Psychodynamics: Treating Mental Illness at the Source

Facing a mental health issue can be painful, frustrating, and demoralizing (both to the individual contending with it directly, and to those around them). Many patients wary of invasive procedures or the side effects of medication opt for treatments with greater tolerability.

Among these more tolerable options are Deep Transcranial Magnetic Stimulation (or Deep TMSTM), a noninvasive, FDA-cleared medical device treatment that utilizes electromagnetic fields to regulate neural activity found to be related to depression, anxious depression, obsessive-compulsive disorder (or OCD), and smoking addiction. Due to its noninvasive nature, Deep TMSTM does not necessitate the use of anesthesia, and does not cause any long-lasting or severe side effects. It can also be combined with other forms of treatment, for enhanced, overall efficacy.

Another route, which may be combined with either medication or Deep TMS, is psychodynamic therapy, a main branch in the larger field of psychotherapy, whose definitive feature is verbal communication. Psychodynamic therapy (or psychodynamics) has been shown to offer much-needed support and symptom alleviation for a variety of conditions. But what is psychodynamic therapy, and in what cases has it been proven to help? Read on to find out.

what is psychodynamic therapy

Psychotherapy: A Short Definition

As stated above, psychodynamics is a form of psychotherapy, otherwise known as talk therapy. The most succinct psychodynamic therapy definition highlights conversation as the key element to this form of therapy, which allows patient and therapist to consider the thoughts, emotions, beliefs or wishes the patient holds within them, which may cause them adverse emotions, or hinder their quality of life in different ways.

Psychodynamics evolved out of psychoanalysis, a more intensive form of psychotherapy that aims to examine the seemingly illogical or detrimental responses, mechanisms and patterns carried out by the patient (here called analysand) to factors, objects or individuals in their lives.

According to the American Psychological Association (APA), the main distinction between psychoanalysis and psychodynamics lies within their individual settings. Psychoanalysis usually includes three-to-five sessions a week, compared to psychodynamics, whose setting tends to include one-to-two weekly sessions. This sets the stage for longer, less interrupted deep dives into one’s emotional landscape, offering a larger portion of the week during which the analysand is able to consider their mental health within a therapeutic setting.

That said, at five sessions a week psychoanalysis is usually far more expensive than psychodynamic therapy, placing it out of reach of many individuals seeking mental healthcare. Due to its intensive schedule, psychoanalysis can also be overwhelming for some, making psychodynamics a more manageable treatment option.

Despite their differences in setting, psychodynamic therapy shares many of its goals and theoretical sources with psychoanalysis. Both branches are heavily influenced by the writings of Sigmund Freud, who sought to excavate unconscious mental connections and release the mind from their control, through such psychodynamic therapy techniques as dream analysis, tracing one’s present life to formative experiences in their past, transference within the therapeutic relationship, and free association. Later psychoanalysts developed and challenged Freud’s theory by focusing on the aspects that interested them, such as defense mechanisms (expanded upon by Freud’s daughter, Anna Freud) and aggression (elaborated on by her chief adversary, Melanie Klein).

Psychodynamics also seeks to offer the patient empathy, and warmth. It incorporates symbolic gestures, while maintaining a clear therapeutic setting and boundaries, to acknowledge the patient’s emotional needs, and allow them to feel comforted, and appreciated.

True to its name, a key feature of psychodynamic therapy is the interplay between different mental structures, relationships, central figures in the patient’s life, their concept of self, perspective of the world around them, and basic beliefs. It also tends to consider the patient’s past continues to affect their present, and what factors in their current life may have contributed to any mental health adversity they are experiencing. As the therapy progresses, patients may find themselves opening up, expressing greater vulnerability, and exploring together with their therapists’ aspects of their life they were unable to approach in the past.

Though psychodynamics is a gradual process, psychodynamic therapy examples that evolved more recently also include focused, short-term approaches. Regardless of its length of treatment, psychodynamics is usually less intensive than psychoanalysis, with meetings tending to take place once-to-twice a week. Psychodynamic treatment also tends to be shorter than psychoanalysis, typically lasting anywhere from several months to several years.
Psychodynamic therapy examples

The Mental Health Benefits of Psychodynamic Therapy

The APA further states that psychodynamics has not only been found to be effective in treating a variety of mental health conditions, but that it holds the added advantage of a long-lasting beneficial effect. Specifically, psychodynamic therapy for depression has been shown significant efficacy, with some studies concluding that psychodynamics offers greater depression symptom relief than antidepressant medication. Indeed, many patients find it beneficial to share their own experiences and inner thoughts and feelings, while contemplating what may have brought on their depression. The FDA has similarly recognized the benefits of psychodynamic therapy as on par with selective serotonin reuptake inhibitor antidepressants (SSRIs), marking both as first-line depression treatment options.

Anxiety is another family of mental health disorders found to benefit from psychodynamic therapy. Generally including more acute symptomatology than depression, anxiety is defined as a survival mechanism that has gone into overdrive, so that instead of watching out for possible, real threats, it maintains an unpleasantly high level of hypervigilance even when no such threat exists. According to the National Institute of Health (NIH), psychodynamics has been shown to facilitate significant rates of remission from anxiety-based disorders, and to maintain such beneficial treatment effects during a six-month follow-up. The NIH additionally cites studies highlighting psychodynamics’ long-term advantages when treating anxiety symptoms, which may not be as evident in the immediate time period.

The continuous support and insight that psychodynamic therapy provides was found to have a significant effect in cases of personality disorders. Pervasive, maladaptive, and influencing different areas of one’s life, personality disorders are particularly difficult to treat. Yet over time, and as a solid bond of trust was established between patient and therapist, symptoms of personality disorders have also been shown to become less severe.