I am often asked similar questions about psychoanalysis by people who are curious but find the terminology confusing. I have compiled these psychoanalysis FAQs not only to clarify the process but also to challenge the unbearable clichés often repeated by both laypeople and professionals. This is my attempt to go beyond those stereotypes—even if it requires a more articulated argument—to share what I truly believe is peculiar and valuable about this practice.
Index
- 1 How does psychoanalysis differ from therapeutic approaches like CBT or counseling?
- 2 What’s the difference between psychoanalysis and psychodynamic psychotherapy?
- 3 What is the goal of psychoanalysis?
- 4 What will happen if I open Pandora’s box?
- 5 Will psychoanalysis lead to nihilism? Will I lose myself or become cynical?
- 6 Does psychoanalysis take forever?
- 7 Is psychoanalysis opposed to medication?
- 8 Is it possible to do analysis online?
- 9 Do I have to lie on the couch?
- 10 Is it true that the analyst is often silent?
1. How does psychoanalysis differ from therapeutic approaches like CBT or counseling?
Focus on the Unconscious
What sets psychoanalysis apart is its focus on the unconscious—those thoughts, feelings, and desires that affect your everyday life without you being aware of them. Its aim is to bring these processes to light so we can grasp the underlying logic behind our behaviors, repetitions, and feelings.
Beyond Symptom Management
You may have already sat in a therapist’s chair. You might have learned techniques to manage anxiety or tools to “fix” negative thoughts. You may have felt understood, validated, and supported. And yet, a question remains. A pattern repeats. A feeling lingers—a sense that while you have managed the symptoms, the root of the matter remains untouched.
Unlike approaches focused on quick fixes, advice, or strategies, analysis offers a space for listening beyond manifest content—through free association, dreams, transference, slips of the tongue, and other formations of the unconscious.
The Analyst’s Stance
An analyst analyzes: that implies refraining from much else—judgment, answers, suggestions, personal opinions. Analysis is non-directive; it follows what emerges, allowing meaning to surface rather than steering toward preset goals. Psychoanalysis does not impose a “right way” to think or live; it creates a space where something new can emerge, inviting people to listen to (and understand) themselves differently. Symptoms aren’t merely problems to remove but meaningful formations to understand. The aim is deeper, more durable change, not just symptom management.
By contrast, CBT and many humanistic/integrative models prioritize goals and skills, are symptom-focused, and do not centrally work with the unconscious in the way analysis does.
When I listen to someone, I don’t focus on eliminating the symptom but on the conditions that made it possible and the meaning it has within the patient’s history. This is also why many counsellors and psychologists tend to work with certain symptom clusters and not others, whereas analysts often do not restrict their practice to particular problems or diagnoses, working instead with people presenting a wide range of issues.
Painting vs. Sculpture
Freud famously distinguished psychoanalysis from other psychotherapies using an analogy from the arts: painting vs. sculpture.
- Painting (Via di porre): Most therapeutic approaches (such as coaching or supportive counseling) work by ‘via di porre’ (by adding). They apply layers of paint to the canvas: adding new coping strategies, homework exercises, and positive affirmations. While this can smooth the surface, it often relies on providing new rules or principles to follow. Ultimately, this risks merely substituting one set of beliefs for another, covering the core issues without resolving them.
- Sculpture (Via di levare): Psychoanalysis works by ‘via di levare’ (by taking away). The sculptor does not add clay to the block of stone; rather, they chip away the excess material to reveal the statue hidden inside.It is a non-judgmental process of subtraction. It strips away social conditioning, the expectations of others, and those unexamined assumptions and rigid beliefs we hold without knowing why—the very ones that often fuel our suffering.
By clearing away this debris, psychoanalysis does not hand you a new map of how to live. Instead, it offers you the freedom to read yourself and the world differently, empowering you to question your reality rather than simply following a new set of instructions.
2. What’s the difference between psychoanalysis and psychodynamic psychotherapy?
People often distinguish these by practical markers like session frequency, setting, or the therapist’s title. While useful, these do not fully capture what defines psychoanalysis. For instance, some people claim that “real” psychoanalysis requires lying on a couch 4 times a week, while anything less is merely (“psychoanalytically inspired” or psychodynamic) psychotherapy.
I find this distinction superficial. Frequency of sessions makes a difference, but in itself, it is not sufficient to guarantee that a qualitative transformation is taking place.
