This article gives you a simple introdution to psychodynamic theory and therapy. Learn about the six basic assumptions of the psychodynamic appraoch and the six important psychodynamic treatment features. Use the table of contents to get exactly the information you’re looking for ⤵️
Before we diving into the common features and core assumptions of psychodynamic therapy, I would like to clarify the terminology. You might have heard the terms psychoanalytic, psychodynamic and depth psychology. In most literature those three terms are used interchangeably. The closer a theory is associated with Sigmund Freud’s theories, the more likely it will be called “psychoanalytic“. While “psychodynamic” refers to any theory within the psychodynamic approach.
When Freud started this school of thought he was not just trying to develop a treatment for mental illness. He also founded a theory to understand human development, human nature what it means to be human, how we become who we are in general. He developed a psychoanalytic theory and based on that he developed a treatment for mental illnesses which he called psychoanalysis.
After Freud there have been many different psychodynamic theories and many different treatment models. There have been long-term psychodynamic approaches, there have been brief psychodynamic treatments, and lots of incredibly interesting theories. So by now there is a huge diversity in the psychodynamic field.
Basic Assumptions of Psychodynamic Theory and Therapy
For a proper introduction to psychodynamic theory and therapy, you need to know the six basic assumptions of the psychodynamic approach.
1. Developmental Perspective
The first one is the developmental perspective. Which refers to a huge emphasis on early childhood experiences. Psychodynamic theory assumes that in early childhood you get a blueprint of how life works, how relationship works, how you’re supposed to regulate yourself. And this blueprint is something that you will carry with you for the rest of your life.
Freud is often displayed as someone who basically thought childhood was everything, but he also warned against oversimplifying development. He wrote: “The synthesis is thus not so satisfactory as the analysis in other words from a knowledge of the premises we could not have foretold the nature of the result”. This means we can know everything that happened in your childhood but can’t predict how your life is going to turn out.
Within the psychodynamic approach there are different people who place different emphasis on childhood. There are some especially in the Freudian lineage who place a great emphasis on childhood experiences. And then there are other theories such as Alfred Adler, who doesn’t really care that much about childhood and doesn’t really think it defines you in the way that other theorists do.
While a lot of theories are focused on childhood development there are also people like Erik Erikson who developed a developmental model that really takes the whole lifespan into account. From the day you’re born until the day you die he describes the different developmental stages you go through and the different conflicts you have to resolve.
2. Transference (and Countertransference)
The second shared characteristics is transference. Remember the blueprint I just talked about? Transference means that templates of past relationships and ways of thinking influence current relationships and perceptions.
This in turn is closely related to attachment theory. I’m pretty sure you heard about secure, anxious, and avoidant attachment style. It refers to the way you were attached to your primary caregiver (your mom, your dad, another person that took care of you) and how that is going to influence the way you approach relationships later in life. They will give you a template about how relationships work and how people are there for you – or not.
The reason that transference is so important in the psychodynamic approach is because the therapist and your older caregiver are not the same person. Which means they’re not going to behave the same way. Because you will find out as a patient in therapy that your therapist acts very different to your caregiver, you suddenly have the opportunity to learn a new template. One that will hopefully be more functional and adaptive.
3. The Unconscious
The third and probably most well-known common feature is unconsciousness. There are factors outside of the individual’s awareness that play an important role in explaining the development and maintenance of psychopathology. Discovering and dealing with the unconscious used to be quite the unique selling point of psychodynamic theory. But now unconscious processes are studied everywhere: neuroscience, social psychology, cognitive science.
The thing with unconscious motivation is that people assume that it’s your consciousness against your unconsciousness but that is not true. Almost all the conflicts that you experience actually take place in your unconsciousness but I’ll leave that for another time.
4. Person-Oriented Perspective
Next up in the common features is the person-oriented perspective. The focus is on understanding the whole person including strengths and vulnerabilities. Psychodynamic therapy is not just concerned with getting rid of symptoms. A psychodynamic psychotherapist doesn’t see symptoms as the problem but as a representation of and way to cope with the real underlying problem.
In a psychodynamic approach, for example, depression is not just something to get rid of, that a depression is just a problem. A depression also serves the patient one way or another. In order to remove the depressive symptoms, it needs to be understood why it’s there in the first place and the underlying problem has to be addressed.
That is good because it doesn’t reduce the person down to her problem. On the other hand it can also be bad because sometimes it leads to treatments that are way too long and could be much more focused and efficient.
5. Recognition of Complexity
The fifth common feature is recognition of complexity. Going to therapy is not a linear approach. It is not always you do not always get better and better and better there are also times where you regress which means that you get worse and there are times when you progress which means that you get better. A lot of different developments can happen in the same therapy, they affect one another, they interact with one another. So it’s not a straightforward process. It’s very complex.
The last common feature shared among different psychodynamic approaches is the continuity between normal and abnormal. It is not one or the other. You’re always moving on a spectrum. Especially the psychodynamic approach recognises how vulnerable humans are to developing mental illness because there’s so many developmental tasks, there’s so many factors influencing us that it’s very hard to survive this life without ever venturing from mental health into mental illness.
Treatment Features of Psychodynamic Theory and Therapy
For an introduction to psychodynamic theory and therapy, you also need to be aware of the following six specific treatment features. Some of them are specific to the psychodynamic approach. And for others it’s just that a psychodynamic therapist would pay more attention or put a greater focus on these features but they are also present in other approaches.
1. Focus on Emotions
Number one is the greater focus on emotions instead of thoughts. Especially in cognitive-behavioural therapy there is a great emphasis on thoughts, while the psychodynamic places greater emphasis on emotions. That means in a psychodynamic therapy you will definitely work a lot with difficult emotions such as aggression, anger, sadness. And not just with the thoughts and behaviour surrounding them.
2. Exploring Defense Mechanisms
The second specific treatment feature is called “exploring the defenses”. Maybe you already heard of defense mechanisms which is everything that we apply in order to not be confronted with things we don’t want to be confronted with. A psychodynamic therapist will always pay special attention to how a patient is avoiding certain topics or emotions.
3. Repetition of Patterns
The third specific feature is what patterns come back. This is something psychodynamic therapist is going to pay great attention to what are the parallels between how you grow up and how you behave now.
4. Biography & the Past
The fourth specific treatment feature might be very obvious but it is a great focus on the past. In a psychodynamic therapy you will often explore your childhood. How you’re related to your parents when you were young, if there were any defining events that happened and shaped you into the person who you become today. On the other hand it is not that if you go to a psychodynamic therapist they will have you talk about your childhood at infinitum without any reason. Probably they will start exploring the problem that you came with to therapy and then they’re going to see if there are any connections to earlier experiences. So don’t fear, you will not talk about your mom and your dad all the time.
5. Interpersonal Relationships
The fifth important feature is the focus on interpersonal relationships. Hello transference, here we go again! It is very important to see how you relate to people. And not just how you relate to other people but also how you relate to the therapist.
6. Wishes, Dreams, and Fantasies
The sixth specific feature of treatment can include exploring wishes, dreams and fantasies. This is where dream interpretation which Freud and also Jung have written a great deal about comes into play. And again this can be a source about what is going on in your consciousness, what you might be suppressing but it is not that in psychodynamic therapy your therapist will ask you every time to tell them about your dreams.