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What is Psychodynamic Therapy?

Medically Reviewed and Edited by 
Olga Kyrychenko, Psychologist

When you undergo psychodynamic therapy you may expect psychoanalytic principles will be applied but the fundamentals are “radically different”. Both are Freudian therapeutic techniques and primarily anchored on his theory, but psychodynamic, as the word dynamic suggests, requires more active participation from the patient as well.

This diverges from the traditional psychoanalytic approach wherein you simply speak your mind to your therapist and they will be the one to attach meaning to those thoughts. The contemporary psychodynamic therapy process is comparable to that of CBT:  short-term, spaced-out sessions and the therapist assumes the role of an “assister”. 

Through this article, I also aim to reduce the skepticism surrounding psychodynamic therapy by letting you understand each psychodynamic therapy type as well as the techniques that are commonly applied. Furthermore, by understanding how does psychodynamic therapy work, the benefits and the issues with psychodynamic therapy, you’ll be able to determine if this approach is right for you. 

Different Types of Psychodynamic Therapy

Before we list the different types of psychodynamic therapy, we have to understand the role of the unconscious mind in psychodynamic therapy. 

Rooted in your unconscious mind are emotions, feelings, and most especially, what psychodynamic therapists want to tap into, memories. The goal of psychodynamic therapy is to make the “trapped” cognitions emerge in order to correct your maladaptive behaviors which, as the theoretical perspective of this therapy suggests, are rooted in your unconscious.

The psychodynamic therapy treatment types I will be discussing are centered around the aforementioned hypothesis. Consequently, all mention of cognition, emotion, and behavior refers to what lies in the unconscious or products of unconscious motives.

Time-limited Dynamic Psychotherapy (TLDP)

As the term implies, TLDP puts emphasis on the duration of treatment. In this type of therapy, you and your therapist come up with goals that can be fast-tracked using psychodynamic techniques. This treatment type may also be referred to as brief psychodynamic therapy.

The themes of those therapeutic goals are new experiences and new understandings. New experiences are defined by how you manifest the behaviors that stemmed from your thoughts and emotions. These experiences encompass both personal and interpersonal ones. 

Meanwhile, new understandings are hallmarked by comprehending the reasons behind emotional shifts or relational shifts. For example, a new understanding of why you were sad yesterday yet happy today. If before you blamed your partner for such, after undergoing TLDP, you are now able to consider other circumstances. This also applies to relational shifts like losing a friend or befriending a previous adversary.

The duration of the intervention is very important because the success of TLDP is not defined by “therapeutic perfectionism” or in other words, complete correction of cognition, emotion, and behavior. Rather, the therapeutic relationship between you and your therapist will conclude once both of you recognize that you are able to independently and continuously construct new experiences and new understandings. As such, this treatment type, very much like CBT, is suitable for those looking for affordable therapy options.

Psychodynamic Family Therapy

One of the theoretical principles that psychodynamic therapy is grounded on is the view of past experiences as the primary drivers of cognition, emotion, and behavior. Your experiences with your family are undeniably the most prominent of those. 

In psychodynamic family therapy, the family is viewed as the context wherein “individual and relational dysfunction develops”. With such intervention focused on eliminating disorderly interaction patterns between family members, significant change will most likely occur. 

One of the major concepts psychodynamic family therapy highlights is the “holding environment”. The holding environment refers to a “safe and nurturing environment” provided by either your immediate parents or your primary caregivers. Thus, your therapist ensures that a safe environment is established so that you and your family members are able to move toward growth and healing.

The conclusion of the therapeutic process is dependent on whether you and all the other members of your family become more insightful and understanding not just of yourselves but of others as well. Read our guide on online family therapy if you are interested in this form of treatment.

Mentalization-based Therapy (MBT)

As I have previously emphasized, psychodynamic therapy focuses on the unconscious mind. In MBT, the process of mentalizing involves “subjective states and mental processes” which, viewed through the psychodynamic lens, comes from your unconscious. 

Your therapist helps you construct and continuously reconstruct your “self” according to your cognitions and emotions. In turn, the behaviors you allow to manifest will then be congruent with your thoughts and what you are actually feeling. Through such a process, you are also able to compare the version of yourself you have created with your therapist to versions of yourself perceived by others.

The goal of MBT is mainly for you to be able to gain a positive view of yourself and develop healthier internal processing patterns. Once this is achieved, your interpersonal relationships will flourish and your self-esteem will be stabilized.

