What is Psychodynamic Psychotherapy? | What is Psychotherapy?

What Is Psychodynamic Psychotherapy....?

Psychodynamic psychotherapy is a type of therapy that helps people work through emotional and relationship issues. It’s a form of talk therapy rooted in psychoanalysis, and is sometimes called psychoanalytic psychotherapy. However, this distinction is less important than the shared aim: to get to come to understand what has been exiled from our minds and feelings that have not been given room to be felt. Sometimes this is because these thoughts are too painful to bear, sometimes because these feelings haven't been allowed to be there.

One idea in psychodynamic therapy is that when something is really painful, we tend to push it away and try and ignore it. Sometimes we’re aware we’re doing this, but other times, we bury things so deep that we forget they’re even there. The problem is, those buried experiences can still affect how we feel and act in the present.

The process involves thinking about and learning to observe how our mind moves and functions around sites of pain. When we spend time with someone trained to work this way, we often find ancient ways of being and thinking that have been there to protect us from dangers, once real and sometimes imagined. Further still, we might find that the things we thought or hoped to forget don’t disappear but linger, leaving scars that cleave our present in ways we can’t always see.

The central insight here is that we are all, in some sense, haunted by our experiences, by emotions we’ve pushed away, by versions of ourselves we’ve tried to leave behind or have never gotten to know.

We might learn that the past doesn’t stay past; it seeps into the present, coloring our relationships, our choices, and the sense of who we are. Psychodynamic therapy offers a space where these hauntings can come alive and be named. Often, it is finding feelings and words for things that have not been given the room to breathe.

Take, for example, someone who grew up suffering the sting of parental rejection. To survive, they might have learned to bury the pain, to try and stop thinking about it altogether. As an adult, they might find themselves withdrawing from relationships, convinced that it’s safer to be alone than to risk being hurt again.

The irony, of course, is that this self-protection becomes its own kind of prison. They avoid rejection, but at the cost of connection. They stay safe, but at the cost of aliveness. They might come cautiously to therapy with a sense of disconnection, a feeling that something inside feels wrong, or a worry that they can’t feel their feelings at all.

How would a psychodynamic therapist approach this person? Not as a problem to be fixed but as a story to be understood. By inviting the person to speak freely, the therapist might help them see how their fear of rejection has become a kind of reflex, a way of preempting pain by pushing others away. What feels like a fact may turn out to be a pattern or a belief, one that can be traced back to those early wounds or messages. Psychodynamic therapy, in one sense, is a process of unlearning, of deconstructing, of de-coding and re-coding messages, myth and behaviours we’ve internalised. Many of these are unconscious, automatic, and can be very unknown.

Psychodynamic therapy is, in a way, a particular way of listening, and of being listened to. When certain things are heard, and in a certain sort of way, you might begin to hear yourself differently, and you might find you begin to speak differently too. With more freedom, flexibility, and self-authority.

The Goal of Psychodynamic Therapy

The goal isn’t to erase the past but to loosen its grip. In the fictional case above, it might be to help the person recognise that their withdrawal is a relic of an old survival strategy, one that may have outlived its usefulness. But it isn't a matter of putting it to someone as a fact like that can be learnt. Rather, it is by bringing these dynamics alive, into awareness, and into a full feeling experience that therapy creates the possibility of something new: not a life free of pain, but one where pain doesn’t have the final say.

How this is gone about by a therapist is particular and complicated, but in short, a certain sort of listening is offered, a certain sort of setting is maintained, and a certain sort of conversation is offered. Psychodynamic therapy is, in a way, a particular way of listening and of being listened to. When certain things are heard, and in a certain sort of way, you might begin to hear yourself differently, and you might find you begin to speak differently too. With more freedom, flexibility, and self-authority.

Further Reading

• Do I Need a Diagnosis to Start Therapy?

• Common Myths About Starting Therapy

  
  

If you're considering beginning therapy, you might find these articles helpful.

About the Author

I'm a trauma-informed psychodynamic psychotherapist working in the Tavistock Trauma Service, and a private practice in Hackney, East London, and online. I am a member of the British Psychoanalytic Council (BPC) and abide by their codes of ethics. I hold a Master’s degree with distinction and am a Clinical Fellow of the Neuropsychoanalysis Association, as well as a registered member of the British Association for Counselling and Psychotherapy (BACP)