Understanding Psychodynamic Psychotherapy: The Benefits Of Psychodynamic Therapy
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Psychodynamic theory and finding a therapist
Today, over 400 modalities and approaches to talk therapy exist. Deciding on a type of mental health counseling can be challenging with so many options available, and some people may feel unsure about how to start their search for a psychotherapist. Here, we’ll explore one type in particular: psychodynamic psychotherapy, a talk therapy modality inspired by certain well-known psychologists throughout history. Learning more about the potential benefits of psychodynamic psychotherapy can help you make an informed decision about your care, whether you choose this approach or another.
What is psychodynamic psychotherapy?
Psychodynamic psychotherapy and psychoanalytic therapy
Psychodynamic theory is similar to psychoanalytic therapy, a type of counseling popularized by psychologists like Sigmund Freud. Psychoanalysis is an in-depth method that encourages participants to freely verbally express their thoughts, dreams, urges, and ideas. This type of psychotherapy often focuses on how clients react to and interact with the world around them and the influence of their subconscious minds.
Psychodynamic psychotherapy vs. cognitive behavioral therapy
Both forms of therapy aim to improve the mental health condition. However, they differ in core principles, techniques, structure, and length of therapy sessions. Psychodynamic therapy, with 25 sessions or longer, focuses on finding and solving the root cause of the problem to improve the current situation. CBT, which typically lasts 2-3 months, targets modifying present irrational thoughts to address current issues.
Psychodynamic psychotherapy with a therapist
Unlike other forms of psychotherapy, like cognitive behavioral therapy, psychodynamic therapy is usually a long-term type of treatment and often dives deeply into various areas of psychology—unless it’s specifically being practiced as brief psychodynamic psychotherapy or short-term psychodynamic psychotherapy. It focuses on self-expression, self-examination, and cognitive function, and the goal of sessions is often to help the client lead a more fulfilling life or meet their personal goals.
Typically, individuals who engage in psychodynamic psychotherapies will participate in ongoing discussions with their psychotherapist about their thoughts, ideas, emotions, and beliefs. This form of talk therapy can be used to treat mental illness or address daily stressors related to school, work, or relationships. During long-term or brief psychodynamic sessions, clients will use self-reflection to answer their questions with the help of the counselor's guidance and the counselor’s insights into current psychological research.
Is free association used in psychodynamic psychotherapies?
Free association is a psychodynamic psychotherapy technique where a psychotherapist states a word or concept and the client responds with a word, thought, or image that pops into their mind after being prompted. Afterward, they may use self-reflection or consult with their psychotherapist to further understand the meaning of their association. Dream interpretation might also be utilized in this type of treatment, which is when the psychotherapist asks about the client's dreams and helps them draw conclusions about their meanings.
Improving mental health: How can psychodynamic therapy benefit me?
A primary concept in psychodynamic psychotherapy sessions is self-esteem, and psychodynamic therapy aims to build self-esteem in many cases. Through exploring the inner workings of the mind and how specific memories might impact an individual, that individual may start to recognize their ability to make inferences and solve problems, and they may build self-esteem as a result. Improved self-esteem may help reduce symptoms of common mental health conditions like major depression and depressive symptoms. Psychodynamic therapeutic approaches may also be helpful in treating certain personality disorders and social anxiety disorder, according to randomized clinical trials analyzed in a systematic review.
Mental health and psychodynamic theory
Through this type of psychotherapy, you might also identify thoughts, emotions, memories, or relationship patterns you didn't previously consider working through in other forms of psychotherapy. Findings from randomized trials suggest that suppressing emotions may negatively affect physical and emotional health, so being able to identify and label your emotions and how they affect present behavior may be beneficial.
In addition, psychodynamic psychotherapy focuses on the present and releasing a client from past experiences that may be holding them back. They can learn how their past impacts their present reality and work with the psychotherapist to develop a healthy treatment plan for their future, often involving psychological medicine and therapeutic techniques. The psychotherapist can also offer coping mechanisms for the patient’s life that they can practice in sessions and at home.
When would psychodynamic therapy not be beneficial?
This type of treatment is not necessarily beneficial for every client. As it is a historical treatment, it forms the basis of modern talk therapy. However, many of its concepts are controversial in modern psychology due to limited and inconsistent evidence for its effectiveness.
Psychodynamic therapy can be less helpful to some mental health conditions
You might not benefit from the psychodynamic perspective if you are experiencing symptoms of psychological disorders like psychosis, schizophrenia, mania, delusions, or post-traumatic stress disorder (PTSD). In addition, free association’s aim of trying to bring to light repressed emotions may be associated with false memories, which are memories imposed by a mental health professional and "discovered" in psychotherapy that clients may not have actually experienced. False memories can cause individuals to feel that someone in their life has harmed them in a way that they have not and may also harm the patient-therapist relationship.
