What Is Psychodynamic Therapy?

What is Psychodynamic Therapy?

Psychodynamic therapy (PDT)  is one of the original therapy modalities, deriving from Sigmund Freud’s psychoanalytic theory. Picture traditional talk therapy, but without the client lying down or facing away from the therapist. Through client-led dialogue, PDT aims to uncover unconscious emotions and beliefs that a person is unaware of.

The theory driving this modality is that past experiences shape present day behavior and perception. In short, it is connecting the past to the present.

PDT is unique in that it focuses on uncovering the “why” of our behaviors as opposed to practicing problem solving methods.

Why use Psychodynamic Therapy?

PDT is not “quick fix” therapy. Before learning coping strategies, it helps to first understand who we are and identify what might be problematic in our lives in the first place. Jumping to skill-building and symptom reduction too rapidly can result in us missing important details about ourselves. PDT posits that our past experiences shape who we are today, and our current experiences shape who we will become. By digging deeper and examining our past in more detail, we gain an understanding into what our negative patterns are.

I often receive new clients who are looking for the opportunity to gain insight into who they are and do not want structured, goal-focused therapy (for example, cognitive behavioral therapy) with homework between each session. For many people, talking out loud is what helps them discover their own beliefs, thinking patterns, and strengths.

In this way, PDT feels freeing and empowering. PDT’s open-ended timeline does not require a hard termination date, allowing clients to feel that there is no “pass/fail” deadline if they have not reached a goal in a specified amount of time.

What Does Psychodynamic Therapy Look Like in the Room?

PDT centers on the connection between therapist and client. As described previously, PDT is talk therapy with the client and therapist sitting down and facing each other. In session, the relationship between therapist and client serves as an opening into understanding problematic relationship patterns in the client’s life.

Because therapy uses personal and sensitive material, building the therapeutic alliance enables the client to more easily open up and examine unresolved conflicts and symptoms that arise from dysfunctional relationships.

Discussion is client-led, flows freely and is unstructured. The therapist may interject to clarify, ask questions, or reflect back, however it is the client who provides most of the dialogue. The therapist mainly listens and observes, providing minimal interpretation.

The therapist can point out their observations that the client may be unaware of. For example, “I noticed you looked down after you mentioned your brother’s name. Can you tell me what you were feeling in that moment?”  

The therapist may help the client discover repetitive patterns that seem harmful, with statements such as, “You mentioned that the last time you had a break up, you avoided going outside and seeing friends. It seems that after this most recent loss, you also stayed indoors and ignored your friends' outreach.”

What Conditions Does Psychodynamic Therapy Treat?

PDT is an option for clients with a variety of mental health disorders. Outcome studies have shown PDT to be effective for depression, some anxiety disorders, eating disorders and somatic disorders.

Depression can often result in a person losing meaning in their life. PDT provides deeper exploration of a person’s identity and what drives them, helping a person to gain a sense of who they are. Through the use of self-reflection in the therapeutic space, clients begin to understand the root causes of why they are feeling certain emotions and what drives destructive behaviors. By gaining insight into stressors that cause their symptoms, clients learn how to manage problems and become more intentional, rather than reactive with their behaviors.

PDT is also meant to help people who are experiencing problems with interpersonal relationships, such as with a romantic partner, friend, or family member. PDT utilizes the therapeutic alliance as a model for relationships outside of the therapeutic space. Through discussion and deep exploration, a client learns to recognize when they are using defense mechanisms which disrupt relationships.

Conclusion

There is a therapy modality out there for everyone, and for many people, PDT is what works best. It is a modality that is meant to help people analyze, reach epiphanies, and understand how they interact with the world around them.

If you are new to therapy, ask your therapist about trying this modality and seeing if it works for you. You may notice significantly improved symptoms, lasting psychological changes, and a stronger sense of self.