Psychodynamic Therapy
Psychodynamic therapy helps you understand how your past shapes your present, guiding you toward lasting change and deeper self-awareness.
Psychodynamic therapy is a type of talk therapy that helps you understand how unconscious thoughts, emotions, and past experiences influence your current behaviour and relationships. This therapy focuses on uncovering hidden patterns in your life to help you gain insight into yourself and your motivations.
Table of Contents | Jump Ahead
What Is Psychodynamic Therapy?
Transference and Countertransference
Types of Psychodynamic Therapy
Applications of Psychodynamic Therapy
Psychodynamic Therapy with Different Populations
Integration with Other Approaches
Technology and Psychodynamic Therapy
What Is Psychodynamic Therapy?
Psychodynamic therapy is based on the idea that many thoughts, feelings, and behaviours arise from unconscious processes and early life experiences, especially those from childhood. The goal is to bring these unconscious patterns to your awareness so you can better understand and change them.
Key principles of psychodynamic therapy:
- Unconscious Processes: Much of your mental activity happens outside your conscious awareness but affects your behaviour.
- Past Influences Present: Early relationships, especially with caregivers, shape how you act and feel today.
- Insight and Understanding: Becoming aware of hidden patterns leads to meaningful change.
- Therapeutic Relationship: The connection with your therapist reveals important relationship dynamics.
- Defence Mechanisms: Your mind uses unconscious strategies to protect you from painful feelings.
- Transference and Countertransference: Feelings that come up during therapy reflect past relationship patterns between you and your therapist.
Core Concepts
- Unconscious Mind: The part of your mind holding thoughts and feelings you are not aware of.
- Defence Mechanisms: Ways your mind shields itself from anxiety and emotional pain without your awareness.
- Transference: Projecting feelings from past relationships onto your therapist.
- Countertransference: The therapist’s emotional responses to you can reveal helpful insights.
- Resistance: Unconscious avoidance of painful topics during therapy.
- Working Through: The process of exploring and understanding patterns repeatedly until lasting change happens.
Defence Mechanisms
Defence mechanisms are unconscious mental processes that protect you from painful feelings or thoughts. Here are some common types:
- Repression: Blocking out painful memories or feelings without realising it.
- Denial: Refusing to accept a painful reality.
- Projection: Attributing your own unwanted feelings or thoughts to someone else.
- Displacement: Redirecting strong emotions to a safer target instead of the real source.
- Rationalisation: Creating logical reasons to explain behaviours driven by unconscious motives.
- Sublimation: Turning unacceptable urges into positive, socially acceptable actions.
Therapeutic Process
- Assessment and Formulation: Understanding your history and hidden mental patterns.
- Building Therapeutic Alliance: Creating a trusting relationship to explore your thoughts deeply.
- Exploration and Insight: Examining your feelings, dreams, and how you relate to others.
- Working Through: Repeatedly exploring these patterns until you fully understand and integrate them.
- Termination: Ending therapy in a way that reinforces your progress and addresses goodbyes.
- Integration: Applying what you’ve learned for lasting positive change.
Techniques and Methods
- Free Association: Saying whatever comes to mind without filtering your thoughts.
- Dream Analysis: Using dreams to explore hidden feelings and thoughts.
- Interpretation: Your therapist explains what unconscious patterns might mean.
- Clarification: Helping you better understand and express your feelings and thoughts.
- Confrontation: Gently pointing out contradictions or hidden patterns you may not see.
- Working with Resistance: Exploring your hesitations or avoidance of difficult topics.
Transference and Countertransference
Transference occurs when you unconsciously project feelings and expectations from past relationships onto your therapist. This can reveal important patterns in how you relate to others. It can be positive, such as admiration or affection, or negative, like anger or disappointment.
Countertransference happens when your therapist experiences emotional reactions toward you, often influenced by their own past experiences. Therapists stay aware of these feelings to provide effective treatment.
Both transference and countertransference are used in therapy to help understand and heal relationship patterns.
Types of Psychodynamic Therapy
- Classical Psychoanalysis: A traditional, intensive therapy involving several sessions per week over the years.
- Psychodynamic Psychotherapy: A less intensive and typically shorter form of psychoanalysis.
- Brief Psychodynamic Therapy: Short-term therapy focusing on specific issues using psychodynamic ideas.
- Interpersonal Psychotherapy: Focuses on present relationships affected by past experiences.
- Object Relations Therapy: Studies how early relationships shape your inner world.
- Self Psychology: Emphasises developing a healthy sense of self.
