Psychodynamic Therapy | Halifax, Tantallon, Timberlea
Psychodynamic therapy is a general term for types of psychological therapy that emphasize conscious and unconscious processes, especially emotions, and the importance of childhood experiences in shaping personality. Research has shown that psychodynamic therapy is highly effective. This style of therapy is used to treat chronic anxiety, depression, psychosomatic issues, relationship problems, and other mental health issues.
Cognitive-Behavioral vs. Psychodynamic Therapy
One of the best ways to understand psychodynamic therapy is to contrast it to other therapies. Most psychologists and counsellors use some form of Cognitive-Behavioral Therapy (CBT) in their practice. Such approaches tend to be more 'top-down' in their assumptions about human personality and mental health problems.
For example, many CBT therapists assume that psychological problems are often the result of erroneous or maladaptive thoughts that tend to precede distressing emotions and problematic behaviors. Thus, if a client can be taught to identify and challenge their ‘automatic thoughts’ (much of what CBT practitioners do), they can begin to alter such thoughts and the core beliefs maintaining the distressing symptoms.
In contrast to this top-down approach, psychodynamic therapists might be said to approach things from a ‘bottom-up’ set of assumptions. It is not so much that we have thoughts determining emotions and behaviors, but that we are always already in some kind of mood, emotion, or experiential state – something we often seem to ‘find ourselves in’ – without any thoughts necessarily getting us there.
In other words, these moods and emotions serve as a metaphorical ‘soil’ from which thoughts emerge and behaviors unfold. Thus, if you find yourself in a state of irritability, you are more likely to perceive the world as full of irritants. If you find yourself in a state of anxious hypervigilance, you will tend to interpret the world as threatening.
Knowing vs Feeling
It is often the case that a therapy client will ‘know’ that it is irrational to think and feel certain ways, and yet such thoughts and feelings persist. Instead of focusing on the ‘logic’ of various thoughts and assumptions, the psychodynamic therapist wants to understand the relevant moods and emotions on their own terms. They might wonder, for instance:
- ‘why does this person, who struggles with confrontation, feel anxious instead of assertive?’
- ‘why is this person, who wants to make friends, seem so closed off and irritable with others?’
- ‘why does this person, who longs to feel alive and with purpose, appear emotionally flat and devoid of meaning?’
A psychodynamic therapist will ask questions to better understand why certain patterns of thought and feeling persist over others. They will then consider what needs to happen to open the client to healthier feeling states.
Some of the key concepts in psychodynamic therapy include Defense Mechanisms, the role of Unresolved Emotions, and Interpersonal Dynamics.
Key Concepts: Defense Mechanisms
An important concept among dynamic therapies is that of a defense mechanism. Defense mechanisms describe reflexive ways in which we deny or distort a situation or event, to avoid overwhelming thoughts and feelings. Defense mechanisms operate entirely outside of our awareness. There are endless examples, though they may include denial, repression, and intellectualization. See below, for instance.
Psychotherapist: “How did you feel about your mother dying?”
Patient: “Well, she was old. Everybody dies, so it was not entirely unexpected, I suppose.”
The above response suggests that this patient may be engaging in the defense mechanism of intellectualization. Notice that the therapist asked how the patient felt. It is possible that the patient avoided engaging with the feeling, likely without realizing it, by offering their thoughts.
Defense mechanisms are by no means problematic on their own. In fact, nearly everyone indulges in them from time to time. The problem arises when it becomes an ingrained habit that can contribute to other distressing symptoms (e.g. chronic anxiety, depression). In such cases, a person may find themselves stuck and unable to thrive.
Key Concepts: Unresolved Emotions
An underlying assumption of psychodynamic therapy is that the client’s issues are often caused by conflicted or unprocessed emotion. The dynamic therapist is thus an expert at identifying signs of inner conflict or avoidance (e.g. anxiety or defenses). If such signs arise in session, and if they appear relevant to the client’s problems and goals for therapy, the therapist will draw attention to them.
The therapist and client will then work together to ‘challenge’ defense mechanisms and patterns of avoidance. This may cause some short-term anxiety, which is perfectly normal. The therapist will be keen to ensure that the client does not feel overwhelmed. A good psychologist will help a client regulate their anxiety before inviting them to explore an issue in greater depth. The above process will often lead to a lessening of anxiety. It may also initiate an emotional breakthrough, which can range from subtle 'release,' to cathartic and emotionally transformative.
Key Concepts: Interpersonal Dynamics
Psychodynamic therapists pay close attention to the quality of here and now relationships – both outside of the therapy session and within. Dynamics within the therapy session can sometimes shed light on how a person is ‘out there in the world,’ as well as what they may have learned in their early development.
For instance, a client who experienced significant criticism in childhood, and who adapted by being a ‘people pleaser,’ may intuitively prefer to have the therapist take the lead in the session, leading them to be passive. Most people are not aware of such tendencies, since it is perhaps all they’ve known. It is like an unconscious habit. The therapist may draw attention to this tendency and ask questions, allowing the client to better understand what it is all about. By bringing unconscious phenomena into awareness and by experiencing relevant feelings that may have been warded off, the client is able to reclaim a hidden part of themselves – in this case, being more engaged without fear of judgment.
Types of Psychodynamic Therapy
Recall that psychodynamic therapy is a general term that may include many specific styles of therapy. One should not, for instance, confuse psychodynamic therapy with psychoanalysis – a very specific form of dynamic therapy developed by Freud. His approach was partly based on theories of psychosexual development which have been largely discredited. Freud’s form of therapy was also very lengthy – years of weekly or biweekly sessions, whereas modern psychodynamic therapies attempt to be more short-term.
Modern psychodynamic schools of therapy include, but are not limited to:
- Time Limited Dynamic Psychotherapy (TLDP)
- Accelerated Experiential Dynamic Psychotherapy (AEDP)
- Short-Term Dynamic Psychotherapy (STDP)
- Intensive Short-Term Dynamic Psychotherapy (ISTDP)
Once could even argue that Existential, Phenomenological, and Attachment based forms of therapy are also, broadly speaking, types of psychodynamic therapy.
For over 15 years, Brad has studied, practiced, and sometimes taught psychodynamic and related forms of therapy. During that time, he has integrated different approaches into his own style. Brad will choose an approach to best suit your specific needs, based on primary concerns and goals.