What Is Psychodynamic Therapy?

Psychodynamic Therapy (PDT) originates from the work of Sigmund Freud. It is a form of talk therapy that explores the connection between a patient's past experiences – often from childhood – and their current mindset.

Psychodynamic Therapy is a therapeutic approach that helps individuals explore unresolved issues and conflicts from their past, often rooted in their childhood, to understand how these issues affect their current behaviors, thoughts, and feelings (Shedler, 2010). The process of Psychodynamic Therapy is characterized by its focus on the unconscious, the therapeutic relationship, and the interpretation of mental processes.

The therapeutic process typically begins with an initial period of assessment, during which the therapist gets to know the client, understand their history, and identify important themes or patterns in their experiences (Gabbard, 2014). This exploration may involve discussing the client's relationships, past experiences, dreams, or spontaneous thoughts.

One of the unique features of Psychodynamic Therapy is the emphasis on the therapeutic relationship as a critical source of insight. The client's interactions with the therapist are seen as a microcosm of their relationships outside Therapy, providing a window into the patterns that may be causing distress in their lives. For example, if a client consistently feels misunderstood by the therapist, this could reflect a broader pattern of feeling misunderstood by others (Gabbard, 2014).

The therapist uses techniques such as clarification, confrontation, and interpretation throughout the Therapy to help the client gain insight into their unconscious patterns. These therapy interventions involve drawing attention to things the client might not have noticed, challenging them to consider things in a new light, and offering interpretations that might help them make sense of their experiences (Shedler, 2010).

Psychodynamic Therapy aims to alleviate symptoms and help the client achieve deeper and lasting changes in their personality and emotional functioning. It's a journey of self-discovery and self-understanding that can be challenging but ultimately rewarding.

The Benefits of Psychodynamic Therapy

These are the main benefits of Psychodynamic Therapy:

Increased self-awareness: This Therapy can give individuals a deeper understanding of their emotions, thoughts, and behaviors. It allows individuals to recognize patterns in their actions, understand their subconscious motivations, and gain insights into their past experiences that might affect their present behavior (Shedler, 2010).

Improved interpersonal relationships: Through exploring past and present relationships in Therapy, individuals can develop a better understanding and empathy for others, improving their social interactions and relationship satisfaction (Levy et al., 2006).

Long-term change: Psychodynamic Therapy aims at symptom relief and personality structure changes, which are stable over time. These changes may result in more enduring improvements than therapeutic approaches (Shedler, 2010).

Reduced symptoms of mental health disorders: Research has shown that psychodynamic Therapy can be effective in reducing symptoms of a variety of mental health disorders, including depression, anxiety, personality disorders, and others (Driessen et al., 2015).

Improved emotional expression: Psychodynamic Therapy helps individuals express and process suppressed or unrecognized emotions. This processing often improves mood and psychological well-being (Gabbard, 2014).

Increased self-esteem and life satisfaction: Through exploring and understanding one's motivations and past experiences, individuals can often experience improved self-esteem and overall life satisfaction (Leichsenring et al., 2013).

How Psychodynamic Therapy Works?

Psychodynamic therapies derive insights from childhood and can give patients insights about their current problems. This insight can ultimately help them achieve a higher quality of life.

The relationship between the patient and therapist is essential in any psychotherapy, especially in Psychodynamic Therapy. Psychodynamic Therapy's success relies heavily on trust since the topics discussed during sessions are often sensitive or traumatic.

Psychodynamic Therapy can be used to help individuals, couples, and families. Sometimes it is short-term, lasting only 10-20 sessions, but Psychodynamic Therapy can be conducted over a period of 1-2 years.

Psychodynamic Therapy can be compared to other popular forms of Therapy, such as Cognitive Behavioral Therapy (CBT). Both aim to help patients increase their self-awareness and gain more control over their mental health.

Psychodynamic Therapy emphasizes unpacking how past traumas affect current emotions, while CBT focuses on how present thoughts and perceptions play into behaviors.

The Effectiveness of Psychodynamic Therapy

A few recent studies are measuring the success of Psychodynamic therapy and observing its benefits. A 2018 study found that psychoanalytic and Psychodynamic therapies effectively improved general psychosocial well-being and reduced the number of patients who attempted suicide. Another study found that Psychodynamic Therapy can also help reduce symptoms of PTSD.

Researchers sought to determine whether or not Psychodynamic Therapy is as effective when conducted online. They found Psychodynamic Therapy was effective when delivered via video and phone, especially for depression.

Recent research supports the effectiveness of Psychodynamic Therapy across a broad range of conditions. In a meta-analysis of 23 studies, Shedler (2010) found that the benefits of Psychodynamic Therapy extended beyond symptom reduction, with patients continuing to improve after treatment had ended. Shedler's findings indicated that Psychodynamic Therapy could benefit individuals with depression, anxiety, somatic disorders, and personality disorders.

Another comprehensive review suggested that Psychodynamic Therapy effectively reduced suicide attempts and self-harm incidents (Khalifeh, Brauer, Teytelboym, & Pritchard, 2019). This research underscores the potential value of Psychodynamic Therapy in treating individuals with severe emotional distress and those at risk for self-harm.

Additionally, Psychodynamic Therapy is effective for Post-Traumatic Stress Disorder (PTSD). A review of the literature by Gerger, Kley, Bohner, and Machmutow (2012) showed that Psychodynamic Therapy, among other psychological treatments, demonstrated significant effectiveness in treating PTSD symptoms.

