Psychodynamic psychotherapy is a method of verbal communication used to help a person find relief from emotional pain. It is based on the theories and techniques of psychoanalysis. Psychodynamic psychotherapy is similar to psychoanalysis in that it attributes emotional problems to the patient's unconscious motives and conflicts. It differs from classical psychoanalysis, however, in that psychodynamic psychotherapists do not necessarily accept Freud's view that these unconscious motives and conflicts are ultimately sexual in nature.
The goals of psychodynamic psychotherapy vary depending on the method of treatment, which can be broadly described as either expressive or supportive. Expressive therapy seeks to relieve symptoms through the development of insight, or the slowly developing awareness of feelings and thoughts that were once outside of the person's awareness. Expressive therapy is based on the rationale that difficulties experienced in adult life originate in childhood; that children do not possess the maturity for making effective choices nor the independence to do so; and that methods of adapting that were developed in childhood may no longer be effective for adapting to the world as an adult. Through guidance from a therapist, the adult becomes aware of present ways of coping that are ineffective and how they served a purpose in childhood that is no longer relevant. The person learns that he or she now has a range of new options for solving problems, and for living in general that are now based on his or her maturity and independence.
In contrast to expressive therapy which is exploratory, supportive therapy remains closer to the surface of the patient's issues. Supportive therapy is an approach that is used to relieve immediate distress; to return the person to his or her previous level of functioning; and to strengthen adaptive ways of coping that the individual already possesses in order to prevent further discomfort. Expressive and supportive methods of treatment are not completely separate categories because elements of supportive therapy are used in expressive treatment and vice versa, depending on the therapeutic need. For instance, if a person in exploratory treatment is experiencing distress, a supportive approach may be used for a period of time in order to help the person feel more stable.
While many patients benefit from individual psychotherapy alone, some instances call for such additional therapies as family therapy, couples therapy, or group therapy in combination with individual treatment. A second treatment modality might be recommended when the patient's progress in individual treatment is highly dependent on relationships with significant others or with interpersonal relationships in general. Psychotropic (mood- or behavior-altering) medication may also be prescribed as an adjunct (help) to treatment in order to manage disturbances in anxiety level, mood or thinking. Whether additional treatments are recommended is based on the needs of the individual.
People seek psychodynamic psychotherapy for a variety of reasons that include but are not limited to the following: prolonged sadness, anxiety, sexual difficulties, physical symptoms without physical basis, persistent feelings of isolation and loneliness, and the desire to be more successful in work or love. People seek therapy because they have not been able to develop a stable resolution for their difficulties on their own or with the help of friends and family members.
Susan Fine Psy.D., The Gale Group Inc., Gale, Detroit,