Psychodynamic therapy

Psychodynamic therapy is a type of talk therapy that focuses on how unconscious thoughts and past experiences shape current behavior, emotions, and relationships. It’s commonly used to treat depression, anxiety disorders, eating disorders, personality disorders, and relationship difficulties. Psychodynamic therapy emphasizes childhood, where many of these patterns began. Psychodynamic therapy aims to help people gain insight into deep-seated patterns, improve self-awareness, and resolve internal conflicts.

What are the origins of psychodynamic therapy?

Psychodynamic therapy evolved from the psychoanalytic theories developed by Sigmund Freud, Anna Freud, Alfred Dler, and D.W. Winnicott. Freud developed psychoanalysis as a method of exploring the unconscious mind through techniques like free association and dream analysis.

Over time, his ideas evolved and became more flexible, leading to what is now called psychodynamic psychotherapy. It’s a modern, evidence-based evolution of Freudian theory.

Freud’s theories were first developed in clinical settings and later studied in academic institutions throughout Europe. His work was further refined by contributors like Carl Jung, Melanie Klein, and Erik Erikson, and incorporated concepts from ego psychology and object relations theory.

Today, psychodynamic therapy is considered a distinct form of therapy with a strong foundation in clinical psychology and psychiatry.

When is psychodynamic therapy used?

Psychodynamic therapy can be used in individual, group, couples, or family settings. It’s commonly used with adults, but it can also be adapted for adolescents and children. It’s especially helpful for individuals who want to understand recurring emotional patterns, chronic symptoms, or unresolved past experiences.

This therapy is often used to treat a wide range of mental health conditions, including:

• Depression
• Anxiety disorders
• Eating disorders
• Personality disorders
• Trauma-related disorders
• Relationship issues

It’s useful for those looking for a deeper understanding of their inner world, interpersonal relationships, and emotional responses.

Lastly, psychodynamic therapy can be tailored for adolescents, helping them explore identity, emotions, and relationships during a key developmental stage.

How does psychodynamic therapy work?

Psychodynamic therapy works by helping people uncover and explore unconscious thoughts, unresolved conflicts, and defense mechanisms that may be influencing their current behaviors.

Through regular therapy sessions, the therapist helps the client recognize patterns rooted in early life experiences and examine how these patterns impact present-day life. The therapist relies on psychodynamic theory to guide their intuition and responses.

Key techniques include:

• Free association – Saying whatever comes to mind without self-editing or censoring
• Dreams analysis – Exploring the symbolic meaning of dreams to uncover unconscious thoughts
• Analysis of transference and countertransference – Learning how we project dynamics from one relationship onto another
• Understanding defense mechanisms – Examples include denial or projection, which help the mind cope with emotional conflict

By understanding these patterns, clients develop greater self-awareness and emotional insight, which can lead to improved coping, more satisfying relationships, and a reduction in mental health symptoms.

What is psychodynamic therapy like?

In psychodynamic therapy, sessions typically involve open-ended dialogue. There’s no rigid structure. In fact, clients are encouraged to speak freely about thoughts, memories, dreams, and feelings.

The therapist may ask questions about past relationships, family dynamics, and early childhood experiences to help uncover deeper emotional patterns. In general, the therapist does not give a lot of instructions or directions — instead, they gently steer the conversation based on the things the client is bringing up.

Clients might explore recurring thoughts, dreams, or behaviors, notice how they respond emotionally to the therapist, and reflect on moments of resistance or discomfort. These moments are valuable and often lead to breakthroughs in therapy. Emotional safety and trust in the therapeutic relationship are central to this process.

How long does psychodynamic therapy take?

Short-term psychodynamic therapy may last between 12 and 24 sessions, while long-term psychodynamic therapy can continue for a year or more. Sessions are typically held once per week, sometimes twice, and last around 45 to 50 minutes. Overall, psychodynamic therapy will vary in length depending on individual needs and goals.

Unlike some forms of therapy that focus on quick symptom relief, psychodynamic therapy prioritizes lasting emotional insight and change.

Some clients benefit from brief interventions, while others engage in ongoing therapy over months or years. Therapy can be paused and resumed depending on a client’s life circumstances or evolving goals.

Is psychodynamic therapy effective?

Yes, psychodynamic therapy is considered to be evidence based and has been shown to be effective for a range of mental disorders, including depression, anxiety, borderline personality disorder, self-esteem, and somatic symptom disorders. Psychodynamic therapy can produce lasting improvements in symptoms even after therapy ends.

How does psychodynamic therapy differ from CBT?

Cognitive behavioral therapy (CBT) targets current thoughts, feelings, and behaviors. It teaches practical strategies to reduce symptoms, such as reframing anxious thinking, challenging cognitive distortions, and teaching relaxation techniques. It’s structured, short-term, and skills-based.

Psychodynamic therapy digs deeper. The psychodynamic approach examines unconscious thoughts, early childhood experiences, and relational patterns that drive behavior. Rather than symptom management, it aims for long-term change through insight.

Both are evidence-based. CBT suits those seeking fast, solution-focused relief.  Psychodynamic therapy is a good option for people who are interested in longer-term treatment. — a similar modality, brief psychodynamic therapy is also available.

How to find a psychodynamic therapist

If you think psychodynamic therapy might be right for you, it’s important to speak with a licensed and experienced clinician. There are many types of mental health care providers who practice psychodynamic therapy,  including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs), and more.

On top of finding a therapist who is skilled in psychodynamic therapy, you want to make sure they meet your other needs. For example, because psychodynamic therapy is reliant on your therapist’s experience and interpretation, finding a therapist who is more likely to understand your identity — whether it’s around your race, culture, age, gender, or sexual orientation — can be helpful.

In addition, finding a therapist who accepts your insurance can make therapy much more affordable. You can find a therapist who accepts your insurance, shares your identity, and specializes in psychodynamic therapy by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Psychodynamic” from the “Treatment methods” drop-down.