Psychodynamic Therapy

Through techniques like free association, Psychodynamic therapy connects past and present experiences to foster insight and better relationship patterns.

Introduction

The basics

What is Psychodynamic Therapy?

Psychodynamic Therapy is a form of Insight-Oriented Therapy. Like all therapies in this category, Psychodynamic Therapy is centered on increasing self-awareness and understanding of how your past experience influences your present behavior.

Goal

What is the goal of Psychodynamic Therapy?

Psychodynamic therapy aims to help you understand why you do what you do, feel what you feel, and relate to others in particular ways. This increased self-awareness then allows for more choice in how you handle situations and relationships.

Uses

What conditions does Psychodynamic Therapy treat?

Psychodynamic therapy can be beneficial for a variety of mental health related concerns. This type of therapy could be effective for treating:

  • Depression
  • Anxiety
  • Disordered eating
  • Personality disorders
  • Psychosomatic issues
  • Relationship difficulties

You might be best suited for Psychodynamic Therapy if you have the capacity to be self-reflective and are looking to obtain insight into yourself and your behavior.

Subtypes

What are the subtypes of Psychodynamic Therapy?

Several variations of psychodynamic therapy have been developed to achieve a specific goal or treat a specific mental health condition.

Types of psychodynamic therapy include:

  • Brief Psychodynamic Therapy: short term approach focused on one specific issue
  • Mentalization-based treatment (MBT): used mainly for borderline personality disorder, MBT is used to help clients understand their own thoughts, feelings, and motivations, as well as those of others
  • Transference-focused psychotherapy: a combination of Psychodynamic Therapy and object relations theory, focused on understanding how a client’s internalized images of self and others influence their relationships
  • Supportive-expressive therapy: a short term treatment targeting substance use disorders
  • Cognitive-analytic therapy: a combination of psychodynamic and cognitive approaches; this approach helps people, specifically those who have experienced trauma, understand how past experiences are impacting current thoughts, feelings, and behaviors

Effectiveness

Origins

Who developed Psychodynamic Therapy and when?

Psychodynamic therapy evolved from Psychoanalysis in the mid-20th century, developing as a more flexible and accessible adaptation of psychoanalytic principles. Rather than being created by a single person, it emerged through the work of many theorists and practitioners who sought to make psychoanalytic insights more practical and applicable to a wider range of clients.

Key contributors to Psychodynamic Therapy included Erik Erikson, Karen Horney, and Donald Winnicott, who each added important perspectives about human development and psychological functioning.

Evidence Base

Is Psychodynamic Therapy evidence based?

The evidence base for Psychodynamic Therapy is quite strong. Modern research, including numerous randomized controlled trials and meta-analyses, demonstrates its effectiveness for various conditions.

Particularly noteworthy is the finding that the benefits of Psychodynamic Therapy often continue to grow after treatment ends. Studies show that the therapeutic gains tend to be stable and long-lasting, with patients continuing to process and integrate their insights even after therapy concludes.

How it works

Techniques Used

How does Psychodynamic Therapy work?

Psychodynamic Therapy works by using a variety of techniques to help you make connections between your past and present experiences, and your conscious and unconscious mind.

Techniques used in psychodynamic therapy include:

  • Free association: talking freely about anything that comes to mind
  • Dream analysis: finding symbolic meaning in dreams
  • Transference: recognizing how past relationships and experiences are connected to the therapeutic one
  • Interpretation: understanding the deeper meaning of thoughts, feelings, and behaviors
  • Working through: finding interpretations in different contexts
  • Catharsis: releasing repressed emotions to promote healing

A psychodynamic therapist will help you notice patterns in your thoughts, feelings, and relationships; they may encourage you to express and process difficult emotions; and/or psychodynamic therapists may have you examine unresolved conflicts and symptoms from past relationships or experiences. Through these techniques and processes, you’re encouraged to gain new perspectives.

What to expect in a session

What can I expect from sessions in Psychodynamic Therapy?

  1. You'll sit face-to-face with your therapist and talk about whatever is on your mind through free association.
  2. The therapist listens carefully not just to what you say, but how you say it and what you might be leaving out.
  3. They might draw your attention to patterns they notice, ask about your feelings in the moment, or help you make connections between current situations and past experiences.

The atmosphere is usually thoughtful and exploratory rather than directive.

Treatment length & structure

How long does Psychodynamic Therapy typically take? Is there any set structure?

Unlike traditional psychoanalysis, Psychodynamic Therapy typically involves one or two sessions per week and can last anywhere from a few months to several years.

While there isn't a rigid structure, the therapy tends to move through phases:

  1. Beginning with building trust and exploring current difficulties
  2. Gradually examining deeper patterns and their origins
  3. Working toward integration and ending

The length often depends on the depth of the work needed and your personal goals.

Getting care

Finding a therapist

How do I find a therapist who uses Psychodynamic Therapy?

Alma’s directory has many therapists who specialize in Psychodynamic Therapy, including:

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This article was written and medically validated by Elise Mendelsohn, LMSW.

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