Psychodynamic Therapy

What is Psychodynamic Therapy?

Psychodynamic therapy is an approach to psychotherapy that grew out of the theories and practices of Sigmund Freud (neurologist and founder of psychoanalysis). Freud believed that the unconscious mind is one of the most powerful drivers of human emotion and behavior and that no behavior is without cause. Freud also emphasized the impact childhood can have on an adult’s thoughts, behavior, and emotions. While Freud’s theories were the basis for the psychoanalytic approach to therapy, they also helped form the methods and techniques of psychodynamic therapy.

Psychodynamic therapy looks at the inner drives and forces of an individual and how those drives and forces affect their relationship with the external world. Essentially, psychodynamic therapy helps clients increase insight and awareness into unresolved, repressed, and/or unconscious issues, needs, desires, and urges. Psychodynamic therapy can help clients identify emotional patterns and core beliefs (often stemming from early life experiences). By gaining insight into the driving force(s) of these patterns and behaviors, clients can begin to develop more helpful coping mechanisms.

Psychodynamic therapy is primarily used to treat individuals with depression but has also proven effective in treating a variety of anxiety disorders, addictions, and eating disorders.

Psychodynamic therapy may be either short-term or long-term and is effective in individual, group, and couples counseling settings.

What to Expect in Psychodynamic Therapy

A psychodynamic therapist aims to not only help the client explore the unconscious (thoughts, feelings, behaviors, unresolved issues), but also to identify the bases of the presenting issue(s) or symptoms.

A psychodynamic therapist aids the client in finding meaning and significance as the “contents” of the unconscious mind begin to be uncovered.

Psychodynamic therapy sessions are not as structured as cognitive-behavioral approaches, and are much more open-ended, as they are based in free-association.

Accessing the Unconscious

• Denial 
• Repression
• Rationalization

Beyond the focus on emotions, psychodynamic therapy helps clients recognize and address their inherent defense mechanisms (the impulses, reactions, and behaviors used to avoid distress).

Psychodynamic therapy also explores the client’s fantasy life and attempts to identify the possible psychological meaning(s) behind the imagery and/or content.

Free Association

Free association is the most commonly used and important technique used in psychodynamic therapy. When a therapist uses free association, they encourage the client to freely share their thoughts and feelings. This means the client will verbalize whatever comes to mind, without the need to make sense of the thoughts. Thus, what the client says may not be fully coherent, and that is OK. Free association allows for true thoughts and feelings to emerge without concern for how logical, silly, or strange they may sound to the therapist. The client is able, to be honest, and open, without fear of judgment. Free association can also be applied using writing/journaling. While free association is a fairly simple technique, it can be very effective.

Therapeutic Transference

In terms of the therapeutic relationship (the relationship between a therapist and a client), transference is when the client projects feelings they have for someone onto their therapist. The feelings projected onto the therapist are, more often than not, feelings the client has regarding someone from their childhood. Clients are not typically conscious of these feelings (and thus the transference of these feelings), which can range from anything from erotic attraction to hatred. Bringing these unconscious feelings to a client’s awareness (and exploring these feelings) can help a client gain a better understanding as to the unresolved issues in the past relationship, and begin to heal.

Dream Analysis

Another well-known technique used in psychodynamic therapy is dream analysis or “dreamwork”. Freud believed that dreams can give significant insight into a person’s unconscious mind, therefore providing insight into unresolved and/or repressed issues.

In dream analysis, a client is encouraged to discuss their dreams in as much detail as possible.  The therapist will help guide this discussion by asking questions and encouraging further description. As the dream is being recounted, the therapist will assist the client in distinguishing between “latent” and “manifest” content. The manifest content is what the client recalls from the dream – what happened, where it took place, how it felt, who was there, etc. The latent content is what is underneath the manifest content (i.e. – the deeper meaning).

Psychodynamic therapy tends to be less intense than traditional psychoanalysis, which can make it feel more approachable for tentative clients. Therapy sessions typically occur one time per week and last approximately 50 minutes.

Psychodynamic therapy can take many forms:

• Brief psychodynamic therapy – often used with clients who have experienced car accidents, been a victim of rape, encountered an act of terrorism or had a traumatic family event.
• Psychodynamic family therapy – can be applied to various kinds of family units (i.e. – two adults in a romantic relationship, a parent and child(ren), grandparents, siblings, etc.)
• Psychodynamic art therapy – this non-traditional form of psychodynamic therapy uses art and music to help the client express emotions and thoughts.

How to find a Psychodynamic Therapist?

Psychodynamic therapists are licensed and experienced mental health professionals with specific training in psychoanalysis. While it is essential to find someone with the appropriate background and experience, it is just as important that the therapist be someone you like and feel at ease with.  Additionally, when looking for a psychodynamic therapist, it is important to find out if:

1. They have the appropriate training, expertise, and licensure.
2. They demonstrate a clear knowledge of psychodynamic theory.
3. They have experience in working with your specific issue (depression, anxiety, etc.).
4. You feel comfortable opening up with them and feel there is potential to establish a trusting therapeutic relationship.

References

Luborsky, Ellen, O’Reilly-Landry, Maureen, and Arlow, Jacob. (2008). Psychoanalysis. In Raymond J. Corsini and Danny Wedding (Eds.), Current Psychotherapies (pp. 15–62).

Redmond, J., & Shulman, M. (2008). Access to psychoanalytic ideas in American undergraduate institutions. Journal of the American Psychoanalytic Association, 56, 391– 408.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. University of Colorado Denver School of Medicine; American Psychologist, 65 (2).