Blending Psychodynamic Therapy with Solution-Focused Therapy and Coaching

Most therapists use a combination of therapy modalities with patients to optimize their therapy outcomes. This could mean using a Psychodynamic therapy-oriented approach during the initial stage of getting to know a patient and switching to another approach later.

Blending Psychodynamic Therapy and Solution-Focused Therapy (SFT) and coaching can be highly effective therapeutic approaches for specific individuals. This approach integrates Psychodynamic Therapy's depth and reflective nature with the goal-directed, future-focused strategies of Solution-Focused Therapy and coaching.

Psychodynamic Therapy provides insights into how past experiences, especially those from childhood, influence present behavior and emotions (Shedler, 2010). Understanding these underlying issues can be invaluable for people struggling with deeply rooted problems. However, some criticisms of Psychodynamic Therapy include that it can be lengthy and overly focused on the past.

On the other hand, solution-focused Therapy and coaching emphasize present and future circumstances, concentrating on solutions rather than problems (De Shazer et al., 2007). They are action-oriented and typically shorter-term than Psychodynamic therapy, focusing on helping clients develop practical steps to achieve their goals. However, they may need to fully address more complex underlying issues contributing to a person's challenges.

By integrating Psychodynamic Therapy with Solution-Focused Therapy and coaching, therapists can help their clients understand their problems' roots while developing actionable strategies for change. The process begins with Psychodynamic Therapy to uncover underlying issues, followed by SFT and coaching to help clients set and achieve their goals. This combined approach can provide a more holistic and effective therapeutic experience (Lazarus, 1997).

Conclusion

Psychodynamic Therapy (PDT) is a talk therapy approach that explores the connection between an individual's past experiences, often from childhood, and their current mindset. This Therapy helps individuals understand and resolve issues and conflicts from their past that affect their present behaviors, thoughts, and emotions.

The process begins with an assessment where the therapist learns the client's history and identifies themes or patterns in their experiences. The emphasis on the therapeutic relationship is unique to Psychodynamic Therapy, which provides a window into the client's relationship patterns that may be causing distress in their lives.

Benefits of Psychodynamic Therapy include:

• Increased self-awareness.
• Improved interpersonal relationships.
• Long-term change.
• Reduced symptoms of mental health disorders.
• Enhanced emotional expression.
• Increased self-esteem and life satisfaction.

However, individual results can vary based on various factors.

Psychodynamic Therapy relies heavily on the patient-therapist relationship and can be used for individuals, couples, and families. Duration ranges from short-term (10-20 sessions) to long-term (1-2 years).

Psychodynamic Therapy can be contrasted with cognitive behavioral Therapy (CBT). While both aim for increased self-awareness and control over mental health, Psychodynamic Therapy focuses on how past traumas affect current emotions. In contrast, CBT focuses on the impact of current thoughts and perceptions on behaviors.

Recent research has highlighted the effectiveness of Psychodynamic Therapy across various conditions, improving general psychosocial well-being, reducing suicide attempts, and aiding the reduction of PTSD symptoms. Psychodynamic Therapy has also been found effective when conducted online.

Therapists often blend Psychodynamic Therapy with Solution-Focused Therapy and coaching. This integrated approach allows the therapist to help the client understand the roots of their problems (through Psychodynamic Therapy) while developing actionable strategies for change (through Solution-Focused Therapy and coaching), thereby providing a more holistic and effective therapeutic experience.

References

De Shazer, S., Dolan, Y., Korman, H., Trepper, T., McCollum, E., & Berg, I. K. (2007). More than miracles: The state of the art of solution-focused brief Therapy. Haworth Press.

Driessen, E., Van, H. L., Don, F. J., Peen, J., Kool, S., Westra, D., ... & Dekker, J. J. (2015). The efficacy of cognitive-behavioral Therapy and psychodynamic Therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry, 172(9), 839-847.

Dekker, J. J. (2015). The efficacy of cognitive-behavioral Therapy and psychodynamic Therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry, 172(9), 839-847.

Gabbard, G. O. (2014). Psychodynamic psychiatry in clinical practice. American Psychiatric Pub.

Gerger, H., Kley, H., Bohner, G., & Machmutow, K. (2012). Psychotherapy for posttraumatic stress disorder in adults. Cochrane Database of Systematic Reviews, 2012(9). https://doi.org/10.1002/14651858.CD003388.pub4

Khalifeh, H., Brauer, R., Teytelboym, A., & Pritchard, M. (2019). Effectiveness of psychoanalytic/psychodynamic psychotherapy for reducing suicide attempts and self-harm: systematic review and meta-analysis. The British Journal of Psychiatry, 214(6):320-328. https://doi.org/10.1192/bjp.2019.33

Lazarus, A. A. (1997). Brief but comprehensive psychotherapy: The multimodal way. Springer Publishing Company.

Leichsenring, F., Rabung, S., & Leibing, E. (2013). The Efficacy of Short-Term Psychodynamic Psychotherapy in Specific Psychiatric Disorders: A Meta-Analysis. Archives of General Psychiatry, 61(12), 1208–1216.

Levy, K. N., Meehan, K. B., Kelly, K. M., Reynoso, J. S., Weber, M., Clarkin, J. F., & Kernberg, O. F. (2006). Change in Attachment Patterns and Reflective Function in a Randomized Control Trial of Transference-Focused Psychotherapy for Borderline Personality Disorder. Journal of Consulting and Clinical Psychology, 74(6), 1027–1040.