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Psychoanalytic Psychotherapy

What is Psychoanalytic Psychotherapy?

Psychoanalytic psychotherapy is typically depicted in movies as someone lying on a couch and free-associating while the therapist says “uhm-hum” and silently scribbles away on a notepad. Fortunately, this approach has evolved over the years since the early days of Freud, while retaining many of its key ingredients, such as the role of the unconscious, and defense mechanisms.

How does Psychoanalytic therapy work?

Free association:

Your therapist may encourage you to “say whatever comes to mind”, and may notice a pattern in the way that you link topics together (the associations that you make), or topics that you seem to avoid altogether.

Your therapist will discuss these links, gaps, and interpretations with you, to see if they have any relevance on your unconscious emotions, desires, or anxieties.

Attachment style:

This is the way that you typically relate to others, and is based on your early childhood experiences. There are 4 attachment styles: Secure, Anxious-Preoccupied, Dismissive-Avoidant, and Fearful-Avoidant.

Your therapist can help you to better understand your attachment style, so that you can learn how to develop relationships that feel safe and secure.


Interpersonal relationships always prone to misinterpretations, or projections. Meaning that the way we interpret what others say is filtered through our preconceived notions of others, which are often based on our early life experiences.

There may be times in therapy when you misperceive the therapist’s intentions. For example, if your therapist says “Nice shoes! Where did you get those?” They may mean “Nice shoes, you look great today, I’m happy you’ve been out of the house and shopping again” but you interpret it as “Nice shoes (sarcasm), did you get them at a bargain shop?”

By working through these types of misinterpretations you can come to understand that the way you “hear” others may sometimes be based on your past, rather than your present relationship with them. By understanding this, you can learn to really “hear” others in your life now, and form relationships based on what’s in front of you, instead of misinterpreting things based on a painful past.

Defense mechanisms:

Therapy can help you to gain awareness of your defense mechanisms, and to process the underlying conflicts or difficult emotional reactions that evoke them.

Defense mechanisms include things like: denial, projection, passive aggression, acting out, intellectualization, reaction formation, displacement, repression, rationalization, regression, splitting, displacement, humour, sublimation, suppression, altruism, anticipation.

Some defenses are almost always maladaptive (e.g., splitting), whereas others may be useful in certain contexts, and if used in a flexible, moderate manner (e.g., humour, suppression, sublimation).

Dream analysis:

Your dreams may be discussed so that themes can be explored and interpreted to uncover hidden thoughts, feelings, or desires.

What sort of problems can Psychoanalytic therapy help with?

Due to the emphasis on the therapeutic relationship and examination of the past, psychoanalytic psychotherapy is often used to help people with personality disorders, interpersonal relationship difficulties, self-sabotaging behaviour, depression, trauma, child abuse, and so on.