What is psychodynamic therapy?
My theoretical orientation is grounded in modern psychodynamic theory.
What is psychodynamic therapy?
While psychodynamic therapists don’t always approach treatment the same way, we do make the following assumptions:
There is an unconscious. One fundamental belief psychodynamic therapists hold is that we are never fully aware of everything that is influencing our choices. Many of the ways we engage with the world exist in us like muscle memory. We learn to do them without needing to think, similar to the way we might learn to ride a bike, and we don’t always consciously understand what we’re doing. A large focus of psychodynamic therapy is to develop our awareness of these unconscious dynamics, because self-understanding allows us to meet our challenges with compassion and create lasting change.
Our present is greatly shaped by our past experiences. Psychodynamic therapists generally include consideration for our client’s history when we think about how to address their concerns. Even for something that many people experience, like depression, we believe our client’s concerns are unique because they occur in the context of their unique personhood and history. We take a disciplined and highly individualized approach to intervention.
We are always growing. I believe psychodynamic therapy is, at its core, an exercise in hope. Psychodynamic clinicians tend to be optimists in the way we imagine possibilities for happiness and healing in our clients, and we tend to work from the belief that profound change is possible throughout the lifespan.
Is psychodynamic therapy evidence-based?
Yes. There are attitudes within the mental health community that psychodynamic therapy is not evidence-based, and I still encounter this from time to time when speaking with other clinicians. I believe this is unfortunate misconception is worth addressing.
Modern psychodynamic theories are alive, they are evolving, and the effectiveness of psychodynamic therapy has been demonstrated in research. Studies have shown that psychodynamic treatment is as effective as cognitive behavior therapy (CBT) in treating chronic depression, and it is particularly effective for complex, deeply entrenched and lifelong concerns. In addition, there is evidence that after treatment ends, the long-term benefits of psychodynamic treatment tend to keep growing.
When is psychodynamic therapy the best fit?
Psychodynamic therapy is often the most effective approach for someone experiencing concerns that are chronic, complex, and threaded with questions about identity or painful relationship patterns. It helps get to the “root” of the problem. Some concerns, like specific phobias, are usually most effectively treated with other approaches, like CBT.
When deciding if this style is right for you, please know that with this approach, conversations tend to be open-ended and the therapy generally doesn’t emphasize advice, instruction or homework in the way that, for example, CBT or formal dialectical behavior therapy (DBT) might. Given this, it can be an empowering and profound approach for some, but it might not the best approach for everyone at all times. Some people genuinely feel that a deeper self-understanding will not be useful for them, and some people genuinely prefer learning skills with a therapist whose theoretical home emphasizes instruction and homework. These are legitimate reasons to seek a more instructional approach.
In sum, when is psychodynamic therapy a good fit? It’s an excellent fit if you’re interested in self-exploration. Even if thinking about your own mind isn’t your favorite thing in the world, complex, chronic and entrenched concerns, like lifelong difficulties with depression, uncertainty in identity, painful relationship patterns, and grief are often best resolved with psychodynamic therapy, as well as concerns related to family of origin and community, a sense of core instability, emptiness, and disconnection. I particularly admire the capacity of psychodynamic theory to make space for empowerment and holistic change; for me, its potential to create lasting change is unparalleled.
If you think psychodynamic therapy would be a good fit, or you’re unsure, I’d encourage you to reach out for a free 30-minute consultation.