Therapy is an umbrella term under which a variety of styles, modalities, settings, and outcomes can be expected. This Modalities Series is intended to help you better understand the terminology so that you can navigate online therapy directories with more clarity, and find a therapist most aligned with your needs.
In addition to learning about the different approaches therapists take, be sure to ask any therapist you're interested in working with if they offer a free consultation. This meeting or phone call will help you gain more insight into how they practice before getting started. Once the therapy process begins, don't hesitate to let your therapist know if you feel unsupported in the way you expected.
With a focus on psychodynamic therapy, we'll explore its principles, process, and what to expect.
As a psychodynamic therapist myself, I appreciate the depths this particular modality invites us into, both as client and clinician.
Exploring the Unconscious
Put simply, psychodynamic therapy is a type of talk therapy that invites the client's unconscious thoughts and feelings into session, rather than only discussing what is already known. This is useful in order to uncover the root causes of emotional pain and struggle.
This depth approach considers that repressed memories, emotions, and conflicts still impact the thoughts, reactions, and experiences of the present. There are many times throughout our lives when events occur that we struggle to tolerate emotionally. Our defenses typically pop up automatically in order to safeguard us from things that would overwhelm us.
But left unprocessed, these experiences tend to inform us without us even knowing. They manifest as reactions, beliefs about ourselves, and fears about the world. As Carl Jung said:
Until you make the unconscious conscious, it will direct your life and you will call it fate.
The image of an iceberg arises for me when I consider this work. The top of any iceberg is easy to spot and easy to impress. Beautiful, captivating, and powerful, it may seem like that surface indicates the entirety of the berg.
However, it's only once you discover its even more massive underbelly that you really begin to understand it. While behavior modification modalities such as CBT will address the top of the iceberg, psychodynamic therapy asks us to tend to what lies beneath lest we think the top is all there is. By tending to the base, our relationship with the surface inherently shifts, and almost always for the better.
Therapeutic Relationship
A key element of psychodynamic therapy is the therapeutic relationship between client and therapist. This relationship is one meant to support the unconscious material that arises, while providing the client with a safe space to be seen fully and authentically as themselves.
One of my graduate school instructors called therapy a "controlled attachment experience" in which the client can move deeply inward, leave behind the weight of the daily, material world, and come into relationship with parts of self otherwise left abandoned.
Repair can happen in this realm of connection and vulnerability, as can expansion and a coming home to oneself.
Meaning-Making
The insight and self-awareness gained through psychodynamic therapy can lead to long-lasting change, as well as meaning-making in the client's life. In other words, instead of eradicating depression, we'll seek to reduce symptoms and alchemize it into something more purposeful by gaining a deeper understanding of the unmet need it's expressing.
Using art, literature, mythology, dreams, and other archetypes and symbols of the collective unconscious, we'll give context to your experiences so that you feel less alone. Instead, you may begin to feel part of the larger collective, understanding the purpose, lessons, and gains from events otherwise experienced only as dread.
Gradual and Unpredictable Process
While other forms of talk therapy, including behavior modification approaches like CBT and DBT, may offer tangible results more quickly, psychodynamic therapy typically takes place over a longer period of time. This is because the process of exploring the unconscious and developing insight into one's behavior and emotions can be a gradual, unpredictable, and ongoing process.
Because of the deeper insights available, however, psychodynamic therapy can yield more long-lasting results. Instead of responding to every behavior and thought with modification skills, the psychodynamic idea is that tending to the unconscious helps to rewire the system on a deeper level of being and provide a more meaningful relationship with self overall.
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Vanessa Setteducato, LMFT is a licensed psychotherapist offering psychodynamic online therapy sessions in California to adult individuals.