Freudian Therapy: How Does Psychoanalysis Work?

Freudian therapy, also called psychoanalytic therapy or psychoanalysis, is an approach to mental health treatment that dates back to the early 20th century. While its creator, Sigmund Freud, may be seen as a controversial figure, some of his theories and tools have been updated and are still used today in some form. Understanding what psychoanalysis is, the concepts it’s built on, and what it may help with may be useful in determining whether it’s the right type of care for you. If you’re not sure what type of care you might benefit from but are looking for support, consider meeting with a general in-person or online therapist for guidance.

What is Freudian therapy?

The American Psychological Association (APA) defines Freudian therapy, more commonly known as psychoanalysis, as “an approach to the mind, personality, psychological disorders, and psychological treatment originally developed by Sigmund Freud at the beginning of the 20th century.” The APA notes that this approach presumes that “much mental activity is unconscious and that understanding people requires interpreting the unconscious meaning underlying their overt, or manifest, behavior.”

Over time, psychoanalysis may help a person understand why they think or behave the way they do, which may be the first step toward addressing many different types of challenges. The core framework of psychoanalysis was created by Sigmund Freud, an Austrian neurologist born in 1856, though other researchers and experts have refined the method over time.

Psychoanalysis and many other types of talk therapy may be available online. A platform like BetterHelp can get you connected to a licensed therapist, virtually.

Core ideas behind Freud’s work

Psychoanalysis is built on a few key psychological principles that Freud developed or refined. The three parts of human personality (ego, superego, and id) and the subconscious mind are two of these key ideas behind Freud’s work.

The ego, the superego, and the id 

Freud is well-known for his personality theory, which proposes that the human personality is composed of three different parts: the superego, the ego, and the id. According to the American Psychoanalytic Association, the id can be considered an animalistic instinct that controls all of our most primal urges. The superego may be viewed as the source of all our moral ideals. Meanwhile, the ego may compromise or mediate between the other two.

The id isn't generally seen as bad or wrong; it's simply filled with thoughts, feelings, and childlike impulses that usually do not consider consequences or planning and could occasionally lead to poor choices and self-destructive behaviors. As a result, according to Freud’s ego psychology, each individual may need to learn to control the id to live in society appropriately.

The subconscious or unconscious mind

One of the most significant contributions of Sigmund Freud to the field of psychology may be the idea of the subconscious or unconscious mind.

He also believed that the conscious mind might grow and change with us, but that the subconscious mind may be formed primarily during early childhood and, therefore, can only be reached in adulthood through psychoanalytic approaches. In his way, he proposed, early childhood experiences may influence behavior in adulthood.

Freud believed that understanding and truly controlling the conscious mind may require understanding the subconscious mind. Tapping the subconscious mind could be difficult, according to him, but not impossible. Helping the patient understand their subconscious mind was a core goal of Freud’s psychoanalytic technique. He believed this could be done by interpreting how the individual made sense of the world, both waking and sleeping.

Other well-known concepts from Freud’s work

Defense mechanisms are another well-known concept from Freud’s body of work. These psychological aspects were then further researched and clarified by his daughter, Anna Freud. She defined them as “unconscious resources used by the ego,” often to manage underlying emotional conflicts. Examples of common defense mechanisms that may influence behavior in various ways include:

• Avoidance
• Denial
• Projection
• Repression

Finally, many people also associate Freud with the concept of the Oedipus complex, which proposes that children have an innate sexual desire for their parent of the opposite sex during one stage of development. However, there is significant controversy about this theory in modern psychology for many reasons—because it can be seen as male-centric and heteronormative, and because it lacks significant empirical evidence, for example.

The impacts of Freud’s work on clinical psychology today

While not all of Freud’s theories are widely accepted today, his work laid the foundation for several aspects of modern clinical psychology. For example, John Bowlby’s attachment theory may have stemmed from, at least in part, his issues with Freud’s object relations theory and other views on early childhood relationships. Harry Stack Sullivan, who devised the approach of interpersonal psychoanalysis, is said to have built off of Freud’s theories. In addition, updated versions of Freud’s traditional psychoanalysis techniques are still practiced by many clinicians today.

Common techniques used in Freudian psychoanalysis

The framework of psychoanalysis may be considered another of Freud’s most impactful contributions to modern psychology, since a version of it is still used by many mental health professionals today. Free association, transference analysis, and dream interpretation are three of its key components.

Free association 

Free association is a technique Freud created that is still used by some psychotherapists today. Word association is one of its simplest forms, where the psychoanalyst gives the client a word and asks them to share the words, concepts, or emotional responses that come to mind in relation to it. The Rorschach test is another form of free association, which works similarly but involves showing the client several inkblot images rather than giving them a single-word prompt. Either way, the psychoanalyst’s aim is to uncover any subconscious associations between the prompt and the client's response, which may point to underlying emotional conflicts or unconscious ideas.

