The psychodynamic approach to therapy begins with the premise that our personalities and actions are the result of the changes and movements (the dynamics) of psychological energy. This means that our personalities and experiences are fluid, adaptable, and ever-changing.
At the same time, this energy flows in patterns and along pathways that are partly natural disposition, but also the direct result of learning and life experience. Most importantly, because of this tendency to do things as we are used to doing them, we often seem to get stuck in a rut, and our attention and efforts can become fixated on particular events in the past, particular interpretations of words and actions, and specific self-protective behaviours. This often leads us to responding to new events as if it was the past, ie. in ways that don’t line up with what is actually happening.
At its simplest, this is how psychodynamic theory understands emotional distress and unhealthy coping. Common experiences like depression, anxiety, and even our strangest fantasies are understood as patterns of thought and action which contain, limit, and protect us from our emotions, and block our ability to adapt flexibly and feel safe with the fact that everything in life is always moving and always changing.
Self-Protection
Emotional pain is real pain, and we don’t like pain. As simple as that is to say, and as silly as it may sound—pain is bad. This is by far the most important and helpful idea in the psychodynamic approach: our problematic and “crazy” habits and behaviours are actually ways of
- protecting ourselves from emotional pain
- expressing the fact that we are in pain or that we feel unsafe
In other words, the famous “defence mechanisms” like denial, repression, and projection are psychological tools we use to manage our emotions and stop us having to endure experiences which cause pain. In particular, the actions we take towards other people can be understood this way, too. “Oversensitivity” and erratic behaviour, clinginess and neediness, lying and cheating, controlling and micro-managing, avoidance and dismissiveness.
We also do this towards the world more generally. Anxiety and hyper-awareness of danger, apathy towards things you know you should care about, as well as greed, hoarding, and acquisitiveness—these are all ways of protecting ourselves from the pain of abandonment, rejection, disappointment, and all of the other things that make us hurt.
Psychodynamic theory argues that everyone uses these tools all the time, and that “mental illness” is not illness per se, it’s simply that we’ve come to rely too heavily on only one or two of these tools. This means that emotionally, we spend a lot of life trying to eat soup with a fork, and wondering why we’re so hungry all the time.
As the old saying goes, if all you have is a hammer, everything starts to look like a nail…
Striving for Health
The upshot is that most of the time, even the weirdest and most frustrating “bad habits” are actually the person trying to help themselves, but not knowing how to do it in any other way. So they are not “exhibiting maladaptive behaviours,” they are striving for health.
The goal of psychodynamic therapy, therefore, is to help you strive in a way that fits better with both your own personality and the reality of world you live in. This means managing events and emotions in a way that makes your life better, not worse.
Starting from this perspective, then, psychodynamic therapy works towards finding the answers to the following questions:
- What are you suffering from?
- What emotional tools are you using to help yourself?
- Why do you use that particular set of tools?
- Where or from whom did you learn them?
- How well are they working?
- What tools would be more effective?
Talk Therapy
Talking these things through might seem like ‘just talking’ but there is a lot more going on than you might think. Speech is not the only way of exploring these questions, but talking allows us to express thoughts and emotions in a way that others can clearly understand, or figure out why we might not be able to express or even feel them in the first place. It also helps us:
- feel safe in our surroundings
- signal empathy and understanding and establish trust
- confirm that we are percieving people and events correctly
- make sense of confusing or painful memories
- prepare for future experiences we’re not sure how to handle
- normalize so-called ‘weird’ thoughts
A psychodynamic therapist uses the emotional power of speech not simply to help you understand yourself, but to soothe distress and resolve anxiety, to encourage mental and emotional flexibility, and to support and maintain the development of new emotional tools, new ways of thinking and feeling. Most importantly, it is in itself healing to have someone non-judgemental to talk to about things that frighten you or which you fear might push other people away.
Process Focused Therapy
To use another old expression, the proof of the pudding is in the eating. The same is true of psychodynamic therapy: the most important part of the process is the process itself.
A science-like approach using measurements, prediction, and goal setting can sometimes seem helpful and enlightening, but more often than not it interferes with the actual mental and emotional healing of therapy—ie. it reinforces already problematic defence mechanisms. Which is to say, most people are already experts at setting expectations that are too explicit, to high, and too rigid, pushing themselves to the breaking point to achieve them, and then punishing themselves harshly for “failing” to live up to these impossible demands.
This creates what is effectively a self-fulfilling prophecy of failure and low self-esteem. By setting all of these expectations aside and allowing the conversation to go as it goes, and focusing on the things you are actually feeling right now, the emotional work itself becomes much easier and more effective—because you are not continually interrupting yourself with judgements and criticisms.
As mentioned, most unhealthy and problematic defences are exactly this, our best attempt at living up to unachievable expectations while also trying to prevent ourselves from failing. The only way to resolve this emotional paradox is intentionally learning to tolerate ambiguity: talking about what you need to talk about, without worrying whether it’s the “right thing,” “important enough,” or contributing to your “forward progress.”
Long-Term Repetition
There are exceedingly few people who can learn to play piano in 12 weeks. The same is true of learning to tolerate and manage thoughts and emotions. Building confidence in our ability to tolerate bad feelings is not an easy skill to learn, and the above process needs many repetitions and many variations in order for it to become a automatic part of our everyday experience. This is why the psychodynamic approach is considered a long-term therapy. It takes time and it cannot be rushed.
You won’t be on the hook for the rest of your life, but there is way to predict how many sessions you will need. A large part of your therapist’s job is to try and make your work together efficient and effective, but, ultimately, it takes as long as it takes. As mentioned above, having rigid expectations interferes with your ability to do the emotional work you need to do. Beating yourself up and stressing yourself out for “taking too long” will only make the process take longer.
Working Through
Many people find that they need to talk about the same person or event over and over again, and worry that they’re being boring or obsessive. In fact, this is a natural and expected part of the process, particularly when they have experienced trauma and/or neglect. This stage of the process is called “working through” and many therapists and theorists consider it the heart of all effective therapy.
The most important thing to remember is that the impulse to repeat is a sign that whatever it is, it’s important for you. There’s something there that you need to figure out, and so that’s what you need to talk about, whether it’s once, or a thousand times.
Summary
Ultimately, psychodynamic therapy is about emotions and how they influence and motivate the things we do and say, most of the time without us even noticing. When we find that we are afraid where we don’t need to be, or aggressive when it’s not appropriate, or depressed when we have no reason to be, there is always an explanation and a way in which it makes sense. This requires us to start paying attention to what we are feeling, and to accept those feelings as they are, whatever they may be.
The method of psychodynamic therapy is to actively seek insights into and explanations for emotions, questions, and actions we either ignore or take for granted because “that’s just the way I am.” The one and only goal is to look at these unexamined feelings and ideas without judging or making excuses, so that you can decide for yourself if, what, and how to change.
Your therapist’s job is to be the mirror that helps you see yourself and cultivate this new perspective on your relationships, and who and how you want to be for others.
This takes time, repetition, and it can be hard work. After all, we get stuck in our protective patterns for good reasons, and it can be difficult to believe that a new way of doing things will actually work. But if you can trust the process, and yourself, it does, and it will.