Psychodynamic Psychotherapy: Overview

Psychodynamic therapy, also known as insight-oriented or psychoanalytic therapy, examines the complexities of interpersonal relationships. It stresses two important assumptions:
  1. Each individual and their difficulties are unique.
  2. Factors outside of our awareness influence our thoughts and behavior.
Psychodynamic therapy is the oldest of current therapies and while it evolved from Freudian psychoanalytic theory, it is also quite contemporary. It is generally what is meant by traditional “talk therapy”. Considerable research supports the efficacy of psychodynamic therapy. If you like to read research studies, you can download a recent review article on the efficacy of psychodynamic therapy here.

People and their problems are unique
In this kind of therapy, “one size fits all” prescriptives are not thought to be useful at producing lasting change (e.g., "Ten Steps to Manage Depression" or "Five Time-Management Techniques to Stop Procrastination”). If such directive techniques appeal to you, Cognitive-Behavioral Therapy (CBT) may be a better fit for you.

Psychodynamic therapy assumes that our personalities are shaped by several developmental stages.  What happens when we are infants, children, adolescents, and young adults affects the way we see the world, the types of relationships that we have and the way we feel about ourselves in relation to others. Therefore, your therapist will try to understand your difficulties in the context of who you are as an individual, including your family history and upbringing.

Our difficulties often root in factors outside of our awareness
Most people intuitively grasp that we all find ourselves behaving at times in ways we don't fully understand.
Psychodynamic therapy is in part based on the idea that we are not transparent to ourselves and that sometimes, what we do not know or understand about ourselves causes us problems. The less aware we are of these unconscious factors, the more they control us and the more we stay stuck in unproductive patterns of thinking, feeling, and behaving that disable and limit us.

These problematic patterns are sometimes more obvious to us in others than in ourselves. It’s easy to notice that a friend keeps getting involved with one troubled guy after the other. Or your brother who has so much potential but never manages to get his act together, or your controlling co-worker who is always negative and pessimistic, or your insecure, over-achieving friend who works herself to death to the detriment of her family.

The role of the therapist is to help you come into greater contact with yourself, especially with thoughts and feelings that may not be readily visible to you. We all have psychological blind spots but the more we’re able to know ourselves, the less these blind spots interfere with our being able to have nourishing, healthy relationships and lead fuller, more satisfying lives.

Psychodynamic psychotherapy also makes use of the relationship that develops between the client and the therapist as a means of learning about how a client relates to others in his or her life. To read more about this aspect of psychodynamic therapy referred to as transference, click here.

What types of problems respond to psychodynamic therapy?
Psychodynamic therapy can be useful for both general distress and more specific issues. Some examples of problems for which it is helpful include:
  • repeated disappointments in relationships
  • discouragement, depression, loneliness
  • anxiety and fears
  • low self-esteem
  • fear of emotional intimacy, closeness, and trusting others
  • inability to sustain feelings of pleasure or happiness
  • self-destructive behavior patterns
  • lack of goals, difficulty in concentrating or feeling motivated
  • physical problems that have a psychological origin
Who benefits from psychodynamic therapy?
People who tend to benefit most from psychodynamic therapy are generally those who are curious about themselves and seek self-knowledge in addition to symptom relief. Some of the personal qualities that can facilitate this type of therapy include:
  • the capacity for self-reflection
  • a curiosity about oneself and one’s internal life
  • a desire for honesty and truth
  • a willingness to tolerate vulnerable and painful feelings
  • and last but not least, a sense of humor
Click here to read Clinical Vignettes or examples of psychodynamic therapy to get a better sense of what this type of therapy might look like.