What Is Psychodynamic Therapy?

There are over 400 types of therapies practiced worldwide. With many options to choose from, clients may feel overwhelmed by opportunities. One of the oldest types of therapy, stemming from the workings of Sigmund Freud and Carl Jung, is psychodynamic therapy, which focuses on how the unconscious and conscious minds interact. Learning about psychodynamic therapy, its history, and the theories surrounding it can help you make an informed decision on your preferred modality when looking for a therapist.

What is the history behind psychodynamic therapy? 

The term “psychodynamic psychotherapy” has a rich history in the psychological community and has inspired many modern forms of therapy. It is believed that this form of counseling was developed from the original psychodynamic theory, which is based on Freud's theories of psychosexual development and the influence of unconscious mental processes. The psychodynamic approach emphasizes the role of emotional forces and unconscious motives in shaping adult personality and affecting behavior.

Psychoanalytic therapy and psychodynamic therapy are forms of psychotherapy that may sound similar, but they are fundamentally different. Psychoanalytic therapy, also known as Freudian therapy, focuses on Freud's theory of the id, the ego, and the superego, while psychodynamic therapy utilizes theories from Freud's followers as well, including his daughter, Anna Freud, and the American Psychoanalytic Association. Psychodynamic principles take into account early childhood experiences, defense mechanisms, and the collaborative unconscious.

Psychodynamic therapy was developed to be a long-term treatment requiring up to two years of sessions or longer, which may not be as available in the short terms that the therapeutic modalities of today typically employ. In the early days of its use, the therapy was employed to "change" an individual's personality or identity through increasing self-awareness and accounting for both biological and environmental factors. The psychodynamic model acknowledges the complex interplay of psychological forces and unconscious processes.

A few common modern types of therapy that use aspects of psychodynamic therapy are dream analysis, cognitive behavioral therapy, therapy involving hypnosis, and play therapy. These methods can be helpful ways of implementing short-term psychodynamic psychotherapy principles. The psychodynamic perspective has also influenced the development of the Psychodynamic Diagnostic Manual, a resource for mental health professionals.

What is psychodynamic theory? 

Psychodynamic theory, developed by Sigmund Freud, is a model of personality rooted in psychoanalysis. Freud posited that unconscious factors and psychological forces, often hidden from our awareness, profoundly affect behavior and shape our personalities. The psychodynamic perspective, upon which psychodynamic therapy is founded, asserts that mental or emotional forces can significantly influence an individual's behavior.

Although developed as a single theory, the psychodynamic theory now combines various approaches from several psychologists, including: 

• Carl Jung
• Sigmund Freud
• Anna Freud
• Melanie Klein
• Alfred Adler
• Erik Erikson

Aspects of psychodynamic theory 

Psychodynamic therapy involves four theories, including the following: 

• Drive theory 
• Object relations theory
• Ego, id, and superego theory 
• Self-psychology 

Drive theory 

The drive theory of social psychology delves into human behavior by examining an individual's motivations. Psychologists differentiate between primary and secondary drives, which encompass basic needs like food, water, and shelter, as well as cultural necessities such as social acceptance or employment. Drive theory seeks to explain what propels people to act in specific ways.

In the context of the psychodynamic model, drive theory can assist individuals in comprehending the underlying motivations for their behavior. Freud, who formulated the psychosexual stages of the model, maintained that all humans possessed an innate sexual drive, and unfulfilled sexual needs could lead to mental health issues. Conversely, American psychologist Abraham Maslow posited that not having our primary needs satisfied could result in emotional and physical distress.

Ego psychology

Within his theory of psychoanalysis, Freud developed ego psychology, which posited that each person has three parts of their inner selves, including the ego, the id, and the superego. The parts were defined as follows: 

• Ego: The ego is the part of your personality you are consciously aware of. It is what many people think of themselves as and is impacted by an individual's environment and society.
• Id: According to Freud, the id is an instinctual, subconscious aspect of an individual's self that is difficult to see. It can be impacted by biology and experiences.
• Superego: The superego is the part of the unconscious mind that is shaped by external and societal influences. Freud believed that the superego forms many people's inner voice that discusses the difference between "right" and "wrong." 

Object relations

Object relations theory delves into the topic of how relationships and external factors impact an individual's personality. It is related to attachment theory, developed by John Bowlby and Mary Ainsworth. Attachment theory focuses on how an infant or young child's attachment to their primary caregiver can impact adult relationships and expectations.

Object relations theory argues that people can develop self-objects, or expectations around other people’s behaviors, to cope with relationship attachments. Some psychologists in this school of thought also theorize that people with a challenging relationship with their caregivers in childhood may develop psychological challenges surrounding body image. 

Self-psychology

Self-psychology, a more contemporary aspect of psychodynamic theories and psychoanalysis, investigates the self and the role of motivational forces acting on self-esteem, relationships, and childhood experiences. This approach examines psychological processes that may contribute to some individuals' tendency to seek the spotlight, while others prefer to remain in the background, struggling to believe in their capacity for success.

How does psychodynamic therapy work? 

In a psychodynamic therapy session, your therapist may use several treatment methods, such as free association, motivational interviewing, and conversations about repressed emotions. 

Free association involves viewing random images or listening to random words and telling your therapist the first thoughts that come to mind. Free association can start a discussion about what these thoughts might mean about your unconscious mind. 

With motivational interviewing, a therapist uses drive theory to help clients understand their internal and external motivations. This form of therapy is often used for people with substance use disorders or habits they'd like to change. Therapist questions are structured in a way that empowers the client to make their own decisions and come to their own conclusions. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

When discussing repressed emotions or memories, a psychodynamic therapist may offer ideas or research to help the client make associations. They may discuss the client's dreams or ask about their current relationship patterns or attachments. 

The benefits of psychodynamics

Psychodynamic therapies can treat various mental illnesses, symptoms, and concerns, but you do not need to have a diagnosed mental illness to attend therapy. Many clients use the psychodynamic approach as tools to better understand their personalities or circumstances surrounding their past. A few benefits you might receive from psychodynamic counseling include the following: 

• Achieving long-term goals
• Having a more profound sense of self-awareness
• Targeting mental health symptoms
• Understanding the past 
• Reducing social anxiety 
• Feeling in tune with your thoughts and feelings 
• Understanding what occurred in your childhood 

Note that processes like repressed memory retrieval may be seen as controversial by many psychologists. Many studies have found that there is a possibility of false memories being planted in a client's mind through the process of free association or unconscious work. 

Counseling options

If you're interested in trying psychodynamic therapy or another type of counseling, various options are available. You can contact your doctor for a referral to a local psychologist, search online, or consider asking friends and family for recommendations. You can also try online counseling if you're unsure whether in-person therapy would work with your schedule. 

Studies have found that online therapy can be as effective or more effective than in-person therapy for various concerns, including depression, anxiety, stress, and post-traumatic stress disorder. However, online therapy is available to everyone, and you do not have to be diagnosed to use it. Once you sign up, you can connect with a therapist through phone, video, or live chat sessions. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Through an online platform like BetterHelp, you can get matched with a therapist within around 48 hours or less, with thousands of therapists available and specializing in various therapy forms. Note that you're interested in trying psychodynamic therapy upon signup to find someone educated in this method.