History And Principles Of The Psychodynamic Therapy Model
Many are familiar with Sigmund Freud and the work he contributed to the field of psychology. The psychodynamic model is perhaps the most influential part of his legacy, parts of which are still used in psychology today. In general, it posits that the subconscious mind plays a major role in human behavior, including some psychological and emotional challenges an individual may face. The psychodynamic model guides a branch of psychology with the same name that examines these forces. Below is an overview of the model and its history.
A brief history of the psychodynamic model
While the psychodynamic model is commonly attributed to Freud, his ideas on the subject were largely inspired by his former adviser, Ernst Wilhelm von Brücke. Freud molded von Brücke’s thoughts on the subject into a developed model. As he began publishing and speaking on elements of the model, many in the field were intrigued and sought to study with him. He soon amassed a group of fellow psychoanalysts who were seeking to apply the theory in their own work. In the following years, many found issues with or otherwise built on the theory—including his daughter Anna Frued as well as Carl Jung, Alfred Adler, and others—resulting in the version of the psychodynamic model that is known today.
Key elements of Freud's original psychodynamic model
Let’s first look at a couple of the core pillars of the original Freudian version of the psychodynamic model.
Psychodynamic structure of the mind
The psychodynamic structure of the mind is one of Freud’s most well-known applications of his psychodynamic model. He originally proposed three levels to the human mind: the conscious (easily reached), the preconscious (below awareness), and the unconscious. For him, the most interesting level was the unconscious. He believed that people are greatly affected by their unconscious without realizing it. He thought this effect often caused psychological disorders.
Further, Freud believed that people are driven by three different forces of psychic energy that govern personality:
The id
In his belief, people are born with the id, which resides in the unconscious and drives instinctive behaviors for pleasure, such as sex and destruction.
The superego
The superego is a moral center which he believed operated in both the conscious and unconscious awareness. He posited that this center would grow through life experiences (e.g., family, church, school, and society) that teach moral values.
The ego
The ego resides in conscious awareness. The ego works as a sort of general manager for the other components, per his theory. It observes what the id wants and what the superego suggests and usually tries to find a balance between them.
The five stages of psychosexual development
Another well-known application of Freud’s psychodynamic model is the five stages of psychosexual development. In it, he argued that people are born with an innate energy that drives certain actions derived from pleasure-seeking.
In each stage, he posited, a different body part would elicit pleasure for the individual. The five stages were: oral, anal, phallic, latent, and genital. Through normal development, people would learn to direct their psychic energy toward healthy outlets. However, Freud also believed that people could become fixated at any of these five stages, which could lead to the development of unhealthy behaviors. For example, someone with a fixation in the oral stage might come to enjoy smoking cigarettes or chewing gum.
Further, Freud believed that as people go through life, they can have impulses and drives that do not match the moral direction of the superego. In some cases, people would unconsciously use defense mechanisms to alleviate any anxiety that those drives might cause. Defensive mechanisms include responses such as repression, regression, sublimation, projection, and others.
Finally, Freud theorized that conflicts over unwanted feelings and unacceptable motivations often caused people psychological distress, even if they were not directly aware of it. Those unconscious drives might appear as destructive behaviors, disturbing dreams, or psychological symptoms. When he treated patients, he generally assumed that their problems were driven by some such conflict in the unconscious.
The psychodynamic model in therapy: Then and now
When Freud practiced therapy, he used an approach that he called psychoanalysis. This entailed having his clients come to his office regularly—usually three to five times per week. There, they would lie on a couch to relax and talk aloud. Freud often sat somewhat behind them and out of view. The goal was to give the clients a sort of open space, free from any influence he might have on them if he was in view. He also believed that clients would project onto him any unconscious feelings they had about other people in their life. While modern psychoanalysis has many differences, the core tenets of offering the client a safe space where they can explore their thoughts and feelings with the aim of reducing psychological distress remains key to the practice.
Weaknesses of the psychodynamic model
Freud did most of his work in the late 1800s, meaning that he didn’t have reach to the technology or scientific methods that could’ve helped him test and refine his theories. He also based his models off of his patients—who were primarily wealthy white women—which meant that they didn’t apply accurately to the broader population. Finally, he seemed to have had a rather narrow and negative view of people, which his original model reflects. He saw most as harboring dark drives—especially psychosexual ones—that they were struggling to keep at bay. He assumed that when someone was experiencing a mental health concern, it was due to their inability to deal properly with those drives.
