Looking Beyond Symptoms With Psychodynamic Therapy Techniques

Many forms of therapy focus on reducing current symptoms and developing practical coping skills. While these approaches are highly effective, some people continue to feel like they’re repeating the same emotional patterns or relationship struggles without fully understanding why. Exploring the deeper origins of those patterns can provide a different path toward lasting change.

Psychodynamic therapy exists to get to that deeper level. It is an evidence-based practice that acknowledges that present-day distress usually begins in the past, and for most people, relief will come when we look at why it started rather than just treating its symptoms.

Psychodynamic therapy is a form of talk therapy that is based in psychoanalytic theory: the school of thought that emerged out of Sigmund Freud’s ideas about the nature of human behavior and emotion and further developed over the years by other psychologists such as Carl Jung, Alfred Adler, and later object relations and self-psychology theorists.[1] Although psychodynamic therapy today looks much different from classic psychoanalysis, the main idea that psychodynamic therapists subscribe to is that unconscious forces, thoughts, and feelings experienced during early childhood, and internalized relational patterns, are a major factor in determining how people think and behave emotionally as adults.[2]

As opposed to cognitive behavioral therapy (CBT), which generally deals with someone’s current thoughts and actions, psychodynamic therapy takes a longer perspective, looking at how early experiences influence a person’s identity, how they interact with others, and the defenses used to avoid experiencing painful emotions.[3] The goal of psychodynamic therapy is to provide a deep understanding of oneself so that a person can identify the unconscious processes that lead them to create the problems they now face. Not only do patients see symptom reduction, they also begin to understand the unconscious processes that contribute to their distress.

Psychodynamic therapy can be delivered in both longer-term and shorter formats. Brief psychodynamic therapy and short-term psychodynamic psychotherapy are structured, time-limited approaches that retain the core principles of psychodynamic work while focusing on a specific central conflict or relational pattern, making psychodynamic techniques accessible in the context of a structured treatment program. At Agape Behavioral Health, psychodynamic therapies are used as clinically indicated in each patient’s treatment plan.

Psychodynamic therapy allows clients to gain insight into unconscious material by creating opportunities for that information to become consciously available. 

Several key concepts and psychodynamic therapy techniques guide this work, including:

• Free association — A client speaks freely and spontaneously regarding their thoughts and feelings without censoring themselves, saying whatever comes to mind regardless of whether it relates directly to the immediate subject of discussion. By using free association, clients bypass their conscious mind’s tendency to filter out “irrelevant” thoughts, thereby exposing underlying associations and feelings.
• Transference — A client transfers their feelings and relational patterns from a past significant relationship onto the therapist. Through identifying and exploring transference, the therapist gains direct access to a client’s unconscious relational patterns in a real-time context.
• Countertransference — The therapist uses their own emotional reactions to the client as additional clinical data to help better understand the relational patterns that the client brings to their relationships more broadly.
• Defense mechanisms — People use various defense mechanisms such as denial, repression, and projection to avoid overwhelming pain. However, these mechanisms also prevent them from gaining self-awareness and continue to cause distress. Psychodynamic therapy encourages clients to gently bring their defensive behaviors into consciousness without fear of judgment.
• Dream analysis — Unconscious material such as repressed emotions, unresolved conflicts, or wishes, expressed in symbolic fashion through dreams, is another vehicle for accessing material that does not emerge easily through direct dialogue.
• Object Relations and Early Childhood Experiences —  Psychodynamic therapy works by bringing unconscious material into conscious awareness, making it possible to understand, process, and ultimately change patterns that have been operating below the surface. The therapist and client work together to explore the meanings behind symptoms, feelings, behaviors, and relational patterns, tracing them back to their origins and examining how they continue to shape present experience.

Psychodynamic therapy works best for people who want to explore their feelings and understand how past experiences may affect their thoughts and actions today. 

It can be especially beneficial for those managing:

• Depression, especially chronic or repeated episodes that has not fully responded to other forms of treatment
• Anxiety disorders, especially when anxiety is related to past experiences with others such as family members or authority figures
• Post-traumatic stress disorder (PTSD) or complex trauma, especially if early childhood experiences significantly contribute to the trauma history
• Personality disorders, specifically borderline personality disorder, especially when the pattern of relating to others early in life contributes to the person’s struggles
• Eating disorders, relationship challenges, and low self-esteem issues, especially those with clearly identified origins
• ADHD, when the individual is also struggling emotionally and having relational challenges alongside their attention difficulties
• Anyone who senses that their distress has deeper origins than current symptoms alone reflect and who is interested in exploratory, insight-oriented work

While CBT and psychodynamic therapies are often framed as opposing therapies (one is structured and present-focused while the other is more open-ended and past-oriented), they actually complement each other.

CBT is very effective at reducing specific behaviors and symptoms and developing specific behavioral skills. Where psychodynamic therapy provides additional benefit is in examining the reasons for developing these patterns and the role they play in functioning, providing the type of understanding that transforms insight into structural change rather than just symptom reduction. 

Through individualized treatment plans that include both psychodynamic and cognitive-behavioral elements, the clinicians at Agape are able to address both the surface-level symptoms and the underlying dynamic factors that support those symptoms.