PSYCHODYNAMIC THERAPY IN DC

Psychodynamic Therapy in Washington DC

Therapy that goes deeper than symptoms — to the patterns that keep driving them.

83% of people who receive psychodynamic therapy improve more than untreated controls — with benefits that continue growing after treatment ends (Shedler, 2010)
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You’ve tried managing the symptoms. You’ve learned coping strategies, set goals, and pushed yourself to change. But the same patterns keep returning — in your relationships, your career, the way you talk to yourself when no one’s watching. Psychodynamic therapy offers a different path: instead of managing what’s on the surface, it helps you understand what’s driving it.

Psychodynamic therapy is a form of talk therapy rooted in one essential idea — that much of what shapes your thoughts, feelings, and choices operates outside conscious awareness. Past experiences, especially early relationships, create unconscious patterns that continue influencing your present behavior long after the original circumstances have changed. This therapeutic approach brings those patterns into view so you can finally do something about them.

At Therapy Group of DC, our psychodynamic therapists help you understand why you do what you do, not just what to do differently. Our practice was built on the psychodynamic perspective, and several of our doctoral-level therapists practice psychodynamic psychotherapy as a primary orientation. We don’t treat it as one tool among many — it’s the foundation of how we understand people and how change actually happens. Our psychodynamic therapists integrate psychoanalytic theory with modern attachment research and neuroscience to create therapy that produces lasting change.

Whether you’re navigating depression, anxiety disorders, personality disorders, relationship difficulties, or a persistent sense that something deeper is keeping you stuck, psychodynamic therapy helps you understand the psychological roots — not just manage the symptoms.

From Our Practice

Most of the clients who come to us for psychodynamic therapy have done therapy before. They’ve learned strategies, built awareness, made real progress — and still feel like they’re circling the same core issues. That’s not a failure of willpower. It usually means the work hasn’t gone deep enough yet. Psychodynamic therapy is designed for exactly that.

What Is Psychodynamic Therapy?

Psychodynamic therapy is a therapeutic approach that explores how unconscious thoughts, past experiences, and early life experiences shape your present behavior and relationships. Originally rooted in psychoanalytic theory developed by Sigmund Freud in the 1890s — Freud introduced the term “psychoanalysis” in 1896, building on psychodynamic principles first articulated by Ernst Wilhelm von Brücke — the approach was expanded by figures like Carl Jung, Alfred Adler, and Melanie Klein. Psychodynamic psychotherapy has since evolved into a modern, empirically supported treatment for a wide range of mental health conditions. It differs from more structured therapies like cognitive behavioral therapy by focusing on the deeper forces beneath your symptoms rather than targeting specific thought patterns or behaviors.

  • Exploring unconscious processes. Much of what drives your behavior — your reactions, your relationship choices, your emotional responses — operates below conscious awareness. Psychodynamic therapy brings these unconscious patterns into view so they lose their automatic grip.
  • Understanding how your past shapes your present. Early childhood experiences and relationships with caregivers create templates for how you see yourself, connect with others, and respond to stress. Psychodynamic theory holds that these templates continue shaping your present behavior until they’re consciously examined.
  • Using the therapeutic relationship as a tool for change. How you relate to your therapist often mirrors how you relate to everyone else. The patient-therapist relationship becomes a live laboratory for understanding and shifting your relational dynamics.
  • Working toward lasting insight, not just symptom relief. Psychodynamic therapy aims to help you understand why you think and feel the way you do — producing deeper personality changes that persist and even grow after treatment ends.

The goal isn’t to eliminate difficult emotions or achieve permanent calm. It’s to help you understand yourself well enough that old patterns stop running the show — and new ways of relating to yourself and others become possible.

Our Psychodynamic Therapists
Doctoral-level therapists with advanced training in psychodynamic and psychoanalytic approaches.
Regan Mayo Regan
Michael Burrows Michael
Kevin Isserman Kevin
Rose Medcalf Rose
Rob Drinkwater Rob
Ready to go deeper?
Psychodynamic therapy helps you understand the patterns beneath your symptoms — and change them at the root. Our therapists are here when you're ready.

