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  • Writer's pictureDr. Maura Ferguson

What is psychodynamic psychotherapy?



You may have heard the term psychodynamic or psychoanalytic psychotherapy and wondered what it is and what it could offer you.


Psychodynamic or psychoanalytic psychotherapy is confusing to many people as they are not forms of therapy that have received as much publicity and promotion as other evidence-based treatments. Yet, there exists a hunger among therapists and the public alike for a comprehensive way of understanding ourselves and others that represents an alternative to the reductionistic biological treatment approaches that view people simply as a collection of neurotransmitters or as a constellation of symptoms to be managed or eliminated.


Psychodynamic therapy is an interpersonal, collaborative process that takes place between a therapist and a *patient to understand better how a person came to be who they are and make the choices they make every day about their work, relationships with friends, co-workers, and family members. In other words: Psychodynamic and psychoanalytic theory is complex and diverse but tends to operate on the following assumptions:

  • Parts of ourselves, our thoughts and feelings, are not fully known to us and occur outside of our unconscious awareness. Psychologists also refer to these processes as implicit or procedural forms of memory. Sometimes the things we are unconscious of affect how we behave in a way that can limit our choices.

  • We can have two or more feelings about something at the same time. Sometimes these feelings and motives can be overwhelming, confusing and make us feel stuck. For example, we may want closeness with another person but fear depending on others. We may want and fear something simultaneously and not understand why. Feeling different things at once can create a cognitive dissonance that can be paralyzing.

  • The past affects us in the present. We tend to repeat patterns that we learned in the past. Repetitive patterns can be most noticeable when people find themselves having the same kind of relationship over and over again. Past experiences inevitably influence our perceptions, interpretations and reactions until we bring awareness to them.

  • Transference, the idea of transference, is inextricably linked to the previous tenants of psychodynamic theory. We tend to experience people in the present as essential people from our past. In the context of therapy, there is a compelling pull to experience the therapist in the same way that we felt about our parents or early caregivers. Working through the feelings evoked by the therapist can be a unique and productive part of therapy.

  • Defence. We defend against things that we don't want to know. We may find ways to distract ourselves from addressing such uncomfortable truths. Sometimes those defences can be critical coping skills. At the same time, other times, coping skills can become maladaptive. They can tip into something that harms us or prevents us from seeing something critically important. Over time, our defences can become so habitual that they can become part of our personality unless someone helps us to see them and find new ways of coping.


Psychodynamic therapy aims to expand our awareness of the causes of our thoughts and feelings to offer people more freedom of choice. People can change and often do in profound ways and lasting ways. Psychodynamic and psychoanalytic therapists apply these theoretical concepts to themselves as well as to their patients, which is partially why this type of therapy was on the wane (it is experiencing a resurgence in many areas): the effective and nuanced practice of psychoanalytic psychotherapy requires a long and intensive period or education and training including an emphasis on the importance of the supervisory and teaching relationships as well as the therapist engaging in a therapeutic themselves that allows them to be more aware of their unconscious lens.


Psychoanalytic psychotherapy may not be for everyone. In my professional experience, I have found that people often come to this type of treatment because their life experiences and distress do not fit neatly into a diagnostic box. Sometimes people come to this type of therapy from a personal referral or because they have experienced other forms of treatment that were only effective for a limited time but didn't get to the root of the problem. It is easier to know if this type of therapy is for you by experiencing it; a skilled and seasoned clinician will generally offer to meet with you, depending on their availability, so you can get a feel for how it feels. Discussing your hopes and fears about psychotherapy can be a vibrant starting point.


*Some people object to the term patient. The word patient means "one who suffers." I use this word consciously to honour the fact suffering is a universal human experience and acknowledge psychotherapy's seriousness. If the term troubles you, please substitute "client" as neededYou may have heard the term psychodynamic or psychoanalytic psychotherapy and wondered what it is and what it could offer you.


Psychodynamic or psychoanalytic psychotherapy are confusing to many people as they are not forms of therapy that have received as much publicity and promotion as other forms of evidence based therapies. Yet, there exists a hunger among therapists and the public alike for a comprehensive way of understanding ourselves and others that represent an alternative to the biological reductionistic treatment approaches that view people simply as a collection of neurotransmitters or as a collection of symptoms to be managed or eliminated.


Psychodynamic therapy is an interpersonal collaborative process that takes place between a therapist and a *patient to better understand how a person came to be who they are and to make the choices that they make every day about their work, their relationships with friends, co-workers, and family members. In other words: Psychodynamic and psychoanalytic theory is complex and diverse but tends to operate on the following assumptions:

  • Parts of ourselves, our thoughts and feelings are not fully known to us and occur outside of our unconscious awareness. Psychologists also refer to these processes as implicit or procedural forms of memory. Sometimes the things that we are unconscious of affect the ways that we behave in a way that can limit our choices.

  • We can have two or more feelings about something at the same time. Sometimes these feelings and motives can be overwhelming, confusing and make us feel stuck. For example, we may want closeness with another person but fear depending on others. We may want and fear something at the same time and not understand why. This can be paralyzing.

  • The past affects us in the present. We tend to repeat patterns that we learned in our past. This can be most noticeable when people find themselves having the same kind of relationship over and over again. Past experienced inevitably influence our perceptions, interpretations and reactions until we bring awareness to them.

  • Transference the idea of transference, is inextricably linked to the previous tenants of psychodynamic theory. We tend to experience people in the present as important people from our past. In the context of therapy, there is a strong pull to experience the therapist in the same way that we felt about our parents or early caregivers. Working through the feelings that are evoked towards the therapist can be a unique and productive part of therapy.

  • Defense. We defend against things that we don't want to know. We may find ways to distract ourselves from addressing such things and sometimes those defences can be critical coping skills while other times they can tip into something that harms us or prevents us from seeing something critically important. Over time, our defences can become so habitual that they can become part of our personality unless someone helps us to see them and find new ways of coping.

Psychodynamic therapy aims to expand our awareness of the causes of our thoughts and feelings to offer people more freedom of choice. People can change and often do in profound ways and lasting ways. Psychodynamic and psychoanalytic therapists apply these theoretical concepts to themselves as well as to their patients, which is partially why this type of therapy had been on the wane (it is experiencing a resurgence in many areas): the effective and nuanced practice of psychoanalytic psychotherapy requires a long and intensive period or education and training including an emphasis on the importance of the supervisory and teaching relationships as well as the therapist engaging in a therapeutic themselves that allows them to be more aware of their own unconscious lens.

Psychoanalytic psychotherapy may not be for everyone. In my professional experience, I have found that people often come to this type of treatment because their life experiences and distress do not fit neatly into a diagnostic box. Sometimes people come to this type of therapy from a personal referral or because they have experienced other forms of therapy that were effective to a point but didn't get to the root of the problem and address the source of the symptoms they were experiencing. It is difficult to know if this type of therapy is for you without having experienced it; a skilled and seasoned clinician will generally offer to meet with you, depending on their availability, so you can get a feel for how it feels to you. Discussing your hopes and fears about psychotherapy can itself be a very rich starting point.


*Some people object to the term patient. The word patient means "one who suffers". I use this word consciously to honour that suffering is a universal human experience and to acknowledge the seriousness and privileged nature of therapeutic treatment. If the term troubles you, please feel free to substitute the term "client" as needed.





Seven principles of Psychoanalytic Psychotherapy by Jonathan Shedler (video):


The Therapeutic Relationship in Psychodynamic Psychotherapy vs CBT by Jonathan Shedler (Article):






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