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 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.
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.
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
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.
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.
Multiple Choice Questions
1) Which of the following is not an antidepressant drug?
a) Tricyclic antidepressants. b) Monoamine oxidase inhibitors (MAOIs). c) Selective serotonin reuptake inhibitors (SSRIs). d) Antinoamine tritase rehibitor (ATRs).
Antidepressant Drugs: Drug treatments intended to treat symptoms of depression and mood disorder.
2) Anxiolytic drugs are used to treat:
a) The symptoms of depression and mood disorder. b) The symptoms of anxiety and stress. c) The symptoms of psychosis and schizophrenia. d) None of the above.
Anxiolytic Drugs: Drug treatments intended to treat symptoms of anxiety and stress.
3) What is a major side effect of Prozac?
a) Loss of sexual desire. b) Loss of hair. c) Weight loss. d) Weight gain.
Fluoxetine (Prozac): A selective serotonin reuptake inhibitor (SSRI) which reduces the uptake of serotonin in the brain and is taken to treat depression.
4) antipsychotics do which of the following?
a) Alleviate Major positive symptoms (such as thought disorder and hallucinations). b) Alleviate Major negative symptoms (such as social withdrawal). c) Reducing the burden of institutional care. d) All of the above.
Antipsychotic Drugs : Drug treatments intended to treat symptoms of psychosis and schizophrenia.
5) Beck’s Cognitive therapy for depression requires the individual to:
a) Make an objective assessment of their beliefs. b) Keep a dream diary. c) Keep a mood diary. d) Set attainable life goals.
Cognitive Behavioural Therapy (CBT): A form of counselling and psychological therapy with a focus on understanding how our thoughts effect our behaviour.
6) Behaviour analysis is based upon the principles of:
a) Classical conditioning. b) Operant conditioning. c) Dream analysis. d) All of the above.
Behaviour Analysis: An approach to psychopathology based on the principles of operant conditioning.
7) Behaviour modification is a type of:
a) Behaviour therapy. b) Cognitive behavioural therapy. c) Humanistic therapy. d) Client centred therapy.
Behaviour Modification: A set of therapies based on the principles of operant conditioning.
8) Drugs called Benzodiazepines are used to treat:
a) Depression. b) Anxiety disorders. c) Schizophrenia. d) Mood disorders
Benzodiazipines: A group of anxiolytics which have their effect by increasing the level of the neurotransmitter GABA at synapses in the brain.
9) Client centred therapy is a type of:
a) Humanistic therapy. b) Psychodynamic therapy. c) Cognitive therapy. d) Behavioural therapy.
Humanistic Therapies: Therapies that attempt to consider the ‘whole’ person and not just the symptoms of psychopathology.
10) Which of the following might be considered as the central tenets of Client-Centred Therapy:
a) Empathy. b) Unconditional positive regard. c) Congruence. d) All of the above.
Client-Centred Therapy: An approach to psychopathology stressing the goodness of human nature, assuming that if individuals are unrestricted by fears and conflicts, they will develop into well-adjusted, happy individuals.
11) It is generally considered that Cognitive behavioural therapy changes:
a) Thought processes. b) Behaviour. c) Thoughts and behaviour. d) Mood states.
Cognitive Behaviour Therapy (CBT): An intervention for changing both thoughts and behaviour. CBT represents an umbrella term for many different therapies that share the common aim of changing both cognitions and behaviour.
12) Cognitive Behavioural Therapy is generally perceived as:
a) Phenomenological. b) Psychodynamic. c) Humanistic. d) Evidence-based.
Evidence-based: Treatments whose efficacy has been proven through research using the scientific method.
13) Which of the following is not a Behaviour Therapy technique?
a) Flooding. b) Counter transference. c) Counterconditioning. d) Systematic desensitisation.
Behaviour Therapy: Therapies which are mainly based on the principles of classical and operant conditioning.
14) The principle of extinction assumes that emotional problems can be:
a) Unlearned. b) Removed from your mental lexicon. c) Derived from childhood experiences. d) Become prehistoric.
Extinction: The classical conditioning principle which assumes that if emotional problems such as anxiety disorders were learned through classical conditioning, they could be ‘unlearned’ by disrupting the association between the anxiety provoking cues or situations and the threat or traumatic outcomes that they have become associated with.
15) Counterconditioning is an exposure therapy technique which involves:
a) Learning that one negative event may be linked to another. b) Exposing the client to the feared stimulus. c) Learning that an event or situation is no longer threatening. d) Helping the client to see that their behaviour is counterproductive.