How Psychodynamic Therapy Actually Works

Psychodynamic therapy isn’t a set of techniques applied to a problem. It’s a particular kind of relationship — one where careful attention to what you think, feel, and avoid gradually makes the invisible visible. The work unfolds through four interconnected processes:

Exploring What's Below the Surface

Most of what drives your behavior — your emotional reactions, relationship choices, self-sabotaging patterns — operates outside conscious awareness. Rather than targeting specific symptoms directly, psychodynamic therapy helps you examine the unconscious processes underneath them. When you understand what’s actually driving a pattern, you gain real leverage to change it.

Understanding Your Relational History

Early relationships with caregivers create templates for how you expect to be treated, what feels safe, and how you connect with others. These templates run quietly in the background — shaping your personal relationships, your self-image, your emotional responses — long after the original relationships ended. Psychodynamic therapy brings these patterns into focus so they stop operating automatically.

Working With Emotion in Real Time

Rather than just analyzing feelings intellectually, psychodynamic therapy pays attention to what you’re actually experiencing in the room — the moment you go quiet, the emotion that surfaces unexpectedly, the topic you keep circling back to. Engaging with emotional suffering as it arises, rather than managing it from a distance, is what produces lasting change rather than temporary symptom relief.

Using the Therapeutic Relationship as a Mirror

How you relate to your therapist tends to mirror how you relate to people outside the room. This isn’t incidental — it’s one of the most powerful tools in psychodynamic work. Noticing what happens between you and your therapist in real time provides direct insight into your relational dynamics and opens up the possibility of experiencing something genuinely different.


Psychodynamic Therapy vs. CBT

If you’ve researched therapy options, you’ve likely encountered both psychodynamic therapy and cognitive behavioral therapy (CBT). Both are empirically supported treatments with strong research backing — including multiple randomized controlled trials and meta-analyses. The differences lie in what they target and how they work.

Psychodynamic Therapy

Explores why you think, feel, and behave the way you do. Examines unconscious patterns, early relationships, and the psychological roots of difficulties. Sessions are open-ended, following your thoughts and feelings where they lead. The patient-therapist relationship is itself a tool for change. Suited to people seeking deep self-understanding and lasting transformation — not just symptom management.

Cognitive Behavioral Therapy

Focuses on what you can change now. Targets specific negative thought patterns and behaviors, teaching concrete skills to interrupt them. More structured, with homework and defined techniques. Better suited when you want rapid symptom relief for specific conditions or prefer a skill-building approach. Often shorter-term than psychodynamic therapy.

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Neither approach is inherently better. Psychodynamic psychotherapy tends to suit people willing to invest in longer-term exploration of deeper psychological issues. Cognitive behavioral therapy and other therapies may be preferable when you need concrete skills quickly. Many of our therapists integrate elements from both, tailoring the comprehensive treatment plan to your specific mental health needs.

Not sure which approach fits?

Our matching tool asks about your goals and preferences — then shows you therapists trained in the approaches most likely to help.


Is Psychodynamic Therapy Right for You?

Psychodynamic therapy focuses on root causes rather than symptom management alone. It tends to be particularly valuable for people who recognize themselves in some of these patterns:

The same relationship patterns keep repeating across different partners, friendships, or workplaces
Anxiety, depression, or other symptoms return even after treatment — acute symptoms improve but something deeper persists
You feel disconnected from your emotions or struggle to identify what you’re actually feeling
You sense that something deeper is driving your difficulties — beyond what’s visible on the surface
Uncomfortable feelings seem to come from nowhere or feel disproportionate to the situation
Early life experiences continue to affect you in ways you haven’t fully understood
You want to understand why you think and behave the way you do — not just manage symptoms
You feel stuck in problematic relationship patterns around work, intimacy, or self-image

Psychodynamic therapy is effective for depression, anxiety disorders (including social anxiety disorder and generalized anxiety), post-traumatic stress disorder, personality disorders, eating disorders including bulimia nervosa, substance use concerns, and chronic difficulties in personal relationships. It’s particularly well-suited to common mental disorders that haven’t responded fully to other therapies, or where symptoms improve temporarily but return.

What the Research Shows

Psychodynamic therapy is an empirically supported treatment backed by decades of clinical research. Meta-analyses consistently demonstrate that psychodynamic psychotherapy produces significant symptom improvement across a wide range of psychological disorders — comparable to cognitive behavioral and other evidence-based therapies. One major meta-analysis found large effect sizes for overall symptom improvement, interpersonal functioning, and social adjustment.

