Psychodynamic Therapy

What is it?

Psychodynamic therapy (or Psychoanalytic Psychotherapy as it is sometimes called) is a general name for therapeutic approaches which try to get the patient to bring to the surface their true feelings, so that they can experience them and understand them.

Like Psychoanalysis, Psychodynamic Psychotherapy uses the basic assumption that everyone has an unconscious mind (this is sometimes called the subconscious), and that feelings held in the unconscious mind are often too painful to be faced. Thus we come up with defences to protect us knowing about these painful feelings. An example of one of these defences is called denial - which you may have already come across.

Psychodynamic therapy assumes that these defences have gone wrong and are causing more harm than good, that is why you have needed to seek help. It tries to unravel them, as once again, it is assumed that once you are aware of what is really going on in your mind the feelings will not be as painful.

How long does it last?

This can vary quite a lot. The length of treatment can vary anywhere from 8 weekly sessions, to therapy going on three times a week for a number of years.
In the UK, psychodynamic therapy on the NHS is relatively rare, and tends to be performed mainly by Clinical Psychologists. This tends to be of the shorter variety.

What's the difference between Psychodynamic Therapy and Psychoanalysis?
Although similar to Psychoanalysis, in fact it was derived from a similar background!, it tends to differ in two obvious ways. Firstly it is shorter (usually!), and secondly there tends to be a more specific aim to psychodynamic therapy. For example, sorting out a phobia. Whereas, Psychoanalysis will tend to look to affect a lot more of your personality.

How does the Therapist work?

The therapist normally takes an attitude of unconditional acceptance. This basically means that the therapist holds you in high regard because you are a person, no matter what your problem is.

The therapist tries to develop a relationship with you, to help you discover what is going on in your unconscious mind. They do this partly by theoretical knowledge (academic stuff!), partly by experience, and partly through their knowledge of themselves.

We know the last part must seem quite weired, but actually it is critical. The therapist often uses how they feel in the room with you, as a guide to how you are feeling. They are, for lack of a better way of putting it, testing the relationship with you to discover more about you than you are aware of. The therapist uses interpretations, which are a way of making sense to you about what is going on, in order to help you become aware of your unconscious feelings.

So, in every session, the therapist is trying to judge, how much you are in touch with your own feelings, what feelings you are not aware of, how close are you to knowing the unconscious feelings, how painful these feelings are to you, and how well you can tolerate the pain that becoming aware of these feelings will bring.

How the therapist works is actually more complicated than we have presented here, but we hope this gives you a rough idea.

Does it Work?

Sometimes, but not always.

Psychodynamic therapy has got a scientific record of its effectiveness for certain conditions (e.g. depression). However, because of the way it is carried out it is really hard to judge just how well it does work. The experts tend to argue amongst themselves whether it works, but we think the best judge of the issue are the patients themselves. A lot of patients have reported that it has helped them enormously, and indeed some go on to full psychoanalysis. However, equally a lot of patients, really disliked it. These people tended to drop out of therapy quite quickly.

Psychodynamic therapy is one of the few mainstream therapies that focusses on aspects of your personality, and although it is used to treat a wide variety of conditions, it seems to us particularly suited for problems to do with personalities, and past and present relationships.

Therefore, the advice that we offer to you is that if this type of therapy appeals to you, then find out a bit more, and give it a go. There are a lot of people that are glad they did. However, be prepared to be open and honest, and be prepared to find the going difficult, especially at first. Even, if it doesn't seem appealing now, you may find someway down the line, that you would like to give it a go.

Like in all therapies, there are no guarantees