While psychoanalytic theory has had tremendous influence on the mental health field as a whole, the practice of classical psychoanalysis has become far less common than it was in its heyday in the first half of the twentieth century. Psychodynamic psychotherapy has adjusted to the financial and schedule constraints of modern life. In typical psychodynamic therapy, there are one to two forty-five- to fifty-minute sessions per week. Both therapist and patient sit up and face each other. There is no couch. The emphasis on unconscious patterns of thought, emotion, and desire is retained, however, as well as the belief that patterns learned in childhood influence adult emotional experiences and ways of relating to others.

As with psychoanalysis, psychodynamic therapy tends to be of indefinite length (often for many years) and relatively non-directive. The therapist aims to guide self-exploration, rather than provide answers or educate the patient in new modes of behavior. In other words, both psychoanalysis and psychodynamic therapy provide social support and promote insight, but neither one teaches specific skills.