What is Psychodynamic Counselling and Psychotherapy?

Psychodynamic therapies aim to help people with psychological disorders to understand and change complex, deep-seated and often unconsciously based emotional and relationship problems and thereby reducing symptoms and alleviating distress. However, many people who experience dissatisfaction in their lives or who are seeking a greater sense of fulfilment may also attend regular therapy as a way of engaging in a very powerful and in depth form of self development.

Psychodynamic Approaches and Theories

Most psychodynamic approaches are drawn from either drive-based Freudian theories and his followers or object relations theories. In a very simplified way, one could say that the former theories explain human suffering and difficulties as a source of constant psychic struggle that is generated by repressed, unsatisfied and unconscious drives and the dilemma we face as it is often difficult or even impossible to get all one's needs met at all times. The latter focus more on human relationships as the source of all human suffering, but also one's identity and meaning in life.  Principal theorists drawn upon are Freud, Winnicott, Guntrip, Bion, Jung or Lacan.

Core principles and characteristics 

The aim of psychodynamic therapy is to bring the unconscious mind into consciousness - helping individuals to identify, experience and understand their true feelings and reasons for behaving in particular ways, in order to resolve them. It takes the view that our unconscious holds onto painful feelings and memories, which are too difficult for the conscious mind to process. In order to ensure these memories and experiences do not surface, many people will develop defenses. These defenses are unconsciously thought of to be the lesser of the two evils as facing one's painful experiences and feelings causes great anxiety. However, defenses will often do more harm than good in the long-term and create psychological disorders and symptoms.  

Other principles and characteristics include that psychopathology develops especially from early childhood as this is when we are most susceptible and form our identity and ways of coping in life. Furthermore, it is thought that internal representations and experiences are organised around interpersonal relationship patterns. The client-therapist relationship is insofar important as these early patterns and experiences are usually repeated with other people in life and thus will also re-emerge in the context of therapy, where they can be looked at and worked through.

In contrast to other therapies which focus more on behavioural change and are more directive, psychodynamic therapies postulate that insight into one's intra-psychic difficulties and making unconscious processes conscious is the key to real lasting change and the dissolution of problems.

What happens and what do you work on in a therapy session?

You will usually decide what you want to talk about and while it might take some time to get used to, you will learn to trust that what you will bring to the session is usually central to your problems. You will usually talk about what is currently causing you difficulties in your life, particularly any difficult feelings or problems in relationships. Sometimes you might also want to talk through things that have happened in the past and might still be affecting you now or still be on your mind.

Your therapist will help you to identify any unconscious feelings and defenses and help you to make connections between the past and the present as well as between your symptoms and unconscious feelings and relationship patterns.  He or she will often comment on what happens in the sessions as you talk together. This can help to show how some of the things that you feel, do and say are not driven by your conscious thoughts and feelings, but by unconscious feelings from your past. If it is happening in your therapy sessions, it will also be happening in your day-to-day life and vice versa. Developing these insights and being more aware of connections will enable you to make decisions based on what you want or need now, not what your past experiences drive you to do.

You can find out more about psychoanalytic/psychodynamic therapies on the web page of the British Psychoanalytic Council.