Psychodynamic Therapy
By Jessica Chang, MHC-LP
What is it?
Psychodynamic therapy is an in-depth form of talk therapy rooted in psychoanalytic theory and based on the work of Sigmund Freud, however different from psychoanalysis. Psychodynamic therapy emphasizes how a person’s feelings, past experiences, and subconscious thoughts may be affecting their current behavior. It takes into account the multifaceted nature of an individual’s life and sense of being. Psychodynamic therapy aims to relieve present symptoms through gaining insight, understanding, and self-awareness, which further allows the individual to gain agency and make informed decisions in how they navigate life and relationships moving forward.
How is it different from psychoanalysis?
Psychodynamic therapy is typically less intensive, i.e. less frequent per week, and shorter in duration than psychoanalysis. While psychoanalysis mainly focuses on the client-therapist relationship, psychodynamic therapy investigates the client’s relationships with their external world in addition to the relationship between client and therapist.
What can it help treat?
Depression
Eating disorders
Interpersonal problems
Personality disorders
Psychological distress
Social anxiety disorder
Substance use disorder
Chronic and abdominal pain
Less effective pertaining to ptsd, ocd, drug addiction, and psychosis
Who is a good candidate for psychodynamic therapy?
A psychodynamic approach has been shown to be effective with children, adolescents, and adults for individuals, couples, families, and in group therapy situations. Psychodynamic therapy is most effective for those who are open to delving into their life history. As this therapeutic orientation requires clients to look inwards to gain insight into themselves and their behavior, it is best-suited for those who have the capacity to be self-reflective and introspective at the time of treatment.
How does it work?
Psychodynamic therapy focuses on recognizing, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions from the past which are showing up in the present to improve the client’s interpersonal experiences and relationships. The client is encouraged to speak freely about whatever comes to mind, including present difficulties, fears, desires, dreams, fantasies, etc. The therapist will inquire about the client’s individual thoughts, emotions, beliefs, experiences from early life, interpersonal relationships and relationship history. Through practice, clients learn to investigate their current difficulties through deep exploration and curiosity of earlier experiences and emotions from their past, which they can continue to practice even after termination of treatment. Concisely, psychodynamic therapy helps clients address their current issues through exploring their past and gaining awareness on how previous experiences are influencing their current behavior and relationships.
What does psychodynamic therapy look like in practice?
Identifying patterns and emotions
Through speaking about current and past experiences, the client and therapist will begin to recognize repeated struggles and cycles in personal behavior and interpersonal relationships. By tuning into and gaining awareness of what emotions, thoughts, sensations, reactions, and often automatic responses are coming up in various interactions with oneself and others, clients can identify areas they have not yet fully processed.
Gaining understanding
The client and therapist will explore and gain insight on overt and repressed emotions, their function, and how they may contribute towards unwanted behaviors and patterns, decision-making, and relationships. Self-defeating behaviors and origins of social difficulties will also be investigated. By gaining understanding of emotions, thoughts, behaviors, and patterns, clients will be able to identify areas of opportunity for change and improvement as well as their strengths and capabilities.
Exploring transference and countertransference
Transference and countertransference are inevitable in psychodynamic work and can be utilized to gain further insight into the client’s presenting problems. Transference occurs when a client redirects their feelings toward someone onto the therapist, and countertransference is a therapist’s reactions and feelings towards the client. The relationship between the therapist and client provides a container in which a client’s identity, beliefs, feelings, thoughts, perspectives, and past experiences can be explored. This container can also be used to try out new ways of interacting and addressing thoughts and behaviors in real time as they come up.
Improving relationships with others
Psychodynamic therapy emphasizes relationships with oneself and others; understanding one’s thoughts and responses to others allows clients to identify what is coming up for them within and outside of various relationships and gain awareness and sense of agency in their interactions with themself and others. These responses and patterns are often reenacted in the therapy space within the client and between the client and clinician, creating a less risky environment to identify old patterns and practice new responses.
Explore new ways of being in the world
Once awareness and understanding are accessed, psychodynamic therapy can help clients to imagine what they want their life to look like and acknowledge and identify opportunities to enact change in their life to move in the direction they want to go. In addition to remission of present symptoms, psychodynamic therapy offers potential for increased self-worth, embracing and utilizing one’s own talents and abilities, and increased capacity for developing and maintaining more satisfying relationships.
Sources
Cherry, K. (2024). What is Psychodynamic Therapy? VeryWell Mind.
Dresden, D. (2020). What is psychodynamic therapy? MedicalNewsToday.
Psychodynamic Therapy | Psychology Today.