A continual criticism of the psychoanalytic approach is the scarce amount of empirical evidence of its concepts and treatments. Some of the causes for the lack of evidence are the poor methodology in previous studies, reluctance to research methods, doubts about whether unconscious conflicts, defenses, and fantasies could be measured, and complications with exploring long term treatments and its outcomes (Ulberg & Dahl, 2018). The psychoanalytic approach is centered on the subjective experience of an individual (Ulberg & Dahl, 2018), and this is important to recognize when working with families. Family interactions and relationships influence the characteristics for each individual in the family.
The psychoanalytic approach is a very subjective approach; it emphasizes that whatever the pressures of the external circumstances, the ways in which these external pressures are engaged with is significantly influenced by how individual family members function internally (Brodie & Wright, 2002). Psychoanalysis is suggested to be a knowledge limited by the a principle interest in intrapsychic experiences (Flaskas, 2005). In relation to family therapy, a psychoanalytic family therapy session would focus on a long-term integration of relational understandings in intrapsychic experiences of each family member (Flaskas, 2005). Flaskas (2005) identified four key ideas that psychoanalysis utilizes in a therapeutic setting: the idea of the unconscious and unconscious communication, the use of transference, countertransference, and projective identification to understand certain types of experiences among each member; attachment, and thinking and emotional containment and its relationship.
Pozzi-Monzo et al. (2012) created a study that examined the impact of brief psychoanalytic psychotherapy with children under the age of five with behavioral and emotional problems, and their families. It was hypothesized that with presence of a therapist, using reflections and interpretations, the parents' state of mind, regarding their child's behavior, would change from reactive to reflective and reparative (Pozzi-Monzo et al., 2012). Inadvertently, this would also result a decrease in the frequency and/or severity of the child's presenting severity (Pozzi-Monzo et al., 2012). This study found that parents became less blaming and more reparative in their comments toward their children, and six out of the seven children studied displayed a reduction/termination of negative behavioral symptoms (Pozzi-Monzo et al., 2012).
In a quasi-experimental study that compared the effectiveness of psychoanalysis with two short-term therapies and one long-term psychotherapy among patients with depressive or anxiety disorders, it was found that while clients treated with short-term therapies recovered faster from their self-reported depressive symptoms within the first follow up year, at the five year follow-up, the situation was reversed with a stronger interviewer-rated treatment effect in the psychoanalysis group both for depressive and anxiety symptoms in comparison to the short-term therapies (Knekt et al., 2011). This could be beneficial for families with extremely unhealthy relationships, for it can take a significant amount of time for each individual to explore, uncover, and understand not just their own unconscious desires, but every other member of the family's. A short-term therapy may not be as beneficial for a family in this situation.