Approaches / Psychodynamic
Psychodynamic therapy
A group of approaches, rooted in psychoanalysis, that explore whether earlier experience and processes outside awareness influence present life.
Overview
Psychodynamic therapy is a broad term for approaches that grew from psychoanalysis. They explore feelings, relationships and patterns that a person may not be fully aware of, often with attention to earlier experience.
Core ideas
Common themes include the influence of unconscious processes, defences, early relationships and the relationship with the therapist. Transference, meaning feelings brought into the therapy from other relationships, is a central concept.
Theories differ between schools, including drive, ego, object relations, self psychology and attachment-informed approaches.
What a session can involve
Sessions are usually open-ended conversations in which the person speaks freely and the therapist listens for patterns, which they may reflect back. Short-term models set a focus and a limited number of sessions.
Formats and settings
Psychodynamic work ranges from intensive psychoanalysis to once-weekly or short-term therapy. It is offered individually, in groups and in services for children, adults and families.
How it relates to other approaches
Interpersonal psychotherapy shares some of its interest in relationships. Gestalt and person-centred therapy arose in part as responses to it. Attachment theory, developed by John Bowlby, has influenced both psychodynamic and other approaches.
Limits and open questions
Some concepts are difficult to test, and critics question how far claims about the unconscious can be checked. Waiting lists for long-term work can be long.
For a new episode of depression in adults, the NICE guideline lists short-term psychodynamic psychotherapy among several treatment options for both less severe and more severe depression. It emphasises a shared decision based on the person’s needs and preferences. Guidance elsewhere should be checked.
History
Sigmund Freud and Josef Breuer published Studies on Hysteria in 1895. The field later diversified through the work of Anna Freud, Melanie Klein, Donald Winnicott, Heinz Kohut and others.
Key people
Sigmund Freud, Anna Freud, Melanie Klein, Donald Winnicott, Heinz Kohut and John Bowlby are among the figures linked to psychodynamic thought.
Sources and inspection notes
Supports: An introductory description of the approach from a UK professional body.
NICE, Depression in adults: treatment and management (NG222)
Supports: Recommendations for a new episode of depression in adults, including short-term psychodynamic psychotherapy among treatment options and shared decision-making (England and Wales).