My Approach: Psychodynamic Psychotherapy

Psychodynamic psychotherapy is often referred to as psychoanalytically oriented psychotherapy. Psychoanalytically oriented approaches follow Sigmund Freud’s theory developed at the end of the 19th century and beginning of the 20th century. Psychodynamic theory is an umbrella term that is not based on unified theories. Contemporary psychodynamic approaches continue to emphasize unconscious processes, early childhood experiences in shaping personality as well as manifestations of defense mechanisms. They, however, usually deemphasize infantile sexuality, in favor of acknowledging both innate and internal processes as well as the external environment’s contribution to adult personality. There are many schools of thought in addition to the classic Freudian theories. They include Object Relations, Self Psychology and Interpersonal Theories.

A psychoanalytic term that has found its way into popular everyday English expression is “defense mechanism”. People often use the term in conversation to mean the way we protect ourselves from feeling hurt. Many therapists across different styles of therapy use the term synonymously to self-protection. Defense mechanism as a psychoanalytic term, however, refers to unconscious mental processes that enable our mind to reach compromises to conflicts that we are unable to resolve. The term was first used by Freud in his paper “The Neuro-Psychoses of Defense” (1894). Examples of defense mechanisms include repression, acting out, regression, denial, disassociation, projection, splitting, displacement, intellectualization, isolation of affect, sexualization, reaction formation, suppression, humor, altruism and sublimation.

Psychodynamic therapists work with clients in the context of their personality and their unique lives. They focus on the client’s affect and help them to explore a full range of their feelings and emotions. This includes good feelings, ambivalence, discomfort or distressing feelings. They also include feelings that the client may not initially recognize that they have been struggling with. Over time, the client comes to understand that their unconscious attempts to avoid uncomfortable or distressing feelings fuel the inner sources of their symptoms, inhibitions or negative moods. They come to see what is standing in the way of living a more satisfying life

Psychodynamic therapists work with clients in the context of their personality and their unique lives. They focus on the client’s affect and help them to explore a full range of their feelings and emotions. This includes good feelings, ambivalence, discomfort or distressing feelings. They also include feelings that the client may not initially recognize that they have been struggling with. Over time, the client comes to understand that their unconscious attempts to avoid uncomfortable or distressing feelings fuel the inner sources of their symptoms, inhibitions or negative moods. They come to see what is standing in the way of living a more satisfying life.

Psychodynamic therapists provide a safe, caring and nonjudgmental space to help connect the client’s current thoughts, feelings and behaviors to their deep and unconscious mind. In the exploration of recurring themes and patterns, sometimes attention is called to past experiences, especially early experiences with their parents. Here, the purpose is not to study the past for its own sake, but rather to understand how the past affects the client’s experiences in the present and the way they relate to others. This knowledge may help the client to break away from the confinement of their past and to live or at least experiment with an orientation that is more congruent with spontaneous authentic experience, a feeling of being alive and with a greater sense of freedom.

Another focus of Psychodynamic therapy is interpersonal relationships. The client learns about themselves by exploring patterns and themes in their interpersonal interactions including the interactions with the therapist. Psychodynamic therapy is characterized by a close therapeutic relationship between the therapist and the client. In session, patterns of interpersonal interaction, including maladaptive ones tend to emerge and reoccur (see transference). These interactions serve as “experiential” encounters, a closeup view of the client’s underlying conflicts and current functioning. Through corrective emotional experiences, they gain insight into recurring themes and patterns. They learn to articulate their underlying wants and needs and, experience new emotions and desires. Ultimately, the goals are to achieve a greater understanding of the self and others, an enhanced sense of well-being, greater emotional resilience and, healthy relatedness with others.

The main methods in psychoanalytically oriented therapy include free association, dream interpretation and transference analysis. While I employ these techniques from time to time, I generally focus on the content the client brings up in session as the client communicates at various levels. They communicate semantically through their words and, through their nonverbal language as well as accompanying emotions that the therapist observes. They also construct meaning within communicative contexts, such as intention, assumption, inclusion, sequencing and prior knowledge. Processing with the client the content, including the nuanced and implied content, often allows access to the unconscious mind of the clients. It, in turn, may help us better understand and improve their experiences.