Why Frequency Matters (But isn’t everything)
Many people tell me: “I wouldn’t even know what to say if I had to come that often.” But that is precisely the point: you don’t have to know or to plan what to say. Coming with greater frequency helps detach you from the “reporting” style of daily communication. There is no need to recount what has happened since the last time we met. The fundamental rule of analysis is free association: to say whatever comes into your mind in that moment, without filtering and without exercising any censorship. You can start from whatever is passing through your head in that moment, maintaining a curiosity for what you happen to say.
This distinguishes analysis from therapies aimed merely at problem-solving. Analysis does not have to end when the symptom is resolved; in fact, it may truly begin precisely because there is less of an agenda to cover, and therefore more space for something unprecedented to present itself.
The Issue with the term “Psychodynamic”
“Psychodynamic” is a colloquial term often used as a synonym for psychoanalytic therapy, but strictly speaking, they are not the same. The term originates from a mechanical, hydraulic view of the mind—influenced by 19th-century physics—as a system of forces and energies.
While popular, this label often obscures the specificity of the analytic experience. We are not dealing with mechanics, but with speech, history, and meaning. Therefore, I prefer to stick to “psychoanalysis,” as it emphasizes the unique work of listening to the subject, rather than managing psychological dynamics.
The Effect is What Counts
Psychoanalysis happens in the act, in the encounter between patient and analyst. An intervention is “psychoanalytic” if it resonates with the unconscious and brings about a meaningful shift for the patient. You cannot predetermine that by theory or credentials; you judge it by its effects. Analysts (Freudian, Kleinian, Lacanian, etc.) often disagree about what counts as “real” psychoanalysis. But analysis isn’t about rigid frameworks or titles—it’s about how we listen, engage the unconscious, and the effects our interventions produce.
Think of it this way: knowing 1,000 jokes or having a comedy certificate doesn’t make you funny; laughter does. Likewise, diplomas or frequency don’t make work analytic—its effects do.
3. What is the goal of psychoanalysis?
I think it would be a problem if psychoanalysis had a one-size-fits-all goal—because then there would be no analysis to begin with!
Psychoanalysis isn’t a doctrine, a religion, a method, or a philosophy; it doesn’t already hold the answers the analysand is seeking, but wagers that through a process of inquiry and free association, the analysand can come to know a bit more. In other disciplines, answers are pre-given and universal.
If anything, the goal of psycho-analysis is to analyze: plain and simple. Or, as Lacan put it, “the desire of the analyst is to analyze”—not to cure, not to help, not to advise, and certainly not to impose a direction or hand out prepackaged answers.
Do therapeutic results happen?
Absolutely. But in analysis, relief and “cure” are more likely the consequences of the work, not a target we aim at directly to the detriment of understanding.
Helpful effects are not random; they occur precisely because there is analysis, because there is active participation, and because the person is willing to question what they believe they know. Then, when we grasp the logic of a symptom, its necessity often falls away, and relief follows.
When I first meet someone, I usually ask: “What would you like to get out of these sessions?” People want different things: some may want to understand something opaque about themselves; to feel a bit better; to have a space where they can speak freely and maybe say what they’ve never said before—to someone who truly listens. Others may just want relief from a symptom or a persistent discomfort. These aims can also change over time: someone might come because of a troubling symptom, and once it eases or disappears, they may continue because they’ve developed a taste for analysis. To each, their goal.
Growth and “The End”
Some even say: “psychoanalysis truly begins where psychotherapy ends”—when the urgency to eliminate symptoms fades, and one becomes absorbed in analyzing the unconscious, dreams, and one’s part in one’s own narrative. A condition of analysis—and, in a sense, its “goal”—is being able to ask: What is my role in what happens to me? In my story, my symptoms, my misadventures?
Psychoanalysis helps question certain beliefs, statements, or illusions. In that sense, analysis does mean putting assertions into question, loosening certainties, inserting a dose of skepticism, and shuffling beliefs. Of course, we should distinguish between the clinics of neurosis and psychosis, but I’d say that for most people suffering comes from certainties—rigid statements, rituals, and small or large delusions. Analysis should loosen and dissipate these certainties to set desire in motion again, so a person can live more fully—without the crutches of fixed representations of self and world.
