Psychodynamic Therapy

What is psychodynamic therapy?

Psychodynamic therapy is a form of talk therapy that can reveal how buried thoughts and feelings shape your behavior and perception of the world. Psychodynamic therapy is interested in the role of the unconscious mind—that is, things that happen in your mind without your awareness.

By becoming more aware of unconscious thoughts and feelings, you can increase your self-awareness and make better decisions. Uncovering those buried or suppressed feelings can also be a cathartic experience.

Psychodynamic therapy can be a tool that leads to incredible revelations. For instance, the treatment might help you understand how past bullying has contributed to your low self-esteem or high anxiety. Or perhaps, during the sessions, you realize that you project feelings about an overbearing parent onto your spouse. You might discover that you avoid work promotions due to fear of failure, or you avoid conflict because you weren’t allowed to safely express your opinions as a child.

These insights can lead to transformative changes that improve everything from your relationships to your self-image. If you’re curious about this approach to psychotherapy, it can be helpful to learn more about its history, benefits, and limitations.

History of psychodynamic therapy

Psychodynamic therapy is one of the oldest forms of modern therapy. It has its roots in Sigmund Freud’s psychoanalysis model, which he developed in the 1890s. Freud proposed that subconscious forces, such as repressed memories, could contribute to psychological challenges and influence behavior. He believed that certain techniques could be used to uncover the unconscious, but his early approach was extremely intensive and required years of treatment, with each patient having multiple sessions per week.

Later, other psychologists, including Carl Jung, Anna Freud, and Alfred Adler, would build on this model. Modern-day psychodynamic therapy, a less intensive and more accessible approach to subconscious exploration, eventually emerged.

Principles of psychodynamic therapy

Psychodynamic therapy focuses on several principles. As mentioned, it considers the hidden aspects of your mind and how unconscious thoughts and feelings motivate your behavior. This type of therapy also emphasizes the importance of childhood experiences and their lasting impact on your approach to relationships and your sense of self. Moreover, the therapeutic relationship is an important element because only a safe environment will allow you to work through deeply ingrained conflicts and patterns.

Unconscious processes and influences

One of the core concepts in psychodynamic theory is that your daily thoughts, feelings, and actions are influenced by unconscious processes. Unconscious processes might be fears, desires, memories, or internal conflicts that are outside of your awareness. You suppress these processes because they feel overwhelming, shameful, and generally uncomfortable to acknowledge.

For instance, you might feel lonely, but don’t realize that an unconscious fear of rejection is steering you away from people. Or perhaps you’re mean to a coworker because, on some unconscious level, they remind you of your abusive sibling.

A common metaphor for the unconscious is an iceberg. The tip of the iceberg represents things within your awareness. However, the bulk of the iceberg—your unconsciousness—is actually hidden beneath the water. Psychodynamic therapists help their patients explore what’s beneath the surface.

Childhood experiences

Psychodynamic therapy is interested in how early life experiences shape your identity. Your past interactions with parents, other family members, or caregivers can influence your current self-image, personality, and your relationships with others.

For instance, maybe you struggle with low self-esteem and always assume that other people are silently judging your appearance. Psychodynamic therapy might help you connect those issues with unconscious memories from childhood—in this case, past instances of a parent body-shaming you in front of your siblings.

The therapeutic relationship

A key component of this therapy is the therapeutic relationship itself. An effective therapist will establish a safe space for you to talk openly without feeling judged or dismissed. If you don’t trust your therapist, you’ll likely go through sessions wth your guard up, which makes it harder to dig into the unconscious.

In psychodynamic therapy, your relationship with your therapist can also serve as a mirror for other relationships. The way in which you engage with them is reflective of how you engage with others.

Techniques used in psychodynamic therapy

Traditionally, psychodynamic sessions are conversational and flow without a set agenda. The therapist contributes to the conversation by asking questions to help you explore unconscious thoughts and offering support. However, it’s an open-ended process, so you can speak freely about whatever comes to your mind.

Psychodynamic therapists use a mix of techniques to help you uncover unconscious feelings and thoughts, as well as provide you with support throughout a session. The exact techniques and the order in which the therapist relies on them will depend on your specific needs.

Some common ones include free association, dream analysis, and transference analysis.

Free association

Free association is when a therapist encourages you to say whatever comes to your mind. The idea is that when you verbalize your thoughts and feelings without stopping to edit the content, unconscious content can emerge. It can be surprisingly difficult. People edit themselves all the time without realizing it.

However, any mental blocks you encounter during your session can also provide insight. Being unable to freely talk about something can indicate discomfort with the subject. And that discomfort could point to related unconscious thoughts and feelings. For instance, you might have difficulty talking about family vacations because you’re struggling with unresolved feelings toward family members.

Dream analysis

In psychodynamic therapy, dream analysis is another way to explore the unconscious. Contrary to popular misconceptions, neither you nor the therapist has to decode a dream or “know” what a dream means. You can think of dreams as a combination of memories and unconscious musings. You might stumble on some useful self-discoveries by focusing on different elements of the dream and drawing associations to possible unconscious content.

For instance, you might have a dream that involves feeling distant from your partner. However, in reality, your relationship feels smooth and easy. The dream might hint that some part of you is concerned that things are actually being felt unsaid, or that your partner is secretly holding something back.