Transference-focused Psychotherapy

Transference is the therapeutic process in which you direct your “unconscious feelings and wishes” toward your therapist. You and your therapist will then try to understand and put meaning to those unconscious musings. By doing so, the sources of your psychological distress will then be identified. After identification, you are now able to act on those and feel relieved.

The aforementioned therapeutic process is at the center of transference-focused psychotherapy. In this treatment type, transference is used to solve the problem of identity diffusion. Identity diffusion happens when you do not have a concrete picture of yourself and often rely solely on what others think of you. It brings you distress mainly because having an unclear understanding of yourself hinders you from committing to healthy action patterns.

At the start of transference-focused psychotherapy the affects you express are predominantly negative or at times, even aggressive. Due to this, your interpersonal relationships are sure to be dysfunctional or decaying. There is also little you can do considering your perspective of your thoughts and emotions is ambiguous at best.

Transference-focused psychotherapy sessions end when you have successfully refined your ability to control your behavior, your ability to reflect, and your ability to regulate your emotions. One of its goals is to replace identity diffusion with identity integration which is defined by your subjective feeling that your life is one “worth living”.

Cognitive Analytic Psychotherapy

At first glance, cognitive analytic psychotherapy may seem more aligned with psychoanalytic therapy but much like TLDP, cognitive analytic psychotherapy is also time-bound and usually short-term which is an important feature of psychodynamic therapy. 

This psychodynamic therapy treatment type focuses on the cognitions brought about by your unconscious mind. Through these cognitions, you then form roles that are “formative” and “responsive” in nature. These roles play huge parts in self-management, ways of living, coping strategies, and in interpersonal relationships.

Therapists who are practicing cognitive analytic psychotherapy aim to help you remove the “roadblocks” that were hoisted up by the roles you have formed. These blockages restrict your growth and cage you in distress, unable to move forward.

Psychodynamic Therapy Techniques

The following psychodynamic therapy techniques make psychodynamic therapy a distinct approach from other therapy options. These exercises raise the empirical soundness of this treatment option which has been highly criticized right from its origins. As a result, the effectiveness of psychodynamic therapy now depends on whether these techniques are adhered to.

Focus on Affect and Expression of Emotion

You are encouraged to explore and openly talk about your feelings in psychodynamic therapy. If you have emotions that are upsetting or contradicting then you are even more encouraged to express them. 

Psychodynamic therapy recognizes that merely comprehending things intellectually is insufficient for acquiring emotional insight and making major changes. You are not expected to be “bright, psychologically aware” but rather connected to your emotions and able to recognize them as your own.

Exploration of Attempts to Avoid Distressing Thoughts and Feelings

Your actions are divided into conscious and unconscious and are what you use to cope with distressing experiences. In psychodynamic therapy, these actions are called defense mechanisms (or now, in more contemporary times, psychological resistance). When you start the treatment process, these behaviors may come in the form of skipping therapy sessions, evading queries, or purposefully being late. 

However, these action patterns are not overt or blatant all the time. Sometimes psychological resistance does not come in the form of behaviors but rather, cognitions and emotions. Therefore, in psychodynamic therapy, these are deliberately identified and investigated so that corrective measures may be applied.

Identification of Recurring Themes and Patterns

The therapist will work with you to spot and investigate recurring themes and patterns in your experiences, feelings, relationships, and thoughts. How you constantly view yourself will also be evaluated since you have the ability to recognize the habits that bother you but find them difficult to break free from.

If you are unaware of these patterns, your therapist will help you realize them and realign them to turn them into healthy patterns of cognition, emotion, and behavior.

Discussion of Past Experiences (Developmental Focus)

This technique places a strong emphasis on how your current relationships and life experiences are influenced by your past experiences, particularly early encounters with attachment figures such as parents or caregivers. Using this approach, therapists investigate the relationship between the past and the present and teach you to acknowledge that the past still has a big impact on your life.

As you may recall, one of the goals of psychodynamic therapy is to comprehend how the past illuminates current psychological issues rather than merely dwell on the past – as opposed to the old psychoanalytic practice. Through this technique, your therapist will be able to assist you in overcoming the residual effects of prior experiences so you can engage more fully and actively in the present.

Focus on Interpersonal Relations

Since psychodynamic therapy also considers aspects of non-Freudian theories as its theoretical foundations, in the context of object relations and attachment theory, psychodynamic therapy lays a strong emphasis on the significance of your relationships and experiences in relating to others. 

Remembering the different types of psychodynamic therapy, we can deduce that psychological issues frequently develop when your ability to meet your emotional needs is hampered by negative interpersonal relationships. This will lead to the development of negative self-perception which your therapist would actively try to halt or prevent.

