Psychodynamic Therapy: A Beginner’s Guide

When you imagine therapy, you probably picture someone sitting on a couch and pouring out their heart to a therapist, who’s nodding along sympathetically and writing on a notepad. This mirrors what Psychodynamic therapy is: A form of talk therapy that helps you understand yourself better, reflect on how past experiences have shaped you and find relief from mental or emotional stress.

Psychodynamic Therapy: What Is It?

Our lives consist of the sum of all the experiences that we’ve ever had. Each experience leaves a mark, either positively or negatively. Over time, these experiences build up and create habits or patterns of behavior. As human beings, we usually tend to carry on living without pausing to understand how our experiences have shaped us. Some of the habits and patterns of behavior that are formed can become very hard to break out of.

Psychodynamic therapy examines the process behind certain behaviors and the reason(s) for those behaviors. It digs deep in a bid to answer the question: “Why are you who you are? What experiences shaped you into the person who you currently are?”.

The brain tends to bury painful or traumatic memories and events. When this happens, we often subconsciously develop coping mechanisms, so we don’t have to confront these painful emotions. This is commonly referred to as ‘denial’ or ‘projection’. People usually aren’t aware of doing it.

Psychodynamic therapy, sometimes referred to as psychodynamic counseling or insight-oriented therapy, is centered on self-awareness and understanding how past events or trauma currently affect a person. Psychodynamic therapists help people gain insight by helping them recognize certain patterns that have developed over time.

Psychodynamic Theory

Psychodynamic therapy developed from the theories of Sigmund Freud, who believed that our childhood experiences are significant, and they continue to have an impact on us during adulthood. He posited that the human mind has three parts:

  • The id, made up of natural instinct and forms the unconscious mind
  • The superego, which is the moral part of the brain that contains our beliefs of right and wrong
  • The ego, which is the bridge between the animal instinct of the id and the refined moral thoughts of the superego (Haggerty, 2016)

This hypothesis led to the logical conclusion that his theory is based on: Our personalities are formed through our childhood experiences.

Freud’s hypothesis was that these components developed in certain stages of childhood. He believed that we are born with the id, the ego is developed when we are toddlers and the superego comes around the age of five. Freud also believed that the development of each component is significantly influenced by relationships, such as family relationships and the environments. These factors could aid the development of a healthy sense of self or lead an individual to exhibit dysfunctional behavior. Basically, Freud believed that human behavior is driven by that which is buried deep within the mind. He called this the unconscious mind.

Based on this, Freud believed that to truly solve human problems, we must find the roots of the problems in the unconscious mind. The unconscious mind houses our innermost beliefs, thoughts, and patterns of behavior developed in childhood. It is upon this foundation that Psychodynamic Theory is established. Many of the themes in the psychodynamic approach mirror Freud’s theories:

  • The unconscious mind controls human behavior and emotion
  • Every behavior is influenced by something
  • Childhood experiences shape who we become as adults

These theories have formed the basis of psychodynamic therapy and greatly influenced the methods and techniques that are used.

How Does Psychodynamic Therapy Suggest The Mind Works?

Proponents of psychodynamic therapy believe that the way we behave is influenced by both conscious and unconscious motives and that by talking about their problems and experiences, people find ways of understanding how their past influences their present behavior.

How does Psychodynamic Therapy Cause Change?

The fundamental goal of psychodynamic therapy is to bring painful memories and events that have been buried in the subconscious mind to the conscious mind by helping individuals to unravel and experience these feelings so they can be resolved. In essence, Psychodynamic therapy helps individuals:

  • Develop self-awareness.
  • Understand the past.
  • Realize how the past has influenced and shaped the present.
  • Understand the reasons they act the way they do.
  • Feel better equipped to handle life, and be the best person they can be.

What Happens In A Psychodynamic Therapy Session?

As explained above, Psychodynamic therapy is a process which aims to understand how the subconscious such as traumatic experiences and events that have been suppressed, affect a person’s behavior. To do this, psychodynamic therapy uses the relationship that exists between the therapist and the client. This relationship is built on trust and openness and unconditional acceptance. The therapist creates an enabling environment that encourages the patient to open up and share freely.  The direction that the therapy session takes is usually governed by how the patient is feeling at that moment. The patient is encouraged to talk about their feelings, emotions, fears, and desires with minimal interruption from the therapist. As the patient does this, patterns of behavior that are rooted in past experiences, emerge. The therapist guides the patient in seeing how past experiences are currently affecting them and helps the patient develop the ability to deal with these issues in a healthy manner.

Techniques Used In Psychodynamic Therapy

Psychodynamic therapy sessions can last for months or years. Although it’s typically less intense than psychoanalysis, it uses similar techniques to psychoanalytic therapy. These techniques are used by therapists to help patients understand how their mind works, and they include the following:

Free Association: This technique is very simple, yet very effective. It involves letting the patient lead the discussion in a psychodynamic therapy session. The patient is encouraged to talk freely to the therapist by saying the first thing that they think of. It’s spontaneous and allows true thoughts and feelings to emerge without restraint. It allows the patient to share how they truly feel without any form of censorship.

Therapeutic Transference-  This kind of therapy is heavily focused on deep-rooted and intense emotions, so it’s likely that those feelings will manifest in the relationship between the therapist and the patient. Depending on the types of feelings, the patient may begin to feel a range of emotions such as love, hate, distrust, or anger towards the therapist. These feelings usually mirror the feelings that the patient has towards the cause of their problems. By being able to recognize and explore this relationship, the patient will begin to understand how and why they feel the way they do.

