Psychoanalysis refers to an intensive form of psychotherapy that is especially useful for people with longstanding personality problems that result in internal anguish and often difficult relationships. It requires meeting three or more times a week and the therapeutic relationship becomes a vehicle for effecting deep and lasting changes that are often transformative in one's life. Psychodynamic psychotherapy utilizes the same approach as psychoanalysis, but tends to be less intense, with sessions typically taking place one to two times per week. When effective, psychoanalysis has the potential to bring about positive, long lasting changes.

The psychoanalytic/psychodynamic approach pays close attention to the underlying dynamics of the client, which are often outside of awareness, but can nonetheless result in patterns that are destructive to the individual and those around him. The psychoanalytic or psychodynamic treatment works on identifying and eventually shifting these structures that organize one's means of seeing, understanding and behaving in the world to more adaptive patterns that result in greater inner harmony and more meaningful and adaptive relationships with others. 

Psychoanalytic and psychodynamic treatment overlaps with other therapies, but also has some characteristics that render it unique.

First, it is an approach that assumes that many of the things we say and do are determined by factors that are 'beneath the surface', and that thus bypass conscious awareness. Another way to say it is that there are often unconscious determinants to what is displayed in our speech, behavior and demeanor towards others. These determinants were established during development and represent what was internalized by the child in their interactions with their caregivers as they were growing up. Put differently the patterning of interactions in our early years can determine how we interact in our world for the rest of our lives. This patterning has both conscious and unconscious elements and determines how we view our world, how we interact with each other, how we deal with new situations, etc... Problems arise when an individual has learned a pattern of behavior in interacting with their world that is destructive to them and those around them, but the pattern bypassess awareness and can thus not be influenced, resulting in the repetitive and destructive behaviors that we sometimes see in ourselves and others. The reasons that certain patterns are unconscious tend to be complex, but a simple way to understand it might be to consider normal vs pathological unconscious processess. In a normal process, things become automatized and bypass consciousness as a means of 'cognitive efficiency'. For instance, imagine riding a bicycle and having to consciously be aware of everything you do, including how you are maintaining balance! That information becomes automated and allows us to do many things in our lives without putting much conscious thought into them. In the pathological unconscious, the reason memories and patterns are out of awareness is because they could not be tolerated in consciousness, and they have thus gone 'underground', manifesting themselves in destructive ways of living, unhappiness, mental illness etc... It is these patterns that psychoanalytic/psychodynamic treatment addresses, with the goal being to help the client establish different patterns of being in the world that result in a freer, more self-directing and ultimately more meaningful life.

A second characteristic that is very much a part of psychoanalysis, and that follows from the above, is that this approach to understanding and treating people views symptoms as surface manifestations of underlying issues. Consequently, in this type of treatment, the underlying dynamics are seen as essential to identify and process before symptoms can be altered or eliminated. In fact, the treatment of isolated symptoms is not considered a first line of intervention because if the underlying dynamics remain the same then one symptom will be replaced by another. Let's take a simple example. If a person is dangerously obese and wants treatment for over eating, they may very well be provided with a diet and exercise regimen that results in weight loss. But if the problem of over-eating is part of a more general problem of difficulty with regulating one's negative (and sometimes positive) emotions, then we may very well find that the individual who has lost weight and is no longer overeating is now drinking too much alcohol, or obsessively exercising 5 hours a day etc.. In such a case, exploring the underlying issues that may be contributing to emotional dysregulation and the undesirable behavior might lead to a more productive and longer lasting solution. 

A third characteristic that is strongly associated with modern psychoanalytic thought is the importance of the therapeutic relationship, which is considered the primary vehicle in which change can occur. Most psychotherapy modalities have come to the conclusion that the therapy relationship is essential to successful treatment. The psychoanalytic approach has gone to great lengths to explore how both the client's and the therapist's underlying, unconscious means of organizing experience intersect in the therapy room, offering a unique experiential opportunity to explore and understand in a very immediate and emotionally powerful way what the dynamic might be that results in the problem for which the client has come to therapy. To put it a bit differently, psychoanalysis is about both client and therapist being fully emotionally present in the room, exploring the client's difficulties and discovering together, through their interactions, other ways of being that are more adaptable and less destructive. The focus of course is on the client's subjectivity, but the process also requires the therapist to bring in their own subjectivity (their actual thoughts and feelings, not their theories)to reflect upon and utilize in the therapeutic relationship.