Transference analysis

According to Freud, transference is when a patient attaches or redirects their feelings, frustrations, anger, or symptoms toward their therapist. It may be viewed as a kind of projection in which repressed emotional responses and resulting behaviors get transferred from the original source (such as a parent) to someone else (in this case, the analyst). Transference analysis is when the psychoanalyst evaluates how the way the patient behaves and expresses themselves in the therapeutic relationship may reflect their early relational patterns and experiences.

Dream interpretation

Freud generally believed that dreams were another window into unconscious wishes or feelings but that they had a language of their own. Learning about what the subconscious has to say through dreams, he believed, can require learning to speak that language.

Much of that language was deciphered not by Freud, but by his student, colleague, future rival, and later successor, Carl Jung. Jung studied dreams and broke them down into recurring themes and symbols which, he noticed, tended to have similar significance to people regardless of which culture they were raised in. Both Freud and Jung believed dreams could be used to understand and guide our current behavior and interpersonal relationships. If you’re looking to discuss your dreams, address nightmares, or get another type of emotional and mental health support, online therapy may be a convenient option for care.

What can Freudian therapy sessions help with?

Modern versions of Freudian therapy (psychoanalysis) may help improve self-understanding and promote positive behavior change. It may be used to treat a variety of mental health challenges, including but not limited to: 

• Depression
• Anxiety
• Eating disorders
• Post-traumatic stress disorder
• Obsessive-compulsive disorder
• Relationship challenges
• A harsh inner critic
• A lack of purpose 

This form of treatment may sometimes be used in conjunction with others, like additional forms of therapy and/or medication.

Psychoanalysis vs. cognitive behavioral therapy

If you're interested in receiving psychoanalysis, consider consulting with a mental health professional for advice on whether this approach may be right for your needs. In some cases, they may recommend a different approach before, instead of, or in addition to Freudian psychoanalysis. 

For example, cognitive behavioral therapy (CBT) is an evidence-based practice that’s widely used for a variety of mental health challenges. Instead of deeply exploring any relational or childhood roots of a person’s concerns, CBT focuses more on teaching the skillset of recognizing and then shifting distorted thoughts that may be contributing to symptoms. Both CBT and psychoanalysis may be used to treat similar concerns; the right modality for you may depend on your unique needs and situation.

How Freudian therapy sessions work in practice

Psychoanalysis sessions have some similarities to other types of talk therapy sessions. You’ll meet with a therapist—often more than once a week—to have a conversation that they guide using the principles of this method. With psychoanalysis, this usually means the therapist providing minimal guidance, instead letting you discuss whatever’s on your mind and seeing where associations can be made. 

For example, they may observe patterns in the way you think or what you talk about that could indicate a certain subconscious tendency, which the two of you can then work together to address. Over time, this approach may help you learn more about yourself, your experiences, and your patterns. The process may also help you address symptoms of certain mental health conditions or life challenges like relationship conflict or a lack of purpose. 

The importance of the therapeutic relationship

Research suggests that having a stable, trusting relationship between a therapist and a client can be important for effective therapy, and this may be especially true with psychoanalysis. For instance, it’s possible for dynamics from a person’s childhood relationships to manifest in how they engage with the therapist, and a strong connection may help the therapeutic process continue in a healthy and effective way in such cases.

How to find support: In-person and online options

A first step toward receiving mental health support can be to decide whether you would prefer online or in-person care. If you prefer in-person sessions, you might ask for a list of covered providers through your insurance company or do an internet search for clinicians who practice nearby. You might also explore an online directory, filtering for your location and the type of provider you’d like to work with. If you're looking for psychoanalysis, keep in mind that some providers may require in-person visits, while others may offer online options.

If you prefer to work with a provider virtually, you might consider using an online therapy platform like BetterHelp. This service can match you with a licensed mental health professional according to the needs and preferences you outline in your onboarding questionnaire, which may make finding a therapist easier. Once you’ve been matched, you can connect with your provider remotely, via phone, video, or live chat—no commuting required.

Does online therapy really work?

A growing body of research points to online therapy as a potentially effective form of mental health care. For example, one study suggests that virtual talk therapy sessions may be “no less efficacious” than in-person sessions.

What to look for in a therapist

Since the quality of the therapeutic relationship can be tied to therapy outcomes, finding the right professional for you may be important. Regardless of the type of therapy you’re looking for, it might help to look for a provider who:

• Is experienced in the area(s) you need help with
• Holds a relevant degree, training, and licensure
• Makes you feel emotionally safe, heard, and supported 

If the first provider you meet with doesn’t seem like the right fit for you, it’s okay to switch. It can be common to consult with a few therapists before finding one who meets your needs. With BetterHelp, you can switch therapists at any time for no additional cost until you find the right match.