Psychodynamic therapy is an effective treatment for a range of problems, including depression, anxiety, eating disorders, personality disorders, unstable self-esteem, and interpersonal difficulties.
This type of therapy aims to help you to better understand the self-defeating patterns that play out in your life, how your mind works, the internal conflicts you wrestle with, the defense mechanisms you use, and other things that might be outside of your awareness. Psychodynamic therapy centers internal experience. Much of the exploration is on your subjective experience, and observations of your behavior, rather than a focus on external events.
Instead of teaching skills or providing recommendations to manage symptoms, psychodynamic therapists focus on increasing self-understanding. By learning more about yourself and your struggles, you will be better equipped to make changes in your life, solve your problems in the ways you want to solve them, and break out of the self-defeating patterns you find yourself stuck in.
Your task is to speak freely in an uncensored way about what’s on your mind, especially in regards to your struggles.
This takes time to get used to. Psychodynamic therapy is unlike normal conversation. Most obviously, it’s not a two-way conversation in which I share my life or struggles with you. It’s also unlike normal conversation in that there is not always a consistent back and forth. I will be sharing my thoughts with you when I think I have something useful to say. But sometimes you will say something, and I will remain quiet. At other times, I might interrupt you because I’m not understanding. Though I will be asking questions from time to time, sessions are not supposed to have an interview-like quality. Psychodynamic therapy is unlike polite conversation in that you are encouraged to share how you’re feeling about me and the therapy, even (sometimes especially) when the feelings are negative.
Since this type of therapy aims to explore difficult parts of yourself, and motivations and behaviors that might be outside your awareness, some of the things I say might be challenging and anxiety-provoking.
At the start of each session, other than greeting you, I will likely stay quiet and refrain from small talk. Listening to you speak freely is the best way I know to understand you and your struggles.Another way in which therapy is unlike normal conversation is that I will likely not be very reassuring in sessions. Reassurance can feel good in the moment, but is not helpful in the long run and, sometimes, can even be detrimental.
This type of treatment requires me to be therapeutically “neutral,” which is not the same thing as being indifferent or cold. Humans are ambivalent by nature; they have mixed feelings and conflicting motivations about many things. Therapeutic neutrality means I endeavor to observe different parts of you, in a nonjudgmental manner, without encouraging one part or discouraging another. I am here to observe and understand, not to judge, tell you what to do, or advocate for any part of yourself.
Since you’re interested in psychodynamic therapy, I will presume you want to gain a greater understanding of yourself and your struggles. While this is an outcome of psychodynamic therapy, it’s not a goal in itself.
Think of treatment goals as the functional, often tangible changes you want to make in your life. They could be personal, interpersonal, or professional. Examples include: I want to make friends and go out more; I want to stop having so many fights with my significant other; I want to speak up and be more assertive with my boss; I want to find a significant other and settle down; I want to behave more confidently when I go out in public; I want to go back to school and finish my degree. A greater understanding of yourself and your struggles helps to facilitate achieving your goals.
Why are they important? Firstly, goals ground therapy in reality. Without them, therapy can become an intellectual exercise, disconnected from real life. Secondly, goals help you to stay attached to therapy when you are feeling frustrated, disappointed, or apathetic. When the going gets tough, goals remind you why therapy matters to you.
We meet once- or twice-weekly for psychodynamic therapy, depending on your goals and the nature of your struggles. Sometimes, after working together for a while, a person might request to meet every other week, instead of weekly. This is generally done short term, as a transitional phase to ending treatment.
Be aware that psychodynamic therapy will not be helpful without consistent attendance. If you are not able to commit to consistently attending, I recommend you explore other treatment options.
It depends. Short term psychodynamic therapy is generally 4 to 6 months. This is an option for people with circumscribed problems. Longstanding problems generally require a longer term therapy. Psychodynamic therapy for personality disorder, for example, can be 3 to 4 years in length.