Therapist

How long does psychodynamic therapy last

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? 

Man having psychodynamic therapy.

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Credit Image: PavelIvanov/Getty Images

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.

Psychodynamic therapy takes some of the same ideas as psychoanalysis — like free association and self-discovery — and applies them in an up-to-date way.

Psychodynamic therapy can address a range of mental health conditions by diving deep into the root cause of symptoms. It can also be beneficial for anyone who wants to understand themselves better and live a more fulfilling life.

In psychodynamic therapy, you might learn how your past has shaped your present, so you can move mindfully into the future.

What is psychodynamic therapy?

If you’re like most people, your knowledge of psychodynamic therapy comes from a psychology class or its depictions in television and film. If this is the case, your understanding is likely not so accurate. This is because the media and even modern textbooks tend to get it wrong.

Overall, psychodynamic therapy is an effective way to explore the sources of your symptoms and the challenging situations you face.

Psychodynamic therapy investigates the “why” behind our thoughts and actions. It focuses on questions such as “Why am I doing what I’m doing?” and “Why am I feeling this way?”

Unlike cognitive behavioral therapy (CBT), which is highly structured and often comes with between-session homework, psychodynamic therapy tends to be open-ended and excludes worksheets and assignments.

But like CBT, some psychodynamic therapies have manuals that therapists use to guide their sessions.

It’s important to note that both psychodynamic therapy and CBT can be effective. And some therapists may mix approaches.

Either way, the question isn’t, “Which approach is superior?” The question is, “Which is a better fit for you right now?”

Psychodynamic theory: How does it work?

Psychodynamic therapy’s roots go way back to Sigmund Freud, the father of psychoanalysis. Freud developed psychoanalysis in the 1890s to essentially help people make the unconscious conscious.

Over the years, psychodynamic therapy has greatly evolved from its psychoanalytic predecessor. Some therapists may use the terms “psychoanalysis” and “psychodynamic therapy” interchangeably.

Unlike “old-school” psychoanalysis, today’s psychodynamic therapy is evidence-backed and time-limited. Sessions are typically 50 minutes long, and they occur one to two times a week for up to a year.

Overall, psychodynamic therapy helps you gain insight into yourself, supporting you in developing a nuanced understanding of how your prior experiences have shaped your current behavior and relationships.

In psychodynamic therapy, you also explore:

All your emotions

You examine the full range of your emotions, including contradictory feelings and feelings that initially make little sense to you.

Patterns that don’t work for you

You work on spotting self-defeating patterns so you can stop replaying them. For example, you might learn that you end relationships before they get too intimate or sabotage yourself at work because of a fear of failure.

Your defenses

You explore how and why you avoid distressing situations — known as your defenses — in order to face them. Confronting stressful experiences and patterns can help you build up strength and resilience.

Free association

Your therapist encourages you to say whatever is on your mind, no matter how silly, strange, or unrelated it might initially seem.

Seemingly arbitrary thoughts may actually be anything but. Your daydreams, random thoughts, and fantasies can provide clues into your wants, desires, and fears.

Relationships

The relationship between you and your therapist is a pivotal part of psychodynamic therapy. How you relate and respond to your therapist usually mirrors how you behave in other relationships.

This means you can work with your therapist in real time to improve certain relationship patterns. For example, you may work on expressing yourself better or speaking up for yourself.

Goals of psychodynamic therapy

The goals of psychodynamic therapy center on gaining greater insight into your thoughts, feelings, and actions — many of which you might not even be consciously aware of.

Additional goals include:

Making mindful choices

Rather than letting reflexive actions fling you into problematic situations, psychodynamic therapy helps you make deliberate choices. This way you’re in the driver’s seat, fully mindful of what’s going on.

Want to learn more? Here are seven easy ways to practice mindfulness daily.

Getting free of the past

A common misconception is that psychodynamic therapy dwells on the past, rehashing childhood experiences and events for no reason. In reality, psychodynamic therapists use the past strategically to connect the dots to today’s unhelpful patterns.

You realize that certain ways of relating and being that you picked up during your formative years are no longer serving you. Over time, you stop using these damaging scripts to approach new situations.

Improving relationships

By understanding how you interact with others and working on these dynamics with your therapist, you start to improve the relationships in your life. For instance, you might get better at:

  • voicing your needs
  • setting clear-cut boundaries
  • choosing emotionally available partners

Want more info? Here’s a deeper dive on setting boundaries and getting your needs met.

Role of the psychodynamic therapist

Your therapist plays a critical role in helping you gain insight and effect change. As mentioned above, how you act with your therapist can often be similar to how you act with other people in your life.

As one expert notes, the same therapist is a different person to each person in therapy. Without even realizing it, your view of your therapist is based on years of personal experiences and expectations. This is known as transference. These in-session interactions help you to improve your relationships outside of therapy.

In addition, a psychodynamic therapist:

  • models what healthy relationships look like
  • creates a supportive environment in which you’re able to share anything that comes to mind, including difficult feelings and experiences
  • helps you explore and question your worldview
  • helps you examine your dreams and fantasies for deeper insights
  • works with you to develop constructive ways to handle your emotions and challenging situations

Is psychodynamic therapy right for me?

Multiple studies have found that psychodynamic therapy can treat a variety of mental health conditions, including:

  • depression
  • social anxiety disorder
  • panic disorder
  • somatic disorders
  • some personality disorders
  • PTSD

Also, it might help to ask yourself these questions:

  • Am I looking to better understand myself?
  • Am I repeating patterns that don’t serve me and finding it really difficult to change?
  • Are healthy relationships difficult or rare for me?
  • Do I have trouble feeling all my emotions?
  • Do I find myself making decisions that don’t serve me?
  • Do I prefer a highly structured therapy or more open-ended approach?

Next steps

Psychodynamic therapy can be a powerful treatment for different mental health conditions. It helps to get to the root cause of symptoms and any self-defeating patterns.

Psychodynamic therapy provides you with a fuller, deeper understanding of your thoughts, feelings, and dreams, so you can make positive changes.

To find a psychodynamic therapist, you can start by checking out:

  • The American Psychoanalytic Association’s Find An Analyst tool
  • Psych Central’s Find a Therapist resource

It can also be helpful to get referrals from your primary care doctor and loved ones, when possible.

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