Psychoanalytic psychotherapy is a derivative of psychoanalysis. For that reason, it may be helpful to read what I have written about psychoanalysis before reading my description of psychoanalytic psychotherapy.

There are many varieties of “psychotherapy” available in the marketplace. Many focus upon changing behavior (e.g., “behavior therapy”) or thinking (e.g., “cognitive therapy” or “cognitive-behavioral therapy,” which also is known as “CBT”). Psychoanalytic psychotherapy tends to give more weight to feelings and to the kind of thinking that goes on beneath the surface of the mind than these other techniques do. By taking and applying some of the insights gleaned from more intensive psychoanalytic work, the psychoanalytic psychotherapist tries to provide fairly rapid, problem-centered assistance to patients. This kind of work can truly be very helpful and many patients find that it meets their needs very well.

As in psychoanalysis, the goal in psychoanalytic psychotherapy is to become familiar with one’s own mind – and especially with those levels of the mind that often stay beneath the surface. In psychotherapy patients usually meet with their therapists face-to-face (instead of lying on a couch) once or twice a week (instead of every day). This reduced frequency of meetings means that it is usually more difficult or takes longer to develop the depth of understanding that one strives for in psychoanalysis. However, realistic limitations (of time and/or money) often make psychoanalytic work impracticable.

In psychotherapy the focus tends, not surprisingly, to be more on the here and now events of everyday life than upon the ways in which unconscious fantasies from the past continue to operate in the present. Fortunately quite a lot can be learned from a focus upon one’s current life and its complications and conflicts.

The goals of psychotherapy tend to be somewhat more limited than those of psychoanalysis; patients often  are seeking relief from a current stress or conflict rather than help with long-standing and ingrained patterns of behavior and feelings that have proven to be costly and resistant to change.

Some of the avenues available in psychoanalysis – e.g., transference and dream interpretation – are less prominent in psychoanalytic psychotherapy. Nonetheless, they are not completely absent and can play an important part in this less intensive work.

It probably is fair to say that, in psychoanalytic psychotherapy, there tends to be more activity on the part of both the patient and the therapist than in psychoanalysis. Put another way, while in psychoanalysis the therapist might hold back and wait for issues to arise of their own accord and in their own time, in psychotherapy a therapist  might do a bit more prodding of the patient. A therapist might tend to give more advice to his patient when doing psychotherapeutic work than he or she would in an analysis. The patient might be more problem-focused, too: There tends to be more talk about symptoms and behaviors than about wishes and fantasies.

Despite these differences, psychoanalytic psychotherapy requires much the same commitments from both patient and therapist regarding consistency and confidentiality as are required in psychoanalysis. Sessions are held at regular times and in regular places. Issues discussed in psychoanalytic psychotherapy remain confidential within the relationship between the two partners. Patients are asked to speak as openly as possible about whatever is troubling them, voicing even those thoughts that may seem silly or irrelevant. The therapist pays close and respectful attention to everything that goes on, looking for the patterns that may help the two partners unblock avenues that have been unavailable to the patient.

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