Exploration of Fantasy Life

The role of the unconscious mind in psychodynamic therapy is highlighted in this technique since you are encouraged to openly disclose your thoughts and emotions without any constraints. Your therapist guides you on how to examine your mental life, especially the hidden aspects such as your desires and dreams.

After executing this technique, you are then expected to be able to comprehend how you see yourself, other people, and your experiences. This is what psychodynamic therapy defines as “living more fully” wherein positive psychological capacities are learned or improved.

Psychodynamic Therapy Use

To answer the question of what psychodynamic therapy is used for, I would like to reiterate that psychodynamic therapists analyze the cognitions, emotions, and behaviors influenced by the unconscious. Therefore, the psychodynamic treatment option is mostly used to treat clinical populations that have internalizing disorders.

Numerous empirical studies regarding the use of psychodynamic therapy have been conducted among people who have the following psychological conditions:

Besides treating mental disorders, psychodynamic therapy, specifically the brief type, is mainly used as a way to achieve a better quality of life or exhaust maladaptive behaviors among distressed people.

Is Psychodynamic Therapy Effective?

The contemporary approach of psychodynamic therapy and its adaptation of more evidence-based techniques have improved its effectiveness. Now the query, “Does psychodynamic therapy work?”, is not raised as much as before. 

A meta-analytic study presented data on the effectiveness of psychodynamic therapy. The study states that although other therapeutic strategies are more widely-studied, those therapies also apply some of the major techniques of psychodynamic therapy. Thus, it may be concluded that psychodynamic therapy is as effective as other counterparts in the same clinical populations.

In the context of online therapy, however, psychodynamic therapy has its limitations. I will discuss those drawbacks further down this page but, due to those cons, there is a need for more study about online psychodynamic therapy. Despite that, results show that the current path is
“promising” and is expected to continue moving in the positive direction.

What are the Benefits of Psychodynamic Therapy?

Through psychodynamic therapy, you will be guided to thoroughly grasp your unresolved psychological traumas and unconscious emotions. These traumas and emotions have significant effects on your behavior and mental health.

It is also worth noting that although psychodynamic theory is not purely problem-focused, you are expected to learn skills you may need to better control maladaptive coping mechanisms and navigate your social surroundings more effectively.

Here are some of the specific advantages of psychodynamic therapy:

  • Learn how to properly self-reflect
  • Be able to understand internal processes clearly
  • Encouraged to continuously learn more about themselves
  • Increased self-esteem
  • Foster healthier and more sustainable relationships
  • Increased understanding of self and others
  • Understand a wider array of emotions 

What are the Drawbacks of Psychodynamic Therapy?

As I’ve mentioned, psychodynamic therapy has a couple of limitations in terms of online modality. I have also discussed that one of the major considerations when it comes to psychodynamic therapy is that the therapist is expected to be able to create a safe environment for you to be able to freely express yourself.

Although there are a lot of measures that can be taken in terms of security and being able to reach out to your therapist when necessary, undergoing psychodynamic therapy online is not as effective as in-person psychodynamic therapy.

A couple of psychodynamic therapy techniques are also somewhat hindered such as transference, behavioral observation to determine underpinnings, and close monitoring to evaluate repetitive action patterns and thought themes.

Getting Started With Psychodynamic Therapy

Even if there are cons to psychodynamic therapy when done online, a lot of online therapy sites do offer psychodynamic therapy. If undergoing this therapy option online would not be a problem for you, then you may visit websites and opt to see a psychodynamic psychotherapist.

Unlike in psychoanalytic therapy, therapists who practice psychodynamic therapy need not be experts but should be trained adequately. You may consult directories for therapists such as Therapy Route and Psychology Today if you are not able to locate a therapist in your area. 

Visiting your local community mental health centers and private clinics may also help you match with a psychodynamic therapist that can help you.

Is Psychodynamic Therapy Right For You?

There is no denying that psychodynamic therapy has a long history. In fact, most shallow connotations of therapy involve you sitting on a chair or lying down on a couch while your therapist asks you questions that are derived from the idea of psychodynamic therapy.

Due to such, a lot of experts and common folk alike have scrutinized the efficacy and legitimacy of the psychodynamic approach. At present, a lot of research has provided empirical data that psychodynamic therapy is effective and therapists who practice such therapy are as evidence-based practitioners as those with other clinical perspectives.

To sum it up, by carefully considering the principles, benefits, and limitations of psychodynamic therapy and reflecting on your own needs and goals you can make a well-informed decision about whether this treatment option is right for you.