Others in the field would go on to challenge many elements of his original model, taking what was useful, leaving the rest, and filling in the gaps with their own, more modern research. For example, psychologist Karen Horney pushed back against his idea that women experienced mental distress as a result of “penis envy,” suggesting instead that gender inequality in society was likelier to cause psychological challenges.
Other psychologists also went on to build off of Freud’s original ideas and produce theories that became more widely accepted. For example, Carl Jung developed his own branch of psychodynamic psychology called analytical psychology. He believed that people's minds are comprised of an ego, personal unconscious, and a group unconscious, but he took a more positive view of humans, believing that the psyche strives for wholeness. Later, psychologists John Bowlby and Mary Ainsworth looked into how the care a child receives from their caregivers in their early years—rather than subconscious hang-ups about their own psychosexual development, as Freud believed—can affect their future emotional health and development. Bowlby and Ainsworth developed attachment theory to reflect this.
Seeking the support of a therapist today
Though a therapy session today looks far different from one conducted in Freud’s day, the basic premise is the same: the therapist offers you a safe space in which you can express your thoughts and emotions in order to identify what may be causing you distress. If you’re interested in meeting with a therapist to address the challenges you may be facing, you can generally do so online or in person. For those who prefer to meet with a counselor from the comfort of home, online therapy is an option to consider.
With an online therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging from home or anywhere you have an internet connection. Research suggests that online therapy can be as effective as in-person sessions in many cases, so you can generally choose whichever format is most comfortable for you. If you’re interested in online therapy, see below for client reviews of BetterHelp counselors.
Counselor reviews
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Takeaway
What is the history of the psychodynamic approach?
The history of psychodynamic theory began with Sigmund Freud’s psychoanalysis method and the theories of mental functioning he developed to explain it. In Freud’s view, human behavior is shaped by powerful unconscious drives, most notably the libido (the urge to pursue pleasure and sex). He believed that when these drives were repressed by the rules of society, people tended to express them in distorted ways. They would not realize they were doing so, because their action would be driven by unconscious motives they couldn’t acknowledge, even to themselves.
As described in the Polish Psychological Bulletin, Freud also believed that trauma could interfere with the healthy expression of the libido. He felt that traumatic events often could not be effectively integrated into a person’s self-image or worldview, leading to dysfunction.
Freud’s theories were developed and expanded in collaboration with several other psychologists, such as Erik Erikson, Carl Jung, and Alfred Adler. Their informal meetings eventually developed into a formalized organization called the Vienna Psychoanalytic Society.
Many of these colleagues proposed significant changes to the original psychodynamic model, such as expanding Freud’s exclusively sexual definition of the contents of the subconscious. Sometimes this led to serious conflicts. For example, while Freud designated Carl Jung as his successor as head of the International Psychoanalytical Association, the two later had a bitter split over differences in their theories.
Freud’s daughter Anna Freud also helped to further systematize and refine the psychoanalytic approach after her father’s death. She expanded on many of his early concepts, such as the idea of psychological ”defense mechanisms”.
Psychodynamic theory has evolved considerably since then, retaining some of Freud’s original ideas while discarding others, as well as incorporating concepts from the other theorists who worked with Freud during his life.
There has been considerable pushback against psychodynamic theory, beginning in the 1970s. With the development of cognitive and behavioral approaches to psychiatric treatment, psychoanalysis came to be seen as outdated, and many believe that its theories had little basis in evidence. However, more recent research has begun to demonstrate that the psychodynamic approach can be as effective as other forms of therapy such as cognitive-behavioral therapy (CBT).
When was psychodynamic theory invented?
Freud invented psychodynamic theory during his clinical work in the 1880s and 1890s. While treating a patient through hypnosis, he found that her symptoms were greatly reduced as she talked about childhood experiences linked to the origins of her disorder. He published his findings in an 1896 paper called “Heredity and the Aetiology of the Neuroses”, in which he first used the term “psychoanalysis”.
