Psychodynamic therapy can help people improve their quality of life by helping them gain a better understanding of the way they think and feel. The idea is that this will improve their ability to make choices, relate to others, and forge the kind of life they would like to live.
When most people think of therapy, the thoughts and images that come to mind tend to be those related to psychodynamic therapy. This is because psychodynamic therapy is based on the work of Sigmund Freud, who many people know as the “father of psychoanalysis.”
Although the American Psychological Association identify five general categories of therapy — with many more subtypes — most types have roots that are traceable to Freud’s groundbreaking work.
Keep reading to learn more about psychodynamic therapy, including its origins, how it works, and its potential benefits.
What is it?
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Psychodynamic therapy is a talking therapy. This means that it is based on the concept that talking about problems can help people learn and develop the skills they need to address them.
It is an approach that embraces the multifaceted aspects of an individual’s life. It strives to help people understand the sometimes unknown or unconscious motivations behind difficult feelings and behaviors.
Having this insight can lead to symptom relief, help people feel better, and allow them to make better choices.
How does it work?
Psychodynamic therapy is based on the following key principles:
- Unconscious motivations — such as social pressure, biology, and psychology — can affect behavior.
- Experience shapes personality, which can, in return, affect an individual’s response to that experience.
- Past experiences affect the present.
- Developing insight and emotional understanding can help individuals with psychological issues.
- Expanding the range of choices and improving personal relationships can help people address their problems.
- Freeing themselves from their pasts can help people live better in the future.
Transference and countertransference are also important. With this approach, the client will transfer their feelings toward someone onto the therapist, and the therapist will redirect these feelings back toward the client. It can take place without the client’s awareness, and many therapists have varying approaches to this concept.
In psychodynamic therapy, the relationship between the therapist and the client is very important. It provides a container in which people can gain insights into themselves, their pasts, and their feelings. They can develop a better understanding of how they see the world and the ways in which all these factors affect their experiences.
With the help of a therapist, people undergoing psychodynamic therapy will work to understand their feelings, beliefs, and childhood experiences. The goal is to help people recognize self-defeating patterns, explore new ways of being in the world, and help people feel better.
A psychodynamic approach to therapy can work with individuals, couples, families, and in group therapy situations.
Because its focus tends to be on relationships and understanding thoughts and feelings, which people may have avoided confronting, psychodynamic therapy can be time consuming.
Short-term psychodynamic therapy generally lasts for 25–30 sessions over a period of 6–8 months, while long-term psychodynamic therapy — according to one study — may last for longer than a year or span more than 50 sessions.
History and origins
Psychodynamic therapy grew out of the theories of Sigmund Freud. However, it has evolved considerably from the 19th-century model.
Early leaders in the field who contributed to the development of this approach include Carl Jung, Melanie Klein, and Anna Freud.
In its earlier stages, therapy could last for years, with a person even having several therapy sessions per week.
Practitioners typically had a medical background and a paternalistic approach.
Is it effective?
Measuring the impact of treatment for psychological issues can be complicated. That said, there is evidence to suggest that psychodynamic therapy works for the following conditions:
- Depression: Studies indicate that it can help people address recurring life patterns that play a part in their depression.
- Social anxiety, social phobia, and panic disorder: Studies have found promising results and improved remission.
- Anorexia nervosa: Strong evidence suggests that it promotes recovery from anorexia nervosa.
- Pain: Unexplained chronic and abdominal pain respond well to this therapy, data suggest.
- Borderline personality disorder: Studies have found structured, integrated, and supervised treatment to be effective.
- Psychopathological issues in children and adolescents: Researchers have found psychodynamic treatment to be effective overall in reducing symptoms of psychopathological issues in children aged 6–18 years.
Experts report that psychodynamic therapy can also improve people’s lives by helping them:
- strengthen their self-understanding to break self-defeating cycles
- address issues with avoidance
- improve their understanding of relationship dynamics
One of the most intriguing benefits of psychodynamic therapy, according to multiple studies, is that they keep on coming.
What this means is that individuals who undergo this kind of treatment continue to show improvement months after they complete it.
Vs. other forms of therapy
Although there is variety in the results, most studies have found psychodynamic therapy to be roughly as effective as two of the most common other forms of therapy: cognitive behavioral therapy (CBT) and medication.
CBT
CBT is a popular form of therapy that focuses on helping people adopt healthier ways of thinking and acting by enhancing their awareness of their choices.
Medication
Antidepressants and other medications have proven effective in treating depression and other mental health conditions.
Anyone who thinks that they may be experiencing a mental health condition should speak to a doctor to determine which type of antidepressant is most suitable for them.
