What is psychodynamic therapy?
Introduction to Psychodynamic Therapy
Psychodynamic therapy is a form of talk therapy that delves into the unconscious processes and unresolved conflicts shaping present behavior, helping individuals gain self-awareness and resolve psychological issues.
What You’ll Learn
- The core principles of psychodynamic therapy, including its focus on unconscious patterns, defense mechanisms, and the therapeutic relationship.
- How psychodynamic therapy differs from cognitive behavioral therapy (CBT) in its approach to mental health treatment.
- The effectiveness of psychodynamic therapy in treating various psychological disorders and how it can be integrated with other therapeutic approaches.
The Foundations and Evolution of Psychodynamic Therapy
With roots in traditional psychological theories by Melanie Klein and Sigmund Freud, psychodynamic therapy draws on the principles of object relations, self-psychology, and ego psychology.
The psychodynamic approach to talk therapy was initially developed as an alternative to psychoanalytic therapy, which is historically significant as a foundation for many therapies.
Psychodynamic therapy is similar to psychoanalytic theory in that it is an in-depth form of therapy to guide people to better understand themselves and what is going on under the surface. Psychoanalysis, which happens 4-5 times a week, tends to focus strongly on the fine details of how people relate to their therapist, others, and themselves. While it does that too, psychodynamic therapy does this to a lesser degree.
As a form of psychotherapy or talk therapy, psychodynamic therapy aims to address the foundation and formation of psychological processes and emotional distress. With the help of psychodynamic treatment, clients can improve mental health symptoms, navigate interpersonal problems, focus on their strengths and goals, and live more fulfilling lives.
Core Principles of Psychodynamic Therapy
In psychodynamic therapy, therapists help clients gain insight into their daily lives and present-day mental health concerns. Various therapeutic techniques are employed to help clients gain this insight. The psychodynamic perspective focuses on the psychological roots of emotional suffering. It helps clients engage in self-reflection and self-examination.
Essentially, the patient-therapist relationship, or therapeutic alliance, encourages patients to dive into problematic relationship patterns, behaviors, and beliefs in their life. During therapy sessions, psychodynamic therapists evaluate thinking and behavioral patterns that clients have developed over time. Although the structure of psychodynamic therapy will vary depending on the psychotherapist, most psychodynamic approaches involve:
- Focusing on the affect and expression of emotions. With the help of open-ended questions, transference, and free association, the psychotherapist helps the patient explore and discuss the full range of their feelings, unconscious conflicts, and conscious thoughts. The therapist helps the patient put words to feelings, including feelings that are difficult to acknowledge.
- Exploring attempts to avoid distressing thoughts and feelings. Knowingly and unknowingly, patients develop defense mechanisms and unconscious processes to avoid painful thoughts and feelings. Psychodynamic therapists actively explore these attempts.
- Identifying recurring themes and patterns. Psychodynamic therapists work to identify recurring themes in patients’ life experiences, interpersonal relationships, thoughts, and feelings. Sometimes, a patient may be aware that these patterns and unconscious thoughts are self-defeating but feel unable to overcome them. In other cases, the patient may be unaware of these patterns until the therapist brings them to light.
- Discussing past experiences. Therapists explore early-life experiences, the relationship between the past and present, and how past experiences may shape the patient’s current feelings, thoughts, and beliefs. Ultimately, psychodynamic therapists aim to help patients overcome these past experiences and live in the present.
Key Concepts in Contemporary Psychodynamic Therapy
Psychodynamic therapy is an insight-oriented approach that explores emotional and relational patterns influencing thoughts, feelings, and behaviors. Rooted in traditional psychoanalytic theory, contemporary psychodynamic therapy integrates modern research on attachment, neuroscience, and relational psychology.
The following concepts form the foundation of modern psychodynamic therapy:
- Unconscious Patterns: Rather than a hidden “unconscious mind,” contemporary psychodynamic therapy focuses on automatic emotional and relational patterns outside conscious awareness. Identifying and understanding these patterns can help individuals make meaningful changes.
- Defense Mechanisms: Defense mechanisms—such as avoidance, repression, or rationalization—are unconscious strategies used to manage anxiety or emotional distress. Therapists help clients recognize when these defenses are helpful or when they might hinder personal growth.
- Relational Dynamics and Transference: Modern psychodynamic therapy emphasizes recognizing and understanding recurring relationship patterns. Therapists help clients identify how past relational experiences influence current interactions, including those with the therapist, to promote healthier relationships.
- Attachment and Early Experiences: Drawing from attachment theory, psychodynamic therapists examine how early relationships shape an individual’s emotional life and relational style. By exploring these formative experiences, clients gain insight into current emotional and interpersonal difficulties.
