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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?
- You'll sit face-to-face with your therapist and talk about whatever is on your mind through free association.
- The therapist listens carefully not just to what you say, but how you say it and what you might be leaving out.
- 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:
- Beginning with building trust and exploring current difficulties
- Gradually examining deeper patterns and their origins
- 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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Similar types of therapy
Besides Psychodynamic Therapy, what other types of therapy might be right for me?
If after reading this, you’re not sure if Psychodynamic Therapy is quite the right fit, here are some other types that might be worth looking into:
Psychoanalysis: if deeper long-term insight feels useful
Psychoanalysis explores unconscious patterns, early experiences, and recurring conflicts through deep, long-term self-exploration.
Attachment-Focused Psychotherapy: if relational safety feels central
Attachment-focused psychotherapy explores how early caregiving and relational patterns shape trust, safety, intimacy, and emotional regulation.
Interpersonal Psychotherapy: if relationships are affecting symptoms
IPT focuses on how mood symptoms are connected to relationship patterns, role transitions, grief, and interpersonal stress.
Internal Family Systems (IFS): if inner conflict feels familiar
IFS helps people understand inner “parts” with curiosity and compassion, with the goal of strengthening a grounded, compassionate self-leadership.
This article was written and medically validated by Elise Mendelsohn, LCSW.
FAQs
Psychodynamic therapy tends to be a strong fit for people who are curious about themselves and drawn to understanding the deeper "why" behind their patterns — why they keep ending up in the same kinds of relationships, why certain emotions feel impossible to access, or why they react to things in ways that don't quite make sense even to them. It's particularly well-suited to people whose struggles feel more complex or long-standing than a specific symptom that needs fixing. If you're the kind of person who wants more than coping strategies and finds meaning through exploration and reflection, psychodynamic therapy is worth exploring.
Absolutely. This therapy can be delivered successfully and securely through video sessions. Research has proven that the outcomes for online therapy are comparable to face-to-face sessions across most therapeutic approaches and concerns. If you're looking for this type of therapy online, you can use this link to find an in-network therapist who is trained in psychodynamic therapy.
Whether psychodynamic therapy sessions are covered for you depends on your individual insurance plan. Most major insurance plans cover therapy when it's provided by a licensed mental health professional, regardless of the type of therapy you choose. What matters more is whether therapy is considered medically necessary given your diagnosis. The best way to find out what you'll pay is to check your plan's explanation of benefits, call the member services number on your insurance card, or use Alma's free cost estimator tool before booking.
CBT is structured, present-focused, and skills-oriented — it works best when you want to identify and change specific unhelpful thoughts or behaviors in a relatively short time frame. Psychodynamic therapy is more exploratory and open-ended, focused on uncovering the unconscious patterns and past experiences that shape how you feel and relate to others. Where CBT might help you challenge an anxious thought, psychodynamic therapy asks where that anxiety came from and what it might be protecting you from. Both have strong evidence bases, but they offer different things — one is more like targeted problem-solving, the other is more like a deep and meaningful excavation.
Yes, and this is one of the areas where psychodynamic therapy particularly shines. The approach is centrally concerned with how our earliest relationships — with parents, caregivers, and siblings — become templates for how we connect with people throughout our lives. A psychodynamic therapist will help you recognize these patterns as they show up in your current relationships, including, sometimes, in your relationship with your therapist. Through that process of noticing, understanding, and experiencing something different, many people find that long-standing relational patterns begin to shift.
Psychodynamic therapy's attention to the past doesn’t require you to dwell on difficult memories. Instead, it's about understanding how it lives in the present. The premise is that many of our automatic reactions, emotional blocks, and relationship difficulties are shaped by experiences and patterns we developed early in life, often without being aware of it. By bringing those influences into consciousness, you gain more choice about how you respond. Notably, research has shown that the benefits of psychodynamic therapy often continue to grow after treatment ends, as insights deepen over time — a finding that distinguishes it from more symptom-focused approaches.
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