Psychodynamic Therapy: Theory, Techniques and Example

Psychodynamic therapy (also known as psychodynamic psychotherapy or dynamic psychotherapy) is a type of talk therapy. In psychodynamic theory, understanding your thoughts and emotional patterns and their roots in early life experiences helps break down unconscious defense mechanisms and allows you to cope with your problems in a healthier way.

Psychodynamic therapists treat adults, adolescents, and children for various mental health conditions, including depression, social anxiety disorder, eating disorders, substance abuse, borderline personality disorder, and post-traumatic stress disorder.

Based on the work of Sigmund Freud, the psychodynamic approach shares similarities with psychoanalytic theory (or Freudian psychoanalytic psychotherapy), but while traditional psychoanalysis involves many years of multiple weekly sessions, psychodynamic treatment requires fewer therapy sessions over a shorter time. For example, brief psychodynamic therapy (or short-term psychodynamic psychotherapy) may include meeting your psychotherapist once or twice a week for a limited number of sessions over six months.

Psychodynamic therapy helps you recognize the emotional driving forces behind your behavior, to understand and change how you respond to different circumstances and improve your self-esteem and overall mental health. During your therapy session, your therapist can help you:

• Assess mental illness: Though psychodynamic therapy focuses on identifying patterns and emotions, your therapist may also work in collaboration with a psychiatrist to diagnose and treat a mental health condition.
• Identify damaging patterns: Psychodynamic therapists help you see how past experiences have shaped your response to certain emotional stimuli, creating a pattern of unconscious behavior and suffering that no longer serves you. For example, you might push people away when they get too close to avoid being vulnerable. Building a therapeutic alliance with your therapist can help you overcome fears of intimacy in a relationship.
• Identify defense mechanisms: When you experience difficulty, you may turn to defense mechanisms that harm you, such as isolating or blaming others for your problems. Your therapist will help you identify your defense mechanisms so you recognize them when they come up.
• Improve your relationships: Your therapeutic relationship with your therapist allows for transference, allowing you to process your emotions about an external relationship directly to your therapist. Transference can enable you to break unhealthy relationship patterns and practice healthier behavior to resolve conflict in your relationships.
• Understand your emotions: Evidence-based clinical trials show the efficacy of psychodynamic psychotherapy in helping you understand, explore, and process your feelings. This skill ties into recognizing behavioral patterns since emotions dictate how we behave in many circumstances. The more you understand your feelings, the more likely you’ll recognize when they drive unwanted behavior.

Some of the main techniques used in this type of therapy include:

1. 1. Building up your emotional resilience: During treatment, you and your therapist may discuss ways to build your emotional resilience during stressful times to avoid leaning on old, harmful behavioral patterns.
2. 2. Discussing your relationships: To improve your relationships with others, your therapist may ask you to talk about your loved ones, including the details of friends, family, partners, and anyone else who has an emotional impact on your life.
3. 3. Free association: Your therapist will encourage you to talk about anything that comes into your mind, including your fantasies, desires, and fears. Free association means you talk about whatever thought pops into your mind without censorship or embarrassment.
4. 4. Modeling healthy relationships: Through transference, your therapist helps you to understand a healthy relationship built on trust and communication.
5. 5. Processing the full range of your emotions through talk therapy: During your sessions, your therapist will create a supportive environment where you can process any feelings you might have, including unconscious feelings and emotions felt during past events.
6. 6. Releasing the past: Your therapist may encourage you to connect your childhood experiences with your behavior in the present.

As an example, let’s say you experience a bout of depression. After finding a psychodynamic therapist you like (the American Psychological Association or APA website lists psychologists by area), your therapy experience might proceed as follows:

1. 1. First appointment: The first time you meet with your therapist, you’ll spend some time discussing your feelings and relationships in an open-ended way. Most likely, this will take place seated and face-to-face. At the end of the appointment, your therapist may tell you how often they think you should have sessions each week.
2. 2. Regular appointments: From that point on, you’ll most likely meet once a week or more for several months or possibly years, depending on your needs. Most appointments last about an hour.
3. 3. Free association with guidance: During your appointments, your therapist will let you speak about whatever occurs to you at the moment, then ask questions to help you understand your behaviors and patterns. Your therapist will avoid having strong opinions about your thoughts and allow you to make realizations on your own.
4. 4. Discover emotions and patterns: Over time, you’ll be able to identify repeating patterns and feelings and see how responses to past experiences may have created a blueprint for current behaviors. These realizations will help you discover healthier habits, boost your self-esteem, and live a more balanced and serene life.

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