What is Psychodynamic Psychotherapy and why does a therapist's theoretical orientation matter?

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Searching for a therapist that is a good match for your goals and way of viewing the world can be a daunting and complicated process.  One aspect that is important to consider is the theoretical orientation your therapist primarily takes as this will guide their process of conceptualizing the cause of your difficulties, tailoring treatment to your specific needs, and determining how success in therapy is achieved.  While most approaches to therapy share similarities, there are some key differences that are important to discuss with any potential new therapist as research on predictors of success in therapy suggests the core facets of change are a strong therapeutic relationship (i.e., that you trust  your therapist and feel comfortable discussing your experiences with them), that their way of viewing the mind and understanding your difficulties makes sense to you, and the expectations of what therapy will involve and in line with what actually occurs in therapy.   

 

I primarily take a psychodynamic approach to conceptualizing the mind, interpersonal relationships, and the underlying causes of psychological distress that focuses on understanding and treating these causes in addition to the symptoms.  Key aspects of this approach include a focus on the mind involving both conscious and unconscious material and that both combine to produce our behaviors, ways of viewing the self, and how we relate to others.  A primary goal of therapy from this approach is to determine and work through past attachment-based and interpersonally focused experiences, often times originating in childhood with primary attachment figures, that may have led to specific ways of needing to be with others and ways of viewing the self that are so engrained they seem to be automatic.  This can often lead to people engaging in behaviors of relating to others in ways that ultimately do not work well for them based on a lack of awareness of how these past experiences may have shaped current behavior.  For example, if someone grows up in a household with a parent who is overly critical and judgmental, then this person may have learned to "walk on eggshells" or do what this parent tells them to do as a child in order to minimize any criticism or judgment.  This may have been adaptive as a child but then forms the foundation of the sense of self or ways of relating to others, which can manifest in a variety of ways of relating to others now (i.e., a people pleasing mentally, becoming overly anxious in relationships, difficulties committing or engaging in romantic relationships) that are due to learning to be this way with others as a child.  This often leads to sypmtosm of anxiety or depression and my approach is focused on incorporating coping skills initially to decrease the intensity of these symptoms while also working through the past experiences that may have caused this dynamic to address the underlying root of these symptoms.  

 

Am I a Good Candidate for Psychodynamic Therapy?

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You may be a good candidate for this approach if you are looking for relief of symptoms or difficulties as well as working through the underlying causes of these symptoms in a more direct manner.  Often times this leads to being in therapy for a longer period of time, although research shows this approach can lead to more longer-lasting change within people as compared to focusing solely on symptom reduction.  

 

You may also be a good candidate for this approach if you have tried therapy before but feel stuck in repetitive patterns without seeing new outcomes, especially if those patterns come up in the context of interpersonal relationships (romantic, friends, family in particular).  Psychodynamic psychotherapy may also be a good fit if you have been in therapy before but felt as though significant progress was not made despite having a decrease in symptoms.