At its core, psychodynamic therapy aims to foster psychological growth by developing greater awareness and access to the human experience. To this end, therapy fosters honesty and values authenticity with the understanding that this can lead to greater life satisfaction and personal agency or freedom.

Psychodynamic therapy and the ways in which it is practiced have evolved significantly since the time of Freud. Rather than having a client lay down on a couch and a therapist or analyst sit out of sight or behind the client largely in silence, most current practitioners of psychodynamic therapy are more active, interpersonally engaged, and strive to foster a trusting emotional connection with their clients.  

What makes psychodynamic therapy unique?

Blagys and Hilsenroch (2000) completed an extensive review of psychotherapy literature prior to the year 2000 and identified seven techniques that distinguish psychodynamic forms of therapy, or are much more prevalent in psychodynamic therapy. [5] These seven techniques are:

1. Focus on Affect and the Expression of Emotion

Here, the therapist might help a client identify and name feelings with a particular emphasis on feelings that are most elusive or difficult. In some cases, the therapy dyad focuses on feelings that are experienced as unacceptable or connected to ideas about how one should or should not feel. There is also an understanding that emotional insight differs from solely gaining an intellectual understanding. Specifically, insights that have an emotional component are often experienced more deeply and are more likely to encourage growth.

2. Exploration of Attempts to Avoid

Similar to avoiding distressing emotions, people may also work hard to avoid other aspects of themselves or honest self-reflection that is encouraged in therapy. Psychodynamic therapy attends to this avoidance, naming and processing it as part of therapy.

3. Identification of Recurring Themes and Patterns

Patterns and themes can be seen in the way everyone moves through life. Often these patterns and themes involve repeated relationships, with, for example, clients finding the same type of destructive partner again and again. Psychodynamic therapy focuses some effort on helping a client identify and process themes in their life as well as their thoughts, feelings and behaviors. This can sometimes include concepts of themselves and others.

4. Discussion of Past Experiences

As described above, a focus on early experiences is a cornerstone of psychodynamic therapy, with the goal of understanding how these early experiences continue to impact current functioning. The focus is generally on insight and awareness on how the past influences the present with the goal of fostering greater freedom in the present.

5. Focus on Interpersonal Relations

Early experiences in significant relationships form another cornerstone of psychodynamic therapy. The emphasis here is on how these early relationships influenced personality and self-concept, as well as values and worldview. Attachment patterns are also of significant importance, and therapists are interested in how interactions with early caregivers influence current views of others and the manner in which a person gets their needs met through relationships.

6. Focus on the Therapeutic Relationship

This focus includes transference and countertransference with attention to the themes that arise between the therapist and client and how these may parallel themes in the person’s relationships outside of therapy. There is also increasing acknowledgment of the contributions of the therapist as a unique person with a unique psychology and values that influence how this relationship unfolds.

7. Exploration of Wishes, Dreams and Fantasies

Generally, this technique refers to creating a space where a client can speak freely. This exploration allows for a broad range of content to emerge that can be used to further understand the unique way that a client navigates the world around them. It can also be a rich source of metaphor and meaning.

Psychodynamic therapists have a strong appreciation for the complexity and contradiction that often exists within the human experience. Likewise, we have an appreciation for our common human struggles (both therapist’s and client’s) and the subjectivity of each person’s experiences. Lastly, an enduring curiosity and focus on expanding the human experience to allow for a greater sense of authenticity is paramount. 

Click here to read a summary of empirical evidence supporting the efficacy of psychodynamic therapy.

.