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What is psychodynamic therapy?

If you're thinking of trying therapy, the number of different types can seem overwhelming. Although therapy is a catch-all term, approaches and styles can differ considerably - and the kind you may benefit from can depend on lots of factors. This series will look at the various options, so you can find the therapy suitable for you.

What is psychodynamic therapy?

The roots of psychodynamic therapy lie in Sigmund Freud's psychoanalysis, coined in the late 1800s. At the core of psychoanalysis is the belief that people harbour unconscious thoughts, feelings, memories and desires, which can drive their behaviour.

It also states emotional and psychological problems, such as anxiety, are rooted in repressed, unconscious thoughts and desires. By bringing these into conscious awareness, it is believed people can find relief from distress.

Freud wasn't the only influence on modern psychodynamic therapy. A number of psychologists, theorists and psychoanalysts (including Carl Jung, Alfred Adler, Otto Rank and Melanie Klein) also helped develop the approach, .

Psychodynamic therapy focuses on past experiences

"The core concept is a focus on the unconscious process. It is believed that feelings, thoughts and behaviours that are causing a current predicament or suffering originate from the past or childhood experiences," says Yuko Nippoda, a psychotherapist and spokesperson for the UK Council for Psychotherapy (UKCP).

"In addition, current issues are not the result of only one past episode but from many different incidents during the lifetime. These events have not been dealt with properly and the current feelings, thoughts and behaviours happen unconsciously. The unconscious mind is key in creating the current suffering."

In psychodynamic therapy, the therapist will help the client explore how unprocessed past or childhood experiences connect to their unconscious feelings. It is believed that people use defence mechanisms to protect themselves from information contained in the unconscious.

"By identifying the unconscious mind and making the unconscious conscious, the client has a better understanding of their own issues, which enables them to bring about change," says Nippoda.

The difference between psychodynamic and psychoanalytic

The words psychodynamic and psychoanalytic are often confused and used interchangeably. However, the two terms are different. Freud's original theories were psychoanalytic. The phrase psychodynamic, by contrast, refers to the modern approach to this kind of therapy, which includes Freud’s theory of psychoanalysis as well as theories of his predecessors.

What does a psychodynamic therapist do?

"A psychodynamic therapist does not set goals for the client and doesn't dictate the sessions. Instead, they invite the client to talk freely, openly and honestly about their feelings, whether positive or negative," explains Nippoda.

"When the client talks about themself, they begin to see patterns. Psychodynamic therapists interpret what the client is saying and can direct them to the unconscious level so the client becomes aware of how their past or childhood experiences are relevant to their current issues."

Psychodynamic therapists also observe the client's body language and tone of voice too.

"In the relationship between therapist and client, the client often mirrors their feelings about past relationships on to the therapist," she adds. "Through this process, the therapist helps clients who are stuck in the unconscious mind from repeating the same patterns of their past. This allows them to update their feelings in accordance with the present situation."

The length of a psychodynamic therapy session depends on the client, their needs and what the therapist offers. At the initial session, an assessment will be carried out so the therapist can give their professional opinion about the duration of therapy needed, depending on the presenting issues of the client. Both the client and therapist can discuss how they will work together.

What is psychodynamic therapy used for?

Psychodynamic therapy deals with issues that are deeply rooted in the past, so may be beneficial for people who have had traumatic experiences.

"As with other forms of therapy, it is also beneficial for people who have depression, anxiety, fear, a sense of loss, anger and suicidal thoughts," says Nippoda. "In addition, psychodynamic therapy deals with issues in-depth, so people who have personality disorders can also benefit."

Is psychodynamic therapy available on the NHS?

The NHS has mainly provided cognitive behavioural therapy (CBT) for psychological and mental health issues. You can self-refer for NHS talking therapy.

"Psychodynamic therapy is only offered on the NHS on a smaller scale," Nippoda adds. “However, CBT is not suitable for everybody and now the NHS is planning to expand available treatments to other approaches, including psychodynamic therapy."

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