Psychodynamic therapy is a type of talk therapy that helps people bring their unconscious (hidden) feelings to the surface. This form of therapy can help them understand and eventually manage the unconscious feelings that can influence their daily lives.
This type of therapy is based on the assumption that feelings held in the unconscious mind are often too painful or uncomfortable to be realized. For that reason, people develop defense mechanisms to protect themselves from actually knowing about, dealing with, or confronting these feelings.
Defense mechanisms are patterns of feelings, thoughts, or behaviors that are unconscious. These mechanisms can be either healthy or unhealthy, depending on what they are and how they are used. They are meant to reduce stress, anxiety, and internal conflict—a way to cope with the world.
Common defense mechanisms include:
- Denial—refusing to face or perceive an unpleasant reality
- Projection—attributing one's unacceptable characteristics or motives to others
- Displacement—changing the target of built-up emotions or feelings, often anger, onto those (usually people or animals) who are less threatening
- Rationalization—making up logical explanations to conceal the real motives of one's thoughts or behavior
- Reaction formation—adopting the opposite point of view or acting in a contradictory way than one really feels in an effort to hide from unacceptable emotions or impulses
When these defenses start causing problems in a person's life, it may serve as a trigger to seek help with psychodynamic therapy.
How the Therapy Works
The therapist should have an attitude of unconditional acceptance toward the person. This means that the person is respected as an individual and not judged or criticized, regardless of the problem. As a trusting relationship develops, the therapist uses their knowledge and experience to help the person understand what is going on in the unconscious mind. This process may include:
Transference
The person transfers aspects of an earlier important relationship onto the therapist. This includes the feelings, thoughts, and defenses that the person experienced in the early relationship.
Transference is believed to help the person work through conflicts so that permanent change can take place. Through this process, the person develops self-awareness and insight into current and childhood relationships. Then the person can respond in terms of what is really happening instead of what happened in the past.
Countertransference
Countertransference refers to the therapist's unconscious and conscious emotional feelings toward the person. It is the therapist’s thoughts and feelings directed towards the person. The therapist uses how they feel to understand how the person feels.
Interpretation
In each session, the therapist tries to gain insight into the person's problem by looking at a number of different aspects. For example, whether the person is acknowledging their feelings, moving closer to finding out about their unconscious feelings, or able to endure the pain of these feelings. The therapist uses their interpretations to help the person make sense of what is going on and to become more aware.
Benefits and Limitations
Psychodynamic psychotherapy is used to treat a variety of conditions, such as:
- Anxiety
- Depression
- Panic disorder
- Post-traumatic stress disorder
- Personality disorders
Psychodynamic therapy has been effective in treating some conditions, like depression. However, as with other therapies, this technique does not work for everyone. If you are interested in trying psychodynamic therapy, keep in mind that it will require you to be committed to the process. You will have to actively participate. Your doctor may be able to refer you to a psychologist who specializes in psychodynamic therapy.
RESOURCES
The American Psychological Association http://www.apa.org
Mental Health America http://www.nmha.org
CANADIAN RESOURCES
Canadian Mental Health Association http://ontario.cmha.ca
Mental Health Canada http://www.mentalhealthcanada.com
References
Defense mechanisms. True Center Publishing website. Available at: http://truecenterpublishing.com/tcp/defense%5Fmechanisms.pdf. Accessed October 16, 2017.
Generalized anxiety disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder . Updated January 23, 2017. Accessed October 16, 2017.
Jobst A, Brakemeier EL, Buchheim A, et al. European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe. Eur Psychiatry. 2016 Mar;33:18-36.
Leichsenring F, Leibing E. The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. Am J Psychiatry. 2003;160(7):1223-1232.
Major depressive disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116638/Major-depressive-disorder-MDD . Updated July 19, 2017. Accessed October 16, 2017.
Panic disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115030/Panic-disorder . Updated April 17, 2017. Accessed October 16, 2017.
Posttraumatic stress disorder (PTSD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-stress-disorder-PTSD . Updated June 26, 2017. Accessed October 16, 2017.
Psychoanalytic psychotherapy. American Pyschoanalytic Association website. Available at: http://www.apsa.org/content/psychoanalytic-psychotherapy. Accessed October 16, 2017.
Psychoanalytic terms & concepts defined. American Psychoanalytic Association website. Available at: http://www.apsa.org/content/psychoanalytic-terms-concepts-defined. Accessed October 16, 2017.
Reaction formation. Changing Minds website. Available at: http://changingminds.org/explanations/behaviors/coping/reaction%5Fformation.htm. Accessed October 16, 2017.
Revision Information
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 10/2017
- Update Date: 12/02/2015