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Psychoanalytic psychotherapy

Psychoanalytic psychotherapy is a talking therapy based on saying whatever is going through your mind.

This helps you become aware of hidden meanings or patterns in what you do or say that may contribute to your problems. 

Many people come to us because they feel they are trapped by their past and want to talk it through with someone.

We provide a safe, personal space where you can talk about yourself and what troubles you, to try to understand the connections and patterns of your experiences. 

Through understanding these connections and patterns therapy can:

  • bring relief
  • reduce confusion about what helps and what doesn’t
  • identify changes that can be made in your life
  • help you come to terms with what can’t be changed

Psychoanalysis is based on the modern developments of the theories of Sigmund Freud. Freud believed that bad thoughts and experiences from childhood are repressed but continue to influence your feelings as an adult.

Who it’s for

Psychoanalytic psychotherapy is for adults experiencing psychological problems.

Issues we can help with

Psychoanalytic psychotherapy can help with a range of psychological problems, particularly difficulties that can impact on relationships:

  • depression
  • anxiety disorders
  • relationship difficulties
  • post traumatic difficulties
  • couple difficulties
  • personality difficulties

Psychoanalytic psychotherapy is not recommended for psychotic illness, but can be very helpful in relapse prevention and when a psychotic episode has come to an end. 

Length of treatment

Psychoanalytic psychotherapy sessions last for 50 minutes. They usually take place once a week, but sometimes more frequently. Within the Trauma Service this treatment is usually offered at fortnightly intervals.

Treatment usually lasts for one year, but can vary from four sessions to two years.

Patients are seen on their own at the same time and in the same room, as this consistency helps people get the most out of their treatment.


People only enter psychoanalytic psychotherapy after a detailed consultation, which takes place over two to six meetings. During consultation we try to get to know you and get a picture of your difficulties. This is called brief psychotherapy and we offer it to everyone.

The consultation gives you and your therapist an idea of whether talking to someone in this way is going to help you or not. At the end of the consultation your therapist helps you to think about the most appropriate treatment for you. 

If you are offered psychoanalytic psychotherapy, you may have to wait for a treatment vacancy to become available. If you do have to wait, your therapist helps you access appropriate support during this time. 

Therapy sessions

Psychoanalytic psychotherapists wait for you to talk. This can feel like silence, but it doesn’t mean the therapist is unhelpful. The therapist is interested in what’s on your mind. As a session develops this includes possible feelings about the therapist. There are no expectations and you are free to talk about whatever is on your mind. 

The therapist tries to understand and point out particular difficulties in talking or thinking about certain things. Although we know that it’s helpful to talk, we also know it’s not always easy. It’s important to understand what might get in the way. 

Psychoanalytic psychotherapists often have couches in their therapy rooms, as some people find it easier to talk whilst lying on the couch. This is personal choice. 


Research shows that psychoanalytic psychotherapy is effective in the treatment of both mild and complex mental health problems. 

Studies show that psychotherapy in addition to antidepressant medication significantly reduces depressive symptoms, compared to antidepressants alone. 

Studies also show that for somatic disorders short term psychoanalytic therapy can be more effective than other therapies. Somatic disorders are physical complaints that initially appear to be medical but after investigation can’t be explained with a medical diagnosis. 

Risks and side effects

Talking and thinking about emotional problems can be difficult. For this reason some people can feel worse before they feel better. We work with you to manage strong emotional reactions.

Sometimes this kind of therapy can make people feel too angry or makes their depression worse, or some can feel too criticised. It can be painful to face the past and the truth, but this has its limits and the therapist respects that. The therapist also has their limits on what they can understand and help with. 


Psychoanalytic psychotherapy is not for everyone. There is a range of alternative treatments that your therapist talks to you about during assessment. 

Other psychological treatments include: 

In some cases patients are helped by medication which can be prescribed by a doctor and on rare occasions by our staff. 

Patients may choose not to take up any form of professional help for their issue and manage the problem themself. 

Questions or worries

Therapy can bring up difficult issues. We want you to feel able to discuss any questions or worries with your therapist. This is important to progress your therapy. 

If you would like to discuss any concerns with someone independent of your therapy please contact our patient advice and liaison service.