Psychodynamic Therapy (PDT)
In the intricate tapestry of mental health treatments, psychodynamic therapy stands as a profound and time-tested approach. Rooted in the depths of human psychology, this therapeutic method explores the intricate connections between past experiences, unconscious thoughts, and present behaviour
What is psychodynamic therapy?
Psychodynamic therapy is the therapeutic modality that most closely aligns with the popular perception of “talk therapy.”
In psychodynamic therapy, individuals work with therapists to dig into the unconscious psychic factors that shape their current mood and functioning. The individual’s childhood and family context are especially important in this process, since psychodynamic theory views childhood experiences as key defining factors of a person’s psyche. For example, a difficult childhood relationship with an authority figure such as a parent or teacher might lead to ongoing conflicts with people who play similar roles in your adult life, whether or not you’re consciously aware of the parallel.
Psychodynamic therapy involves Sigmund Freud’s psychoanalytical theory of unconscious drives—id, ego, and superego—and how they shape personality, but it also incorporates the later theories of those who expanded on Freud’s work. Psychodynamic therapy emphasizes gaining insight into the ways that the past influences the present and using that insight to understand the unconscious aspects of the psyche and change present behavior.
Psychodynamic therapy sessions most often occur on a weekly basis, and this form of therapy is usually ongoing over the course of several months or even years, though short-term versions also exist.
What is the difference between psychodynamic therapy and cognitive behavioral therapy?
As both psychodynamic therapy and cognitive behavioral therapy (CBT) are forms of talk therapy that are often used to treat depression and anxiety, the efficacy of these therapies is often compared. For the most part, it’s the nature of their psychological focus that distinguishes them.
CBT sessions adhere to formal structures and work towards a set of specific learning agendas. The therapy is focused on understanding and modifying certain processes or behaviors; working on identifying and ultimately changing dysfunctional patterns of thought.
While psychodynamic therapy can be both time-limited (sometimes referred to as brief psychodynamic therapy or brief dynamic therapy) and longer-term, CBT is always a time-limited, short-term therapy that focuses on learning new patterns to deal with current problems rather than understanding why the dysfunctional patterns are present.
In contrast, psychodynamic therapists encourage patients to talk freely about whatever is on their minds and how they are feeling at that moment during the therapy session. By doing this, a pattern of present behavior and feelings related to past experiences will emerge. The psychodynamic therapist will then put the focus on those patterns in order for the patient to recognize the way past experiences are affecting the way they behave in the present, and can begin to recognize these patterns themselves.
Psychodynamic Theory
Psychodynamic therapy developed from the theories of Sigmund Freud, who believed that our childhood experiences are significant, and they continue to have an impact on us during adulthood. He posited that the human mind has three parts:
- The id, made up of natural instinct and forms the unconscious mind
- The superego, which is the moral part of the brain that contains our beliefs of right and wrong
- The ego, which is the bridge between the animal instinct of the id and the refined moral thoughts of the superego (Haggerty, 2016)
This hypothesis led to the logical conclusion that his theory is based on: Our personalities are formed through our childhood experiences.
Freud’s hypothesis was that these components developed in certain stages of childhood. He believed that we are born with the id, the ego is developed when we are toddlers and the superego comes around the age of five. Freud also believed that the development of each component is significantly influenced by relationships, such as family relationships and the environments. These factors could aid the development of a healthy sense of self or lead an individual to exhibit dysfunctional behavior. Basically, Freud believed that human behavior is driven by that which is buried deep within the mind. He called this the unconscious mind.
Based on this, Freud believed that to truly solve human problems, we must find the roots of the problems in the unconscious mind. The unconscious mind houses our innermost beliefs, thoughts, and patterns of behavior developed in childhood. It is upon this foundation that Psychodynamic Theory is established. Many of the themes in the psychodynamic approach mirror Freud’s theories:
- The unconscious mind controls human behavior and emotion
- Every behavior is influenced by something
- Childhood experiences shape who we become as adults
These theories have formed the basis of psychodynamic therapy and greatly influenced the methods and techniques that are used.
What Happens In A Psychodynamic Therapy Session?
Psychodynamic therapy is a process which aims to understand how the subconscious such as traumatic experiences and events that have been suppressed, affect a person’s behavior. To do this, psychodynamic therapy uses the relationship that exists between the therapist and the client. This relationship is built on trust and openness and unconditional acceptance. The therapist creates an enabling environment that encourages the patient to open up and share freely. The direction that the therapy session takes is usually governed by how the patient is feeling at that moment. The patient is encouraged to talk about their feelings, emotions, fears, and desires with minimal interruption from the therapist. As the patient does this, patterns of behavior that are rooted in past experiences, emerge. The therapist guides the patient in seeing how past experiences are currently affecting them and helps the patient develop the ability to deal with these issues in a healthy manner.
What kind of concerns is Psychodynamic Therapy best for?
Psychodynamic therapy can help with a wide range of mental health problems, but it’s primarily used to treat depression and anxiety. It’s focused on helping those who feel like life has no meaning, and have difficulty forming new relationships or maintaining existing ones. Some other conditions psychodynamic therapy is used to treat include:
- Post Traumatic Stress Disorder
- Panic Disorders
- Personality disorders, e.g Borderline Personality disorder
- Prolonged sadness
- Continual feelings of sadness and isolation
- Addiction
- Social anxiety disorder
- Eating disorders
Psychodynamic Therapy FAQ
The time investment needed to see results from PDT depends on each patient. Some see results in a matter of weeks, while others spend 6-12 months or longer in therapy before seeing initial results.
Psychodynamics is a foundational area of study within psychology. Most clinical psychology programs offer courses specific to psychodynamic theory or incorporate psychodynamic principles into various courses.
The success of PDT comes down to three main factors: the therapist's ability and experience, the compatibility between the patient and therapist, and whether or not the patient is well-suited for PDT.
PDT is most effective on those with harmful "internalizing" coping mechanisms as opposed to harmful "externalizing" coping mechanisms. The former describes anxious and depressive symptoms, PTSD, obsessive compulsion, and social withdrawal. The latter mainly refers to outward manifestations of emotions, e.g. aggression, impulsivity, and anger management issues.
People who experience internalizing difficulties may experience substance abuse problems, panic disorders, and personality disorders – all of which can benefit from PDT.
Another good indicator of whether or not you are a good candidate for PDT is if your past experiences and traumas are central to your current negative mental health symptoms.
Let’s talk about your specific needs.