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Psychodynamic therapy is derived from psychoanalytic therapy, and both are based on the work of Sigmund Freud. Psychodynamic therapy is an in-depth form of talk therapy based on the theories and principles of psychoanalysis. In effect, talking about problems in a therapeutic setting can be extremely valuable for the individual. Comparatively, psychodynamic therapy is less focused on the patient-therapist relationship and more focused on the patient’s relationship with their external world.

When It's Used

Psychodynamic therapy is primarily used to treat depression and other serious psychological disorders, especially in those who have lost meaning in their lives and have difficulty forming or maintaining personal relationships. Studies have found that other effective applications of psychodynamic therapy include social anxiety disorder, eating disorders, problems with pain, relationship difficulties, and other areas of concern. This therapy is used with children and adolescents; it is also useful in cases of borderline personality disorder. However, this therapy type is less used in instances of psychosis, post-traumatic stress disorder, and obsessive-compulsive disorder. Research shows that psychodynamic therapy can be just as lastingly effective as therapies such as cognitive-behavioral therapy.

Who is a good candidate for psychodynamic therapy?

Individuals who have the capacity to be self-reflective and are looking to obtain insight into themselves and their behavior are best suited to this type of therapy. Individuals who are not interested in delving into their life history are better candidates for therapies such as CBT. Brief psychodynamic therapy may be limited to 25 sessions but often it is a longer process, and stands in contrast to forms of CBT that are specifically designed to be limited in time scope. 

What is the difference between psychodynamic therapy and psychoanalytic therapy?

Both are forms of talk therapy that focus on intrapsychic processes and on the unconscious processing of experience to a larger degree than do other forms of therapy, However, psychodynamic therapy is more focused on problem-solving and outcomes, as opposed to delving into issues that may arise from early life experience. Psychodynamic therapy is usually shorter than psychoanalytic therapy with respect to the frequency and number of sessions, however, this is not always the case.

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What to Expect

With help from the therapist, the patient is encouraged to speak freely about anything that comes to mind, including current difficulties, fears, desires, dreams, and fantasies. The goal is to experience a remission of symptoms but also derive such benefits as increased self-worth, better use of a patient’s own talents and abilities, and an improved capacity for developing and maintaining more satisfying relationships. Some people are in psychodynamic therapy for shorter periods, and others for longer; patients may experience benefits at varying points of treatment.

Is free association used in psychodynamic therapy?

Free association was used by Sigmund Freud, who founded psychoanalytic therapy. A patient is asked to be spontaneous and free-associate the random thoughts that pop into their mind; sometimes the therapist may give the patient a prompt or a word to begin their free association. Patients are also encouraged to put aside embarrassment and the urge to self-censor. The therapist then tries to identify what the patient might be repressing from their past, and how it may be affecting their present behavior.

Is dream analysis used in psychodynamic therapy?

Dream analysis is a technique used in psychoanalytic and psychodynamic therapies. It is supposed to unlock a patient’s unconscious and open up hidden fears, desires, and motivations. Dreams are non-judgmental, and they are not filled with defenses, allowing an individual to dig up thoughts and feelings that have been long buried. This process is supposed to unveil meaning and truth.

How It Works

The theories and techniques that distinguish psychodynamic therapy from other types of therapy include a focus on recognizing, acknowledging, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions to improve the patient’s interpersonal experiences and relationships. This includes helping the patient understand how repressed emotions from the past affect current decision-making, behavior, and relationships. Psychodynamic therapy also aims to help those who are aware of and understand the origins of their social difficulties but are not able to overcome problems on their own. Patients learn to analyze and resolve their current difficulties and change their behavior in current relationships through deep exploration and analysis of earlier experiences and emotions.

What to Look for in a Psychodynamic Therapist

A psychodynamic therapist is a licensed, experienced social worker, psychotherapist, or other mental health or medical professional. In addition to finding someone with the appropriate educational background and relevant experience, look for a psychodynamic therapist with whom you feel comfortable discussing personal problems. The psychodynamic therapist will review an individual’s thoughts, feelings, emotions, experiences from early life, and the beliefs that they hold.

References
Shedler, J. The Efficacy of Psychodynamic Psychotherapy. American Psychologist. February-March 2010;65(2):98–109.      
Khantzian, E.J. Reflections on treating addictive disorders: a psychodynamic perspective. American Journal on Addictions. May-June 2012;21:274–279.
Driessen, E., Van, H.L., Don, F.J., et al. The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry. September 2013;170(9):1041–1050.
Leichsenring, F., Salzer, S., Beutel, M.E., et al. Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder. American Journal of Psychiatry. October 2014;171(10):1074–1082.
Stefini, A., Salzer, S., Reich, G., et al. Cognitive-behavioral and psychodynamic therapy in female adolescents with bulimia nervosa: A randomized controlled trial. Published online February 10, 2017.
Knekt, P., Lindfors, O., Harkanen, T., Valikoski, M. Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine. May 2008;38(5):689–703. Epub Nov 16, 2007.
Stefini, A., Salzer, S., Reich, G., et al. Cognitive-behavioral and psychodynamic therapy in female adolescents with bulimia nervosa: A randomized controlled trial. Published online February 10, 2017.
Knekt, P., Lindfors, O., Harkanen, T., Valikoski, M. Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine. May 2008;38(5):689–703. Epub Nov 16, 2007.
Last updated: 04/28/2022