Psychotherapy options beyond psychodynamic therapy
If you’re looking for another form of psychotherapy with more robust evidence for its effectiveness than psychodynamic approaches have, you might explore:
- Cognitive-behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Exposure and response prevention (ERP)
- Person-centered therapy
- Solution-focused therapy
- Rapid eye movement and desensitization reprocessing therapy (EMDR)
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How to find psychotherapists for psychodynamic psychotherapy
There are various methods of finding a psychodynamic therapist—especially since psychodynamic therapy online is now available. If you’re interested in in-person psychotherapy or psychodynamic psychiatry (a specialist doctor), you can ask your doctor for a referral, check with your insurance company, or look up providers in your area. If you’re interested in online psychotherapy, see the end of this article for advice on finding a provider virtually. Through an online therapy platform, you can find a provider who’s licensed and practicing in your state, as American psychologists providing online therapy must reside in the same state in which they practice.
Psychotherapists practicing cognitive behavioral therapy (CBT) vs. psychodynamic psychotherapies
Note that although psychodynamic psychotherapy was once popular, many therapists now practice CBT in place of it. That means it may be hard to find a professional who still practices psychodynamic therapy.
If you do find a potential provider of any type, ensure the psychologist you're considering is licensed and experienced. You can verify a psychologist's licensing through your state licensing board or ask them about their credentials during your intake session. Licensing lets you know someone has received the education and clinical hours required to properly support clients.
How to approach your initial therapy session for mental health with a therapist
When you attend the first of your psychotherapy sessions with your psychotherapist, it may be helpful to bring a list of questions, symptoms, or concerns to discuss. Or, if you're uncomfortable sharing vulnerable details during the first session, you can ask your psychotherapist to lead with guiding questions and advice.
Questions for your psychotherapist or psychodynamic therapist:
- How does your approach to psychodynamic therapy differ from other psychologists’?
- Do you prefer to lead sessions or let the client lead?
- How do you know when therapy has been a success?
- Are there any specific techniques you believe in?
- Have you treated the emotional or psychiatric symptoms I’m experiencing in other clients before?
- How long have you been practicing?
- Where are you licensed?
- Can I expect a certain number of sessions for general treatment with you?
Deciding whether to pursue psychotherapy online or in-person
Starting the search for a therapist can be overwhelming. Although talk therapy was historically carried out in a clinical setting while a client lay on a couch and discussed their thoughts with a psychologist quietly taking notes, modern therapy is often less formal and may be more personalized to the client's needs.
Online therapy benefits
Many clients are uncomfortable with the barriers that in-person therapy can come with. Some simply might feel most comfortable at home, while others may not be able to afford traditional in-office sessions. In these cases, partaking in psychodynamic therapy or another type of therapy, such as cognitive behavioral therapy, online can be more comfortable and affordable. With online therapy, clients can interact with a licensed American psychologist in your state from anywhere with an internet connection via phone call, video call, and/or in-app messaging. Plus, research suggests that online therapy can often offer similar benefits to in-person care.
Takeaway
Psychodynamic therapy is a historical treatment approach involving practices like free association, dream interpretation, and free discussion. If you're interested in trying this form of treatment or learning more about the efficacy of psychodynamic psychotherapy, you may be able to find a therapist in your area or sign up online for immediate support, although this type of therapy is far less popular today than it once was. If you’re interested in talk therapy in general—such as cognitive behavior therapy—for addressing mental health challenges, you might pursue in-person or online care.
What is an example of psychodynamic psychotherapy?
Psychodynamic therapy is a form of psychotherapy wherein a therapist helps clients fix present problems by investigating the unconscious mind. Psychodynamic therapists encourage clients to develop self-awareness of their unconscious thoughts to deeply understand how they affect their present behavior. In psychodynamic therapy for anxiety, for instance, psychodynamic therapists help their patients delve into their early childhood experiences to uncover unresolved conflicts or hidden memories contributing to anxiety or current distress. By knowing the association between the root cause and your anxiety, the therapist can help clients fix unresolved internal conflicts and alleviate anxiety symptoms.
What technique is typically used in psychodynamic therapy?
Psychodynamic approaches (psychodynamic techniques) motivate individuals to explore their unconscious thoughts and reactions. Two known major techniques in psychodynamic therapy are free association and dream analysis.
The first technique is free association. Psychodynamic therapists use free association to help clients gain self-awareness by allowing them to examine their unconscious thoughts and emotions. The therapist enables the client to talk freely (without censorship) whatever comes to mind. During free association, the therapist may notice unconscious patterns. The therapist guides the patient in knowing the link between the unresolved conflicts and the present distress.
