What is Psychodynamic Psychotherapy?

Psychodynamic psychotherapy is based upon the following broad principles and aims:

  • People are complex and creative meaning makers, and that much of the meaning we make occurs outside of our awareness. We are not, in other words, transparent to ourselves. There are things that we struggle to understand about our internal worlds.
  • Emotion is a key component of experience, and emotional competence is essential to well-being. In psychodynamic psychotherapy on "associative pathways generally lead to what is emotionally charged or problematic" (p. 39).
  • "Many psychological difficulties were once adaptive solutions to life problems. Difficulties arise when life circumstances change and the old solutions no longer work, or become self-defeating, but we continue to apply them anyway" (p. 15).
  • We naturally tend to "view the present through the lens of past experience, and therefore tend, despite efforts otherwise, to repeat and recreate aspects of the past" (p. 20). One goal of psychoanalytic psychotherapy is to "loosen the bonds past experience to create new life possibilities "(p. 21).
  • Good therapy replicates life. "It is specifically because old patterns, scripts, expectations, desires, schemas (call them what you will) become active and ‘alive' in the therapy sessions that we are able to help patients examine, understand, and rework them" (p. 23). A unique aspect of psychodynamic approaches to psychotherapy is, therefore, attention to what is conventionally called "transference" and "countertransference."
  • Ambivalence is a common and natural state of mind. People who come for psychotherapy tend to be ambivalent out it, "oscillating between the desire to change and the desire to preserve the status quo" (p. 33).
  • Wisdom embraces paradox or, put another way, "the ability to hold two contradictory ideas in mind at the same time and still continue to function" (George Bernard Shaw, cited in Shedler). "Psychoanalytic psychotherapy seeks to cultivate just this form of wisdom" (p. 15).
  • Psychotherapists treat persons, and persons are more than a conglomeration of symptoms or clinical syndromes. "Psychoanalytic therapy is not something done to or practiced on someone; it is something done with another person" (p. 43, italics in original). Also, "the concepts and insights we apply to our patients apply equally to ourselves" (p. 43). And it takes work and practice to apply them.
  • An important goal is freedom. Psychoanalytic psychotherapy helps us recognize the ways in which we disavow aspects of our experience, with the goal of helping us to claim or reclaim what is ours. These leads to greater freedom, flexibility, and wholeness.
  • Psychoanalytic psychotherapy works. The scientific evidence base for its effectiveness is strong. Additionally, far from discrediting core psychoanalytic assumptions, research in cognitive science and neuroscience has provided an empirical foundation for many of those assumptions.

This list is adapted from Shedler, J. (2006). That was then, this is now: Psychoanalytic psychotherapy for the rest of us. Retrieved from http://psychsystems.net/shedler.html

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