What is it?
- Explores unconscious thoughts and feelings.
- Focuses on early childhood experiences.
- Examines patterns in relationships and behavior.
- Aims to resolve internal conflicts and trauma.
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Description
Psychodynamic psychotherapy is a therapeutic approach that delves into how unconscious thoughts and past experiences shape current behavior and emotions. Rooted in psychoanalytic theory, it emphasises exploring early life experiences and their impact on present-day relationships and self-perception.
By examining defense mechanisms, transference (the projection of feelings onto the therapist), and countertransference (the therapist’s projections onto the patient), the therapy aims to bring unconscious conflicts to conscious awareness. The relationship with your therapist is key to psychodynamic psychotherapy. Having an accepting and trusting relationship with them encourages you to talk freely and openly about topics like your childhood and your relationship with your parents which can help you understand what you’re feeling now, why you behave in a certain way and how this affects your relationships.
What is the theory behind psychodynamic psychotherapy?
What is the theory behind psychodynamic psychotherapy?
The theory behind psychodynamic psychotherapy is based on the idea that unconscious thoughts and early childhood experiences profoundly shape an individual’s behavior and emotions. Rooted in Freud’s psychoanalytic concepts, it posits that much of our psychological life is influenced by hidden, repressed conflicts and desires.
Early interactions with primary caregivers are believed to form enduring patterns that go on to affect adult relationships and self-perception. Central to the theory is the use of defense mechanisms, which help manage internal conflict but can also distort reality. Psychodynamic therapy explores these internal conflicts, as well as the phenomena of transference (projecting past relationships onto the therapist) and countertransference (the therapist’s projections onto the patient), to uncover and address underlying issues. By bringing unconscious processes to conscious awareness, the therapy aims to foster insight, resolve internal conflicts, and promote emotional growth.
What to expect from psychodynamic psychotherapy
- Assessment
During your assessment, the therapist will ask questions about your current concerns, personal history, and any significant past experiences. This helps them understand your background and the issues you’re facing.
They might ask about your family history, early childhood experiences, relationships, and major life events. The goal is to uncover patterns or unresolved conflicts that might be influencing your current behavior and emotions. The therapist may also talk with you about what you hope to achieve from therapy and how they plan to help you work towards those goals.
- What might a session look like?
In a session, your therapist will encourage you to talk freely about whatever comes to mind. This is known as free association. You can talk openly, honestly and without being judged.
A key concept in the psychodynamic approach is transference. This is where you redirect feelings you experienced in previous significant relationships, or during childhood, onto your therapist. Transference can help you both learn more about your feelings, behaviours and actions, and then resolve the feelings that originate from these relationships. It can help you understand why you expect to be treated in a certain way and how that impacts on your current relationships.
- Length of treatment
The number of sessions needed can vary from person to person, depending on their individual needs. Long-term psychodynamic therapy can take a year or more, lasting 50 or more sessions. Brief psychodynamic therapy, another form of psychodynamic therapy, aims to see results more quickly (this could be as little as 6+ sessions when used in a solution-focused way). This is often done by determining a specific emotional area in which you want to focus on, and looking into this first.
One specific form of brief psychodynamic psychotherapy is called dynamic interpersonal therapy (DIT) and is sometimes used in the NHS.
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The theory supporting psychodynamic therapy originated in and is informed by psychoanalytic theory, developed by Sigmund Freud.
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What issues can psychodynamic psychotherapy help with?
Psychodynamic therapy can be used to help with a broad range of issues and mental illnesses. Psychodynamic therapy can help with:
- anxiety
- depression
- eating disorders
- loss of meaning in life
- panic disorders
- personality disorders
- post-traumatic stress disorder (PTSD)
- persistent feelings of loneliness
- trouble connecting with others or forming relationships
- sexual issues
- substance misuse (addiction)
Pros and cons of psychodynamic psychotherapy
Research on the effectiveness of psychodynamic psychotherapy indicates that it can be highly effective, especially for certain types of psychological issues such as anxiety, depression and personality disorders. However, it is not for everyone. It is important to talk with a mental health professional to determine if it’s the right fit for you.
- Pros
- Deep Insight: Psychodynamic psychotherapy can help uncover underlying unconscious processes and unresolved conflicts, leading to profound self-awareness and personal growth.
- Long-Term Benefits: By addressing root causes of emotional issues, it can lead to lasting improvements in how you relate to others and handle life challenges.
- Improved Relationships: Understanding past patterns can enhance current relationships and improve interpersonal skills.
- Personal Development: It can foster greater self-understanding and emotional resilience by exploring the influence of early experiences.
- Cons
- Time-Consuming: It often requires a long-term commitment, which may not be feasible for everyone due to time or resource constraints.
- Emotional Intensity: The exploration of deep-seated issues can be emotionally challenging and may initially increase distress before improvement is seen. Your therapist will work with you to manage these feelings.
- Variable Outcomes: Progress can be slow and may not always align with immediate or tangible goals, as it focuses more on deep-seated issues rather than immediate symptom relief.
Voice
Psychodynamic psychotherapists…pay special attention to the therapist’s countertransference, that is, the feelings and emotional reactions that the therapist has towards the patient. These can be a source of useful information about the patient and their internal object relations, which determine their pattern of relating to others.
- Dr Jessica Yakeley, Consultant Psychiatrist in Forensic Psychotherapy
How can I access psychodynamic psychotherapy?
How can I access psychodynamic psychotherapy?
Accessing psychodynamic psychotherapy can be done through several avenues, depending on your needs and circumstances.
1. NHS Services: The first step is to visit your general practitioner (GP). They can assess your needs and refer you to an appropriate mental health service. If psychodynamic therapy is deemed suitable for you, your GP can refer you to a service that offers it if one is available.
2. Private Therapy: Psychoanalytic psychotherapy requires specific training and specialist skills to deliver it safely and competently. To make sure your therapist is professional accredited, you can look on websites such as:
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