Sigmund Freud believed that a person's deepest anxieties and desires can manifest in dreams. Some therapists use dream analysis, a psychoanalytic technique, to unlock the hidden meanings of dreams. In dream analysis, a psychodynamic therapist guides clients to know and understand the hidden meanings of their dreams. Dream analysis can offer various mental health benefits.
What is psychodynamic therapy best for?
Psychodynamic therapy is a holistic approach. It is a good option if the treatment plan includes motivating the exploration of repressed emotions and allowing clients to understand the link between their unconscious minds and current functioning. Psychodynamic therapy can be effective for anxiety and depression. A study published in the American Journal of Psychotherapy shows the effectiveness of psychodynamic therapy for clinically depressed women with infants and young children. Psychodynamic therapists also use this approach to treat clients with panic issues and stress-related physical illnesses.
Can CBT and psychodynamic therapy be used together?
Professionals in the mental health field may utilize the combination of psychodynamic therapy and CBT to achieve better results in mental health therapy. While psychodynamic therapy focuses on determining the main cause of psychological distress through the exploration of past experiences, experts of CBT, on the other hand, target to identify and reframe unhelpful thoughts and behaviors that cause mental health issues. Both have strengths and weaknesses.
In integrative psychology, the strength of one approach can cover the weakness of the other. A randomized controlled trial shows the efficacy of integrative therapy (short-term psychodynamic psychotherapy and CBT) for treating generalized anxiety disorder. Further, the research shows that the combination of CBT and short-term psychodynamic therapy yields better results than CBT alone.
What are the key concepts of psychodynamic therapy?
The human mind is made up of the conscious, preconscious, and unconscious. The unconscious mind has three interacting forces: the id, ego, and superego. The id represents human desires and basic needs. The superego represents the self-critical conscience. The ego handles conflicts between these forces. The ego may handle the conflicts well or use repression, one of the defense mechanisms, to manage the anxiety as the conflict grows. If these unconscious conflicts of life become repressed, psychoanalytic theory believes that it can lead to psychological distress.
Psychodynamic therapy evolved from psychoanalytic theory. In this holistic approach, psychodynamic therapists encourage their clients to examine unresolved conflicts and help them gain self-awareness of the association between their unconscious thoughts and emotional distress. The trusting relationship (therapeutic relationship) between the client and the therapist is one of the critical factors in this form of therapy.
How is psychodynamic therapy different from other therapies?
Psychodynamic therapy differs from other therapies by focusing on the effects of unconscious thoughts from past experiences on the client's present behavior. Psychodynamic therapists motivate patients to speak freely about anything that comes to mind. The therapist guides the patient in resolving the current situation by exploring and analyzing past experiences. Some people need long-term psychodynamic therapy, while others require shorter treatments.
What is psychodynamic therapy effective for?
Psychodynamic therapy is effective for mental health conditions. Empirical data and meta-analyses support the effectiveness of psychodynamic therapy. A systematic review and meta-analysis study states the efficacy of short-term psychodynamic therapy (STPP) for individuals with depressive disorders.
The American Journal of Psychiatry published a study, a randomized controlled trial, stating the effectiveness of short and long-term psychodynamic psychotherapy for patients with mood or anxiety disorders. Short-term yields benefit more quickly, while long-term treatment is better than short-term treatment in the long run. Further research is needed to determine which patients should have long-term or short-term psychodynamic therapies.
Some meta-analyses demonstrate the capacity of psychodynamic therapy for personality disorders. This meta-analysis study, for example, shows the effectiveness of psychodynamic therapy for treating personality disorders.
What are the benefits of psychodynamic therapy?
Psychodynamic therapists allow clients to explore their past experiences that cause their present psychological distress. Psychodynamic therapy offers a range of benefits. Some meta-analyses show its effectiveness for mental health conditions. It also improves the patient's interpersonal relations (internal representations)and self-esteem. Further, it helps clients better understand themselves.
How long is psychodynamic psychotherapy?
The length of time a psychodynamic therapist takes to treat mental health challenges is not the same for everyone. Usually, short-term therapy lasts between 25 and 30 sessions. Long-term psychodynamic therapy, on the other hand, may require at least two years of sessions. The therapist evaluates the severity of the client’s condition to determine the length of the therapy sessions. In psychodynamic therapy or other therapeutic approaches, it is essential to discuss the duration of the treatment with the therapist.
Is psychodynamic therapy effective for anxiety?
Meta-analyses show the efficacy of the psychodynamic approach for anxiety. A study indicates that psychodynamic therapy is an effective treatment for anxiety disorders. A psychodynamic therapist may use techniques to treat patients with anxiety symptoms. Other therapies target the management of symptoms, but psychodynamic therapist seeks to address the root cause. The therapist allows clients to explore the unconscious mind and uncover past conflicts that cause anxiety.
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