Limitations
Although psychodynamic therapy can be an effective form of treatment for many mental health conditions, the researchers behind one report found that it may be less effective for the following conditions:
- post-traumatic stress disorder (PTSD)
- obsessive-compulsive disorder
- drug addiction
- psychosis
Psychodynamic therapy can still be effective for PTSD in some cases, though there is no strong evidence for this.
That said, this same report points out that results from many of the studies into various treatments for mental health conditions tend to lean toward the author’s “theoretical orientation,” or to coincide with the author’s affiliation.
Therefore, the researchers call for more systematic evidence around these treatments. They also highlight the fact that the effectiveness of psychodynamic treatment can greatly depend on the psychiatrist themselves.
Overall, it is clear that more studies into various forms of psychotherapy are necessary. This will help determine which type might be best suited for which individuals and which psychiatric conditions.
Summary
Psychodynamic therapy is a form of talking therapy that has proven effective in helping people dealing with depression, anxiety, pain, and relationship issues.
This treatment approach helps people see what is behind their problems by giving them a better understanding of their unconscious feelings, thoughts, and past experiences.
Developing these psychological skills helps people make better choices and feel better in the long-term.
If you’re thinking of trying therapy, you might’ve already noticed the surprising amount of types available. Though some approaches work best for specific conditions, others can help with a range of issues.
In therapy, you’ll work with a trained mental health professional. What you’ll do in each appointment depends on the preferred methods of your therapist and the issues you’re looking to address.
You can expect to spend some time discussing how challenging situations, emotions, and behaviors affect your life.
This will likely involve working through some negative events or distressing thoughts. It may be difficult in the moment, but the end result is usually a happier, more fulfilling life.
Here’s a look at some common types of therapy and how to choose which one is best for you.
Psychodynamic therapy
Psychodynamic therapy developed from psychoanalysis, a long-term approach to mental health treatment.
In psychoanalysis, you can expect to talk about anything on your mind to uncover patterns in thoughts or behavior that might be contributing to distress. It’s also common to talk about your childhood and past, along with recurring dreams or fantasies you might have.
How it works
In psychodynamic therapy, you’ll work with a therapist to explore the connection between your unconscious mind and your actions. This involves examining your emotions, relationships, and thought patterns.
Psychodynamic therapy can be a longer-term approach to mental health treatment, compared to cognitive behavioral therapy (CBT) and other types of therapy. Traditional psychoanalysis is an intensive form of treatment that people can go to for years.
Research suggests many people continue to improve, even after they complete psychodynamic therapy.
what it’s good for
Psychodynamic therapy may be a good choice for addressing:
- depression
- anxiety
- eating disorders
- somatic symptoms
- substance use disorder
- a variety of other conditions
Behavioral therapy
Behavioral therapy is a focused, action-oriented approach to mental health treatment.
According to behavioral theory, certain behaviors develop from things you learned in your past. Some of these behaviors might affect your life negatively or cause distress.
Behavioral therapy can help you change your behavioral responses.
How it works
In behavioral therapy, you won’t spend much time talking about unconscious reasons for your behavior or working through emotional difficulties.
Instead, you’ll focus on ways to change behavioral reactions and patterns that cause distress.
There are many subtypes of behavioral therapy, including:
- Systematic desensitization. Systematic desensitization combines relaxation exercises with gradual exposure to something you fear. This can help you slowly get used to replacing feelings of fear and anxiety with a relaxation response.
- Aversion therapy. In aversion therapy, you learn to associate the behavior you want to change with something that’s uncomfortable or unpleasant in some way. This association may help you stop the behavior.
- Flooding. This is similar to systematic desensitization, but it involves facing your fears directly from the start, rather than gradually. If you have a phobia of dogs, for example, the first exposure step might be sitting in a room of friendly, playful dogs. With systematic desensitization, on the other hand, your first exposure step might be looking at pictures of dogs.
what it’s good for
Behavioral therapy may be a good option for addressing:
- anxiety
- phobias
- substance use disorder
- attention deficit hyperactivity disorder
- obsessive compulsive disorder (OCD)
- oppositional and defiant behaviors
- behavioral issues that result from communication difficulties or emotional challenges
Cognitive behavioral therapy
Cognitive behavioral therapy is a short-term approach to mental health treatment. It’s similar to behavioral therapy, but it also addresses unhelpful thought patterns or problematic thoughts.
The idea behind CBT is that certain feelings or beliefs you have about yourself or situations in your life can lead to distress.
This distress may contribute to mental health issues, occur alongside them, or develop as a complication of other mental health issues.
