What is Psychodynamic Psychotherapy? How does it differ in, practice and results, from other forms of psychotherapy available today?
Psychodynamic therapy traces its roots right back to the very first psychoanalyst, Sigmund Freud. Though much progress has been made in the field of psychotherapy since Freud pioneered a new understanding the human psyche, it was Freud who created a unique system to enable us to gain access to the unconscious elements of the human mind. Today the concept of the unconscious, or subconscious mind is now widely accepted in our culture. Less well understood is the great influence this unconscious aspect of the psyche has on our day-to-day lives.
Psychodynamic therapy works on the premise that in order to effect positive change in our lives and in our relationships to self and others we need to explore what is going on below the surface. This is where feelings reside. We all know someone who can intellectually understand and discuss at length what is wrong in his or her life but is unable to change it. Cognitive therapies, such as CBT, which focus on exploring a person’s thoughts and beliefs, can have some positive affects in the short term but lasting change is only possible once a person has access to their deeper feelings, even conflicting ones.
Freud believed that the process of free association, in which the patient would lie on a comfortable couch and speak freely about whatever came to mind, would allow the deeper aspects of the psyche to become available to patient and analyst. Today most therapists prefer to work face to face with their client and engage in conversation. The therapist is trained to be receptive to the client in such a way as to allow for the natural unfolding of the many layers of the person’s inner and outer worlds, both past and present. Together, client and therapist observe and reflect on the revelations of this unique conversation and the emotions that are stirred in the process. This can result in many new insights, connections and possibilities for the client as well as a more integrated sense of self.
Much of our worldview and our self-image was formed by feelings we experienced in very early important relationships. Long before we learned to reason objectively we had already “swallowed whole” a sense of self from which our cognitive thinking would later emerge. It stands to reason then that we cannot use cognitive means alone to restructure what underlies the very foundation of our cognitive understanding. To attempt this would be akin to trying to “pull yourself up by your bootstraps”, a strenuous and ultimately futile labour. What was formed in relationship can only be changed in relationship. This is why the relationship between therapist and client is of paramount importance in psychodynamic, or indeed any, therapy. It is rather wonderful that the process of simple human conversation can effect the most profound of changes in the human psyche. Yet this is the very essence of the work of a psychodynamic therapist.
The goal of Psychodynamic therapy is to not only seek the relief of symptoms but to also enlarge the capacity for positive experience of self, relationships and life. The unique experience of working with a psychodynamic therapist allows a person to integrate many levels of his or her experiences including dreams, wishes and fantasies. This brings about an extraordinary richness and creativity of self. Deep integration profoundly nurtures a person’s sense of self worth, which in turn serves as the foundation for the creation of a more meaningful life and more authentic relationships.
How exactly does therapy work? The psychodynamic process is based on the insight and evidence that people are naturally inclined towards integration and expansion. The job of the therapist is to facilitate this process by helping to bring to light and work through some of the conflicts that get in the way of this natural tendency towards feeling good. Of course, as Freud would have been the first to tell you, there are parts of the human psyche that are inaccessible to us. To some extent we are mysterious beings even to ourselves and because each of us is unique and complex we will never completely understand why we feel and behave as we do. However, it is in making the attempt to understand ourselves, to explore those untamed regions within, that we find the treasure we need to enrich our lives.
This article was inspired by Jonathan Schedler’s 2009 paper
The Efficacy of Psychodynamic Therapy
In this paper he provides research that he has compiled from a number of different studies on the results of different types of psychotherapy. His findings show that Psychodynamic Therapy results in lasting and continued change, even long after the end of the therapy. The following link will take you to this very informative paper.
By Maggie Fraser