What are the key principles of the psychodynamic approach
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.
Psychodynamic therapy is the psychological interpretation of mental and emotional processes. Rooted in traditional psychoanalysis, it draws from object relations, ego psychology, and self psychology. It was developed as a simpler, less-lengthy alternative to psychoanalysis.
Psychodynamic therapy aims to address the foundation and formation of psychological processes. In this way, it seeks to reduce symptoms and improve people’s lives.
Core Principles of Psychodynamic Therapy
In psychodynamic therapy, therapists help people gain insight into their lives and present-day problems. They also evaluate patterns people develop over time. To do this, therapists review certain life factors with a person in therapy:
- Early-life experiences
Recognizing recurring patterns can help people see how they avoid distress or develop defense mechanisms to cope. This insight may allow them to begin changing those patterns.
The therapeutic relationship is central to psychodynamic therapy. It can demonstrate how a person interacts with their friends and loved ones. In addition, transference in therapy can show how early-life relationships affect a person today. Transference is the transferring one’s feelings for a parent, for example, onto the therapist. This intimate look at interpersonal relationships can help people understand their part in relationship patterns. It may empower them to transform that dynamic.
Psychodynamic therapy is available to individuals, couples, families, or groups. It can be used as short-term or long-term therapy. Brief psychodynamic therapy is goal-oriented and can take as many as 25 sessions. Long-term psychodynamic therapy may take two years or more.
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Accessing the Unconscious
People tend to develop defense mechanisms. Defense mechanisms may keep painful feelings, memories, and experiences in the unconscious. A few common defense mechanisms include:
Psychodynamic therapists encourage people to speak freely about their emotions, desires, and fears. Being open may help reveal vulnerable feelings that have been pushed out of conscious awareness. According to psychodynamic theory, behavior is influenced by unconscious thought. Once vulnerable or painful feelings are processed, the defense mechanisms reduce or resolve.
Psychodynamic Diagnostic Manual (PDM)
The Psychodynamic Diagnostic Manual (PDM) was released in 2006. Its goal is to offer a conceptual framework for human psychological functioning. It also aims to serve as an alternative to the Diagnostic and Statistical Manual (DSM). The DSM outlines observable symptoms associated with mental health conditions. Meanwhile, the PDM describes subjective experiences.
Improvisational Psychodynamic Music Therapy
One approach to psychodynamic therapy is psychodynamic music therapy. This innovative and creative form of therapy involves exploration of various instruments. Guitars, drums, and pianos a just of few of the instruments used. This kind of music therapy is non-directive. It does not require any musical background. Instead, people are encouraged to improvise and express themselves through music in any way they wish.
Music therapists are highly trained to identify various personality traits and emotional issues. They can do this by observing how a person in therapy creates music. As they build their therapeutic alliance, they also participate in the music making. This can help strengthen their bond and help the therapist access deeper communication tools. For people with high levels of anxiety or fear, the music can be soothing. It may provide an element of release during difficult therapeutic sessions.
- Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., et al. (2008). Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(5), 689-703. doi:http://dx.doi.org/10.1017/S003329170700164X
- Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-behavioral therapy and psychodynamic psychotherapy: Techniques, efficacy, and indications. American Journal of Psychotherapy, 60(3), 233-59. Retrieved from http://search.proquest.com/docview/213135027?accountid=1229
- Luborsky, Ellen, O’Reilly-Landry, Maureen, and Arlow, Jacob. (2008). Psychoanalysis. In Raymond J. Corsini and Danny Wedding (Eds.), Current Psychotherapies (pp. 15–62). Belmont, CA: Thomson Higher Education