Psychodynamic Psychotherapy and Depression

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How Psychodynamic Psychotherapy Works

Psychodynamic psychotherapy is a form of therapy that has roots in psychoanalysis. Psychodynamic psychotherapy, also referred to as insight-oriented therapy, focuses on the uncovering of unconscious conflicts, fantasies, fears and so on, that are causing problems in the patient’s current behavior or emotional state. The theory is that by bringing these processes to light, they lose their hold on the patient, who is thus able to implement changes in his or her behavior. Though uncovering these unconscious processes, the goal is for the client to develop enough insight into their problems from the past in order to see how they are manifesting in the present. There are four main schools of psychodymanic psychotherapy, namely Freudian, Ego Psychology, Object Relations and Self Psychology. Therapists may choose to work based on one or a combination of several of these schools of thought.

People who are depressed often suffer from unconscious mental conflicts, relationship difficulties, unresolved childhood issues or abuse. In psychodynamic psychotherapy, the therapist works with the client by acting as a blank slate onto whom the patient can transfer their unresolved thoughts and conflicts from the past. The process is known as transference, which is one of the most important tools a psychodynamic psychotherapist employs. The therapist then interprets these projected beliefs or feelings back to the client, in an effort to facilitate the development of insight. One of the main themes that the therapist might work on include the patient’s need or desire to repeat the past, for example, through maintaining their current, dysfunctional relationship patterns. This is beneficial to the patient because through the development of insight, the patient becomes empowered to take control over their lives or the unconscious processes contributing to the depression may be resolved or alleviated. Additionally, the patient’s relationship with the therapist plays a large role. Through the development of trust and the therapist’s empathic responses, the patient learns, to an extent, to develop trust in the outside world and to develop hope for the future.

Psychodynamic Psychotherapy Treatment

Psychodynamic psychotherapy is usually a long-term undertaking, although short-term psychodynamic psychotherapy, known as brief dynamic therapy, is also employed by some practitioners in certain circumstances. In general, during your first session, the therapist will ask you what your presenting problem is, that is, why you are seeking treatment at this time. They may ask you for some background information, although most therapists will actually say very little, encouraging the “stream of consciousness” or free association. The use of silence is actually a tool that therapists will employ in order to get to the uncovering of unconscious fears or neuroses.

The length of time that you can expect to be in treatment varies from client to client, based on your issues and your capacity for developing insight and change. Some patients remain in treatment for several years, some people are “life-long” therapy addicts. Depending on your insurance coverage and personal financial status, psychodynamic psychotherapy can be a costly undertaking and you may be in it for the long haul. However, the benefits are most evident for clients who have the ability and desire to understand themselves and their unconscious conflicts causing their depression. People who are looking for a “short-term fix” may be disappointed or frustrated by this process.


Netdoctor: Psychodynamic Psychotherapy:

“Concise Guide to Psychodynamic Psychotherapy”; Robert J. Ursano, Stephen M. Sonnenberg and Susan G. Lazar; 2004