- Open Dialogue and Emotional Exploration: Rather than traditional free association, contemporary practice promotes open and emotionally reflective conversations. Clients are encouraged to explore their thoughts and feelings freely, fostering deeper self-awareness.
- Symbolism and Meaning: While classical dream analysis is less emphasized, therapists may still explore dreams, metaphors, and symbolic language to reveal emotional themes or unresolved conflicts.
Today’s psychodynamic therapy is flexible, personalized, and evidence-informed. It aims to cultivate greater self-awareness and emotional resilience, helping clients address underlying emotional struggles and enhance personal relationships.
What should you expect during psychodynamic therapy and from the therapeutic relationship?
Psychodynamic therapy sessions involve a collaborative approach between you and your therapist. During your first session, your therapist will ask about your medical and mental health history, whether you’ve attended therapy before, and what you’re looking to achieve in psychotherapy.
With help from your psychotherapist, you’ll feel encouraged to speak openly about anything that comes to mind, including current mental health issues, fears, dreams, and urges.
The goal of psychodynamic therapy is to help clients increase self-esteem, recognize their abilities, gain self-awareness, and communicate more effectively with their significant others. Psychodynamic theory assumes that chronic problems are rooted in the unconscious mind, and patients must bring these problems to light to experience relief. Thus, the client’s self-awareness is integral to discovering these unconscious patterns of thought and understanding how past experiences shaped them.
In many cases, clients may experience ongoing improvements after psychodynamic treatment has ended. Although brief psychodynamic therapy is sufficient for some individuals, others may find that long-lasting benefits come from long-term psychodynamic therapy. There are various models of short term psychodynamic psychotherapy that can be effective for different issues, including substance abuse and depression.
Who can benefit from psychodynamic therapy?
Even if you’re not living with a mental health condition, you can still benefit from psychodynamic therapies. It is used to treat anxiety, mood disorders, including depressive symptoms and bipolar disorder, relationship problems, and work and career problems. It is also used to treat other serious mental health conditions, especially among individuals who have lost meaning and experience difficulty maintaining interpersonal relationships.
Research has shown that psychodynamic therapy can effectively treat substance abuse and addiction problems, social anxiety disorder, eating disorders, and post-traumatic stress disorder (PTSD). Psychodynamic therapy can also help clients cope with painful feelings, low self-esteem, and unresolved conflicts by exploring past experiences.
Is psychodynamic therapy effective?
According to extensive research, psychodynamic psychotherapy is an effective treatment for a wide range of psychological disorders, including anxiety disorders, depression, substance abuse, and stress. Even in brief-form psychodynamic therapy, the benefits of it continue to grow after treatment ends, according to new research published by the American Psychological Association.
In the study, American psychologist Jonathan Shedler, Ph.D., reviewed eight meta-analyses comprising 160 studies of psychodynamic therapy, as well as nine meta-analyses of other therapeutic approaches and medications, to demonstrate the efficacy of psychodynamic therapy. Dr. Shedler focused on effect size, which measures the amount of change produced by each type of treatment.
In one major meta-analysis of psychodynamic therapy, 1,431 patients with a range of mental health conditions demonstrated an effect size of 0.97 of overall symptom improvement. When researchers re-evaluated patients nine months after treatment ended, the effect size increased by 50 percent, reaching 1.51.
In his research, Dr. Shedler also noted that previous studies have not adequately captured the benefits that psychodynamic therapy aims to achieve. “It is easy to measure change in acute symptoms, harder to measure deeper personality changes. But it can be done.” Dr. Shedler concluded that when other types of therapy, such as cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), are effective, it may be due to unacknowledged elements of psychodynamic theory.
In sum, Dr. Shedler’s research finds strong evidence that psychodynamic therapy is highly effective, and its benefits keep building over time, even after treatment has stopped.
Comparison to Other Therapies
Psychodynamic therapy is often compared to cognitive-behavioral therapy (CBT), another popular form of psychotherapy. While both aim to improve mental health, they differ significantly in their approaches and focus areas.
Cognitive-behavioral therapy (CBT) is structured and goal-oriented, focusing on identifying and changing negative thought patterns and behaviors. It is particularly effective for treating specific issues like anxiety and depression by teaching clients practical skills to manage their symptoms.
In contrast, psychodynamic therapy explores the unconscious motivations and underlying causes of thoughts, feelings, and behaviors. It is often used to address more complex and deeply ingrained issues, such as personality disorders and trauma. By examining past experiences and unconscious processes, psychodynamic therapy aims to foster long-term emotional growth and self-understanding.
While CBT provides immediate tools for symptom management, psychodynamic therapy offers a deeper exploration of the self, making it suitable for individuals seeking to understand the root causes of their psychological distress.
