I’d like to introduce you to a new form of therapy with which you may be unfamiliar – called psychodynamic therapy. Psychodynamic therapy is an evidence-based (meaning there is a lot of research proving it works) psychotherapy treatment for depression, anxiety, trauma, and relationship problems.
Psychodynamic therapy focuses on unconscious conflict. Unconscious conflict occurs when the brain tries to think two opposite things at the same time. For instance, trying to see one’s life as safe and controllable, and at the same time knowing something very traumatic happened. Psychodynamic therapists help us see these conflicting thoughts and resolve them through acceptance. Afterward, depression, trauma, and anxiety symptoms reduce, and we can manage relationships better.
Psychodynamic therapists don’t say much during therapy and there’s a reason for that. They frequently use silence to help your unconscious thoughts emerge into awareness. This silence can be awkward, but it almost always leads to valuable insights, or “a-ha” moments. Patients describe these moments like this: “that suddenly makes sense…I think I’ve always known that but wasn’t really aware of it…that explains so much that I didn’t understand before…now I see why I’ve been having this problem….”
Psychodynamic therapists rely heavily on the patient-therapist relationship to promote insight. The relationship is carefully controlled and frequently explored. Psychodynamic therapists don’t share much about themselves with patients. This is to remain neutral, or like a “blank slate” to the patient. This way, when the patient has thoughts and feelings about the therapist, those thoughts and feelings can be explored as possibly being about a past or present relationship. Becoming aware of those thoughts and feelings helps the insight process.
The most powerful psychodynamic technique is interpretation, where the therapist points out similarities between a past relationship, a present relationship, and the relationship with the therapist. In my experience as both a psychodynamic therapist and patient, these are the most powerful moments, leading to the “a-ha” feeling, and significant insight and change.
You might think that the therapist-patient relationship needs to be very strong and trusting for all this to happen, and you would be right! Psychodynamic therapists pay careful attention to the therapeutic relationship, avoiding judgement and criticism, and supporting as much as possible the healthiest part of the ego – the part of the personality that makes important decisions.
Psychodynamic patients usually meet with therapists one-two times per week, so that the brain stays in the “insight” mode, versus slipping back into unconscious denial between sessions. Therapy usually lasts between a few months and a couple of years, ending whenever the patient meets their goals.
When searching for a psychodynamic therapist, look for these keywords:
- Psychodynamic
- Object Relations
- Ego Psychology
- Classical
- Psychoanalytic Psychotherapy
Most importantly, ask the therapist if they have been through their own therapy as a patient, perhaps during their training. This is a critical step for therapists who want to practice psychodynamic therapy effectively.
References:
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American psychologist, 65(2), 98.
Driessen, E., Cuijpers, P., de Maat, S. C., Abbass, A. A., de Jonghe, F., & Dekker, J. J. (2010). The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis. Clinical psychology review, 30(1), 25-36.
Levy, K. N., Ehrenthal, J. C., Yeomans, F. E., & Caligor, E. (2014). The efficacy of psychotherapy: focus on psychodynamic psychotherapy as an example. Psychodynamic Psychiatry, 42(3), 377-421.