Why was psychodynamic theory created?
Psychodynamic theory was created in an attempt to find an overarching explanation for the kinds of mental illness not caused by physical diseases or damage to the brain. Freud also wanted to understand why talking with patients about their personal histories could help them with their symptoms. Psychodynamic theory emerged out of his observations in clinical work.
What are the 3 elements of psychodynamic theory?
The original psychodynamic model of the mind involved three elements: id, ego, and superego. The id consists of the primal, instinctive, unconscious drives that motivate a person to act. Meanwhile, the superego refers to the ideas about morality and propriety that an individual acquires from parents, teachers, and other authority figures. The ego represents a person’s individual, conscious identity, which has to moderate between id and superego to control behavior.
Many modern therapists no longer use this terminology. However, the psychodynamic perspective still revolves around the idea that developing a healthy adult personality involves balancing irrational, animalistic drives against moral values and social pressures.
What is the main goal of psychodynamic theory?
The core goal of psychodynamic therapy is to promote better human functioning by helping people overcome counterproductive patterns and fixations. In practice, this often involves helping clients gain a greater degree of self-awareness about the unconscious mental processes driving their actions. Psychodynamic therapists may also aim to help patients understand how their early childhood experiences have shaped their life strategies and worldviews — sometimes in unhealthy ways.
How is psychodynamic theory used today?
Psychodynamic theories are often used in the treatment of long-lasting disorders that may be partially rooted in negative life experiences, such as depression, anxiety, and substance use disorders. Even treatment providers trained in non-psychodynamic approaches may employ concepts and approaches derived from psychodynamic theory. Examples include discussing childhood experiences, highlighting defense mechanisms, and helping patients understand unconscious processes influencing their thinking.
Is psychodynamic theory evidence based?
Some psychologists have criticized psychodynamic theory as unscientific and unfalsifiable. To date, the therapies based on this approach have not received as much systematic study as cognitive and behavioral approaches.
However, many researchers have been working to correct this in recent decades. There is now a substantial and growing body of evidence supporting the idea that psychodynamic therapies can be effective in treating mental illness. Some elements of the underlying theory may need further revision and refinement, but there is an evidence base for psychodynamic treatment.
What are the strengths and weaknesses of psychodynamic theory?
One potentially important strength of the psychodynamic approach is its focus on self-reflection and self-exploration. In addition to finding relief from their mental illnesses, clients in psychodynamic therapy may achieve increased life satisfaction and improvements in their interpersonal relationships. There’s also an emphasis on big-picture mental well-being rather than specific symptoms. This may be helpful for people with complex psychological difficulties that don’t slot neatly into a single diagnosis.
On the other hand, the reduced focus on symptoms may mean it’s less clear when someone is ready to move on from therapy. This may be frustrating for some people, not to mention less cost-effective. Clients may also find that developing an awareness of the roots of their challenges may not be enough to help them change. They may need to adopt behavior-modification strategies like those employed in more modern psychological therapies like CBT.
Another potential weakness of psychodynamic theory is its often confusing terminology. Clients without psychological training may have a hard time grasping the meanings of terms like “transference” or “reaction formation”. This can lead to skepticism and misunderstandings.
How does psychodynamic theory treat depression?
In general, psychodynamic approaches to treating depression involve a combination of “interpretive” and “supportive” methods. Interpretive techniques involve talking with the patient about their personal history and their depressive feelings, helping them uncover the unknown or unacknowledged feelings underlying their symptoms. Supportive methods provide the patient with a sense of affirmation to help them through the difficult emotions that can arise in interpretive work.
During treatment, a psychodynamic therapist will often encourage the patient to reflect on aspects of their thoughts and behaviors, including:
- Repeated behavioral patterns
- Persistent feelings
- Deep-seated wishes and fantasies
- Dreams
- Recurring interpersonal dynamics
Therapists often pay particular attention to the things a client is reluctant to talk about, since these may indicate the greatest sources of inner conflict. Over time, they aim to help patients recognize the unrealistic ideas or unfulfilled desires that are fueling their depressed mood.
What disorders can be treated by psychodynamic therapy?
Researchers have found evidence that psychodynamic therapy can effectively treat a variety of disorders, including:
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