Transference analysis

Psychodynamic therapists also listen for transference. Transference is when your positive or negative feelings toward your therapist are related to memories of previous relationships. In other words, it’s when you project past experiences onto your therapist. Transference can deepen your understanding of unresolved conflicts or other unconscious issues.

You might try to impress your therapist as if they were your mother with high expectations. Or maybe you feel the need to over-explain yourself, as if you were engaging with your dismissive older brother. By identifying transference and calling it to your attention, a therapist can help you become more aware of assumptions you place on others and patterns you tend to repeat in relationships.

Applications and effectiveness

Research has shown that psychodynamic therapy is often an effective form of psychotherapy. When used alongside other forms of psychotherapy, psychodynamic techniques may also improve the effectiveness of other interventions.

It can be used to treat various mental health conditions, including depression, anxiety, panic disorder, eating disorders, attachment issues, and relationship problems. It’s also been shown to help with personality disorders—conditions that involve deeply ingrained, unhealthy behaviors that are often hard to treat.

As is the case with other types of therapy, psychodynamic therapy has its limits. Its effectiveness can vary depending on the condition being treated. For example, less is known about its effectiveness when dealing with conditions like post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). So, it might not be used as a go-to intervention for these conditions.

Psychodynamic therapy vs. Cognitive behavioral therapy (CBT)

Psychodynamic therapy focuses on exploring how early experiences and unconscious feelings and thoughts influence you without your awareness. The sessions involve a deep exploration of the possible origins of and meanings behind your issues.

Cognitive behavioral therapy, on the other hand, is focused on immediately adjusting unhealthy thought patterns and behaviors. CBT sessions might seem more structured, more action-oriented, and come with more concrete goals. This approach is grounded in the present instead of the more reflective psychodynamic approach, and treatment might be shorter.

A therapist using psychodynamic principles might help you uncover how early experiences with a neglectful parent have made you less likely to seek help from others. A therapist using a CBT approach might give you exercises to identify and challenge unhelpful thoughts like, “Asking my partner for help is a sign of weakness.”

It’s important to note that most therapists use a combination of approaches. So, rather than choose between using psychodynamic techniques or a CBT approach, a therapist might use elements of both.

Benefits of psychodynamic therapy

Psychodynamic therapy requires a willingness to be reflective and vulnerable. However, it has far-reaching benefits that can improve self-esteem, relationships, and overall emotional well-being.

Self-knowledge and self-acceptance. A key benefit to this type of therapy is that you gain insight into your unconscious thoughts and feelings and how they affect your actions. Rather than believing that you’re “just naturally clingy,” you might learn to trace your behavioral patterns to specific childhood events.

Analytical skills. Even when your therapist isn’t present, you can use the knowledge you’ve gained during your sessions to better navigate new circumstances. For instance, you might enter into a new relationship knowing that you have difficulty trusting people and then express that to your partner in a healthy way.

Emotional processing and release. Exploring complex emotions and experiences in a safe space can eventually give way to feelings of relief. Psychodynamic therapy might help you work through internal conflicts or unresolved issues from the past.

Some research shows that these benefits continue long after treatment has ended. Psychodynamic therapy can lead to a lasting change in how you view yourself and relate to the world around you.

Criticisms and limitations

The limitations of psychodynamic therapy include:

Difficulty in measuring outcomes. Some aspects of psychodynamic therapy are subjective, so it’s hard to objectively measure progress and outcomes through randomized controlled trials. For instance, assessing how much self-awareness someone has gained during treatment can be difficult. Contrast this with methods like CBT, which have more straightforward treatment goalposts.

Length of treatment. Traditional psychodynamic therapy is an intensive, long-term treatment that requires several years’ worth of sessions. This can be expensive over time and might not be feasible for everyone. However, short-term psychodynamic psychotherapy models have emerged. Brief psychodynamic therapy sessions tend to focus on a single major issue in your life, rather than attempt to explore a wider range of concerns.

Benefits can take time. Although it helps you deepen your understanding of your inner workings, psychodynamic therapy alone may not prioritize immediate relief from your symptoms. However, it’s often combined with approaches that offer more practical coping strategies.

Not always available. If you’re looking for a therapist who specializes specifically in psychodynamic therapy, you might have to be patient with your search. You are more likely to find a therapist who is more experienced in other approaches, such as CBT. Once you find a psychodynamic therapist, the success of your treatment will hinge on how well you and the therapist connect.

Integration with other therapies

Psychotherapists often use a combination of therapy approaches. Because psychodynamic therapy allows you to develop a deeper understanding of yourself, it integrates well with other, more action-oriented therapies.

For instance, psychodynamic techniques might help you understand the roots of your anxiety. Then, your therapist can guide you through CBT practices, such as challenging negative thought patterns, or mindfulness skills, such as deep breathing, to manage anxiety in the moment.

Psychodynamic therapy can help you explore the types of early childhood experiences that contribute to your depressive moods. Then, the therapist could incorporate self-esteem-building exercises to help you cultivate a more positive view of yourself and interpersonal therapy to help you build social support.

The role of psychodynamic therapy today

Even though it’s older than other forms of psychotherapy, psychodynamic therapy remains a relevant approach to improving mental health. In fact, psychodynamic techniques are often used in tandem with other therapies because they encourage gentle self-reflection. As you begin or continue your therapy journey, remember that you don’t necessarily need to choose a single approach. Many providers will use a combination of therapy types, including this one.

Last updated or reviewed on July 31, 2025