0.97
average effect size for overall symptom improvement — a large, clinically meaningful result (Shedler, 2010)
Long-term
benefits that continue growing after treatment ends — unlike many symptom-focused therapies
Comparable
effectiveness to CBT across multiple randomized controlled trials and conditions

Importantly, the changes made through psychodynamic therapy can last a long time — often growing even after treatment has ended. This “sleeper effect” distinguishes psychodynamic therapy from therapies that produce faster short-term gains but less durable change. Research indicates these lasting effects stem from addressing deeper psychological issues rather than just managing acute symptoms.

What to Expect in Psychodynamic Therapy

Psychodynamic therapy is less structured than skills-based approaches. There’s no homework, no worksheets. What there is: consistent space to explore, a therapist paying close attention, and a gradually deepening understanding of yourself.

1

Getting Oriented (Sessions 1–4)

Your therapist focuses on understanding what brings you to therapy and building a picture of your life history, relationships, and patterns. There’s no pressure to reveal everything at once — trust develops over time. Your therapist begins forming a sense of a comprehensive treatment plan based on your unique psychological history and present concerns. The success of therapy often depends on the quality of the therapeutic alliance, so finding a therapist you feel comfortable opening up to is essential.

2

Uncovering Patterns (Months 1–3)

As sessions continue, recurring themes begin to emerge — in what you talk about, how you relate to your therapist, the emotional suffering you return to. Your therapist helps you start connecting present behavior to earlier experiences, making the unconscious processes that have been driving you visible. Defense mechanisms become recognizable rather than automatic.

3

Active Exploration (Months 3–12+)

This is where the deeper work happens. You examine how early life experiences shaped your templates for relationships, self-worth, and emotional regulation. Transference — your reactions to your therapist — becomes a live source of insight. Painful feelings get examined rather than avoided. Problematic relationship patterns become something you can observe and begin to change.

4

Integration & Lasting Change

Progress in psychodynamic therapy looks different from symptom-focused approaches. You may notice you understand yourself better, respond to familiar triggers differently, or find that healthier relationships feel genuinely possible. Beyond overall symptom improvement, you’ll likely see changes in how you relate to yourself and others — changes that research shows often continue growing even after therapy ends.


Why Washington DC Chooses Therapy Group of DC for Psychodynamic Therapy

The psychodynamic perspective is our home base

Our practice was founded by two psychologists trained in counseling and family psychology — both with deep roots in the psychodynamic tradition. This isn’t a practice that offers psychodynamic therapy as one option among fifteen. The psychodynamic perspective is how we understand people: through their history, their relationships, the unconscious conflicts that organize their inner lives. Clients who’ve felt frustrated with symptom-only approaches often find this orientation feels right.

DC attracts people who’ve outgrown surface-level work

Washington draws intellectually curious, high-achieving people who often have complex internal lives beneath their professional success. Many come to us having done therapy before — they’ve managed their anxiety or depression situationally, but the same patterns keep returning. The political volatility, the transient population, the pressure of being constantly measured against your peers: these create fertile ground for the kind of deeper exploration psychodynamic therapy offers. We understand the city and the particular forms of psychological distress it tends to produce.

Specialists in depth work — not generalists

Our psychodynamic therapists hold doctoral-level credentials and have extensive training in psychoanalytic theory, object relations, attachment research, and contemporary psychodynamic psychiatry. We integrate psychodynamic theory with modern neuroscience and empirical evidence — not because it’s trendy, but because it makes the work more effective. We also offer brief psychodynamic therapy for more focused concerns, and can discuss whether short-term psychodynamic psychotherapy or longer-term work fits your situation.

From Our Practice

Many clients tell us they’ve done therapy before but it felt like putting out fires — managing crisis after crisis without ever understanding why the fires kept starting. Psychodynamic therapy addresses the underlying conditions.


