Last updated May 2023 |
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Psychodynamic therapy (also known as psychodynamic counselling) is a therapeutic approach that combines parts of many different types of analytic therapies. Psychoanalytical and psychodynamic therapies work on the idea that each individual’s unconscious thoughts and perceptions are developed throughout their childhood. These unconscious thoughts and perceptions affect their current behaviours and thoughts.
What is psychodynamic therapy?
While the roots of psychodynamic therapy lie predominantly in Freud’s approach to psychoanalysis, Carl Jung, Alfred Adler, Otto Rank, Donald Winnicott and Melanie Klein are all widely recognised for their involvement in further developing the idea and use of psychodynamics.
Like psychoanalysis and psychoanalytic therapy, the aim of psychodynamic therapy is to bring the unconscious mind into consciousness. This means helping you to recognise, experience, and understand your true, deep-rooted feelings, in order to help you resolve them. Based on the idea that our unconscious holds onto painful feelings and memories, psychodynamic therapy believes these are too difficult for your conscious mind to process.
In order to ensure these memories and experiences stay below the surface, many people will develop defences, such as denial and projections. According to psychodynamic therapy, these defences will often do more harm than good.
Integrative psychotherapist and counsellor, Jeremy Sachs (BA Hons, Dip.Couns), explains psychodynamic therapy: how the theory came about and the benefits of the approach.
Despite sharing the same core principles, psychodynamic therapy is typically a less intensive approach than psychoanalysis. Focusing primarily on immediate problems, it looks to find a quicker solution. However, both approaches can help with a range of psychological disorders, helping you to make significant changes to how you make decisions and interact with others.
What are the core principles of psychodynamic therapy?
Psychodynamic therapists help you to get a better insight into your life and the problems you are experiencing here and now. To help monitor how you are developing over time, they typically review the following principles, based on ‘Introduction to Psychotherapy: An Outline of Psychodynamic Principles and Practice’ by Bateman et al. (2000).
bringing the unconscious into consciousness
exploring the impact of early life and childhood
considering conflict between different feelings and aspects of self
uncovering 'defence mechanisms' which are used to avoid painful feelings and experiences
exploring feelings and patterns in relationships with others, including within the therapeutic relationship
Through looking at these, your therapist can help you to recognise recurring patterns, help you to see how you can avoid distress, and develop defence mechanisms to help you cope. With this insight, you can begin changing negative patterns to help you move forward.
The psychodynamic approach can be used to help individuals, couples, families, or even groups with a wide range of problems, including (but not limited to) depression, anxiety, eating disorders, childhood trauma, and difficult relationships. Psychodynamic therapy is particularly useful for people who want to get to the roots of their problems and understand what may be going on unconsciously to affect their thoughts and feelings.
If you have a genuine interest in exploring yourself and seeking self-knowledge, as well as relieving symptoms, have the capacity for self-reflection, and are naturally curious about your internal life and behaviours, then this type of therapy should work well for you.
What can psychodynamic therapy help with?
Psychodynamic therapy can be used to help with a broad range of issues and mental illnesses. Psychodynamic therapy can help with:
loss of meaning in life
post-traumatic stress disorder (PTSD)
persistent feelings of loneliness
trouble connecting with others or forming relationships
substance misuse (addiction)
How does psychodynamic therapy work?
The psychodynamic approach is guided by the core principle that the unconscious mind harbours deep-rooted feelings and memories that can affect our behaviour.
Psychodynamic therapists will work based on this, in context-specific ways, catering their techniques and therapy style to you. Your therapist will maintain an equal relationship with you, adopting the attitude of unconditional acceptance and aiming to develop a trusting relationship. This is to help encourage you to open up and explore any unresolved issues and conflicts hidden in your unconscious that may be affecting your mood and behaviour.
Deep insight into the feelings we act out can be achieved by psychodynamic work. Once we become conscious of our internalised feelings and beliefs, and from where they stem, we no longer need to act them out. Greater internal security and peace then offers us greater freedom.
In order to help you understand what your ‘unconscious disturbances’ are and how your mind works, psychodynamic therapists will draw on similar techniques used in psychoanalysis and psychoanalytic therapy, such as therapeutic transference and interpretation.
You will be encouraged to talk freely to your therapist. There is no attempt to shape ideas before they are said, nor do you need to tell things in a linear story structure. You may also explore dreams, childhood experiences and memories. The spontaneity allows for true thoughts and feelings to emerge without any concern for how painful, illogical or silly you may sound to the therapist. You can be honest and open, without fear of judgement.
This is the redirection of feelings for a significant person, especially those unconsciously retained from childhood, onto the therapist.
You may feel an 'erotic attraction' to your therapist, but this transference can manifest in many other forms, such as hatred, mistrust, extreme dependence and rage. Through recognition and exploration of this relationship, you can begin to understand your feelings and resolve any conflicts with figures from your childhood.
Therapists may offer thoughts or interpretations of the topics you discuss, suggesting links between different feelings, situations and behaviours and helping you identify what’s going on unconsciously.
Short-term psychodynamic therapy
Since the 1950s, a more intense, short-term form of psychodynamic therapy has emerged. Originally introduced in a series of workshops, this method of short-term psychodynamic therapy (also known as intensive short-term dynamic psychotherapy (ISTDP)) was eventually developed 20 years later by psychoanalyst Habib Davanloo. His aim was to enhance the efficacy of psychoanalysis and minimise the length of treatment.
While the primary goal of short-term psychodynamic therapy is very similar to psychoanalysis, rather than acting as a neutral observer of an individual’s personal development, a short-term psychodynamic therapist will be an active advocate of change.
They will guide you through the process by applying non-interpretative techniques, including the encouragement to feel - a method founded on Davanloo’s discovery that the dynamic unconscious has many layers.
These specific interventions allow the therapist to access those layers in the client. When applied in a particular way and at a particular time in the therapeutic process, these interventions can help the client to recognise and overcome their unconscious blocks and any resistance as quickly and efficiently as possible.
Frequently asked questions (FAQs)
How long does psychodynamic therapy take?
The number of sessions needed can vary from person to person, depending on their individual needs. Long-term psychodynamic therapy can take a year or more, lasting 50 or more sessions. Brief psychodynamic therapy, another form of psychodynamic therapy, aims to see results more quickly (this could be as little as 6+ sessions when used in a solution-focused way). This is often done by determining a specific emotional area in which you want to focus on, and looking into this first.
One specific form of brief psychodynamic psychotherapy is called dynamic interpersonal therapy (DIT) and is sometimes used in the NHS.
Is CBT a psychodynamic therapy?
Cognitive behavioural therapy (CBT) and psychodynamic therapy are not the same thing. CBT is a type of therapy which looks to manage problems you are experiencing now, by changing the way you think and behave. Psychodynamic psychotherapy, on the other hand, aims to identify, explore, and address underlying problems which may be affecting your life (through focusing on unconscious processes that affect your current behaviour) rather than focusing on the specific symptoms that are causing you issues right now.
Essentially, psychodynamic therapy tries to identify the root cause and bring awareness and understanding to how that has affected past and present behaviour. CBT may not look for the root cause, instead helping you to change your way of thinking and behaving to manage your problems.
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