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IMAGE Psychodynamic therapy is a type of talk therapy that helps people bring their unconscious (hidden) feelings to the surface. This form of therapy can help them 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, it may serve as a trigger to seek help with psychodynamic therapy.

How the Therapy Works

The therapist should have an attitude of unconditional acceptance toward the person. This means that the person is respected as an individual and not judged or criticized, regardless of the problem. As a trusting relationship develops, the therapist uses their knowledge, experience, and self-knowledge to help the person understand what is going on in the unconscious mind. This process may include:

Transference

The person transfers aspects of an earlier important relationship onto the therapist. This includes the feelings, thoughts, and defenses that the person experienced in the early relationship.

Transference is believed to help the person work through conflicts so that permanent change can take place. Through this process, the person develops self-awareness and insight into current and childhood relationships. Then the person can respond in terms of what is really happening instead of what happened in the past.

Countertransference

Countertransference refers to the therapist's unconscious and conscious emotional feelings toward the person. It is the therapist’s thoughts and feelings directed towards the person. The therapist uses how they feel to understand how the person feels.

Interpretation

In each session, the therapist tries to gain insight into the person's problem by looking at a number of different aspects. For example, is the person acknowledging their feelings? Is the person moving closer to finding out about their unconscious feelings? Is the person able to endure the pain of these feelings? The therapist uses their interpretations to help the person 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:

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.

  • The American Psychological Association

    http://www.apa.org

  • Mental Health America

    http://www.nmha.org

  • Canadian Mental Health Association

    http://www.ontario.cmha.ca

  • Mental Health Canada

    http://www.mentalhealthcanada.com

  • Defense mechanisms. True Center Publishing website. Available at: http://truecenterpublishing.com/tcp/defense%5Fmechanisms.pdf. Accessed February 4, 2014.

  • Depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 22, 2014. Accessed February 4, 2014.

  • Generalized anxiety disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 20, 2014. Accessed February 4, 2014.

  • Leichsenring F, Leibing E. The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. Am J Psychiatry. 2003;160(7):1223-1232.

  • Merits of pyschodynamic therapy. Harvard Medical Letter. American Pyschoanalytic Association website. Available at: http://www.apsa.org/portals/1/docs/news/HarvardMentalHealthLetter092010.pdf. Published September 2010. Accessed February 4, 2014.

  • Panic disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 20, 2014. Accessed February 4, 2014.

  • Post-traumatic stress disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 14, 2014. Accessed February 4, 2014.

  • The psychodynamic approach. Ryerson University website. Available at: http://www.ryerson.ca/~glassman/psychdyn.html?new%5Fsess=1. Accessed February 4, 2014.

  • Reaction formation. Changing Minds website. Available at: http://changingminds.org/explanations/behaviors/coping/reaction%5Fformation.htm. Accessed February 4, 2014.