How it works
In CBT sessions, you’ll work on identifying patterns and learning more about how they might negatively affect you.
With your therapist’s guidance, you’ll explore ways to replace negative thought patterns or behaviors with ones that are more helpful and accurate.
Like behavioral therapy, CBT doesn’t spend much time addressing past events. Instead, it focuses on addressing existing symptoms and making changes.
CBT often involves homework or practice outside the therapy session.
For example, you might keep track of negative thoughts or things that trouble you between sessions in a journal. This practice helps to reinforce what you learn in therapy and apply your new skills to everyday situations.
There are also some subtypes of CBT, such as:
- Dialectical behavioral therapy (DBT). DBT uses CBT skills, but it prioritizes acceptance and emotional regulation. You can expect to work on developing skills to cope with distressing or challenging situations. You may also learn how to accept and deal with difficult emotions when they arise.
- Rational emotive therapy. This approach helps you learn how to challenge irrational beliefs that contribute to emotional distress or other issues. The idea behind rational emotive therapy is that replacing irrational thoughts with more rational ones can improve your well-being.
What it’s good for
CBT may be a good option for addressing:
- mood disorders, such as depression and bipolar disorder
- anxiety and phobias
- eating disorders
- substance use disorders
- OCD
- insomnia
- some symptoms of schizophrenia
CBT can also be very helpful for certain conditions when combined with medication.
Humanistic therapy
Humanistic therapy is an approach that looks at how your worldview affects the choices you make, especially choices that cause distress. It’s based on the belief that you’re the best person to understand your experiences and needs.
Humanistic therapists work to help you better understand what you’re experiencing, offering guidance and support without interpreting your feelings for you.
How it works
Your therapist will help you work toward the goal of living your most fulfilling life, largely by enabling you to be your true self. You’ll spend time exploring ways to grow and increase self-acceptance along with discussing the issues you’re dealing with.
Another important principle in humanistic therapy is unconditional positive regard.
This simply means your therapist will accept you, even if they disagree with you on some things. Humanistic therapy is particularly useful for coping with negative judgement (perceived or real) from others.
Generally, you’ll be the one directing the session. Your therapist will step in when needed, but otherwise they’ll be actively listening to you, occasionally asking questions to ensure they understand what you’re saying.
Humanistic approaches to therapy include:
- Existential therapy. In this philosophical approach to treatment, you’ll consider concepts such as responsibility for your choices and your freedom to make choices. You might spend time talking about what certain parts of your life mean to you and how you might find greater meaning in life.
- Person-centered therapy. This approach works from the belief that emotional distress can result when others criticize you or show disapproval for your choices or actions. This can make self-acceptance and growth difficult. Therapists offer acceptance, empathy, and guidance as you work on personal growth and positive change.
- Gestalt therapy. With this approach, you’ll look at unresolved issues, such as relationship and family conflicts, considering how they affect your emotional well-being. Gestalt therapy focuses on the present moment and often involves role-playing or acting out scenarios with movement or visualization.
what it’s good for
Humanistic therapy can be useful for addressing:
- self-esteem issues
- difficulty coping with chronic health concerns
- effects of trauma
- depression
- relationship issues
- substance use disorder
- feelings of worthlessness or being lost in life
How to make a choice
With so many options, it can feel overwhelming to commit to a specific kind of therapy. If you receive a mental health diagnosis from your healthcare provider, they may have some recommendations based on your needs.
Ultimately, the choice is yours. Keep in mind that many therapists use a combination of techniques from different types of therapy. It’s also perfectly normal to try one approach, find that it doesn’t work for you, and try a different type.
Therapy can be difficult, regardless of the approach you choose. You might feel uncomfortable or nervous about discussing mental health symptoms and personal thoughts with a stranger. This often gets easier with time.
Whether you’re having a difficult time in life or have a mental health issue that causes serious distress, your therapist is trained to help without judgment. If you don’t feel they are, seek out a new therapist.
If you’re not sure where to start, consider looking through the American Psychological Association’s database of therapists in your area. Most list the types of therapy they offer.
As you contact potential therapists, keep a few things in mind:
- What issues do you want to address? These can be specific or vague.
- Are there any specific traits you’d like in a therapist? For example, are you more comfortable with someone who shares your gender?
- How much can you realistically afford to spend per session? Do you want someone who offers sliding-scale prices or payment plans?
- Where will therapy fit into your schedule? Do you need a therapist who can see you on a specific day of the week? Or someone who has nighttime sessions?
Remember, it’s OK to change therapists or therapy types if one isn’t working for you. Keep trying until you find someone who feels right to you.
Online therapy options
Read our review of the best online therapy options to find the right fit for you.
