The Ultimate Guide to Psychodynamic Therapy

Psychodynamic therapy is a type of talk therapy (or psychotherapy) and is useful in many settings for various types of patients. Approaches to psychodynamic therapy are based on a person's diagnosis and the goals of treatment, including reducing symptoms of mood disorders and improving functioning in personality disorders.

Psychodynamic psychotherapy is derived from psychoanalytical theory and psychoanalysis (theories that explain how our personalities develop) and is one of the oldest of modern therapies. 

This article will discuss the important principles of psychodynamic psychotherapy, as well as when it is used, its benefits, its techniques, and how effective it is when implemented. 

Woman psychologist talking to patient

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What Is Psychodynamic Therapy?

Psychodynamic psychotherapy involves looking at how individuals respond to unconscious forces like defenses and conflict. It focuses on the emotional impact of childhood development and uses the relationship between the therapist and patient as a window into problematic patterns in a patient’s life.

In this form of psychotherapy, importance is placed on understanding oneself. It works to not only improve a person's outward symptoms but also to help that person lead a healthier emotional life.  

Psychoanalysis & Psychodynamic Theory

Four conceptual domains help form psychodynamic theory:

  • Freudian drive theory: The idea that our bodies are always trying to maintain homeostasis (internal balance) and that if homeostasis is disturbed, we enter a state where our focus is to correct it (called a drive).
  • Ego psychology: In psychology, the ego is the name for the "self." Ego psychology emphasizes how the ego deals with its external environment.
  • Object relations theory: This theory is centered on our relationship with others and how our relationship skills are based in our attachment to our parents.
  • Self psychology: This explores our growth and development related to our early life experiences.

Core Principles

There are certain areas of focus that will likely be part of a psychodynamic psychotherapy including:

  • A focus on emotions
  • Exploration of defenses against uncomfortable feelings
  • Looking for recurring emotional themes and patterns
  • Discussion of past experiences and how they contribute to current distress
  • Focus on relationships, including the one with the therapist

How Is Psychodynamic Therapy Used?

Psychodynamic therapy has proven helpful for a variety of mental health problems, including:

Benefits of Psychodynamic Therapy

Common goals and benefits of psychodynamic psychotherapy are:

  • Improvement in interpersonal functioning and relationships 
  • Increased functioning at and ability to find satisfaction with work 
  • Improvement in self-esteem 
  • Better ability to pursue long-term goals 
  • Improved management of aggression and negative expressions of emotion
  • Decrease in symptoms of anxiety and depression

While these goals are directly related to the problems the patient is experiencing, the other goals and benefits of treatment are internal changes that the patient will develop and put into practice. These include:

  • Insight into unconscious conflict   
  • Improvement in the use of mature psychological defenses and coping mechanisms
  • More flexibility in perceptions of and behaviors with other people 
  • Improved quality of the patient’s mental representations of relationships 
  • Better ability for the patient to comprehend their and others’ mental states


In psychodynamic psychotherapy, there are a few attitudes and approaches that are common:

  • Accepting: The therapist validates and accepts all aspects of the patient’s current and past experiences. 
  • Understanding: The therapist seeks to understand how the patient’s conscious and unconscious thoughts contribute to their emotional problems.  
  • Explaining: The therapist interprets and explains their understanding to the patient. 

All the techniques used in this therapy combine expressive and supportive interventions. The expressive interventions allow the patient to look inside themselves and think about their emotions, behaviors, experiences, and interactions with others. This helps the patient to become more aware of these aspects while understanding and taking responsibility for them.

How Are Supportive Interventions Used?

Supportive interventions are used in many types of psychotherapy, ranging from directing the patient to utilize specific behavioral strategies to supporting the patient emotionally.

Psychodynamic psychotherapy involves validating the patient’s emotions; bringing their attention to their thoughts, feelings, and behaviors; and asking clarifying questions. Sometimes the therapist will provide more direct guidance, reassure the patient, or teach coping skills.


A lot of research on the effectiveness of psychodynamic psychotherapy has provided evidence supporting the benefits for different types of disorders.

However, the amount of research showing the effectiveness of cognitive behavioral therapy (CBT), a type of talk therapy that helps a person overcome inaccurate or negative thinking to approach challenges more clearly and effectively, is significantly greater.

Of note, some studies have shown that, in contrast to other psychotherapies, psychodynamic psychotherapy promotes certain kinds of emotional growth that extends beyond the duration of the therapy.


Psychodynamic psychotherapy is a method of talk therapy that can help with multiple mental health disorders, including anxiety and depression. It involves the therapist helping the patient to understand their unconscious conflicts and the impact of past experiences on behaviors, thoughts, and feelings, especially relating to relationships with others (including the therapist).

The goals are to improve interpersonal functioning, self-awareness, self-esteem, and symptoms of their underlying mental health disorders. 

A Word From Verywell

Having a mental health illness can make life difficult, especially when interacting with others, from friends and family to coworkers. Psychotherapy can be beneficial for many people with various illnesses, and psychodynamic therapy specifically may be a good option for you.

If you are wondering about or considering how therapy may help you, talk to your healthcare provider or mental health professional.

Frequently Asked Questions

  • How long does it take for psychodynamic therapy to work?

    This depends on several factors. There are both short-term treatments lasting months, and longer-term psychodynamic approaches sometimes lasting years.

  • What is the goal of psychodynamic therapy?

    Goals of psychodynamic therapy typically involve greater self-understanding, improved relationships, more resilient self-esteem, and emotional growth, in addition to improvement in underlying symptoms such as depression and anxiety.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Roberts LW, ed. The American Psychiatric Association Publishing Textbook of Psychiatry. Seventh edition. American Psychiatric Association Publishing; 2019.

  2. Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Substance Abuse and Mental Health Services Administration; 2012.

  3. APA Dictionary of Psychology. Psychodynamic psychotherapy.

  4. Kay J. The essentials of psychodynamic psychotherapy. FOC. 2006;4(2):167-172. doi:10.1176/foc.4.2.167.

  5. Steinert C, Munder T, Rabung S, Hoyer J, Leichsenring F. Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. AJP. 2017;174(10):943-953. doi:10.1176/appi.ajp.2017.17010057

  6. Abbass AA, Kisely SR, Town JM, et al. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews. 2014;(7). doi:10.1002/14651858.CD004687.pub4.

By Alison Yarp, MD, MPH
Alison Yarp, MD, MPH, is a medical professional with experience in both clinical and non-clinical medicine, especially in the areas of mental health and public health. Her research and professional interests include injury and violence prevention, mental health advocacy, and emergency preparedness.