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Understanding what the therapeutic action of psychoanalysis and psychoanalytic therapy have in common with other forms of therapy helps us identify essential elements of therapeutic change. Several processes that cut across diverse psychotherapy approaches are outlined, based on clinical empiricism, theory, and research. A model of therapeutic action is considered that places emotion schemas at the center of therapeutic change across modalities; to modify these memory structures, diverse therapies utilize overtly different, if complementary, methods. These shared processes are drawn together into a common, coherent change model that is further informed by the role of neuroplastic memory reconsolidation. Although the model seeks to explain and to link multiple transformative therapy approaches, and in that sense, is a general model that applies to many therapies, for the purposes of this paper, the case example applies the model to psychoanalytic therapy. Paradoxically, the case illustration brings into sharpened focus what is important and often underemphasized in psychoanalytic therapy, while also opening and extending customary forms of psychoanalytic and psychotherapeutic thinking and methodology.