Brief Psychodynamic Therapy
- Works within a fixed timeframe, usually 12 to 40 sessions.
- Centres on one key issue or pattern.
- Therapist takes a more active, directive role.
- Balances exploring past with focusing on current problems.
- Sets clear and achievable therapy goals.
- Prepares for a planned end to therapy from the start.
Applications of Psychodynamic Therapy
- Depression: Finds deeper causes and patterns behind symptoms.
- Anxiety Disorders: Explores unconscious fears and conflicts causing anxiety.
- Relationship Problems: Examines how past shapes current interactions.
- Personality Issues: Works with long-term thinking and behavioural patterns.
- Trauma Recovery: Helps process and heal from traumatic experiences.
- Identity Concerns: Supports exploring self-understanding and personal identity.
Working with Dreams
- Dream Content: Explore both the obvious (manifest) and hidden (latent) parts of your dreams.
- Symbolism: Understand how dreams use symbols to reveal unconscious thoughts and feelings.
- Personal Associations: Discuss what specific dream elements mean to you personally.
- Recurring Dreams: Look into recurring dreams to identify ongoing unconscious concerns.
- Dream Series: Review dream series to see patterns over time.
- Integration: Connect insights from dreams to your waking life and issues.
Resistance in Therapy
- Recognise resistance as a way your mind protects you from painful awareness.
- Identify different ways you may avoid or oppose therapy.
- Explore resistance gently, rather than forcing change.
- Use resistance as a clue to what feels hard or threatening to face.
- Respect your pace while encouraging exploration.
- Work together with your therapist to understand and handle resistance.
Therapeutic Relationship
- Create a genuine, trusting connection between you and your therapist.
- Establish clear boundaries and structure to make therapy safe.
- Experience your therapist’s empathy and understanding.
- Benefit from your therapist’s neutral, non-judgmental approach.
- Build trust through your therapist’s consistent support.
- Maintain professional limits to keep the relationship therapeutic.
Cultural Considerations
- Understand how your cultural background shapes your psychological growth.
- Consider cultural differences in family structure and relationships.
- Respect your cultural values while exploring your mind.
- Acknowledge cultural differences in how emotions and communication are expressed.
- Adapt therapy for cultures focused more on groups than individuals.
- Recognise the impact of cultural and historical trauma.
Psychodynamic Therapy with Different Populations
- Children and Adolescents: Use therapy methods suited to their age.
- Older Adults: Adapt therapy to address seniors’ life reflections.
- Couples and Families: Apply psychodynamic ideas to relationship therapy.
- Groups: Facilitate therapy in group settings.
- LGBTQ+ Individuals: Understand unique identity and development issues.
- Trauma Survivors: Combine trauma-informed care with psychodynamic therapy.
Research and Evidence
- Outcome Research: Studies show that psychodynamic therapy is effective for many mental health issues.
- Process Research: Research explores how this therapy works and what helps it succeed.
- Comparative Studies: Psychodynamic therapy performs as well as other common treatments.
- Long-Term Benefits: Results from therapy often last well beyond the treatment period.
- Mechanism Research: Insight and understanding during therapy lead to positive psychological change.
- Cultural Research: Adaptations help make therapy effective across different cultural groups.
Training and Practice
- Personal Analysis: Therapists often undergo their own psychodynamic therapy to understand unconscious processes.
- Supervision: Regular supervision helps therapists develop their skills.
- Case Consultation: Therapists consult on difficult cases and their own emotional reactions (countertransference).
- Theoretical Knowledge: Deep study of psychodynamic theory and human growth.
- Self-Awareness: Therapists work to recognise their own unconscious responses.
- Ethical Practice: Understanding ethics specific to psychodynamic therapy.
Challenges and Limitations
- Time and Commitment: Therapy often requires a long-term commitment.
- Emotional Intensity: Deep exploration can bring up strong emotions.
- Uncertainty: The process may feel unclear or unpredictable.
- Cost: Long therapy may be expensive and not always covered by insurance.
- Therapist Skill: Requires highly trained specialists.
- Cultural Fit: May not suit all cultural backgrounds.
Integration with Other Approaches
- Cognitive-Behavioural Integration: Combines deep insight with practical skills.
- Humanistic Integration: Merges psychodynamic ideas with focus on personal growth.
- Mindfulness Integration: Adds mindfulness and meditation to therapy.
- Somatic Integration: Incorporates body-focused methods.
- Medication Integration: Coordinates therapy with psychiatric medication.
- Family Systems Integration: Includes family therapy techniques.