Individual Session Rate
$230–$300
Many clients receive partial reimbursement through out-of-network benefits.
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Frequently Asked Questions About Psychodynamic Therapy

What are the 5 elements of psychodynamic therapy?
The core elements of psychodynamic therapy include: (1) focus on emotions and their expression, including painful feelings and uncomfortable feelings you may typically avoid; (2) exploration of past experiences and early life experiences that shaped your development; (3) examining unconscious processes, unconscious conflicts, and defense mechanisms operating below conscious awareness; (4) attention to relationship patterns and interpersonal relationships; and (5) using the therapeutic relationship to understand and change broader relational dynamics. These core principles distinguish psychodynamic therapy from other therapeutic approaches such as cognitive behavioral therapy.
What are the four techniques of psychodynamic therapy?
The four main psychodynamic therapy techniques are: (1) free association, where you speak openly about whatever comes to mind to help uncover unconscious thoughts and feelings; (2) dream analysis, which treats dreams as a window into the unconscious, surfacing hidden desires, fears, and unconscious conflicts; (3) exploration of transference, examining how you redirect feelings from past relationships onto your therapist to understand your broader relational dynamics; and (4) analysis of defense mechanisms — identifying the unconscious psychological strategies you use to protect yourself from uncomfortable feelings. Modern psychodynamic therapy techniques emphasize the first and third most heavily, with dream analysis playing a less central role than in classical psychoanalytic therapy.
What is psychodynamic therapy vs. CBT?
Psychodynamic therapy explores the unconscious patterns and past experiences driving your difficulties, working toward deep self-understanding and lasting insight. Cognitive behavioral therapy focuses on changing specific thought patterns and behaviors in the present through structured skills. Both are effective treatments with strong empirical evidence — psychodynamic therapy differs from CBT by being longer-term and focusing on underlying causes of behaviors, while cognitive behavior therapy is often shorter and more skills-focused. Research shows psychodynamic therapy benefits often continue growing after treatment ends, which distinguishes it from some other therapies psychodynamic approaches are compared to.
Who is best suited for psychodynamic therapy?
Psychodynamic therapy is particularly valuable for people who want to understand the roots of their difficulties, not just manage symptoms. It’s especially well-suited for those with repeating patterns in relationships or life choices, people whose symptoms return after other treatments, and individuals seeking deeper personality changes. It also tends to work well for those experiencing depression, anxiety disorders, personality disorders, eating disorders, and chronic interpersonal difficulties — particularly when these mental health conditions seem rooted in deeper psychological issues rather than isolated circumstances.
Is psychodynamic therapy evidence-based?
Yes. Multiple randomized controlled trials and meta-analyses demonstrate that psychodynamic psychotherapy is an empirically supported treatment with effectiveness comparable to other evidence-based therapies. One major meta-analysis (Shedler, 2010) found large effect sizes for overall symptom improvement, interpersonal functioning, and quality of life. A distinctive finding: the benefits of psychodynamic therapy often continue growing even after treatment has ended — suggesting deeper psychological roots are being addressed rather than just acute symptoms. This ongoing symptom improvement distinguishes psychodynamic therapy from therapies with faster but less durable effects.
What's the difference between psychodynamic therapy and psychoanalysis?
Psychodynamic therapy evolved from psychoanalytic therapy but is more practical for most people. Psychoanalytic therapy (psychoanalysis) typically involves multiple sessions per week over several years and follows classical psychoanalytic technique more closely — including more intensive use of free association and dream analysis. Psychodynamic psychotherapy usually meets once weekly, is more focused, and integrates modern research on attachment, neuroscience, and relational dynamics. Both explore unconscious processes and how early experiences shape present behavior — psychodynamic therapy does so in a more accessible, contemporary format. Our practice includes therapists trained in both psychoanalytic and psychodynamic approaches.
How long does psychodynamic therapy take?
Treatment length varies based on your goals. Brief psychodynamic therapy or short-term psychodynamic psychotherapy typically runs 12–20 sessions and focuses on a more specific concern. Many people choose long-term psychodynamic therapy for more comprehensive transformation of longstanding patterns — this can range from several months to a few years. Unlike therapies psychodynamic work is sometimes compared to unfavorably on length, the duration reflects the depth of change being pursued: understanding and shifting core personality patterns and relationship dynamics takes more time than learning specific coping skills. Our therapists will discuss what timeline makes sense for your situation.
What mental health conditions does psychodynamic therapy treat?
Psychodynamic therapy effectively treats depression, anxiety disorders (including generalized anxiety, social anxiety disorder, and panic disorder), post-traumatic stress disorder and complex trauma, personality disorders, eating disorders including bulimia nervosa, substance use concerns, and chronic difficulties in interpersonal relationships. Research confirms this therapeutic approach creates lasting overall symptom improvement across a wide range of psychological disorders and common mental disorders. It’s particularly effective when mental health symptoms stem from deeper psychological patterns — or when symptoms return after other treatments have provided only temporary relief.