There are generally considered to be two main theoretical bases for psychotherapy.

Psychoanalytic – based off of the work of Sigmund Freud, and has evolved since the late 1800s. The underlying idea is that there is an unconscious part of everyone’s mind that has a powerful and meaningful effect on our thoughts and everyday actions. By trying to examine the unconscious, a person can better understand their life and gain more control over the things they think, feel and do.

Cognitive Behavioral – focuses more on the present, accessible thoughts and behaviors of people rather than the subconscious and seeks to address them directly in order to make positive change.

Psychodynamic therapy focuses on the psychological roots of emotional suffering. Its hallmarks are self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient’s life. Its goal is not only to alleviate the most obvious symptoms but to help people lead healthier lives.

Various psychotherapies have been used to treat many conditions including mood disorders such as depression and bipolar disorder, Personality disorders, eating disorders, anxiety disorders, and addictions.

Psychotherapies are also used to treat people who may not have a diagnosed mental illness, but need help coping with some kind of life stressor, such as stress from work or family, dealing with disease or health problems, or any kind of major life change, such as the death of a parent, divorce or personal trauma.

Psychodynamic psychotherapy is effective for a wide range of mental health symptoms, including:

  • depressive disorders
  • anxiety disorders
  • somatoform disorders
  • eating disorders
  • substance related disorders
  • borderline personality disorder
  • Cluster C personality disorders

The process required for long-term psychodynamic therapy often takes at least 2 years of sessions. The goal of the therapy is centered around changing a particular part of someone's identity or personality. Brief psychodynamic therapy may happen through a more quick process, or an initial short intervention will start an ongoing process of change that does not need the constant involvement of the therapist.

Most psychodynamic approaches are centered around the concept that some maladaptive functioning is in play, and that this maladaption is, at least in part, unconscious. The presumed maladaption develops early in life and eventually causes dissonance in day to day life. Psychodynamic therapies focus on revealing and resolving these unconscious conflicts that are driving their symptoms. The psychodynamic therapist first intervenes to treat the discomfort associated with the poorly formed function, then helps the client acknowledge the existence of the maladaption, while working with the client to develop strategies for change.

Major techniques used by psychodynamic therapists include free association, recognizing resistance and transference, working through painful memories and difficult issues, catharsis, and building a strong therapeutic alliance. The client is encouraged to talk about childhood relationships with parents and other significant people, the primary focus being to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension.  

Pros for this therapy

Since psychodynamic therapy tries to address the root causes and the deeper issues of psychological problems, the benefits may be longer lasting instead of a quick fix. Patients who are experiencing general distress or anguish, issues with psychosomatic pain, and problems with personality traits such as work or personal relationship difficulties may particularly benefit. Patients may come away with a more complete picture of themselves and who they are.

Cons for this therapy

Contraindications for extended psychodynamic therapy include direct treatment for obsessive-compulsive disorder, the preferred treatment is behavioral therapy and medication. Patients who are actively abusing alcohol or drugs are also unlikely to benefit. Patients with schizophrenia may benefit from some of the principles of psychodynamic therapy, but will also generally require medication, hospital treatment, cognitive behavioral therapy, and supportive therapy as well. 

Psychodynamic therapy usually takes more time and more sessions than cognitive behavioral therapy. People who are reluctant to talk about their childhood may find it difficult.

The principles of psychodynamics were first introduced in the 1874 publication “Lectures on Physiology” by German scientist Ernst Wilhelm von Brücke. Brücke suggested all living organisms are energy systems, governed by the principle of energy conservation. During the same year, Brücke was supervisor to first-year medical student Sigmund Freud at the University of Vienna. Freud later adopted this new construct of “dynamic” physiology to aid in his own conceptualization of the human psyche. Later, both the concept and application of psychodynamics was further developed by the likes of Carl Jung, Alfred Adler, Otto Rank, and Melanie Klein 

Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual's sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialog, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Psychodynamic psychotherapy (also known as insight-oriented therapy) is a form of depth psychology (psychoanalytic approaches to therapy and research that take the unconscious into account), the primary focus of which is to reveal the unconscious content of a person's psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis. It also relies on the interpersonal relationship between client and therapist more than other forms of depth psychology.

The goal of the therapy is to help increase the patient's self-awareness and to help understand the influence of the patient's past on his or her present behavior

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Review Date: 
February 15, 2012