Psychodynamic Psychotherapy
Psychodynamic therapy is a form of therapy with a holistic focus on the perspective of the patient. The alternative, “problem-based” therapies, such as cognitive behavioural therapy (CBT), solution focused therapies (SFT), acceptance and commitment therapy (ACT) etc, aim to reduce or eliminate symptoms instead of exploring the patient’s deep-seated needs, urges, and desires (McLeod, 2014). This translates into significant differences between these therapies in terms of goals, techniques, and general approach.
“In contrast to problem-based modalities, dynamic psychotherapy facilitates a patient’s rewriting of their life narrative, their picture of themselves, their past, present, and future, and is uniquely positioned to address the depth of a individual’s experience.” Richard F. Summers
The holistic vs. problem-based therapy dichotomy is not the only factor that sets psychodynamic therapy apart from these other, more common forms of therapy. Psychodynamic therapy involves the interpretation of mental and emotional processes rather than focusing on behaviour (Strupp, Butler, & Rosser, 1988).
I attempt to help patients find patterns in their emotions, thoughts, and beliefs in order to gain insight into their current self. These patterns are often found to begin in the patient’s childhood since psychodynamic theory holds that early life experiences are extremely influential in the psychological development and functioning of an adult (Matthews & Chu, 1997). This notion is supported extensively by over 60 years of research into child development and attachment theory.
Psychodynamic therapy aims to help the patient identify important pieces of the puzzle that makes them who they are and rearrange them in ways that allow the patient to form a more functional and positive sense of self:
“We see the central task of psychotherapy as the rewriting of a more complex and useful narrative of the patient’s life and experience.” Richard F. Summers
Psychodynamic therapy sessions are intense and open-ended, dictated by the patient’s free association rather than a set schedule or agenda. We will meet at least once a week, however it is not uncommon to meet more frequently should the patient desire.
In these sessions, I will encourage patients to talk freely about whatever is on their (conscious) mind. The thoughts and feelings discussed will be probed for recurring patterns in the unconscious mind.
This form of therapy is commonly used with patients suffering from:
personality disorders
traumatic and dissociative disorders (incl. PTSD and complex PTSD)
anxiety disorders
dysthymia
chronic depression
somatisation
conditions in which chronic complex trauma is a contributing factor.
The main goals of psychodynamic therapy are to:
enhance the patient’s self-awareness and
foster understanding of the patient’s thoughts, feelings, and beliefs in relation to their past experiences, especially his or her experiences as a child (Haggerty, 2016). This is accomplished by the therapist guiding the patient through the examination of unresolved conflicts and significant events in the patient’s past.
The assumption in psychodynamic therapy is that chronic problems are rooted in the unconscious mind and must be brought to light for catharsis to occur.
Goals of Psychodynamic Therapy
Role of the Psychodynamic Therapist
Today, the role of the therapist in psychodynamic therapy is to work with the patient to discover the bases for their symptoms. The therapist plays this role by encouraging the patient to talk about the emotions they are feeling and helping the patient to identify recurring patterns in their thoughts, emotions, and behaviours.
The therapist aids the patient in finding the significance of these patterns and discovering the effects they exert upon the client.
One of the most important roles of the therapist is to probe the patient’s past. Discussion of the patient’s childhood and early life experiences will likely take up a large portion of psychodynamic sessions, as this form of therapy assumes these experiences have a significant impact on the patient’s current issues.
In general, the therapist’s role is to aid the patient in connecting the dots between their past experiences and their current problems, and leverage their internal resources to address these problems.
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