What Is Psychodynamic Therapy?

Psychodynamic Therapy is a longstanding form of psychotherapy, or talk therapy, performed by a mental health professional like a therapist, psychologist or counselor. Psychodynamic Therapy aims to help patients become more self-aware, confront inner conflict, and understand the foundation and formation of their psychological processes and behavioral patterns. Unlike more goal-oriented therapeutic approaches, Psychodynamic Therapy is open-ended and less structured, allowing the patient to lead the conversation and explore their emotions, relationships and past experiences in an authentic and uninhibited way.

Psychodynamic Therapy is rooted in Freud’s 19th century theories of psychoanalysis, and although it looks much different in modern practice, Psychodynamic Therapy still uses techniques informed by Freudian thought and psychoanalysis today. Psychodynamic Therapy’s unique focus on understanding how and why psychological issues and dysfunctional patterns were developed in the first place, rather than simply on trying to cope with and change them, has been beneficial to many patients over the years, especially when it comes to seeing long-term results and overcoming trauma.

What Does Psychodynamic Therapy Treat?

Psychodynamic Therapy has been helpful for many patients, as it addresses a variety of factors that are known to cause or exacerbate mental health problems. Through the exploration of topics such as early childhood experiences and attachments, current relationship issues, coping and defense mechanisms, and distressing  feelings, urges and thoughts, Psychodynamic Therapy allows patients to get to the root of and move past the hurdles in their lives.

Psychodynamic Therapy has been known to reduce symptoms for the following mental health issues:

• Addiction
• Anxiety
• Depression
• Eating Disorders
• Panic Disorders
• Phobias
• Relationship Issues
• Self Esteem Issues
• Stress
• Somatic Disorders
• Trauma or PTSD

Psychodynamic Theory

Although Psychodynamic Therapy has been updated and simplified over the years, the theories and core concepts that support it can be traced back to Sigmund Freud’s theories of psychoanalysis. While not all of Freud’s ideas are still relevant in today’s practice, a handful of his core theories are central to Psychodynamic Therapy and inform its most popular techniques.

The Unconscious

Freud believed that the human mind has multiple levels. There’s a conscious level of the mind, which contains the things that we can remember and are aware of, and there’s an unconscious level of the mind, which contains the things that we cannot remember and are unaware of. According to Freud, the unconscious mind holds things like our early memories, our gut instincts, our deepest urges, fears and desires, our patterns of thought and behavior and our psychological processes that were developed during childhood.

Psychodynamic Therapy places a large emphasis on the unconscious mind, where we tend to push feelings and thoughts that are too painful to face, and memories and beliefs that we might be ashamed of. However, these emotions and impulses still affect us and influence our behavior even though they are outside of our awareness. For example, a person might avoid romantic relationships that bring up painful memories of their parents’ divorce without realizing they’re doing so, keeping them from reaching important milestones in their lives like starting a family or falling in love. A trained Psychodynamic Therapist knows how to recognize these patterns of behavior and help patients confront the contents of their unconscious mind that might be holding them back from reaching their full potential.

By encouraging open discussion and reflection, the Psychodynamic Therapist is able to pinpoint important themes and topics in a patient’s life, probing them with follow up questions and opening up their minds. The goal in Psychodynamic Therapy is to make the unconscious conscious, helping patients to take back control over the harmful feelings and dysfunctional patterns that have been holding them back. For catharsis, or relief from psychological distress, to occur, the client must gain the self-awareness to confront unresolved conflicts, repressed emotions, and maladaptive behaviors.

Inner Conflict (Id, Ego and Superego)

Resolving inner conflicts is a major goal in Psychodynamic Therapy. Oftentimes, inner conflicts exist in the unconscious mind without our knowledge, but still manifest in our everyday behavior and emotions, taking a toll on our mental health. Freud theorized that there are three components of the human mind, two of which are constantly acting in opposition to each other, and one of which is meant to mediate that opposition.

• The Id – Freud theorized that the Id is the most primitive part of our mind. The Id resides in the unconscious mind, containing things like repressed desires, shameful memories, sexual drive and aggressive urges. The Id is motivated only by pleasure, and Freud believed that it was the only active part of the human mind during infancy and very early childhood.

• The Superego – According to Freud, as children grow and begin to experience the world, they eventually develop the Superego. This is our moral conscience, and it enforces the psychological processes that are necessary to exist in civilized society. The Superego contains our value system, feelings of guilt, knowledge of right from wrong, and the standards to which we hold ourselves and others.

• The Ego – Freud held that the Id and the Superego are in constant conflict, and the Ego is the mediator between the two. The Ego allows for rational decision making and drives the ability to satisfy the impulsive needs and urges of the Id in a way that is acceptable to the Superego. For example, if we are upset at work and our impulse is to cry, but we know that crying in the office is considered unprofessional, we might decide to go to the bathroom and take a moment to cry privately, returning to work once we feel better.

In Psychodynamic Therapy, patients examine why they want what they want and how they behave to get there, taking a more objective look at their own processes for dealing with conflict and satisfying or coping with the urges of the unconscious mind.

How Does Psychodynamic Therapy Work?

