Psychoanalytic technique evolved from the treatment of adults through hypnosis, suggestion, and then free association, especially to elements of dreams. One of the first patients called it a “talking cure” and, with the emphasis on free association, the use of the couch, and avoidance of visual contact and action, psychoanalysis was and remains primarily a verbal interaction. The psychoanalytic model of technique is captured in the image of the patient on the couch, attempting to say whatever comes to mind, and the analyst, outside the view of the patient, making very few, but timely and economical, verbal interventions.

When child psychoanalysis started in the 1920s the adult model was the blueprint and it was hoped that adult techniques could be applied down the developmental scale to work with adolescents and children. Deviations from the adult model are considered parameters; child analysts become somewhat apologetic about using such parameters, and many adult analysts dismiss child analysis as a form of analytically oriented psychotherapy