Thoughts and Ideas Related to Psychodynamic Therapy

The following are some concepts which might be helpful as you begin your psychodynamic therapy process, or if you are still unsure about what it is, how it works, and why you might want to start.

The Psychodynamics of Personality

The psychodynamic approach to therapy begins with the idea 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 ourselves 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, my approach to 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

As a psychodynamic therapist, I always try to use 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 is not easy, and the ability to tolerate bad feelings is a complex skill that cannot be learned in one or two sessions. Every stage of any learning process needs many repetitions and many variations in order for the new ability to become an 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 no way to predict how many sessions you will need. A large part of my job as a therapist is to try and make our 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.