How does a psychodynamic therapist work

Deborah C. Escalante

Psychodynamic therapy is an approach that involves facilitation a deeper understanding of one’s emotions and other mental processes. It works to help people gain greater insight into how they feel and think.

By improving this understanding, people can then make better choices about their lives. They can also work on improving their relationships with other people and work toward achieving the goals that will bring them greater happiness and satisfaction.

Psychodynamic therapy is rooted in psychoanalytic theory but is often a less intensive and lengthy process than traditional psychoanalysis. While psychoanalysis tends to focus a great deal on the patient and therapist relationship, psychodynamic therapy also places a great deal of emphasis on a patient’s relationships with other people in the outside world.

What Is Psychodynamic Therapy?

Psychodynamic therapy is a form of talk therapy. It is based on the idea that talking to a professional about problems people are facing can help them find relief and reach solutions. 

Through working with a psychodynamic therapist, people are able to better understand the thoughts, feelings, and conflicts that contribute to their behaviors. This approach to therapy also works to help people better understand some of the unconscious motivations that sometimes influence how people think, feel, and act.

This approach to psychotherapy can be helpful for dealing with mental or emotional distress. It can help promote self-reflection, insight, and emotional growth.

By better understanding your emotional patterns and their roots, you are better equipped to manage your problems and develop coping techniques that will help you both now and in the future.

Uses

While it is similar to psychoanalysis in many respects, it is often less frequent and shorter in duration. Like other forms of therapy, it can be used to treat a variety of mental health problems.

  • Anxiety
  • Depression

    

    

  • Eating disorders
  • Interpersonal problems
  • Personality disorders
  • Psychological distress
  • Post-traumatic stress disorder
  • Social anxiety disorder

    

    

  • Substance use disorders

Factors that may impact what type of treatment is used include cost-effectiveness, availability, patient preferences, and the severity of the symptoms the person is experiencing. While cognitive-behavioral therapy (CBT) is a popular and effective approach, evidence suggests that psychodynamic therapy can be just as effective for many conditions.

Online therapy is another option that you might consider. Some research also suggests that online psychodynamic therapy may be as effective as online CBT.

How It Works

Psychodynamic therapy helps people recognize repressed emotions and unconscious influences that may be affecting their current behavior. Sometimes people act in certain ways or respond to others for reasons that they don’t really understand. 

Psychodynamic therapy helps people learn to acknowledge, bear, and put into perspective their emotional lives. It also helps people learn how to express their emotions in more adaptive and healthier ways.

Important Characteristics

Some important aspects of psychodynamic therapy include:

  • Identifying patterns: Psychodynamic therapy helps people learn to recognize patterns in behavior and relationships. People often develop characteristic ways of responding to problems without really being aware of these tendencies. Learning to spot them, however, can help people find new approaches to coping with problems.
  • Understanding emotions: Research has found that psychodynamic therapy is useful for exploring and understanding emotions. Through gaining insight into emotional experiences, people are better able to recognize patterns that have contributed to dysfunction and then make changes more readily.
  • Improving relationships: Relationships with others are a key focus of psychodynamic therapy. In working with a therapist, people are able to understand how they often respond to others.

The therapeutic relationship itself can serve as a way to look into the relationships a person has with other people through a process known as transference. This gives people an immediate “in vivo” way to explore and then change their pattern of responses in order to improve their relationships.

How Effective Is It?

How effective is psychodynamic therapy and how does it compare to other forms of treatment?

Assessing the efficacy of psychodynamic therapy presents some challenges, but research does suggest that it can be useful in the treatment of a variety of psychological problems.

One reason that it may be difficult to assess the full efficacy of psychodynamic therapy is that many of the changes it produces can be tough to measure.

While it is relatively easy to measure changes in specific acute symptoms, it is much more difficult to measure underlying personality changes, noted researcher Jonathan Shedler in a press release by the American Psychological Association (APA).

Despite this difficulty, research supports the efficacy and use of psychodynamic therapy to treat a variety of conditions.

  • One notable review published in the journal American Psychologist concluded that the evidence supports the efficacy of psychodynamic therapy.
  • Another study found that psychodynamic therapy could be at least as effective as cognitive-behavioral therapy (CBT).
  • A 2017 review published in the American Journal of Psychiatry concluded that psychodynamic therapy was as effective as other established treatments. However, the authors of the study suggested that further research was needed to determine who benefited the most from this type of treatment.

What You Can Expect

If you decide to try psychodynamic therapy, you may meet with your therapist weekly to a few time each week. Each session typically lasts for around 45 minutes and you will continue to see your therapist for several months. In some cases, you may keep having sessions for a year or longer.

During psychodynamic therapy, people are often encouraged to talk about anything that might be on their minds. This might include things they are currently experiencing or memories of things that have happened in the past. 

One form of psychodynamic therapy known as brief psychodynamic therapy is designed to produce results more rapidly, often in 25 to 30 sessions. In this shorter-term form of treatment, people may initially determine a particularly emotional area where they want to focus on.

