When might psychoanalytic psychotherapy be considered unhelpful?

Psychoanalytic psychotherapy is not usually indicated when someone is in an acute crisis. It is more likely to be helpful when there is some stability externally (e.g., a job or supportive relationships). External relationships and a daily structure support the person going through what can, at times, be an unsettling and intensive emotional experience.

If someone is experiencing a psychotic illness, psychoanalytic psychotherapy within the independent sector would not be appropriate. This is because there needs to be a capacity for reality testing in the external world in order to balance the experiences evoked by this model of therapy.

Psychoanalytic psychotherapy would not be offered to people with a primary drug or alcohol problem. For these people, help that focuses on the alcohol or drug abuse would be important in the first instance. As this model of therapy addresses anxieties in order to work towards deepening understanding and leading to change, any existing drug or alcohol habit or addiction would be likely to increase during therapy, interfere with the psychological work, and become more problematic for the individual.