Psychodynamic Therapy is based on the Freudian principle that our deepest and most formative emotions and memories are buried in our unconscious mind, meaning that without self-awareness and guided self-reflection, we usually don’t even know that they exist are or how they affect us. Psychodynamic therapists encourage open, uninhibited discussion, drawing out painful feelings, early memories and unresolved conflicts during therapy sessions that might have been otherwise forgotten or avoided. This process can take time and requires an especially strong patient-therapist relationship, as the patient won’t achieve true vulnerability until he or she feels comfortable opening up to the therapist. This is why Psychodynamic Therapy tends to last longer than other forms of counseling, usually requiring anywhere from 6 months to 2 years of weekly 1 hour sessions. In Psychodynamic Therapy, the therapist looks for patterns of thought and behavior that recur throughout the patient’s life and points them out to the patient, sharing their insights and encouraging the patient to make relevant connections. By helping patients confront the early experiences, unresolved conflicts, and repressed emotions that impact their present-day lives, Psychodynamic Therapy gives patients the self-awareness to take control of their feelings, reactions and relationships.

Transference

The relationship between the therapist and the patient is uniquely important in Psychodynamic Therapy, as it is used as a mirror through which the therapist can gain insight into how the patient navigates relationships in the real world. Freud theorized that humans learn how to interact with others from their early-life attachments and relationships with their primary caregivers, and that this is then reflected in their adult relationships.

Transference refers to when a patient projects feelings for family members or loved ones onto the therapist during counseling sessions, and can demonstrate how a patient interacts with others in the  real world. Transference is a useful tool for therapists as they try to understand the early life experiences and psychological processes that affect their patient’s present-day lives. A good Psychodynamic Therapist is aware of transference and looks for patterns in the therapist-patient dynamic that mirror some of the patient’s other interpersonal conflicts. The therapist then shares these insights with the patient to help them become more self-aware.

Defense Mechanisms

Oftentimes, patients are held back from reaching their full potential because they’ve developed defense mechanisms to avoid dealing with memories or emotions that cause them pain or distress. A Psychodynamic Therapist is trained to recognize unconscious defense mechanisms and help patients break them down so that the underlying issues can be addressed and made sense of.

Below are a few common defense mechanisms:

• Denial – Refusing to believe a truth or face an emotion that is too painful to accept.
• Regression – Returning to an earlier state of consciousness, like childhood, to minimize or avoid distressing situations.
• Repression – Subconsciously pushing painful memories or thoughts out of conscious awareness and forgetting that they ever happened or existed.
• Sublimation – Channeling the energy from a distressing or painful situation into something else to avoid dealing with the original negative event.
• Rationalization- Attempting to logically justify immoral, upsetting, or socially unacceptable behavior to avoid having to deal with the causes for that behavior.

Free Association

Free association is one of the most important parts of Psychodynamic Therapy, and helps set it apart from other therapeutic approaches. Free association refers to how the Psychodynamic Therapist allows the patient to lead the discussion during therapy sessions. This practice encourages the  patient to tap into his or her emotions and thoughts in the most authentic way, and ensures that the therapist is not leading the patient in any particular direction. A patient’s unconscious desires, memories and patterns will not be revealed during therapy unless the patient is able to be fully vulnerable and true to themselves.

Types of Psychodynamic Therapy

Psychodynamic Therapy can come in many forms, including more traditional counseling methods like individual talk therapy and family therapy, and more abstract approaches like art therapy and music therapy.  Below are some common types of Psychodynamic Therapy that differ in style and execution, but are all grounded in the overarching principles of psychodynamic theory.

• Brief Psychodynamic Therapy – Brief Psychodynamic Therapy tends to last around 25 sessions and enables the patient to examine and address unresolved conflicts, such as childhood trauma, or mental health issues and symptoms, like agoraphobia and somatic pain.

• Long-term Psychodynamic Therapy – Long-term Psychodynamic Therapy usually requires at least 2 years of sessions and is meant to change dysfunctional psychological processes that were developed during childhood and are ingrained in a patient’s adult personality, holding them back from reaching their full potential.

• Psychodynamic Family Therapy – Psychodynamic Family Therapy tends to be more long-term and addresses chronic problems within a family, emphasizing the importance of exploring relationship issues and patterns of conflict throughout a family history.

• Psychodynamic Art Therapy – Psychodynamic Art Therapy can be used in a variety of ways and doesn’t require any artistic talent or experience. Patients can express feelings through the creation of art, discuss the emotions evoked by certain pieces of art, find and discuss personal meaning in pieces of art, and connect pieces of art to different events from their childhood.

• Psychodynamic Music Therapy – Psychodynamic Music Therapy can be beneficial for patients with high levels of anxiety or fear who have trouble opening up to a therapist verbally. This approach does not require any musical background or knowledge and encourages self-expression and communication through music. The therapist pays attention to how the patient goes about creating music and the patient can use music as a form of emotional release.

How Identity Can Help

Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan made up of a group of passionate, licensed therapists that are trained and experienced in Psychodynamic Therapy. Identity helps adults and adolescents cope with and manage mental health issues like anxiety, depression, stress, trauma, and relationship issues. If you live in the Ann Arbor area and are interested in, or have questions about Psychodynamic Therapy, please contact us today.