What is… psychodynamic psychotherapy

In this series, I dig a little deeper into the meaning of psychological terms.

This week’s term: psychodynamic psychotherapy

Psychodynamic psychotherapy is a type of talk therapy that does a deep dive into the past to help uncover what’s going on in the unconscious mind in order to figure out problems in the person’s life.  It’s based on psychoanalytic therapy, but is less intensive, with a typical frequency of 1 or 2 sessions per week (as opposed to 4-5 per week for psychoanalysis).  Sigmund Freud was a major theorist who contributed to this therapeutic approach.

Maladaptive approaches, which are often unconscious, are seen as arising early in life, usually in early childhood.  By uncovering and resolving the conflicts that led to the development of these maladaptive responses, symptoms are expected to improve.

The relationship between client and therapist is very important in this type of therapy.  Therapeutic techniques include free association, dream analysis and work with transference.  Repressed emotions are brought to the surface and examined in terms of their effects on current decision-making.  Transference occurs when the client projects feelings toward a figure from their early life onto the therapist.  This can then be explored and underlying conflicts can be addressed.  A high level of trust is required in order for transference to be incorporated effectively in the therapy.  Another element of the therapy is that defense mechanisms are identified and worked through.

The research evidence support for psychodynamic psychotherapy is mixed.  I haven’t looked into this in any detail, but there’s not the clear level of support that there is for, say, cognitive behavioural therapy.  I would suspect, though, with the nature of the therapy it would be more difficult to design solid research studies compared to a more structured, time-limited form of therapy.

This was new to me when I was doing some reading for this post, but there is a Psychodynamic Diagnostic Manual put together by the American Psychoanalytic Association and a few other groups.  It takes a 3-dimensional approach to mental and overall functioning.  The first dimension is personality patterns and disorders.  The second dimension covers mental functioning across a number of different areas, including information processing, self-regulation, establishing and maintaining relationships, and use of coping and defense mechanisms.  The third dimension looks at manifest symptoms and concerns.

Psychodynamic psychotherapy is usually done by therapists in private practice, so it’s not something I’ve encountered in my work as a nurse.  My only up close and personal encounter was during my last hospitalization.  My psychiatrist was a psychodynamic guy, and although I was the patient he was far nuttier than I was.  I was in hospital following a suicide attempt, and his first meeting with me he wanted to know if I remembered my brother being born, and if I enjoyed it the first time I had sex.  I know I shouldn’t judge a whole field of therapy based on one nutbar, but I find it hard to set aside that bias.

Do you have any experience with psychodynamic psychotherapy?

 

You can find the rest of the What Is series here.

Sources:

 

Have you checked out my book Psych Meds Made Simple?  It’s available on Amazon as an ebook or paperback.

12 thoughts on “What is… psychodynamic psychotherapy

  1. Keto For Beginners says:

    I’m not sure that was what it was called back then, but when my middle son started having issues in school, we ran the gamut of drugs, psychiatrists, and a psychologist who did talk therapy as well as biofeedback, which I believed was working great, yet my son did not. Unfortunately for him, he quit everything and decided to self-medicate which caused many of the problems he has to this day. Now he is in his early 30’s and I wish he would find a good psychologist and get back to it, but he is too old to listen to me anymore. 😉

    Liked by 1 person

  2. Invisibly Me says:

    Ooo another one that I loved to read as it reminded me of all the stuff in my psych degree! It’s interesting you’ve had an experience of it as I think psychodynamic psychotherapy is increasingly rare in practical application as a standalone model these days (maybe I’m wrong, but I don’t come across it being employed all that much).xx

    Liked by 1 person

  3. Meg says:

    He wanted to know if you remembered your brother being born and if you enjoyed your first sexual experience? Oh my!!

    I went to see a therapist once. I was wearing my teaching clothes: a peach cardigan over a blouse and nice black pants and shoes.

    The therapist sort of sneered when he asked, “So, are you promiscuous?”

    And I said, “No.” But I’ve always wished I’d yelled, “Look at me! I’m a freakin’ schoolmarm. What do you think, you pervert?”

    And then, despite my response of no, he spent ten minutes discussing issues related to promiscuity. I never went back.

    Liked by 1 person

    • ashleyleia says:

      Yeah it’s never good when the therapist is more screwed up in the head than the client. He sounds like he’s got his own sexual repressions he needs to sort out and stop projecting onto clients.

      Liked by 1 person

  4. eirlysgwenllian says:

    I had psychodynamic therapy for a couple months last year. Before that, I had two CBT therapists, the first one had a more integrative approach though and it wasn’t just pure CBT, plus it was much more extended than CBT due to my life situation back then and that. While with the first therapist it was going great and I found CBT really helpful for things I was struggling with back then, as I changed therapists and my life got more stable I came to a conclusion that most of my major issues are actually rooted in the past and since I had the possibility to finally focus on them I decided to look for some form of therapy that would help me to uncover and get rid of or alter my perception of that past sh*t. And I chose psychodynamic therapy since it seemed to be a fairly good thing for me, considering both my issues and that I generally tend to analyse things a lot, both in terms of my surroundings and other people as well as introspection, though I was a bit afraid of the intensity of it. I had someone asking me why psychodynamic and not psychoanalysis since they are similar but I always had an impression, maybe a bit stereotypical, that psychoanalysis is actually quite nutty and creepy, and too out there haha. I guess this therapeutic model was indeed good for me, but I realised quite quickly that there is almost no connection whatsoever between me and my therapist, and that actually at times I didn’t feel fully safe with her emotionally. She was nice as a person and made an impression of a warm and very spontaneous person on me, but we just didn’t get each other and couldn’t get close enough to each other. I couldn’t trust her fully and felt like she’s pressuring on me that I should. Actually, after almost every session, I felt pretty low and confused and worse than before it. I thought it might be that whole pain of healing thing or such but I guess it was way too early for that and we weren’t doing such deep work yet. Plus she seemed to have some incredible problem with my blindness that was frustrating me immensely, so I felt I need to quit, and that’s what I did. As I said I think psychodynamic therapy isn’t a bad thing, but, as in every kind of therapy, and in every relationship, you just need to find the right person, and you probably need to have a bit of luck to do that. I was also very attached to my first therapist – the CBT one – so it’s possible that I compare other therapists to her so much that no one can be good enough for me to replace her. Funnily enough, the psychodynamic therapist also asked me about the feelings I had when my brother was born, though I guess in my case it could be a bit more relevant since it’s my first memory and my relationship with my brother has always been… mmhmm, odd. And the thing with them being so preoccupied with sex is a little weird indeed, especially in case of people like me who never had sex. 😀

    Liked by 1 person

  5. Luftmentsch says:

    I had a good psychodynamic psychotherapist, although I think she used elements of other types of therapies over time. The relationship between was important, though. The first year or two had a lot of ups and downs before I really began to trust her.

    Liked by 1 person

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