Another way to put it: if there’s an endpoint, it’s having more room to think, to speak freely, and to live with fewer rigid certainties—to live with fewer ready-made formulas and stock phrases; to entertain open questions without jumping to conclusions, without having to divide everything into right and wrong; to replace neurotic doubt with a healthier skepticism—which, I think, allows one to begin desiring and dreaming again. Analysis cultivates precisely this capacity, the space where life, change, and growth can happen; pain—and even trauma—by contrast, coalesces where a representation freezes and admits no other saying.
4. What will happen if I open Pandora’s box?
This is a very common fear. We imagine the unconscious as a cage full of monsters, and we fear that if we open the door, they will overrun us and destroy the life we have built.
But here is the reality: Pandora’s box is already open.
The symptoms you are feeling—the anxiety, the repetitive failures, the unexplainable sadness—are proof that the “monsters” are already out. They are already influencing your life; they are just doing it from the shadows, where you cannot see them. You are currently being directed by scripts you didn’t write and desires you don’t recognize. That is the true loss of control.
Psychoanalysis doesn’t create the chaos; it reveals the logic behind the chaos. By looking into the box, you aren’t letting the demons out; you are turning the lights on. When you can name the thing that haunts you, when you can see the structure of your fear, it loses its power to control you from behind the scenes. You don’t lose control; for the first time, you gain the possibility of a choice.
5. Will psychoanalysis lead to nihilism? Will I lose myself or become cynical?
It is quite the opposite. Nihilism and cynicism represent the belief that nothing matters. Psychoanalysis is the discovery that what you thought mattered might not be yours, but that something else matters intensely.
Certainty as a Defense
Some tend to think of certainty as a sign of health, but often, absolute certainty is actually a trap. Whenever we speak with rigid conviction about who we are (“I am just a depressive person,” “I always ruin relationships”), we are constructing a closed reality—a sort of private “delusion.”
Neurosis (and to some extent psychosis and perversion too) is often just this: a defense against the vibrancy of life, a way of shutting down to stay safe. These rigid beliefs act as crutches; they help us stand, but they prevent us from moving.
Finding the Spark
We deconstruct the rigid beliefs, the “shoulds” imposed by self or by society, the neurotic rituals—so that a more authentic desire can emerge. By dismantling those defenses, we don’t find emptiness; we find the spark of life that was suffocating underneath.
From Delusion to Dream
The goal is to transform that rigid delusion into something more like a dream. A delusion is a certainty that blocks life. A dream, on the other hand, strikes us with its absurdity; it escapes absolute understanding, and precisely because it cannot be pinned down, it opens up new possibilities.
Take the lawyer who comes to admit, through analysis, that he never actually cared about the law, but practiced it because it was the only way he finally felt recognized by his father. Being a lawyer was an identity—a certainty that helped him stand, but prevented him from moving. When that rigid goal dissolves, however, he isn’t left with nothing. On the contrary, he can finally speak about something even more important to him. That vital need underneath—the desire to be recognized—remains intact, only now he is free to give that need a different, more authentic outcome.
Restarting the Story
Analysis clears the weeds so that something new can grow. It loosens the knots not to replace one monolithic truth with another, but so that your story can move again. It allows you to:
- Shed the dead weight: Let go of the uncritical beliefs you inherited.
- Take a stand: Begin to express and defend your own subjective position, while accepting that this position is a “work in progress,” not a final sentence.
It allows you to live without the armor of fixed representations, to entertain open questions, and to begin desiring again. That is not nihilism; that is the very definition of vitality.
6. Does psychoanalysis take forever?
This is perhaps the most persistent cliché about analysis. While it is true that deep structural change does not happen overnight, psychoanalysis is not an infinite process. It takes exactly as long as is necessary to untie the knots currently constraining your desire.
The Rhythm of the Work
The stereotype that psychoanalysis is inherently slower than other approaches is misleading. Analysis is neither slow nor fast in itself; it is singular. Each person has their own rhythm, and speech has its own temporality. Consequently, the process is rarely linear: there may be periods of rapid movement followed by moments of impasse.
A Unique Trajectory
There is no standard path and no pre-packaged solution delivered from on high. The duration depends entirely on how you engage with the adventure: the distance you wish to travel, what you hope to obtain, your level of commitment, and your enthusiasm. It also depends on the events of your life outside the consulting room. Sessions are vital, but so is the life lived in the intervals between them.
