WHAT IS IT?
Psychodynamic therapy involves the interpretation of mental and emotional processes rather than focusing on behavior (Strupp, Butler, & Rosser, 1988). Psychodynamic therapists attempt to help clients find patterns in their emotions, thoughts, and beliefs in order to gain insight into their current self. These patterns are often found to begin in the client’s childhood since psychodynamic theory holds that early life experiences are extremely influential in the psychological development and functioning of an adult (Matthews & Chu, 1997). The psychodynamic focus has distinct areas and goals to help the client understand how experiences and relationships affect their identity and relationship patters and unconscious defenses in their current life. This understanding allows them to gain insight and awareness to help live a more adaptive and quality life. Psychodynamic techniques focus on different core areas that differentiate it from other types of psychotherapy which can be beneficial for clients.
What people see on the surface is just the tip of the iceberg. All of our experiences, relationships, traumas and repressed emotions have created our defense mechanisms. Psychodynamic therapy can help a person rewrite a more positive narrative for them-self and their experiences.
HOW DOES IT WORK?
Like other therapies such as CBT discussed in previous blog posts, psychodynamic therapy has certain areas of focus but has a different structure to the therapy sessions. One area is focusing on affect and expression of emotion. In this area the goal is to explore and discuss the full range of a patient’s emotion. Helping the patient recognize and describe feelings, including those that may be contradictory or troubling (Shedler, p. 99, 2009). Analyzing a client’s feelings such as worthlessness; using this technique to explore feelings of worthlessness can help identify clients emotions surrounding this belief.
The second area of focus is the exploration of attempts to avoid distressing thoughts and feelings. This area focuses on defenses and avoidances that are used knowingly or unconsciously to avoid troubling experiences (Shelder, p. 99, 2009). For many people, this may manifest as isolation or withdrawal.
The third area of focus is on the identification of recurring themes and patterns in the patient’s life including thoughts, feelings, self-concept, relationships and experiences (Shelder, p. 99, 2009). Exploring a client’s life experience, there may be recurring themes such as feelings of being a failure which prevents them from applying themselves. Recognizing these underlying themes can help them identify when they are at risk of repeating the same detrimental cycles.
The fourth area of focus is discussing past experiences to explore how the affects of relationships with early attachment figures manifest in the present (Shelder, p. 99, 2009). Examples such as a client discussing a neglectful relationship with their mother and their father’s constant comparisons of them to their siblings. Shining light on past experiences with attachment figures can help resolve current psychological difficulties in the present.
The fifth area of focus is on interpersonal relations which places emphasis on relationships and interpersonal experience. Focusing on these areas can help identify both adaptive and maladaptive aspects of personality and self-concept which interfere with a person’s ability to meet emotional needs (Shelder, p. 99. 2009). Examples such as a client’s constant belief that he/she is a failure or sub-par compared to others including their friends and siblings, which were forged with the relationship and interpersonal experience with their mother or father. Understanding this connection can help open a client’s mind to the concept that he/she is not a failure, rather that they hold a negative belief in them-self that was seeded in early childhood experiences.
The sixth concept is focusing on the therapy relationship. Often recurring themes of interpersonal relationships and experiences manifest in the patient therapist relationship (Shelder, p. 99. 2009). Understanding and identifying these transferences or countertransferences can help the patient explore and rework their underlying defense mechanisms to create adaptive behaviors in future interpersonal relationships.
The final area of focus is on the exploration of fantasy life. Psychodynamic therapy is less structured than other types of therapy and encourages patients to speak freely about anything on their minds. Having this open and fluid type of therapy allows the patient and therapist to explore many different aspects of the patient’s mental life including dreams, fantasies and daydreams that my play a role in their defenses or potential to find greater enjoyment and meaning in life (Shelder, p. 99. 2009).
Winnicott describes how the foundation of mental health comes from how the mother fulfills the needs of a child in the first five years of life. This foundation creates an internalized unconscious “object” in the child’s psyche and development which he/she carries throughout their life. These internalized objects manifest in their present life in different ways from physical manifestations to emotional and psychological maladaptive patterns (Winnicott, 1931).
The main goals of psychodynamic therapy are to enhance the client’s self-awareness and foster understanding of the client’s thoughts, feelings, and beliefs in relation to their past experiences, especially his or her experiences as a child (Haggerty, 2016). This is achieved through guiding the client through the examination of unresolved conflicts and significant events in the client’s past. Psychodynamic therapy takes a deep dive into the past experiences and relationships to find connections in how they are effecting us today. In addition to the positive effects and outcomes that can be accomplished through psychodynamic therapy, research suggests that the positive effects have a lasting effect even after treatment has ended.
Haggerty, J. (2016). Psychodynamic therapy. Psych Central. Retrieved from https://psychcentral.com/lib/psychodynamic-therapy/
Matthews, J. A., & Chu, J. A. (1997). Psychodynamic therapy for patients with early childhood trauma. In P. S. Appelbaum, L. A. Uyehara, & M. R. Elin (Eds.), Trauma and memory: Clinical and legal controversies (pp. 316–343). Oxford, UK: Oxford University Press.
Shedler, J. (2010). The Efficacy of Psychodynamic Psychotherapy. American Psychologist, 65(2), 98–109. doi: 10.1007/978-1-60761-792-1_2
Strupp, H. H., Butler, S. F., & Rosser, C. L. (1988). Training in psychodynamic therapy. Journal of Consulting and Clinical Psychology, 56(5), 689-695.