Psychodynamic Therapy

Providing Psychodynamic Therapy in NYC

Psychodynamic psychotherapy is rooted in traditional Freudian analysis and was developed as a less time intensive, modernized version of psychoanalysis. Similar to psychoanalysis, the aim of psychodynamic therapy is to help people gain insight into their lives and problems. Several studies have supported the use of psychodynamic psychotherapy for the treatment of personality disorders, major depression, anxiety disorders, and eating disorders. During the treatment, the therapist attempts to learn about your mental life, both conscious and unconscious, and identifies recurring patterns of behavior and beliefs that interfere with your well-being and functioning. Attention is paid to early childhood experience, emotions, beliefs, fears, dreams and fantasies. Psychodynamic psychotherapy distinguishes itself from problem-based therapies, such as Cognitive Behavioral Therapy (CBT), by exploring repressed or unconscious needs, urges, and desires.

What to Expect in Psychodynamic Therapy

Psychodynamic psychotherapy does not utilize the typical analyst couch, but rather the patient and therapist sit facing one another. The patient is encouraged to speak freely and openly while the therapist remains neutral albeit supportive. During sessions, your therapist might take notes and ask clarifying questions. The therapist will thoughtfully listen for self-destructive patterns and beliefs that are often formed in early childhood and unconsciously impact your life and world view. A psychodynamic therapist works with you to recognize these unconscious behavioral patterns and prevent them from inhibiting your potential.

One of the most important aspects of psychodynamic therapy is a thorough history and probing of a client’s past, specifically early childhood experience. These events are foundational to the work and theoretically have a profound impact on adult behavioral patterns. The goal is not to analyze for the sake of analyzing, but rather to learn how developmental trauma or patterns might get in the way of current life progress.

Principles and Techniques of Psychodynamic Psychotherapy

Freud and the Different Levels of the Mind

As mentioned above, psychodynamic therapy has its roots in psychoanalysis, originally developed in the late 19th century by Sigmund Freud. Freud hypothesized that the mind is composed of three parts: the id, the superego, and the ego. The id consists of the unconscious part of the mind that impulsively responds to basic urges and needs. It contains sexual and aggressive drives and hidden memories. The id remains infantile and does not change with time and experience. It is unaffected by logic and reality. The ego is the part of the mind that mediates between the unrealistic and illogical id and the outside world. The ego considers social realities and norms and postpones urges to avoid negative consequences. The superego’s function is to tame the impulses of the id, so that the ego can function within societal norms. It acts as a gatekeeper for the carnal and violent urges of the id, confining it within accepted morals and values.
The primary goal of psychodynamic therapy is to gain a greater understanding of the different levels of the mind and how unconscious conflicts affect your mental life and functioning.

Free Association

During free association, the therapist creates a safe environment where the patient is allowed to speak freely and openly about whatever comes to mind. In this way, the patient drives the discourse, and the therapist’s role is to listen carefully to the content while pointing out relative conflicts and areas for greater exploration and awareness. During this process, the client moves freely from one topic to the next. By following the client’s lead, the therapist uncovers unconscious feelings and beliefs that lead to psychological growth and evolution.

Defense Mechanisms

Defense mechanisms are unconscious strategies used to protect an individual from psychological distress resulting from unacceptable thoughts and feelings. Defense mechanisms are natural and normal, but when used inappropriately and/or with frequency, can result in unhealthy life choices. Denial is a common and colloquial defense mechanism. If a problem overloads an individual’s mental resources, a person may respond by unconsciously refusing to see it or deny that it exists. Many people might use denial in their everyday life, but in the extreme, denial results in impactful mistakes, such as refusing to see a spouse’s infidelity, not preparing for one’s financial future, or studying for an exam. Another common defense mechanism is projection. This occurs when an individual attributes unwanted thoughts, feelings, or motives to another person. For example, if you dislike someone, but your superego finds those feelings unacceptable, you might unconsciously “solve” the problem by believing that he or she hates you. In psychodynamic therapy, your therapist will help you understand when you are using defense mechanisms to protect yourself and identify when they impair your choices and behavior. By bringing awareness to these unconscious patterns, you can make more deliberate and meaningful decisions about how to handle challenging or potentially threatening situations.

Tools for Accessing Unconscious

During sessions, your therapist will listen for gateways to your unconscious mind. For example, “slips of the tongue” occur when you say something accidentally. You might mistakenly say “thanks Mom” to your boss when she unconsciously reminds you of a parental figure. An additional way your therapist might prove your unconscious is through dream interpretation. During this process, the therapist will ask to hear about your dreams and disentangle the “manifest” content from the “latent” content. The manifest content is what you typically remember, for example the plot and story of the dream. The latent content is what lies beneath the surface, often an expression of the id and holding a deeper meaning.

Psychodynamic therapy has a rich tradition in Freudian thought, but it is more accessible and modernized for today’s world. It can be used to help solve deep seated and destructive patterns of behavior. After completing psychodynamic psychotherapy, many clients feel more at ease, more capable of healthy relationships and clearer about their long-term goals and potential. If you are interested In psychodynamic therapy, The Midtown Practice (TMP) has several skillful clinicians that can explore this option with you and determine if it is an appropriate treatment for what you are experiencing.

Resources

• de Maat S, de Jonghe, Schoevers R, Dekker J. The effectiveness of long-term psychoanalytic therapy: a systematic review of empirical studies. Harv Rev Psychiatry. 2009;17:1-23.

• Mcleod, S.A. (2019, September 25). Id, ego and superego. Simply psychology.

• Mcleod, S.A. (2017). Psychodynamic approach. Simply psychology.