July 25, 2025

Psychodynamic psychotherapy is the daughter of classical psychoanalysis and, since its foundation, has spawned children of its own. Let’s debunk some common myths surrounding this approach and demonstrate how much it actually has in common with all modern schools of thought.

Flavours of psychodynamic

Psychotherapy comes in many flavours, and psychodynamic therapy has its own variations. However, this diversity isn’t limited to the techniques themselves, as both therapists and clients bring something unique to each session. Hence, my experience of the same type of therapy may differ drastically depending on the therapist and the issue I’m struggling with.

Psychodynamic approaches are all underpinned by several schools of thoughts of psychoanalysis, and the major ones to be aware of are: Freudian, Jungian, Kleinian, Winnicott, and Adlerian. The founders of each of those schools have each made a huge contribution to the field, and each one had some interesting perspectives to offer. The diversity of thoughts allows one to choose how to best explain one challenge or another. The main foundational premise of all them, which essentially unites them all, is that peoples’ thoughts and feelings are underpinned by unconcious material that has shape certain patterns in thinking, feelings, and behaving. These patterns can serve a person well, but sometimes get in the way and hinder change on the path to happier and more comfortable life. Uncovering those unconscious thoughts (insight) helps the person understand themselves and thus become more open to change.

Psychodynamic and other approaches

Psychodynamic therapy is, of course, not the only one there is. Take, for instance, person-centred, congitive, congitive-behavioural, behavioural, narrative, solution-focused, motivational interviewing, to name a few. Interestingly, whenever I read about any of those approaches, I can’t help but notice how much in common they all have, despite the quibbling about their illusory differences.

What to expect

Here is a short list of the most common things to expect in the course of this therapy:

  1. Quite a lot of questions, clarifing, and whatnot. Some of those questions might be uncomfortable, because unconscious material is often hidden behind the battlements of person’s defenses.
  2. Focused on identifying and analysing patterns, psychodynamic therapy relies on clients history perhaps more than any other modality. So, the threapist will be more helpful when understanding the client’s family and attachment history.
  3. After some time, it’s expected that the threapist begins to interest clients in what is going on in their mind (confrontation) and invite patients explore patterns (clarification) (Cabaniss et al, 2017).
    1. Confrontation example: I noticed that you just stopped talking.
    2. Clarification question question: Have you ever felt like that before with someone else?
  4. Further into therapy, therapist begins to interpret more and more, as more observations are made and patterns identified.
    1. Interpretation examples: I wonder if your impulsive decision to ______, which has left you feeling so anxious, was your attempt to keep your husband from leaving you.
  5. The whole therapy heavily relies on identifying patterns and identifying common responses. Hence, it’s essential for the client to be able to discuss their thoughts and feelings freely.
  6. Dream work is another valuable tool that can be used later in therapy to identify blockers and unconscious material
  7. Therapist may invite the client to use free association technique (more about it in another article) when the client is invited to say whatever comes to mind without any filtering or judgement. This technique often leads to unconscious material otherwise deeply buried.
  8. Silence. Sometimes therapists don’t say anything intentionally. This silence, even though uncomfortable sometimes, can unblock and reveal new material that was otherwise “muted” by common thoughts and feelings on top of awareness. Don’t underestimate silence!
  9. Psychodynamic theory is all about patterns, including patterns in behaviour towards other people. One way to identify those patterns is to get the client’s history, but it’s not the only way. What psychotherapists call transference, is a powerful instrument in the toolkit. Transference is when a client behaves or feels towards the therapist what is usually felt or demostrated to to another person outside therapy. Therapists should be comfortable with both negative and positive emotions towards themselves, as well as being analytically savvy to analyse them together with the client. Analysing those transference feelings helps better understand how the client feels with others and where the problem might be.

Can I benefit from psychodynamic therapy?

To size fits all, and to benefit from this modality clients needs to be able and willing to analyse themselves, be open to a deep and thorough collaborative therapeutic work, intersted in insights and willing to discuss uncomfortable topics. For people with long-lasting challenges like prolonged depression and complex issues like personality disorders this modality is particularily benefitial.

There are certain things where other modalities might be of more value. For example, OCD has been shown to be purely behaviour based and thus psychodynamic approach isn’t suitable. Anxiety and depression (especially short-term) are also effectively treated by CBT. Numerous manuals for different modalities prove effective for various conditions, and in most cases (other than OCD), psychodynamic therapy is equally effective to other modalities.

References

  1. Cabaniss, D. L., Cherry, S., Douglas, C. J., & Schwartz, A. R. (2017). Psychodynamic psychotherapy: A clinical manual (2nd ed.). Wiley-Blackwell.