A different idea of time
Analysis is not an endurance test where results appear only after many years, nor is it a long wait for future benefits. On the contrary, the expectation is that each session carries its own weight—that something shifts, however slightly, in every encounter. We look for efficacy in every conversation, not just “at the end” of the journey.
In a Lacanian approach, time is generally not standardized. Sessions are not rigid 50-minute blocks; rather, they are punctuated—or cut—according to what emerges in speech. This isn’t about shortening the time; it’s about maximizing the impact. Stopping at a crucial moment prevents the conversation from diluting into polite chit-chat. It leaves you with a meaningful question or a realization to ponder until the next time, keeping the unconscious work active between sessions.
This also means that the time of speech (and therefore of the unconscious, and of analysis) is not the time of the clock; it is not something that can be measured by standard metrics.
Ultimately, the aim is not to keep you on the couch for decades, but to reach the point where you no longer need the analyst to sustain your own life.
Why does it take time at all? Can’t you just tell me what’s wrong?
If I told you the “answer” to your problem today, you would likely reject it or simply not believe it. The unconscious is protected by strong defenses. You have spent years, perhaps a lifetime, building the architecture of your symptoms to cope with reality. Dismantling that architecture safely requires a process of working through. You have to arrive at the truth yourself for it to have any transformative power.
7. Is psychoanalysis opposed to medication?
No. This is a common misconception. Medication and psychoanalysis are not mutually exclusive; they operate on different levels. While medication can help manage acute symptoms, analysis works on your personal narration, unconscious assumptions, and beliefs.
Taking medication is not a failure of will; in fact, in some cases, medication is not just compatible but necessary—specifically when it serves as a preparatory step for analysis. It can be vital for enabling you to think, to confront anxiety, or simply to find the strength to get out of bed and come to the session.
However, it is crucial that medication does not extinguish your desire to do the work or create the illusion that the removal of suffering means the problem is solved without your personal input. Medication should become part of the analytic framework, functioning to open up spaces for thought rather than limiting them. It creates the stability needed to speak, but it does not replace the work on the word.
8. Is it possible to do analysis online?
This is something that must be evaluated on a case-by-case basis. We cannot generalize and say that online analysis works or does not work for everyone; it depends on your personal history and the specific issues at stake. If we are in the same city, meeting in person is the priority, as the presence of the body is often an essential part of the experience. However, if distance makes this impossible, we can consider working online. It is worth noting that even when the work is primarily conducted remotely, it is important to plan for in-person sessions periodically whenever possible.
9. Do I have to lie on the couch?
The use of the couch is not a rigid rule enforced from the very first moment, nor is it an obligation. It is a possibility—a tool that many find deeply beneficial, introduced only when the time is right.
Lying down removes the visual cues of social interaction—you do not have to worry about the analyst’s facial expressions or maintaining eye contact. This physical position encourages a shift in attention: you stop focusing on the external world and begin to listen to your internal world. It facilitates “free association,” allowing thoughts, memories, and words to emerge more freely, without the censorship we usually apply in face-to-face conversation.
10. Is it true that the analyst is often silent?
The idea of the “mute” analyst is largely a stereotype. It is not that the analyst must remain silent, but rather that their role is not to teach, judge, or tell you how to live your life.
The analyst is there to help you speak, and more importantly, to help you hear something new in your own words. The work of analysis necessarily passes through your speech—you are the one who must do the work of articulating your truth. However, this does not mean the analyst is absent. The analyst intervenes not to give advice, but to highlight connections, question contradictions, and open up meanings that might otherwise remain hidden. The analyst speaks to help you hear yourself more clearly.
This silence is not one of distance or indifference; it is a “generous silence.” In everyday life, everyone—friends, family, doctors, even strangers—has an opinion. Everyone is quick to offer advice or tell you what to do. While well-intentioned, these are merely personal opinions that often clutter your own thinking. The analyst deliberately abstains from this common impulse.
If the analyst were to respond constantly with advice, it would “plug” the space necessary for your discovery. By holding back their own ego and opinions, the analyst keeps that space open. This invites you to listen to your own unconscious, for that is where both the origins of your questions and the solutions to your problems reside. The analyst’s silence is a tool that facilitates this internal listening, ensuring the path of analysis remains truly yours.
Reading about analysis is different from experiencing it.
These answers are meant to clear the ground, but psychoanalysis remains a practice of the particular, not the general. If you have questions I didn’t cover, or thoughts you would like to add, feel free to share them in the comments.
Further Reading