Q: Is psychoanalysis the way to go for somebody to resolve mental health issues?
The answer is a qualified no, not in its classic form. Freud’s great contribution was his recognition that for deep change to occur, a person needs more than advice or willpower; they need a profound, felt insight like an “aha experience.” His idea was that by talking until unconscious patterns were made conscious, healing would naturally follow.
But, there are more efficient and direct ways to help somebody have an aha experience in therapy. Classic psychoanalysis assumes that if a person talks and gains intellectual insight, they will naturally move away from their “stuck” point. But for conditions like severe anxiety, OCD, or trauma, yes, those “stuck” points are in the mind, but they’re also cemented in the nervous system. Often, the problem isn’t a lack of understanding. It’s that your body feels out of balance, and your mind is stuck in unhelpful habits.
Q: Freud was considered revolutionary for emphasizing how our early experiences shape our adult lives. Was he right?
That idea is now widely accepted across many therapy models. Our earliest experiences leave lasting imprints on how we see the world, trust others, and regulate emotions.
Q: And he thought that just identifying that early hurt would be enough to resolve it.
That’s where his model shows its limits. Identifying the origin is an important first step. And I’d agree; intellectual understanding is the starting point for making sense of one’s story. But without the aha experience that brings the body shift, it often remains just a story. You’re still left with the phrase, “I’m like this because of that,” but without the tools or the physiological release to be different.
Q: So insight doesn’t change anything on its own?
Usually, no. Intellectual insight is just one layer of healing. You’re trying to use the conscious, thinking part of your brain to solve a problem that often exists in the survival-based parts of the brain and the body. Lasting change requires an update to the entire system, not just the intellect.
Q: What does it mean for change to happen on a “body level”?
It means the change is felt in the body. It’s a shift in your physiological state and your automatic reactions. You can know a rollercoaster is safe, but your body still screams in fear. Therapy must help the nervous system learn safety in the same way it learned danger: through direct experience. An intellectual understanding alone doesn’t recalibrate the body’s alarm system. Without that body-level shift, you remain in a cycle where your biology works against your conscious intentions. You might know what you want to heal, but your body stays stuck in survival mode.
Q: So how do you create that kind of “body shift”?
I think of these as “aha experiences.” They’re more than just solving a puzzle in your head. When you experience one of these moments, you feel it in your body as a sense of discovery that often brings a wave of relief. A good therapist knows how to help you gather enough of these moments together so that a new kind of learning takes hold. One that you can actually feel rather than just understand.
This is how the body starts to let go of old, automatic reactions. Therapies such as EMDR (Eye Movement Desensitization and Reprocessing) and Somatic Experiencing are built for this purpose. They guide the nervous system to finish the defensive responses that got stuck during overwhelming times. When that old survival energy finally moves through and releases, something shifts. The world feels different, and you get to meet it with a fresh perspective.
Q: How does a therapist help someone have that kind of experience, rather than just an intellectual one?
It starts with deep, empathetic listening to help a person feel safe enough to explore. The initial stage is often about getting the “saturated” story out. But a skilled therapist also uses specific techniques to help the person access and process the issue where it’s held, whether that’s in the mind, body, nervous system, or some combination.
The limitation of the classic Freudian approach is that it assumes the person’s conscious mind can, on its own, untangle unconscious patterns. But when you’re trapped in a pattern, you often can’t see the prison walls containing you. A good therapist actively helps shine a light on those walls.
Q: So it’s not just about exposing the original memory, but about fundamentally reprocessing it.
Right. Take PTSD. The person almost always knows what caused it. The problem is that the memory isn’t stored like a normal memory. It’s stored in your body as fragmented pieces of sensory and emotional data. So even though the actual event might be long past, a trigger, like a smell or sound, can trigger the body to replay the threat as if it’s happening right now.
This is why therapies like Cognitive Behavioral Therapy (CBT), EMDR, and somatic approaches are so effective. CBT helps identify and challenge fear-driven thoughts, while somatic modalities help the body process and release the survival energy tied to those memories. Healing happens when the entire system (mind, body, and nervous system) can process the memory as something that has happened, not something that is still happening.
I find the most effective approach is often integrative. It combines understanding your patterns, releasing the tension you hold in your body, changing the story you tell yourself in your head, and then actually going out and doing things differently to build new experiences.
The goal is to help the person understand that their diagnosis or painful emotion is a state they are in, not the totality of who they are. It’s about validating their pain and the reality of their experience—making room for the “good cry”—while also building the capacity to shift state and not let that pain define every subsequent moment.
Think of healing as a process that needs two things: the courage to acknowledge your hurt, and the strength to release its grip. Yes, healing starts with insight, but action is where transformation happens. You let yourself feel it, then you practice moving on. Getting stuck in the feeling is just suffering, and trying to move on without feeling it is just denial.