis is largely based on Freudian psychoanalysis, there are numerous disparities with Freuds theories regarding the development and thought processes of the human mind.






This article was written by Nick Davison, Nick writes about Lacanian Psychoanalysis and medical science.

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