Counterconditioning: A behaviour therapy technique designed to use conditioning techniques to establish a response that is antagonistic to the psychopathology.
16) Contininual professional development (CPD) demonstrates that a therapist:
a) Relies on information from informal sources. b) Regularly updates their knowledge of recent developments in treatment techniques. c) Relies solely on research literature as a way of updating their therapeutic skills. d) Attends all therapeutic conferences.
Continuing professional development (CPD): The demonstration by accredited therapists that they regularly update their knowledge of recent developments in treatment techniques.
17) Counselling is a profession that aims to:
a) Promote personal growth and productivity. b) Provide a successful diagnosis in psychopathology. c) Ensure that clients are on the correct medication. d) Solely address behaviour.
Counselling: A profession that aims to both promote personal growth and productivity and to alleviate any personal problems that may reflect underlying psychopathology.
18) According to the psychodynamic view dream analysis is one of the central tenets of:
a) Psychoanalysis. b) Cognitive behaviour therapy. c) Humanistic therapy. d) Client centred therapy.
Case Study: An in-depth investigation of an individual subject.
19) Empathy involves:
a) Feeling sorry for someone. b) Putting others before yourself. c) Putting yourself in someone else’s shoes. d) Putting yourself before others.
Empathy: An ability to understand and experience a client’s own feelings and personal meanings, and a willingness to demonstrate unconditional positive regard for the client.
20) An encounter group:
a) Enables individuals to interact with others in a social setting. b) Encourages team building. c) Aids the therapist in diagnosis. d) Encourages therapy and self-growth through disclosure and interaction.
Encounter Groups: Group therapy which encourages therapy and self-growth through disclosure and interaction.
21) Group therapy can be advantageous when an individual:
a) May need to work out their problems in the presence of others (e.g. in the case of emotional problems relating to relationships, feelings of isolation, loneliness and rejection). b) May need comfort and support from others. c) May acquire therapeutic benefit from observing and watching others. d) All of the above.
Group Therapy: Therapy taken in the form of a group, usually when a group of individuals share similar problems or psychopathologies.
22) Which of the following possibilities makes email a useful adjunct to face to face sessions?
a) Monitor treatment from a distance. b) Monitor behaviour daily. c) Intervene in a crisis. d) All of the above.
E-therapy: A treatment method which involves the use of email and Internet technology.
23) Family therapy is generally used to:
a) Improve communications between members of the family. b) Resolve specific conflicts – for example between adolescents and their parents. c) Attempts to understand the family as a social system. d) All of the above.
Family Therapy: A form of intervention involving family members that is helpful as a means of dealing with psychopathology that may result from the relationship dynamics within the family.
24) Systems theory involves:
a) Uses computer based programs for therapy’ b) Attempts to understand the family as a social system. c) Uses data analysis systems as a diagnostic tool. d) Relies on self-report measures.
Systems Theory: Approaches that attempt to understand the family as a social system.
25) Faulty learning involves:
a) Acquiring psychological disorders through poor school attendance. b) Acquiring psychological disorders through low self esteem. c) Acquiring psychological disorders by exposure to aversive stimuli. d) All of the above.
Faulty Learning: A view that the symptoms of psychological disorders were acquired through the learning of pathological responses.
26) Functional analysis is a therapy based on:
a) Classical conditioning. b) Humanistic principles. c) Operant conditioning. d) Psychodynamic principles.
Functional Analysis: A systematic analysis of the consistencies between problematic behaviours and their consequences.
27) Token Economy is an influential intervention based upon:
a) Classical conditioning. b) Implicit learning. c) Operant conditioning. d) Client centred therapy.
Token Economy: A reward system which involves participants receiving tokens for engaging in certain behaviours which at a later time, these tokens can then be exchanged for a variety of reinforcing or desired items.
28) When determining whether a treatment works because of the principles it contains it is known as:
a) Ecological validity. b) Reliability. c) Internal validity. d) Internal consistency.
Internal Validity: Determining whether a treatment works because of the principles it contains.
29) Meta-analysis is often used to compare the effectiveness of studies that have used:
a) Different procedures. b) Different numbers of participants. c) Different types of control procedures. d) All of the above.
Meta-analyses: Statistically accepted ways of assessing the strength of a particular finding across a number of different studies.
30) Monoamine oxidase inhibitors (MAOIs) are effective for the treatment of:
a) Schizophrenia. b) Major depression. c) Obsessive compulsive disorder. d) Generalized anxiety disorder.
Monoamine Oxidase (MAO) inhibitors: A group of antidepressant drugs which have their effects by increasing levels of both serotonin and norepinephrine in the brain.