Interpretation- The therapist generally lets the patient lead the direction of the conversation, and usually listens quietly. Though, occasionally the therapist may interject with thoughts about the topics the patient chooses to discuss.

Does Psychodynamic Therapy Work?

Studies show that psychodynamic therapy helps patients boost their self-esteem, improve their capacity to create and maintain healthy relationships and become more self-aware.

What Kind Of Concerns Is Psychodynamic Therapy Best For?

Psychodynamic therapy can help with a wide range of mental health problems, but it’s primarily used to treat depression and anxiety. It’s focused on helping those who feel like life has no meaning, and have difficulty forming new relationships or maintaining existing ones. Some other conditions psychodynamic therapy is used to treat include:

  • Post Traumatic Stress Disorder
  • Panic Disorders
  • Personality disorders, e.g Borderline Personality disorder
  • Prolonged sadness
  • Continual feelings of sadness and isolation
  • Addiction
  • Social anxiety disorder
  • Eating disorders

How Are Psychodynamic Therapy Specialists Trained?

Psychodynamic therapists are trained to help patients explore and get to the root of difficult and often painful emotions and experiences, or reflect on patterns of behavior and habits that may not serve them positively. They listen to the patient and guide the patient towards making connections between experiences and events and recognizing patterns. Psychodynamic therapy specialists are usually trained to be non-judgemental. This is essential because the patient needs to be able to trust them in order to share freely. They’re also trained to interpret behaviors and share these interpretations with the patient. The therapy sessions are usually relaxed in nature. The therapist may guide the patient by asking questions like: ‘How does that make you feel’ or ‘What does that remind you of’? Their training helps them to be patient and go at the patient’s pace. Psychodynamic therapists believe that how the client relates to them usually reflects how they act in other relationships. They observe how the client interacts with the therapeutic relationship and use that as a way to understand the client’s relationship habits.

Limitations Of Psychodynamic Therapy

Psychodynamic therapy has great advantages for patients. However, it has some limitations. The key features of psychodynamic therapy such as the lack of a definite structure or agenda, the focus on past experiences, the time span and the role the therapist plays can translate into some negatives. Some of the limitations of psychodynamic therapy include:

  • It could be expensive because of the long-term commitment that’s requirement.
  • People with busy schedules may not be able to set out time for this sort of therapy because it requires at least one session that spans an hour in one week, and it can last for several months or even years.
  • It requires deep digging, probing and sharing personal history which some people may not be comfortable with.
  • It requires dedication because it takes a long time before the patient starts to see visible changes.
  • It relies on theoretical constructs that may be difficult to prove such as the concept of the unconscious mind.
  • It requires interpretation by the therapist which means that it lacks objectivity.
  • The lack of structure can sometimes mean that not much progress is being made.
  • It’s difficult to test in an empirical manner.

It’s important to remember that every form of therapy has its pros and cons, and what’s essential is to for you to find what suits your needs and addresses the specific issues that you have.

How To Find A Therapist

Your therapist plays a very important role in your life, and it’s important that you find one that you can trust. It’s also very important that you find the right one for you. The first thing you should do is figure out the type of professional you need based on the issue you have. If you have no clue what’s wrong with you, you might need to get diagnosed first. After this, the next step should be to search online and ask friends for recommendations. To narrow this down, you need to know the qualities to look for in a therapist.

What Should I Be Looking For In A Licensed Medical Health Practitioner?

When choosing a mental health provider, here are some of the factors you should consider:

  • Their background, education, and training.
  • Their license and years in practice.
  • Their area of specialty.
  • Their treatment approaches and philosophy.
  • The insurance providers that they work with.
  • Their fees, office hours and the typical length of sessions.

This information is typically available on their official website. After this background check, the next step is to schedule a phone call with the potential therapist.

Questions To Ask A Potential Therapist

Your consultation phone call is a great opportunity to know your therapist before committing to an appointment. During the call, you should tell them about your background, what you’re struggling with and your therapy goals. This is also a great time to ask them any questions that you might have about the way they work, their experience and how they suggest treating the problem you have. Don’t hesitate to ask a lot of questions. The answers to these questions help you know if the therapist will be the right fit for you. Here are some sample questions to ask a potential therapist:

  • My problem is ______, how would you treat that?
  • What experience do you have working with the type of problem that I have?
  • What is your approach to situations like mine?
  • Do you tend to lead the session, or do you allow your clients to determine the direction of the sessions?
  • What are your strengths as a therapist?

Always remember that the best therapist is someone you feel comfortable with discussing your personal issues with. This is especially important for psychodynamic therapy because it’s heavily dependent on the relationship between the patient and the therapist.

As an alternative to traditional therapy, ThriveTalk provides online therapy services. We provide therapists trained in many different styles, including psychodynamic therapy, who have great experience working with clients just like you and are committed to creating the best environment for you to flourish. If you’re looking for a psychodynamic therapist, please don’t hesitate to contact us.

Psychodynamic therapy is one of the types of therapies that works best for people with specific needs who are willing to be patient and commit to the process. Individuals who are genuinely interested in exploring their mind and knowing who they really are, in order to solve their present issues usually benefit the most. Psychodynamic therapy goes to the roots of the issue and provides the patient with self-awareness and knowledge that can be applied throughout their life.

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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