1. There is no such thing as the unconscious.
It is a well-established fact that there are unconscious mental processes. As to what these are or what they are about is another matter. Whether called automatic behavior, implicit memory, cognitive unconscious, or non-conscious thinking, different hypotheses abound regarding the nature of unconscious mental activity and its relative importance in daily life. Psychoanalysis offers its own theories in this regard based on many years of clinical experience.
2. It is not evidence-based.
There is evidence for psychoanalytic therapy and research continues to grow in this area. However, it should be kept in mind that there is considerable controversy as to what constitutes evidence and even if this applies to psychoanalysis at all. This continues to be a topic of on-going debate. For those interested in this subject a link is here provided to a recent article on the scientific standing of psychoanalysis (Solms, 2019) and another on the limitations of evidence-based therapies (Shedler, 2018).
3. It does not eliminate symptoms and it takes a long time.
Psychoanalytic therapy is as efficacious as other forms of treatment in removing symptoms and this has recently been demonstrated by comparative meta-analysis for which a link is here provided (Steinert et al, 2017). As regards length, every person is unique and it can not be predicted beforehand if a treatment will be short or long term. A psychoanalytic therapy may thus last weeks, months or years depending on a given individual and what brings him or her to treatment. Every person that comes to therapy is considered individually and no two are treated alike.
4. It's just talk.
Yes it is, but not "just." Talk matters. More specifically, speech matters. Words can hurt and words can heal. It is a basic tenet of Lacanian psychoanalysis that the unconscious is structured like a language. We are literally subjects of language and a psychoanalytic treatment with a Lacanian orientation will make this evident. ("By words, one person can make another blissfully happy or drive him to despair." S. Freud, SE XV, p. 17)
5. It's all about the past and the past doesn't matter.
Should we forget about the atrocities of the Holocaust or the September 11 terrorist attacks? Would you tell a victim of rape or a survivor of child abuse that what happened to them in the past does not matter? To forget about it and move on? The past matters and it matters greatly. Even innocuous events of the past remain embedded in our minds and influence our current thinking. Furthermore, the present and the future matter too, and these are just as important in psychoanalytic therapy as well.
6. It promotes regression.
No. There is no going back. There are no do-overs. The past can be examined as it exists in the present but it is an after-the-fact understanding. Psychoanalytic treatment does not foster regression to infantile states, hypnotic trances, nor pretend to uncover what "really happened" in the past. The aim of psychoanalytic therapy is to detoxify the past as we remember it and not to keep repeating it in the present.
7. Mental problems are all biological, a result of a chemical imbalance in the brain.
All life on Earth is biologically-based, including humans, and it would be naive to claim otherwise. However, dysfunctions of neurotransmitters in the brain, the so-called chemical imbalances, can have multiple causes, including psychological ones and psychological factors are known to influence the most genetically-loaded and biologically-based conditions such as cancer and heart disease. Recognition of the physiological bases of human life does not require rejection of the psychological ones.
8. It's all about sex.
Sexuality is a significant part of human experience and for this reason it would be difficult to ignore in therapy. Since psychoanalytic treatment doesn't judge and asks analysands to speak freely, they in fact do so and thus issues regarding sex come up which would otherwise remain secret. However, such talk about sex is allowed, not imposed, by the therapist.
9. It's an insight therapy that requires high intelligence and cultural sophistication.
"In-sight" can happen during psychoanalytic treatment but it is not an essential part of it. "Out-sight" is just as important. The notion of different inner and outer worlds can be misleading. Dr. Lacan often attempted to re-think notions of subjectivity in terms of equations, strings, knots, rings and other conceptual models in order to brake away from this particular inside-outside thinking. There are also no intellectual or ethnic requirements as psychoanalysis is practiced throughout the world with children, adolescents and adults of all intellectual levels and of different cultures.
10. Psychiatric medications is all that is needed.
Psychiatric medications treat symptoms but not the underlying causes. Mental, emotional and behavioral disturbances can have multiple root causes such as genetic predispositions, adverse childhood experiences, medical diseases, past traumas, current conflicts or a combination of these. If the symptoms are treated but the root causes are ignored, a person will be dependent on medications for a long time, perhaps for life, a common occurrence when you rely solely on psychiatric medications. A combination of both therapy and medications is generally indicated but unfortunately often neglected. Medications make therapy possible and there are no inherent contraindications to the use of psychiatric pharmacotherapy conjointly with psychoanalytic therapy.