Psychoanalysis & Psychotherapy


Psychodynamic Psychotherapy

 About Psychotherapy

Psychodynamic psychotherapy is a type of treatment based on psychoanalytic theory and the observation that factors outside our awareness can affect our thoughts, behaviors and moods. While psychodynamic psychotherapy involves fewer appointments and is considerably briefer in duration than psychoanalysis, the insight and self-understanding can be equally valuable to our sense of personal autonomy and fulfillment.

Psychodynamic psychotherapy differs from cognitive-behavioral therapy (CBT), a more commonly offered type of psychotherapy.  CBT is effective for many distressing psychiatric symptoms and works by exploring the relationship among maladaptive thoughts and behaviors.  CBT is a ‘manualized’ form of psychotherapy, meaning it has a predetermined session structure, a direct time-limited approach and a predetermined agenda.  In contrast to CBT, psychodynamic psychotherapy is unique in several ways (Shedler, 2010):

  • Focus on the expression of emotions that may be difficult to describe or troubling to experience

  • Exploration of attempts to avoid distressing thoughts and feelings

  • Exploring how past experiences or relationships affect our present experiences and relationships

  • Identification of recurring themes and patters in thoughts, feelings, relationships and experiences

  • Central focus on relationships

  • Exploration of fantasy life and dreams

Psychodynamic psychotherapy is often indicated when patients prefer this approach or when other less intensive therapies like CBT fail to achieve the desired results.  It is often more comprehensive and should be considered if symptoms remain after other attempts at treatment with less intensive or briefer psychotherapies. 

Many mental health professionals mistakenly believe that psychodynamic psychotherapy is not an ‘evidence based treatment’, meaning that the medical literature does not show it to be an effective type of psychotherapy.  In fact, psychodynamic psychotherapy is highly effective for many individuals and is superior to CBT in many ways (Shedler, 2010):

‘Empirical evidence supports the efficacy of psychodynamic therapy.  Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as ‘empirically supported’ and ‘evidence based.’  In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends.  Finally, non-psychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice.  The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.’

Shedler, J.  The Efficacy of Psychodynamic Psychotherapy. American Psychologist.  Feb-Mar 2010.  65(2): 98-109.