What Is Psychodynamic Therapy?

Despite being one of the most popular forms of therapy, psychodynamic therapy is often somewhat misunderstood by its practitioners and their clients. Because the psychodynamic tradition was created by Sigmund Freud, psychodynamic therapy is often erroneously conflated with psychoanalysis. Also, the name itself can be misleading to many people due to its Greek roots. Let’s unpack it step-by-step.

While the “psycho” part is easy, the “dynamic” part of the name is often misinterpreted as referring to change, energy, or activity. However, Freud used the Greek root “dynamis” the same way it had been used in physics, namely as force. In other words, the term psychodynamic doesn’t describe psychological lability. Instead, it implies that any complex psychological phenomena can be attributed to the interplay or conflict between various mental forces, both conscious and unconscious. Among such forces, Freud named biological drives, psychological defenses, internalized societal expectations, and the mediating ego. Based on this personality theory—whose core tenets are alive and well to this day—Freud developed the therapeutic method called psychoanalysis, which didn’t age quite as well.

Freud’s original theory and, subsequently, psychoanalytic therapy focused primarily on sexual drives. Despite the later recognition of the death and life drives, Freud attributed most psychological dysfunction to a person’s failure to properly complete one of the childhood psychosexual stages: oral, anal, phallic, or genital. Modern psychodynamic approaches accept that a person’s sexual instincts are among the psychological forces that influence his or her behavior and mental state, but they are far from being the only forces doing so. For example, existential therapy, which is a distinct school of psychodynamic therapy, posits that such fundamental concerns as fear of death or the search for meaning are often the most powerful forces on a client’s mental stage.

Psychoanalysis is just one type of psychodynamic treatment, and a rather exotic one at that. What it has in common with the broader category of psychodynamic therapies that I practice is the attention to unconscious mental processes, early or traumatic life experiences, recurring patterns of thought and behavior, and the curative power of insight.

In practical terms, I prefer a more active stance that involves asking probing questions, suggesting early interpretations, and tactfully challenging avoidance. The goal here is to reveal the hidden force, whether sexual, existential, or of any other nature, and the potentially maladaptive coping strategy used by the client to blunt that force. After that, I help the client connect the two to the resulting psychopathology. As the client identifies the pathology-inducing force and pinpoints his or her suboptimal response to it, insight develops. For some people, understanding the source of their psychological distress is enough to launch them on the path of self-guided improvement. For those struggling with the practical implementation of the newfound insight, further guidance from the therapist may be beneficial.