In-person in Houston, online across Texas • In-network with Aetna, BCBS, Cigna, UHC/Optum, Tricare, Curative, Oscar • Therapy in English, Spanish, Portuguese, Farsi
Psychoanalysis
Psychoanalysis in Houston, Texas
Most forms of psychotherapy begin from the question of what is wrong and how it can be corrected. Psychoanalysis begins from a different question: what a symptom is expressing, why it recurs, and what it maintains in a person's life. Behavior that persists against one's own judgment, relationships that end in the same way, anxiety without an identifiable object, are treated in analysis as formations with a logic of their own, and the work consists in bringing that logic into speech.
Real Talk offers psychoanalysis in Houston in two forms. Psychoanalytic psychotherapy, generally once weekly, is billed as individual psychotherapy and is covered by the insurance plans we accept. Psychoanalysis at higher frequency and structure is available for those who want to pursue the work further, usually paid out of pocket. Both are available in person in Houston and online across Texas, in English, Spanish, and Portuguese.
The analyst does not apply techniques. Instead, they listen for what is singular in how a person speaks: the term that recurs, the account that shifts with each retelling, the point at which the narrative breaks off. The aim is to allow something the patient already knows, without knowing that they know it, to be articulated. This work takes time, and it includes periods of repetition and doubt that are intrinsic to it.
The analysts at Real Talk have undergone their own formation, which includes personal analysis, supervision, and sustained study within a psychoanalytic tradition. That formation is what makes it possible to hold the frame of each treatment.
Presentations We See
Psychoanalysis addresses a wide range of presentations, and it is particularly suited to structural difficulties rather than situational symptoms. This includes: chronic depressive states and anxiety that have persisted through several courses of symptom-focused treatment; relationship patterns that the person recognizes and cannot alter; past experiences that keep interfering in present life. It is also well suited to people who are not in crisis, but for whom something remains in place that symptom relief does not reach.
What We Pay Attention To
We pay attention to repetition, to what the patient says and to how they say it, to where something alive has gone silent and what has been installed in its place. We also attend to the manner in which a person tells their own history, since the narration is itself part of it, and to the points at which the account fails to cohere.
Why Analytic Formation Matters: Analytic listening places considerable demands on the clinician, demands that only ongoing, sustained formation makes it possible to meet. That matters most with presentations that resist categorization, with chronic dissatisfaction that has outlasted previous treatment, and with depression or anxiety that returns after symptom reduction.
Our clinical director reads every inquiry and recommends a clinician within minutes on weekdays, hours on weekends.
Is psychoanalysis covered by insurance?
Psychoanalytic psychotherapy is billed as regular individual psychotherapy and is in-network with the plans we accept. More structured psychoanalytic work is usually paid out of pocket. We verify before treatment begins and tell you what we find.
Is the couch required?
No. Many patients work face to face or even online.
How long does treatment last?
Longer than a manualized treatment, and by design. The length is determined within the treatment, not fixed at the outset.
Casey Schwartz. When Freud Meets fMRI.
The Atlantic. 2015. Read here.
Ben Jeffery. The Sting of Knowledge.
The Point Magazine. 2018. Read here.
From Our Journal
Psychoanalysis and Psychoanalytically Oriented Therapy: Two Forms, One Practice.
2026. Read here.
Sigmund Freud and the Uncomfortable Truth That Started Everything.
2025. Read here.