What a psychoanalyst may do is highly dependent on training, though there are a few basic elements in psychoanalysis that are likely to be similar or the same. It is first important to note that in many places, anyone who practices therapy could claim they practice psychoanalysis because the term is not legally protected. Those who want analysts with real training must investigate if they have undergone the extensive post-graduate work involved in this discipline, which is usually available in each country in only a few places.
It’s also valuable to understand that psychoanalyst and therapist are not exactly the same terms. Psychoanalysis derives from the tradition begun by Sigmund Freud and carried on in different directions by practitioners like Carl Jung. Freudian or Jungian orientation are two completely separate things and people seeing an analyst specializing in one or the other could expect very distinct approaches to the process. What makes them similar is that both use a related format when working with patients.
Essentially, in psychoanalysis the goal is to meet with the patient often, sometimes almost daily, for hour long stretches so that patient can use things such as free association to reveal the unconscious self. The analyst, who could ask questions or ask for clarification, may occasionally direct this, but also listens intently to each client. The patient might lie on a couch not facing the analyst, or sometimes face-to-face work with both people sitting is used. The goal of the analyst is to help the patient, or analysand, process unconscious material, creating a deeper knowledge of self and an end to some problems. This can take several years to accomplish.
The psychoanalyst typically sees many patients a week, but given the time commitment required for each patient, patient load could be much lower than that of therapists who meet once weekly with many of their clients. It is felt that numerous meetings forms a deeper relationship with each analysand, though not all patients complete treatment. At the same time the analyst forms this relationship, he/she must be wary of projecting his/her feelings onto patients and must work to keep his/her countertransferences, wishes, and desires from influencing the emergence of each client’s unconscious thoughts. Generally psychoanalysis depends on creating the transference relationship and the psychoanalyst tries not to impede that process.
Another thing that a psychoanalyst may do is prescribe medications. Many people who come to professional training are doctors or psychiatrists, and as such, they can use prescribing as a method for clearing away those disorders that are biologically based. This leaves the client free to work on those issues simmering in the unconscious that are not based in faulty neurotransmitter action or other medical conditions.
Some psychoanalysts manage their own offices and are responsible for setting all appointments, billing insurance companies or collecting money directly from clients. Others may employ an office manager for this work. In addition to practicing analysis, many could be involved in the field in other ways. They might conduct research, write books or articles, and train or supervise beginning analysts. A few analysts teach or lecture also and are associated with institutions that train in specific psychoanalytic methods.