Psychodynamic therapy takes some of the same ideas as psychoanalysis — like free association and self-discovery — and applies them in an up-to-date way.
Psychodynamic therapy can address a range of mental health conditions by diving deep into the root cause of symptoms. It can also be beneficial for anyone who wants to understand themselves better and live a more fulfilling life.
In psychodynamic therapy, you might learn how your past has shaped your present, so you can move mindfully into the future.
What is psychodynamic therapy?
If you’re like most people, your knowledge of psychodynamic therapy comes from a psychology class or its depictions in television and film. If this is the case, your understanding is likely not so accurate. This is because the media and even modern textbooks tend to get it wrong.
Overall, psychodynamic therapy is an effective way to explore the sources of your symptoms and the challenging situations you face.
Psychodynamic therapy investigates the “why” behind our thoughts and actions. It focuses on questions such as “Why am I doing what I’m doing?” and “Why am I feeling this way?”
Unlike cognitive behavioral therapy (CBT), which is highly structured and often comes with between-session homework, psychodynamic therapy tends to be open-ended and excludes worksheets and assignments.
But like CBT, some psychodynamic therapies have manuals that therapists use to guide their sessions.
It’s important to note that both psychodynamic therapy and CBT can be effective. And some therapists may mix approaches.
Either way, the question isn’t, “Which approach is superior?” The question is, “Which is a better fit for you right now?”
Psychodynamic theory: How does it work?
Psychodynamic therapy’s roots go way back to Sigmund Freud, the father of psychoanalysis. Freud developed psychoanalysis in the 1890s to essentially help people make the unconscious conscious.
Over the years, psychodynamic therapy has greatly evolved from its psychoanalytic predecessor. Some therapists may use the terms “psychoanalysis” and “psychodynamic therapy” interchangeably.
Unlike “old-school” psychoanalysis, today’s psychodynamic therapy is evidence-backed and time-limited. Sessions are typically 50 minutes long, and they occur one to two times a week for up to a year.
Overall, psychodynamic therapy helps you gain insight into yourself, supporting you in developing a nuanced understanding of how your prior experiences have shaped your current behavior and relationships.
In psychodynamic therapy, you also explore:
All your emotions
You examine the full range of your emotions, including contradictory feelings and feelings that initially make little sense to you.
Patterns that don’t work for you
You work on spotting self-defeating patterns so you can stop replaying them. For example, you might learn that you end relationships before they get too intimate or sabotage yourself at work because of a fear of failure.
Your defenses
You explore how and why you avoid distressing situations — known as your defenses — in order to face them. Confronting stressful experiences and patterns can help you build up strength and resilience.
Free association
Your therapist encourages you to say whatever is on your mind, no matter how silly, strange, or unrelated it might initially seem.
Seemingly arbitrary thoughts may actually be anything but. Your daydreams, random thoughts, and fantasies can provide clues into your wants, desires, and fears.
Relationships
The relationship between you and your therapist is a pivotal part of psychodynamic therapy. How you relate and respond to your therapist usually mirrors how you behave in other relationships.
This means you can work with your therapist in real time to improve certain relationship patterns. For example, you may work on expressing yourself better or speaking up for yourself.
Goals of psychodynamic therapy
The goals of psychodynamic therapy center on gaining greater insight into your thoughts, feelings, and actions — many of which you might not even be consciously aware of.
Additional goals include:
Making mindful choices
Rather than letting reflexive actions fling you into problematic situations, psychodynamic therapy helps you make deliberate choices. This way you’re in the driver’s seat, fully mindful of what’s going on.
Want to learn more? Here are seven easy ways to practice mindfulness daily.
Getting free of the past
A common misconception is that psychodynamic therapy dwells on the past, rehashing childhood experiences and events for no reason. In reality, psychodynamic therapists use the past strategically to connect the dots to today’s unhelpful patterns.
You realize that certain ways of relating and being that you picked up during your formative years are no longer serving you. Over time, you stop using these damaging scripts to approach new situations.
Improving relationships
By understanding how you interact with others and working on these dynamics with your therapist, you start to improve the relationships in your life. For instance, you might get better at:
- voicing your needs
- setting clear-cut boundaries
- choosing emotionally available partners
Want more info? Here’s a deeper dive on setting boundaries and getting your needs met.
Role of the psychodynamic therapist
Your therapist plays a critical role in helping you gain insight and effect change. As mentioned above, how you act with your therapist can often be similar to how you act with other people in your life.
As one expert notes, the same therapist is a different person to each person in therapy. Without even realizing it, your view of your therapist is based on years of personal experiences and expectations. This is known as transference. These in-session interactions help you to improve your relationships outside of therapy.
In addition, a psychodynamic therapist:
- models what healthy relationships look like
- creates a supportive environment in which you’re able to share anything that comes to mind, including difficult feelings and experiences
- helps you explore and question your worldview
- helps you examine your dreams and fantasies for deeper insights
- works with you to develop constructive ways to handle your emotions and challenging situations
Is psychodynamic therapy right for me?
Multiple studies have found that psychodynamic therapy can treat a variety of mental health conditions, including:
- depression
- social anxiety disorder
- panic disorder
- somatic disorders
- some personality disorders
- PTSD
Also, it might help to ask yourself these questions:
- Am I looking to better understand myself?
- Am I repeating patterns that don’t serve me and finding it really difficult to change?
- Are healthy relationships difficult or rare for me?
- Do I have trouble feeling all my emotions?
- Do I find myself making decisions that don’t serve me?
- Do I prefer a highly structured therapy or more open-ended approach?
Next steps
Psychodynamic therapy can be a powerful treatment for different mental health conditions. It helps to get to the root cause of symptoms and any self-defeating patterns.
Psychodynamic therapy provides you with a fuller, deeper understanding of your thoughts, feelings, and dreams, so you can make positive changes.
To find a psychodynamic therapist, you can start by checking out:
- The American Psychoanalytic Association’s Find An Analyst tool
- Psych Central’s Find a Therapist resource
It can also be helpful to get referrals from your primary care doctor and loved ones, when possible.
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.
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.
