Psychodynamic Psychotherapy

by Krystal Williams
Reviewed by Dr Sheri Jacobson

Psychodynamic therapy offers you a private, confidential space to gain a deeper insight into your thoughts, behaviour and difficulties and how they link to your earlier experience. In doing so, you can discover new perspectives and lead a more fulfilling life.

Maybe you are experiencing distress, anxiety or worry that no longer feels manageable. Perhaps you are not sure why you keep finding yourself in unsatisfying relationships or engaging in the same unwanted behaviours. Psychodynamic therapy can help you explore and understand what is going on for you in a safe space.

What is psychodynamic psychotherapy?

The psychodynamic approach recognises that your feelings of distress and problems in the present may have connections to your early life experiences.

The goal of psychodynamic therapy is not to dwell on the past but to explore how prior relationships and attachments may provide insight into current psychological problems. By understanding these links, you can make better sense of your situation and find new ways of perceiving the world, yourself and your relationships.

From an early age, we learn ways of coping that continue to influence how we relate to others and how we manage difficult emotions throughout our lives.

Psychodynamic therapy provides a confidential and safe space to explore your feelings and experiences. Your feelings, thoughts, and even dreams can all be thought about to help you to gain a deeper understanding of your internal world and the unconscious processes behind how you relate to yourself and others. The aim of this is so that past experiences and repressed emotions interfere less with your ability to lead a fulfilling life in the here and now.

Unlike short-term cognitive-based therapies, the focus is on why you behave the way you do (as opposed to how to learn new techniques), and there is no homework. While psychodynamic therapy tends to be long-term, time-limited psychodynamic psychotherapy is increasingly popular. Often psychodynamic therapy in a community or charity setting will be limited to between six weeks and one year.

How effective is psychodynamic psychotherapy?

Psychodynamic psychotherapy is one of the main therapy approaches used to treat issues such as depression in the NHS, alongside CBT, CAT and interpersonal therapy.

Psychodynamic therapy can help you to relieve your symptoms and make lasting changes to your life through self-discovery, with the aim of living more freely on your own terms.

The Journal of the American Medical Association published a meta-analysis of multiple studies demonstrating that long-term psychodynamic therapy is very effective for a range of complicated mental health conditions.

A meta-analysis by the Cochrane Collaboration found that when compared with controls (a waiting list, minimal treatment, or treatment as usual), short-term psychodynamic therapy significantly improved symptoms. The results also suggested that psychodynamic therapy led to lasting psychological changes that yielded more benefits as time went on.

These findings were echoed by another meta-analysis published in The Journal of the American Medical Association, which concluded that patients continued improving after long-term psychodynamic therapy ended and that patients with complex psychiatric disorders were significantly benefited.

What can psychodynamic psychotherapy help with?

Psychodynamic therapy has been shown to help with a variety of issues including:

  • anxiety and stress
  • relationship issues
  • sexual difficulties
  • trauma
  • depression
  • phobias
  • eating issues and disorders
  • addiction
  • low self-esteem
  • abuse
  • personality disorders
  • grief and bereavement
  • recurring or long-term issues
  • loss of purpose or lack of fulfilment
  • dissociation
  • anger
  • identity, such as race or gender
  • workplace conflicts, including bullying and discrimination
  • self-harm

How does psychodynamic psychotherapy work?

In a safe, non-judgmental environment, you will explore your feelings and emotions, including those that trouble you. You may be encouraged to say whatever comes to mind (also called free-associating) so that you can access thoughts that might otherwise remain outside of your awareness.

Perhaps you are able to explain the reason for your emotional difficulties rationally or psychology. This does not mean that you feel capable to do anything about them. Psychodynamic therapy can help you to develop new internal resources to deal with these difficulties and find more flexible ways of coping.

You and your therapist will also work with the feelings and responses you have towards your therapist in the present that echo feelings towards significant others from your past. These could be negative feelings of dislike and mistrust or positive feelings of care and concern. By recognising these feelings, and the similarities they have to your relationships elsewhere, you can gain new insights into your perception and more freedom to make choices that better serve you.

Relationships are a significant part of psychodynamic therapy, which makes this therapy very helpful if you are experiencing relationship difficulties in any area of your life. The psychodynamic approach recognises that often psychological difficulties can stem from us relating to others in ways that interfere with our ability to have our emotional needs met. Psychodynamic therapy can help you to find new ways to resolve or cope with such difficulties better.

What can I expect from psychodynamic psychotherapy?

  • relief from symptoms
  • improved self-esteem
  • identifying patterns in your behaviour and thinking and understanding why they keep recurring and what emotional blocks there are to change
  • gain emotional insight
  • improved relationships
  • greater insight about your unconscious conflicts
  • increased self-awareness about your feelings and motivations
  • more flexibility in how you react to and manage difficult emotions
  • greater capacity for dealing with psychological issues

An experienced therapist or counsellor like those listed on the Harley Therapy platform can help you to manage your symptoms and find your own way forward.

Unfortunately, there are currently long waitlists for talking therapy in the NHS, however, you can refer yourself for talking therapy using the Improving Access to Psychological Therapy NHS initiative if you are a UK resident. If you are able to, you can book a psychodynamic therapist privately using this platform for an appointment as soon as tomorrow.


De Maat S, et al. "The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies," Harvard Review of Psychiatry (Jan.–Feb. 2009): Vol. 17, No. 1, pp. 1–23.

Shedler J. "The Efficacy of Psychodynamic Psychotherapy," American Psychologist (Feb.–March 2010): Vol. 65, No. 2, pp. 98–109.

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