Long-term psychodynamic therapy may take a year or longer and involve 50 or more therapy sessions.

A Word From Verywell

If you are experiencing symptoms of a mental health condition, talk to your doctor or mental health professional. They can make a diagnosis and recommend treatment options that may be best for your individual needs. Psychodynamic psychotherapy may be a good fit for you.

It’s a good idea to screen your potential therapist either in person or over video or phone. During this initial introduction, ask the therapist:
How they may help with your particular concerns
Have they dealt with this type of problem before
What is their process
What is the treatment timeline

A psychodynamic therapist is a licensed, experienced social worker, psychotherapist, or other mental health or medical professional. In addition to finding someone with the appropriate educational background and relevant experience, look for a psychodynamic therapist with whom you feel comfortable discussing personal problems. The psychodynamic therapist will review an individual’s thoughts, feelings, emotions, experiences from early life, and the beliefs that they hold. There are training and certification programs in contemporary psychodynamic theory and therapeutic techniques available.

Note that not all types of therapy are covered by insurance, call your carrier for information.

Woman looks out over view of city at sunset.Psychodynamic therapy is the psychological interpretation of mental and emotional processes. Rooted in traditional psychoanalysis, it draws from object relations, ego psychology, and self psychology. It was developed as a simpler, less-lengthy alternative to psychoanalysis. 

Psychodynamic therapy aims to address the foundation and formation of psychological processes. In this way, it seeks to reduce symptoms and improve people’s lives.

Core Principles of Psychodynamic Therapy

In psychodynamic therapy, therapists help people gain insight into their lives and present-day problems. They also evaluate patterns people develop over time. To do this, therapists review certain life factors with a person in therapy:

  • Emotions
  • Thoughts
  • Early-life experiences
  • Beliefs

Recognizing recurring patterns can help people see how they avoid distress or develop defense mechanisms to cope. This insight may allow them to begin changing those patterns.

The therapeutic relationship is central to psychodynamic therapy. It can demonstrate how a person interacts with their friends and loved ones. In addition, transference in therapy can show how early-life relationships affect a person today. Transference is the transferring one’s feelings for a parent, for example, onto the therapist. This intimate look at interpersonal relationships can help people understand their part in relationship patterns. It may empower them to transform that dynamic.

Psychodynamic therapy is available to individuals, couples, families, or groups. It can be used as short-term or long-term therapy. Brief psychodynamic therapy is goal-oriented and can take as many as 25 sessions. Long-term psychodynamic therapy may take two years or more.

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Accessing the Unconscious

People tend to develop defense mechanisms. Defense mechanisms may keep painful feelings, memories, and experiences in the unconscious. A few common defense mechanisms include:

Psychodynamic therapists encourage people to speak freely about their emotions, desires, and fears. Being open may help reveal vulnerable feelings that have been pushed out of conscious awareness. According to psychodynamic theory, behavior is influenced by unconscious thought. Once vulnerable or painful feelings are processed, the defense mechanisms reduce or resolve.

Psychodynamic Diagnostic Manual (PDM)

The Psychodynamic Diagnostic Manual (PDM) was released in 2006. Its goal is to offer a conceptual framework for human psychological functioning. It also aims to serve as an alternative to the Diagnostic and Statistical Manual (DSM). The DSM outlines observable symptoms associated with mental health conditions. Meanwhile, the PDM describes subjective experiences.

Improvisational Psychodynamic Music Therapy

One approach to psychodynamic therapy is psychodynamic music therapy. This innovative and creative form of therapy involves exploration of various instruments. Guitars, drums, and pianos a just of few of the instruments used. This kind of music therapy is non-directive. It does not require any musical background. Instead, people are encouraged to improvise and express themselves through music in any way they wish.

Music therapists are highly trained to identify various personality traits and emotional issues. They can do this by observing how a person in therapy creates music. As they build their therapeutic alliance, they also participate in the music making. This can help strengthen their bond and help the therapist access deeper communication tools. For people with high levels of anxiety or fear, the music can be soothing. It may provide an element of release during difficult therapeutic sessions.

References:

  1. Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., et al. (2008). Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(5), 689-703. doi:http://dx.doi.org/10.1017/S003329170700164X
  2. Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-behavioral therapy and psychodynamic psychotherapy: Techniques, efficacy, and indications. American Journal of Psychotherapy, 60(3), 233-59. Retrieved from http://search.proquest.com/docview/213135027?accountid=1229
  3. Luborsky, Ellen, O’Reilly-Landry, Maureen, and Arlow, Jacob. (2008). Psychoanalysis. In Raymond J. Corsini and Danny Wedding (Eds.), Current Psychotherapies (pp. 15–62). Belmont, CA: Thomson Higher Education
BACA JUGA:   Which of the following is the objective of dream analysis in psychodynamic family therapy

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