Addressing Criticisms and Limitations
Psychodynamic therapy has faced criticism for its focus on the past and the length and cost of treatment. Critics argue that it may not be suitable for everyone and that it can be too time-consuming and expensive.
However, research has demonstrated that psychodynamic therapy can be an effective treatment for a variety of mental health issues, including depression, anxiety, and personality disorders. Studies have shown that the benefits of psychodynamic therapy often continue to grow even after treatment has ended, suggesting long-lasting positive effects.
Moreover, psychodynamic therapy is adaptable. It can be tailored to fit the needs of each individual patient and can be used in conjunction with other forms of therapy, such as cognitive-behavioral therapy (CBT). This flexibility allows therapists to address both immediate symptoms and deeper, underlying issues, providing a comprehensive approach to mental health care.
In summary, while psychodynamic therapy may not be the quickest or cheapest option, its ability to foster profound personal insight and long-term emotional healing makes it a valuable therapeutic approach for many individuals.
How To Find a Psychodynamic Therapist
A psychodynamic therapist is a licensed mental health professional with advanced training in psychodynamic perspectives, Freudian psychology, and psychoanalytic theory.
Some psychotherapists take different approaches to utilize psychodynamic theory, for example, by combining elements of psychodynamic therapy with other types of psychotherapy. Alongside the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some therapists also use the Psychodynamic Diagnostic Manual (PDM), rooted in psychodynamic theory, to assess mental health.
In addition to finding a mental health professional with training in psychodynamic therapy, it’s essential to search for someone you feel comfortable opening up to. Therapy is an intimate experience, and finding the right psychotherapist can make all the difference. According to the American Psychological Association, forming a therapeutic relationship can boost the success of your treatment, leading to better long-term psychological outcomes.
To find the right fit, reach out to a psychodynamic therapist through the Therapy Group of DC. Whether you’re living with painful feelings or looking to improve your interpersonal relationships, we’ll connect you to a mental health professional you feel comfortable with, in keeping with your personal preferences and requirements.
We know that reaching out for help can feel daunting, and we offer guidance every step of the way. One of our compassionate counselors, psychologists, or therapists will help you gain insight into your mental health and live a more fulfilling life.
Frequently Asked Questions about Psychodynamic Therapy
What is psychodynamic therapy?
Psychodynamic therapy is a therapeutic approach rooted in psychoanalytic theory, primarily developed by Sigmund Freud. It focuses on exploring unconscious processes and unresolved conflicts that influence present behavior. By examining early childhood experiences and relationship patterns, psychodynamic therapy aims to foster self-awareness and address psychological problems.
How does psychodynamic therapy differ from cognitive behavioral therapy (CBT)?
While both psychodynamic therapy and cognitive behavioral therapy (CBT) aim to improve mental health, they differ in their approaches. Psychodynamic therapy focuses on uncovering unconscious thoughts, emotions, and past experiences that shape current behavior. In contrast, CBT is more structured and goal-oriented, concentrating on changing negative thought patterns and behaviors through practical skills.
Can psychodynamic therapy help with eating disorders like bulimia nervosa?
Yes, psychodynamic therapy can be effective in treating eating disorders such as bulimia nervosa. By exploring the unconscious patterns and emotional distress underlying these disorders, psychodynamic therapists help clients gain insight into their behaviors and develop healthier relationship patterns with food and self-image.
What role does the therapeutic relationship play in psychodynamic therapy?
The therapeutic relationship is a significant influence in psychodynamic therapy, as it provides a safe space for clients to explore their unconscious thoughts and feelings. A trusting relationship between the patient and therapist facilitates open dialogue and emotional exploration, which are crucial for achieving lasting benefits and self-knowledge.
What are the benefits of brief psychodynamic therapy?
Brief psychodynamic therapy offers a focused approach, addressing specific psychological issues within a shorter time frame than traditional long-term therapy. It is particularly effective for treating depression, anxiety, and interpersonal problems by concentrating on key themes and patterns in a client’s life.
How does psychodynamic therapy address personality disorders?
Psychodynamic therapy addresses personality disorders by exploring the unconscious conflicts and early life experiences that contribute to maladaptive behavior patterns. By gaining insight into these underlying issues, clients can work towards healthier ways of relating to themselves and others.
How is psychodynamic therapy supported by empirical evidence?
Research supports the effectiveness of psychodynamic therapy for a range of psychological disorders. Studies have shown that its benefits often continue to grow after treatment ends, with clients experiencing long-term improvements in emotional resilience and self-awareness.
Can psychodynamic therapy be integrated with other therapeutic approaches?
Yes, psychodynamic therapy can be combined with other therapeutic approaches, such as cognitive behavioral therapy, to address both immediate symptoms and deeper psychological issues. This integrative approach allows for a comprehensive treatment plan tailored to the individual’s unique needs.
