“How does that make you feel?”

This question is probably quite familiar to you.

It is the question most often used in pop culture to indicate or reference therapy. It is also the hallmark of psychodynamic therapy.

Ironically, this phrase that immediately calls to mind the practice of therapy is the signature phrase of a type of therapy 
that is much less common these days. The most popular types of therapy today are actually cognitive behavioral therapy (CBT), 
interpersonal therapy (IPT), and other, more modern forms of therapy.

While psychodynamic therapy is still applied in many situations, its popularity has lagged behind these other types of therapy 
in the last few decades.

However, it is still the most recognizable form to those inexperienced in the theory and application of therapy, and it is still 
a worthwhile goal to understand the basics of psychodynamic therapy.

Read on to learn about the theory behind this seemingly simple question to psychodynamic therapy.
			

What is Psychodynamic Therapy? A Definition
Psychodynamic therapy is a “global therapy,” or form of therapy with a holistic focus on the perspective of the client. 
The alternative, “problem-based” therapies, such as cognitive behavioral therapy, aim to reduce or eliminate symptoms 
instead of exploring the client’s deep-seated needs, urges, and desires (McLeod, 2014).

This translates into significant differences between these therapies in terms of goals, techniques, and general approach.

The global vs. problem-based therapy dichotomy is not the only factor that sets psychodynamic therapy apart from these other, 
more common forms of therapy. Psychodynamic therapy involves the interpretation of mental and emotional processes rather than 
focusing on behavior (Strupp, Butler, & Rosser, 1988).

Psychodynamic therapists attempt to help clients find patterns in their emotions, thoughts, and beliefs in order to gain insight 
into their current self. These patterns are often found to begin in the client’s childhood since psychodynamic theory holds that 
early life experiences are extremely influential in the psychological development and functioning of an adult (Matthews & Chu, 1997).

Psychodynamic therapy aims to help the client identify important pieces of the puzzle that makes them who they are and rearrange 
them in ways that allow the client to form a more functional and positive sense of self:

Psychodynamic therapy sessions are intense and open-ended, dictated by the client’s free association rather than a set schedule or agenda. 
They are typically scheduled once a week and last about an hour. While Freud’s psychoanalytic therapy (described in more detail below) 
demanded a much greater investment of time, current psychodynamic therapy is generally practiced in a less intensive manner (WebMD, 2014).

Modern psychodynamic therapy also substitutes a pair of chairs for the stereotypical couch and usually places the therapist and client 
face-to-face rather than keeping the therapist hidden from the client’s view.

In these sessions, the therapist will encourage the client to talk freely about whatever is on their (conscious) mind. The thoughts 
and feelings discussed will be probed for recurring patterns in the client’s unconscious mind.

This form of therapy is commonly used with clients suffering from depression or anxiety diagnoses, and there is some evidence suggesting 
that psychodynamic therapy may be as effective in treating depression as other forms of therapy (WebMD, 2014).

Goals of Psychodynamic Therapy
The main goals of psychodynamic therapy are to (1) enhance the client’s self-awareness and (2) foster understanding 
of the client’s thoughts, feelings, and beliefs in relation to their past experiences, especially his or her 
experiences as a child (Haggerty, 2016). This is accomplished by the therapist guiding the client through the 
examination of unresolved conflicts and significant events in the client’s past.

The assumption in psychodynamic therapy is that chronic problems are rooted in the unconscious mind and must be brought to
light for catharsis to occur. Thus, the client must have the self-awareness to discover these unconscious patterns of 
thought and an understanding of how these patterns came to be in order to deal with them.

Psychodynamic Theory, Perspective, and Key Concepts
To truly understand psychodynamic therapy, you need to go back to its roots. While this type of therapy has changed over the last century, 
it is still built on the foundations of some of the earliest work in modern psychology.

In the late 19th century, Sigmund Freud was working on his grand idea of the human mind and the theory of human development. His theories 
laid the foundation for decades of psychological research and practice.

While many of these theories were eventually found to conflict with hard evidence gained through scientific research, they formed the basis 
for psychodynamic theory and sparked a bold new school of thought that still exists today, in a modified and updated form.

He proposed that the human mind is composed of three parts:

1. The id, which consists of instinct and forms the basis of the unconscious mind;
2. The superego, or moral component that houses our beliefs of right and wrong;
3. The ego, the mediator between the animal instinct of the id and the enlightened moral thought of the superego (Haggerty, 2016).

Freud hypothesized that these components grew out of certain stages in childhood development. He believed humans are born with the id, 
develop the ego as a toddler, and add the superego around the age of five. Freud’s hypothesis led him to the logical conclusion 
(based on his theory) that one’s personality is firmly rooted in their childhood experiences.

While Freud believed that each component formed in each human, the development of each component could be significantly influenced 
by one’s environment and family relationships. These factors could contribute to the development of a healthy sense of self and effective 
functioning, or they could trigger the development of neuroses and dysfunctional or distressing patterns of thought.

Whether the development led to positive or negative patterns of thoughts and belief, Freud held that that which truly drives human behavior 
is buried deep within the human mind, in what he termed the unconscious mind.

Freud theorized three levels of the mind:

1. The Unconscious: this level is where our instincts, deeply held beliefs, and many patterns of thought and behavior reside; 
	we are not consciously aware of anything at this level, but Freud believed the contents of the unconscious mind make up the vast
	majority of who we are, what we want, and how we behave in order to get what we want.
2. The Subconscious or Preconscious: this level is between the conscious and unconscious, and can be called up to consciousness 
	with a purposeful effort from the individual; the contents of this level are just below the surface of consciousness.
3. The Conscious: this is the level at which we are fully aware; Freud believed this was the level with the least defining 
	content, the level that makes up only a tiny sliver of who we are.

Based on this theory, Freud insisted that to truly address our issues and solve our problems, we must dig deep into the unconscious level. 
This is where we store our unspoken values, the beliefs we do not even realize we have, and the patterns of thought and behavior developed
in our childhood.

While psychodynamic theory has outgrown many of Freud’s simplistic ideas about human nature, many of the assumptions that underlie 
the psychodynamic approach are reminiscent of Freud’s work:

1. The unconscious mind is one of the most powerful drivers of human behavior and emotion;
2. No behavior is without cause—all behavior is determined;
3. Childhood experiences exert a significant influence on thoughts, emotions, and behavior as an adult;
4. Important conflicts during childhood development shape our overall personality as adults (Freud, 1899).

Freud’s theories directly support the methods of psychoanalysis, but also help form the basis of psychodynamic theory and inform the methods
and techniques used in today’s psychodynamic therapy.

Role of the Psychodynamic Therapist
Today, the role of the therapist in psychodynamic therapy is to work with the client to discover the bases for their symptoms.
The therapist plays this role by encouraging the client to talk about the emotions they are feeling and helping the client to 
identify recurring patterns in their thoughts, emotions, and behaviors.
They can aid the client in finding the significance of these patterns and discovering the effects they exert upon the client.
One of the most important roles of the therapist is to probe the client’s past. Discussion of the client’s childhood and early 
life experiences will likely take up a large portion of psychodynamic sessions, as this form of therapy assumes these experiences 
have a significant impact on the client’s current issues.
The therapist observes how the client interacts within the therapeutic relationship and add their own insight into the client’s 
relationship habits to the discussion.
The psychodynamic theory holds that how the client acts in the relationship with the therapist usually mirrors how they act in 
other relationships, such as with a parent or other important adult from their childhood (WebMD, 2014).
In general, the therapist’s role is to aid the client in connecting the dots between their past experiences and their current 
problems, and leverage their internal resources to address these problems.