Psychodynamic Therapy

What is psychodynamic therapy?

Psychodynamic therapy is the therapeutic modality that most closely aligns with the popular perception of “talk therapy.”

In psychodynamic therapy, individuals work with therapists to dig into the unconscious psychic factors that shape their current mood and functioning. The individual’s childhood and family context are especially important in this process, since psychodynamic theory views childhood experiences as key defining factors of a person’s psyche. For example, a difficult childhood relationship with an authority figure such as a parent or teacher might lead to ongoing conflicts with people who play similar roles in your adult life, whether or not you’re consciously aware of the parallel.

Psychodynamic therapy involves Sigmund Freud’s psychoanalytical theory of unconscious drives—id, ego, and superego—and how they shape personality, but it also incorporates the later theories of those who expanded on Freud’s work. Psychodynamic therapy emphasizes gaining insight into the ways that the past influences the present and using that insight to understand the unconscious aspects of the psyche and change present behavior.

Psychodynamic therapy sessions most often occur on a weekly basis, and this form of therapy is usually ongoing over the course of several months or even years, though short-term versions also exist.


What psychodynamic therapy can help with

Psychodynamic therapy most often used as a treatment for depression and anxiety, though it can also be helpful for addictions, eating disorders, and other behavioral issues. You don’t need to have a specific mental health diagnosis or condition to benefit from psychodynamic therapy; it’s also a common choice for individuals who feel that they might benefit from gaining insight into themselves and their pasts but who aren’t targeting a specific current issue.

Effectiveness of psychodynamic therapy  

Psychodynamic therapy is among the oldest forms of therapy currently in use, and it has been shown to be effective in treating a wide variety of mental health conditions. One major review of several studies found that there is a large base of evidence for psychodynamic therapy’s success and also suggested that the positive effects of psychodynamic therapy often continue after sessions have concluded. A similar review of Australian research also found that psychodynamic therapy seems to be a helpful treatment for anxiety and depression, again both during active treatment and after clients complete their sessions.

How psychodynamic therapy works

Psychodynamic therapy is based on the idea that uncovering deep-seated emotions and desires from the subconscious can increase your insight into yourself and your motivations. By discussing your past experiences and current struggles with your therapist, you have the opportunity to spot patterns in your feelings, behavior, and relationships and become aware of aspects of yourself that you may not have understood before. Once you have more insight into these connections between past and present, you can work toward resolving repressed emotions and changing your behavior in the present. Psychodynamic therapy encourages open, wide-ranging discussion and relies on the safe space created by the therapeutic alliance to help you gain new understanding of yourself and your challenges.

In current practice, versions of psychodynamic therapy and aspects of its underlying theories are often used in combination with other modalities, most commonly cognitive-behavioral therapy.

Structure of psychodynamic therapy sessions

Psychodynamic therapy sessions rely heavily on discussion and usually look at lot like the common perception of straightforward “talk therapy.” However, psychodynamic therapy shouldn’t be confused with strictly Freudian psychoanalysis; you won’t be expected to spend sessions lying on a couch or analyzing your relationship to your therapist. Modern psychodynamic therapy places more emphasis on collaborative conversation between therapist and client, in which you work together to gain understanding into your past experiences, relationships, and emotions and how they relate to your behavior and feelings in the present day.

In your first few sessions, you’ll likely focus on building rapport with your therapist and discussing whatever current concerns have led you to seek therapy. Some therapists may have a set series of intake questions that they ask during your first session, which may address topics such as your childhood, family experiences, romantic relationships, social life, and professional life. Other therapists prefer a more free-form approach and will ask you to lead a discussion of whatever comes to your mind, asking clarifying questions and making observations along the way. Dreams, fantasies, and hopes for the future are also common themes of discussion in psychodynamic therapy sessions.

As your sessions continue, your therapist will guide you into a deeper exploration of your past relationships and experiences, with the goal of identifying patterns and themes that can help you understand your current challenges. You may also explore how aspects of your relationship with your therapist can shed light on your other relationships, an idea known as transference. Additionally, you’ll likely discuss how your work in sessions has been affecting your feelings or behavior in the rest of your life. Most psychodynamic therapists will not offer direct advice or judgement; rather, they’re there as guides to help you work toward insights that you can use to reshape your actions in the present.

What to look for in a psychodynamic therapist

All psychodynamic therapists should have an advanced degree in mental health treatment and a current license to practice, as well as additional training in psychodynamic treatment. Psychodynamic therapists may come from a variety of fields including social work, psychology, and psychiatry. Many psychodynamic therapists go through advanced training at psychoanalytic institutes, which can also be a helpful resource for finding practitioners in your area.

New to therapy? Learn about how to find a therapist here.