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Psychodynamic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis. It also relies on the interpersonal relationship between client and therapist more than other forms of depth psychology. In terms of approach, this form of therapy uses psychoanalysis adapted to a less intensive style of working, usually at a frequency of once or twice per week. Principal theorists drawn upon are Freud, Klein and theorists of the object relations movement, eg. Winnicott, Guntrip, and Bion. Some psychodynamic therapists also draw on Jung. It is a focus that has been used in individual psychotherapy, group psychotherapy, family therapy, and to understand and work with institutional and organizational contexts.
The principles of psychodynamics were first introduced in the 1874 publication Lectures on Physiology by German scientist Ernst Wilhelm von Brücke. Brücke, taking a cue from thermodynamics, suggested all living organisms are energy systems, governed by the principle of energy conservation. During the same year, Brücke was supervisor to first-year medical student Sigmund Freud at the University of Vienna. Freud later adopted this new construct of “dynamic” physiology to aid in his own conceptualization of the human psyche. Later, both the concept and application of psychodynamics was further developed by the likes of Carl Jung, Alfred Adler, Otto Rank, and Melanie Klein.
Most psychodynamic approaches are centered on the concept that some maladaptive functioning is in play, and that this maladaption is, at least in part, unconscious. The presumed maladaption develops early in life and eventually causes difficulties in day to day life. Psychodynamic therapies focus on revealing and resolving these unconscious conflicts that are driving their symptoms. Major techniques used by psychodynamic therapists include free association, recognizing resistance and transference, working through painful memories and difficult issues, and building a strong therapeutic alliance. As in some psychoanalytic approaches, the therapeutic relationship is seen as a key means to understanding and working through the relational difficulties which the client has suffered in life.
Core principles and characteristics
Although psychodynamic psychotherapy can take many forms, commonalities include:
- An emphasis on the centrality of intrapsychic and unconscious conflicts, and their relation to development.
- Seeing defenses as developing in internal psychic structures in order to avoid unpleasant consequences of conflict.
- A belief that psychopathology develops especially from early childhood experiences.
- A view that internal representations of experiences are organized around interpersonal relations.
- A conviction that life issues and dynamics will re-emerge in the context of the client-therapist relationship as transference and counter-transference.
- Use of free association as a major method for exploration of internal conflicts and problems.
- Focusing on interpretations of transference, defense mechanisms, and current symptoms and the working through of these present problems.
- Trust in insight as critically important for success in therapy.
A 2011 meta study showing that long-term psychodynamic psychotherapy was superior to less intensive forms of psychotherapy in complex mental disorders, has been challenged on methodology in the British Journal of Psychiatry, stating "we would greatly appreciate caution against a conclusion that the overall effectiveness of LTPP for treating complex mental disorders should now be considered as definitely proven." Positive research on efficacy would be very helpful to increase health systems provision of psychodynamic research.
- psychodynamic psychotherapy - guidetopsychology.com
- Horacio Etchegoyen: The Fundamentals of Psychoanalytic Technique, Karnac Books ed., New Ed, 2005, ISBN 1-85575-455-X
- Sundberg, Norman (2001). Clinical Psychology: Evolving Theory, Practice, and Research. Englewood Cliffs: Prentice Hall. ISBN 0-13-087119-2.
- "Methodological discrepancies in the update of a meta-analysis". Kliem S, Beller J, Kroeger C. Br J Psychiatry. 2012 May; 200(5):429; author reply 429-30.0