Technology and Psychodynamic Therapy
- Online Therapy: Psychodynamic therapy is offered through video calls, making treatment accessible from anywhere.
- Digital Tools: Technology helps enhance self-reflection and insight during therapy.
- Recording and Review: Sessions may be recorded for therapist supervision and training.
- Apps and Resources: Digital apps support psychodynamic exercises and self-exploration.
- Research Tools: Technology aids research on how psychodynamic therapy works and its outcomes.
- Training Platforms: Therapists use online platforms to learn and improve psychodynamic therapy skills.
Self-Understanding and Growth
- Self-Reflection: Learn to examine your thoughts and feelings regularly.
- Pattern Recognition: Identify recurring thoughts, emotions, and behaviours.
- Insight Application: Use new understanding from therapy to make changes in life.
- Relationship Awareness: Improve how you relate to others by applying therapy insights.
- Emotional Intelligence: Develop better awareness and control of your emotions.
- Personal History: Understand how your past continues to shape your present.
Measuring Progress
- Insight Development: Track growth in self-awareness.
- Symptom Reduction: Notice improvements in mental health symptoms.
- Relationship Quality: Evaluate better interactions with others.
- Emotional Regulation: Assess how well you manage emotions.
- Life Satisfaction: Measure overall happiness and fulfilment.
- Behavioural Changes: Monitor changes in habits and behaviours.
Common Misconceptions
- Blame and Pathology: Therapy does not blame parents or focus only on illnesses.
- Endless Analysis: Modern psychodynamic therapy can be short and focused.
- Passive Process: Both you and your therapist actively work together.
- Only for Severe Problems: Therapy helps with many issues, not just serious ones.
- Outdated Approach: Today’s psychodynamic therapy uses current research.
- Therapist as Expert: You are the expert on your own life and experience.
Future Directions
- Neuroscience Integration: Using brain research to enhance therapy.
- Cultural Adaptation: Tailoring therapy for different cultural backgrounds.
- Brief Therapy Development: Creating more effective short-term treatments.
- Technology Integration: Expanding tech use to support therapy.
- Prevention Applications: Applying therapy insights to prevent mental health issues.
- Research Advancement: Continuing studies on how therapy works and its benefits.
Related Terms
- Psychoanalysis - The original form of psychodynamic therapy
- Unconscious - Key concept in psychodynamic theory
- Defence Mechanisms - Important psychodynamic concept
References
Therapy. Psychodynamic Psychiatry, 41, 361–384. https://www.rcpsych.ac.uk/docs/default-source/members/faculties/medical-psychotherapy/med-psy-evidence-support-of-psychodynamic-psychotherapy-march-2018.pdf
Shedler, J. (2010). The Efficacy of Psychodynamic Psychotherapy. American Psychologist, 65(2), 98-109. https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf
Yakeley, J. (2014). Psychodynamic Psychotherapy: Developing the Evidence Base. Advances in Psychiatric Treatment. https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/psychodynamic-psychotherapy-developing-the-evidence-base/FDFB93596F9E502277720F9F4F55563A
British Psychological Society. (2025). What Passes Between Client and Therapist? https://www.bps.org.uk/psychologist/what-passes-between-client-and-therapist
Fonagy, P. (2015). The Effectiveness of Psychodynamic Psychotherapies. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471961/
Midgley, N. (2021). The Evidence Base for Psychodynamic Psychotherapy in Eating Disorders. Frontiers in Psychology. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.662671/full
Opland, C. (2024). Psychodynamic Therapy - StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK606117/
Leichsenring, F. (2019). The Efficacy of Psychodynamic Psychotherapy: An Updated Review. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/B9780128133736000040
Hirschfeld, R. (2024). The Effectiveness of Psychodynamic Therapy in an NHS Setting. Taylor & Francis Online. https://www.tandfonline.com/doi/abs/10.1080/02668734.2023.2295437
Mechler, J. (2024). Internet-Delivered Affect-Focused Psychodynamic Therapy. Taylor & Francis Online. https://www.tandfonline.com/doi/full/10.1080/15289168.2024.2339523
This information is for educational purposes only and is not a substitute for professional mental health treatment. Psychodynamic therapy should be practised by qualified mental health professionals with appropriate training in psychodynamic theory and techniques.
Important:
TherapyRoute does not provide medical advice. All content is for informational purposes and cannot replace consulting a healthcare professional. If you face an emergency, please contact a local emergency service. For immediate emotional support, consider contacting a local helpline.
Find a Therapist
Find skilled psychologists, psychiatrists, and counsellors near you.
