Psychodynamic Therapy takes a holistic approach towards assessing clients in relation to their problems. Insight is essential to achieve success in therapy. This approach helps clients understand their long standing conflicts from the past. These conflicts are a result of unconscious processes. Therefore, psychodynamic therapy focuses on mental and emotional processes rather than unhelpful behaviours. More specifically, this involves recognising and overcoming repressed and upsetting emotions. Through this, clients learn to resolve their issues, improve their relationships, and have increased self esteem. Psychodynamic therapy can be useful for those with: addiction, post traumatic stress disorder, eating disorder, and depression.

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Even though Psychodynamic Therapy originated from Psychoanalytic theory, there are major differences between the two. They are often confused because Freud’s theories are psychoanalytic, whereas psychodynamic includes all theories about the unconscious mind (including Freud’s theories and his followers). A major difference would be the duration of the sessions. Psychodynamic Therapy could entail having one session per week for 15 weeks. However, Psychoanalytic Therapy could involve having two to five sessions per week lasting several years. The last key difference would be the structure of the therapy venue. It is common for psychoanalytic therapists to have a couch in which clients (can be referred to as patients) lie down while psychoanalytic therapists sit behind them. Nevertheless with Psychodynamic Therapy, clients sit facing the therapist.

History

Psychodynamic Therapy’s founder is Sigmund Freud. He pioneered new techniques for understanding human development. He laid the foundation of Psychodynamic Theory which has evolved and been modified to fit the present day context. 

Freud theorised that the mind has three levels.

• Id (already present in babies): Based on instincts and forms the unconscious mind.
• Ego (develops at age 3): The mediator between the id and superego. The ego controls the consciousness and formulates action plans for satisfying needs.
• Superego (develops at age 5): Represents ideal actions, and a person’s moral code. It wants to inhibit the id to strive for perfection.

The development of each component is influenced by family relationships and the environment. This leads to the personality formation.

Freud also contributed the concepts of the unconscious and the different levels of consciousness.

• Unconscious: stores all experiences and repressed memories. Freud believes that the majority of the unconscious mind influences our personality and actions. 
• Conscious: Thoughts and feelings we are aware of. Freud believes this is a thin slice of the whole mind.
• Subconscious or Preconscious: level between conscious and unconscious.

Freud claims that to address our problems and solve them, the unconscious needs to be brought into the consciousness. This is because the unconscious is where the unspoken values and patterns of behaviour develop.

Goals

The goal of psychodynamic therapy is to make the unconscious conscious. This is done by examining and understanding client’s experiences in relation to their childhood experiences. Hence, clients realise how the past has impacted the present, and are able to understand the reason behind their behaviours. Another goal is to ensure behaviour is more realistic instead of basing on instinctual cravings. 

 Procedures and Techniques

Free Association

There are two approaches to free association. First, informal free association involves clients saying anything that comes to mind. It does not matter how illogical, silly or irrelevant it is. The psychodynamic therapists then begins to interpret what the clients have said. Meanwhile, the formal approach involves the psychodynamic therapist saying a list of words and clients respond to the first word that comes to mind. This allows the therapist to identify the associations the clients have made. 

Dream Analysis

Dream analysis is used to explore the unconscious and give insight into unresolved problems. During sleep, defenses are lowered and repressed memories surface. These dreams also provide an understanding of clients’ current functioning. With assisted probing from the therapist, clients discuss the details of the dream. Dreams have two levels of content: latent content and manifest content. Manifest content is what the client remembers about the dream such as the people there and the things that happened. Meanwhile, latent content refers to the meaning of the dream such as unconscious motives, fears and needs. Therapists may also ask clients to free associate some aspects of the dream to uncover latent meanings.

Interpretation

During counselling, the psychotherapist interprets and suggests to the client the meanings of the behaviours displayed during dreams, free associations and the therapy relationship itself. These interpretations are meant to bring unconscious material into consciousness. These interpretations will be made accordingly, and the psychotherapist uses the client’s reactions to gauge the client’s readiness to hear the interpretation.

Resistance

Resistance refers to clients’ ideas, actions or feelings that clients are reluctant to bring into the surface of awareness. This process is viewed as a mechanism to protect against intolerable distress and pain. Resistances cannot be just overcomed, rather accepting change is needed to have a more fulfilled life. It is paramount for the psychotherapist to respect and provide a safe environment to work with these defenses.

Transference 

Transference refers to the unconscious redirecting of significant past feelings and attitudes onto the psychotherapist. Through therapy, clients can better comprehend and work through their “unfinished business”. For example, the client views the psychotherapist as loving and comforting, which were the emotions the client had towards his deceased mother. This could be because the client thinks the therapist and his mother have similar appearances, or mannerisms. Transference may impede the counselling process, because the client is not having a genuine relationship with the therapist, but is projecting onto the therapist emotions of someone else. Nevertheless through transference, the psychotherapist gains better understanding of the client as the psychotherapist gains knowledge of the client’s significant past experiences.

Critiques

Clients could want more structured and directed therapeutic sessions that focuses on behaviour. Clients may also feel uncomfortable with discussing about their childhood. A long time commitment is required for therapy.

To see therapists specialised in this field, visit here.