Psychodynamic Psychotherapy Explained
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Clients are often confused about the difference between psychotherapy, psychology and counselling and the roles of the various professionals practising in these areas. Our web page about “What’s the Difference” gives a brief overview of the definitional and training differences. In this article, I will focus on psychodynamic psychotherapy and attempt to explain how it is different to other types of therapy you may hear about, and how it works. For the rest of this article reference to the term single term psychotherapy will mean psychodynamic psychotherapy.
Psychotherapy has its roots in the psychoanalytic therapies first developed by Freud and others at the beginning of last century. Although often caricatured as old fashioned in cartoons and in some circles, it needs to be acknowledged that Freud, Jung and others were at the forefront of attempting to understand the human mind and to help people suffering with various mental health issues at that time. Further, psychoanalytic therapy was considered the therapy of choice for over 50 years, well into the 1960’s and remains an important approach in certain parts of the world even today.
However modern psychodynamic Therapy is as different from classic psychoanalytic therapy as is modern cognitive behavioural therapy from the original behaviourists and “Pavlov’s dogs”. Modern psychodynamic therapy is founded on well researched and carefully considered approaches to mental well-being and development.
Characteristics of Psychodynamic Approaches
Regardless of the specifics of the therapeutic model employed, psychodynamic psychotherapy has a set of characteristics that uniquely identifies the approach and focus.
A Focus on the Past
Psychotherapy is unashamedly interested in your past and what you experienced while growing up. The thinking behind this is really quite simple. What we experience in growing up, and especially in our earliest years, shapes the way we learn to respond to the world. It also establishes the deeply unconscious values which we absorb from parents and those around us. Often these early experiences act to filter the way we view events in our adult lives and interpret their meaning without us even recognising the automatic nature of those filters. Recognising and understanding how these operate can give both you and your therapist insight into how and why you might respond to certain events in certain ways. It can also help to identify recurrent themes and patterns that occur for you in different aspects of your life. From this insight we can begin to increase our ability to make choices about how we respond to life events.
A Focus on the Present
Our problems and experiences in the present might be influenced by our past experience, but they are not necessarily centred in the past. When events disturb us or cause us mental anguish in the present, it is the current event that we need and want help with. While the past informs the present, psychotherapy is focussed on what is happening in our everyday life here and now. People undertake therapy to solve present problems. Psychotherapy is an excellent way of considering your current problems while using your past learning to help you change the way you respond to current events.
A Focus on Relationships
People are social beings. Most of us are looking for satisfying relationships with others as well as ourselves. Internally many of us struggle with the relationship with ourselves. We may be highly self-critical, internally confused or even feel empty, lost and alone. Our relationship with ourselves then influences how we respond to others. For example, if we are hard on ourselves being self-critical and unable to accept our own limitations, then we may transfer these expectations onto others, respond defensively to comments by others, or perhaps take full uncritical responsibility for “getting it wrong”. Alternatively we may have a tendency to take on so much responsibility that we find ourselves unable to defend ourselves against unjust or excessive criticism.
Psychotherapy is interested in all of our relationships; those with our self, with friends and work colleagues, and with intimate partners. Understanding how we relate and how our relationships reflect those patterns we learned from our earliest relationships can free us to change the way we respond and hence improve our relationships.
A Focus on Development
Some other therapies focus on skills and symptoms. They tend to treat our issues like a physical illness where the focus is on curing the presenting issues. These approaches are useful and psychotherapy does not ignore these aspects. Indeed if you are suffering from severe anxiety or panic attacks, you want and need skills to help with those issues as soon as possible.
However psychotherapy sees these ‘symptoms’ as the result of deeper emotional and experiential ‘scripts’ or ways of responding. It views the issues as being related to automatic and usually unconscious ways of responding. As a result, psychotherapy has a strong focus on helping you to develop your own ability to understand and evaluate your own behaviours and by doing so to be able to change the fundamentals of how you respond. In effect this is the psychological version of “give a person a fish and you relieve their hunger for now, show a person how to fish and they can feed themselves tomorrow”.
The Importance of Emotion
From the earliest days of the development of psychology and psychotherapy there has been a fundamental ‘split’ between the roles of thinking and emotion.
Cognitive therapies in particular focus on a principle that thinking leads to emotional responses. In effect they work on the idea that changing the way we think about things enables us to control our emotions and change the way we behave.
Classical psychoanalytic therapies on the other hand placed great importance on the unconscious and the importance of those processes on our emotional responses to situations. In effect they paid little attention to our thinking modes.
You may well imagine that these two schools of thought diverged and that proponents of one version often decried the other – causing unnecessary and unhelpful splits.
Modern psychotherapy embraces aspects of both approaches. In effect it says “ignore your emotions at your peril; respond from your emotions at your peril”. We are neither emotionally driven beings unable to think because of past experience, nor are we unemotional robots driven by pure rational logic. Indeed neuroscience is proving that we essentially need both our thinking and our emotional world to be fully at peace with ourselves and others and that without access to our emotions we are unable to effect coherent and lasting change within ourselves.
Emotional connection feeds our passions, colours our world and gives life a sense of purpose and meaning that can be felt deeply in our souls. Connected relationships can only exist when we can connect with another person both emotionally and cognitively.
Psychotherapy places a critical importance on understanding our emotional world and how it shapes not only the way we respond to the world, but even to the way that we think about the world. At the same time psychotherapy agrees that without rational thinking we are unable to sooth our emotional states and make adult choices for ourselves. The ideal approach is to be able to utilise both our cognitive thinking functions and our experiential emotional functions to be an integrated whole person.
The Psychotherapeutic Process – What you can expect
Each therapist is a unique individual and each client is likewise a unique individual. Psychotherapy gives value to that uniqueness both in the client and the therapist. As such the process of psychotherapy is a journey taken by you with your therapist to understand your experiences and your ways of responding to the world and to assist you to enact changes that work for you.
Psychotherapy will incorporate skills development and education where necessary; for example, if you are experiencing deep anxiety, then you can reasonably expect your therapist to assist you with ways of managing your anxiety.
However you can also expect your therapist to focus on you as a whole person, exploring your experience of life both in growing up and in your current relationships. Your therapist will listen and work with you to understand how these show as patterns in your life and work with you to develop new ways of responding to life.
Psychotherapy also places an emphasis on the relationship you develop with your therapist. The therapeutic relationship is unique in that the emphasis is on you the client, with both the therapist and yourself focussing on you. The therapeutic relationship itself can also help us to become aware of how we relate; how we develop patterns and ways of responding. Accordingly psychotherapy pays attention to the client/therapist relationship and explores aspects of the client/therapist relationship to assist you to understand the unconscious (automatic) ways that you respond with others and how that may impede your relationships with others.
You should expect your psychotherapist to be empathic, attuned to you and your needs and to be guided by you in exploring the situations which arise in your life. In effect you should expect someone who is not an expert on your life, after all that is you, but rather a person with suitable experience and skill in traversing the journey of self-discovery and development; becoming more of the person you can become.