Freudian Psychoanalysis

Presentation

Psychoanalysis is the first systematic psychotherapeutic method, developed by Sigmund Freud in Vienna in the late 19th century. It constitutes both a theory of psychic functioning (first topography: conscious/preconscious/unconscious; second topography: id/ego/superego), a method for investigating the unconscious and a therapeutic practice aimed at deep transformation of the patient's psychic structure.

Freud postulated that psychological suffering results from unconscious conflicts between drives (id), reality demands (ego) and internalized moral injunctions (superego). These conflicts, often rooted in childhood and infantile sexuality, are repressed into the unconscious but continue to exert influence through symptoms, dreams, slips of the tongue and parapraxes.

Founder: Sigmund Freud (1856–1939), neurologist and psychiatrist, Vienna, Austria

Core Principles

The unconscious: a major part of psychic life escapes consciousness. The unconscious contains repressed desires, traumatic memories, fantasies and conflicts.

Free association: the fundamental rule — the patient says everything that comes to mind without censorship.

Transference: the patient projects onto the analyst emotions, expectations and relational patterns from early relationships. Transference analysis is the main engine of therapeutic change.

Resistance: psychic forces opposing awareness of repressed material.

Interpretation: the analyst formulates hypotheses about unconscious meanings at the appropriate moment.

Main Indications

• Neuroses (anxiety, phobias, obsessions, conversions)
• Personality disorders (neurotic and high borderline organization)
• Recurrent depression
• Chronic relational and affective difficulties
• Creative and professional inhibitions
• Existential suffering and search for meaning
• Repetition of destructive patterns

Session Overview

Classical psychoanalysis takes place lying on a couch with the analyst seated behind, out of the patient's visual field. Sessions last 45-50 minutes, 3-5 times per week. The patient practices free association while the analyst listens with 'evenly hovering attention' and intervenes through interpretations, clarifications or significant silences. Treatment typically spans 3-7 years.

Variations and Sub-techniques

• Classical psychoanalysis (couch, 3-5 sessions/week)
• Psychoanalytic psychotherapy (face-to-face, 1-2 sessions/week)
• Brief psychodynamic psychotherapy (10-30 sessions)
• Child psychoanalysis (play, drawing)
• Group psychoanalysis

Contraindications

• Active unstabilized psychosis
• Severe active untreated addiction
• Acute suicidal crisis
• Severe intellectual disability
• Inability to tolerate frustration and analytic frame
• Lack of motivation for long introspective work