Psychodynamic therapy is a type of talk therapy that helps patients bring their unconscious (hidden) feelings to the surface. This form of therapy can help patients understand and eventually manage the unconscious feelings that can influence their daily lives.
This type of therapy is based on the assumption that feelings held in the unconscious mind are often too painful or uncomfortable to be realized. For that reason, people develop defense mechanisms to protect themselves from actually knowing about, dealing with, or confronting these feelings.
Defense mechanisms are patterns of feelings, thoughts, or behaviors that are unconscious. These mechanisms can be either healthy or unhealthy, depending on what they are and how they are used. They are meant to reduce stress, anxiety, and internal conflict—a way to cope with the world.
Common defense mechanisms include:
- Denial—refusing to face or perceive an unpleasant reality
- Projection—attributing one's unacceptable characteristics or motives to others
- Displacement—changing the target of built-up emotions or feelings, often anger, onto those (usually people or animals) who are less threatening
- Rationalization—making up "logical explanations" to conceal the real motives of one's thoughts or behavior
- Reaction formation—adopting the opposite point of view or acting in a contradictory way than one really feels in an effort to hide from unacceptable emotions or impulses
When these defenses start causing problems in a person's life, that can trigger him to get help through psychodynamic therapy.
How the Therapy Works
The therapist should have an attitude of unconditional acceptance toward the patient. This means that the patient is respected as an individual and not judged or criticized, regardless of the problem. As a trusting relationship develops, the therapist uses her knowledge, experience, and self-knowledge to help the patient understand what is going on in the unconscious mind. This process may include:
The patient transfers aspects of an earlier important relationship onto the therapist. This includes the feelings, thoughts, and defenses that the patient experienced in the early relationship.
Transference is believed to help the patient work through conflicts so that permanent change can take place. Through this process, the patient develops self-awareness and insight into current and childhood relationships. Then the patient can respond in terms of what is really happening instead of what happened in the past.
Countertransference refers to the therapist's unconscious and conscious emotional feelings toward the patient. It is the therapist’s thoughts and feelings directed towards the patient. The therapist uses how she feels to understand how the patient feels.
In each session, the therapist tries to gain insight into the patient's problem by looking at a number of different aspects. For example, is the patient acknowledging his feelings? Is he moving closer to finding out about his unconscious feelings? Is he able to endure the pain of these feelings? The therapist uses her interpretations to help the patient make sense of what is going on and to become more aware.
Benefits and Limitations
Psychodynamic psychotherapy is used to treat a variety of conditions, such as:
- Panic disorder
- Post-traumatic stress disorder
- Personality disorders (eg, passive aggressive personality disorder)
Psychodynamic therapy has been effective in treating some conditions, like depression. However, as with other therapies, this technique does not work for everyone. If you are interested in trying psychodynamic therapy, keep in mind that it will require you to be committed to the process. You will have to actively participate. Your doctor may be able to refer you to a psychologist who specializes in psychodynamic therapy.
- Reviewer: Brian Randall, MD
- Review Date: 05/2012 -
- Update Date: 05/08/2012 -