Psychodynamic therapy

In this episode, I talk about psychodynamic therapy.

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Episode Transcript

Speaker 1 (00:20):
Hello, guys, welcome back to the show. In today's episode,
I want to talk about therapy, and to be more specific,
I want to talk about psychodynamic therapy. So a lot
of people when they're choosing a therapist, they don't really
think about their approach or, in our language, the therapeutic

(00:44):
modality they use. So we usually just want help with
whatever we're dealing with, and we don't necessarily have any
idea what makes a psychodynamic GAESH called cognitive behavioral or
systemic or any other approach different from the rest. But
the truth is not all therapy is the same, So

(01:08):
different therapeutic approaches can vary a lot, and not just
in the methods they use, but also in how they
understand and interpret the problems that clients bring to them.
So right from the start, I have to tell you
that I can't give you a clear cut answer about
which approach is the best or the most effective or

(01:31):
the most efficient for a specific problem. And sure there's
more and more talk these days about cognitive behavioral therapy
being the dominant one because it allows for a more
objective evaluation of its effectiveness. But we'll get into it
later once we know a bit more about different therapeutic methods. Today,

(01:57):
I want to briefly explore explain why one of the
main therapeutic approaches are psychodynamic therapy. And let me make
this clear right away, this is not psychoanalysis. The psychodynamic
approach does come from psychoanalysis and the way early pioneers
understood mental disorders. And I'm talking about the godfathers of

(02:18):
psychoanalysis like Freud or Ying, just to name the most
famous ones. But since their time, our knowledge about mental
disorders and human functioning has evolved a lot, and pure
psychoanalysis as they practice it really isn't used anymore. So

(02:39):
in the psychodynamic approach. The key concept is relationships. And
that is because in the psychodynamic view, it's relationships most
often those from early childhood, meaning relationship with parents and caregivers.
They shape how we function later in life. So that's
why in psycho dynamic therapy you will so often hear

(03:03):
questions about family relationships, about your connection with your mother,
your father, and even the relationship between your parents. And
the idea is that these early relationships are crucial in
shaping how we form relationships as adults, how we deal
with conflict, how we end relationships, how we interpret the

(03:28):
world around us, and so on, and therapists working in
the psychodynamic tradition will often say that what they're really
aiming for is to get to the core of the problem,
and that core often lies in whatever happened in early childhood.

(03:49):
They will also add that there may be things we
simply can't access directly, things buried deep in the unconscious
or subconscious we're not aware of yet that's still a
factor lives And you could say that the whole psychoanalytic paradigm,

(04:09):
going all the way back to Freud, is built on
the belief that to truly understand the human mind, you
have to look at the unconscious, and the role of
psychodynamic therapist is to help you find those patterns and
make sense of them. And of course, there are plenty

(04:30):
of debates and opposing opinions about this approach and about
how much the unconscious really influences our day to day functioning.
But I'm not going to dive into that just yet,
because I don't want to drift away from the main
point of what psychodynamic therapy is really about. And since
we're talking about the importance of relationships, it's worth pointing

(04:54):
out right away that in the psychodynamic approach, the relationship
between the client and the therapists and whatever happens within
that relationship is hugely important, and you could say that
the therapeutic relationship plays a double role here, So first

(05:15):
is the foundation of the entire therapy process, and second
it's an active tool for doing the work itself. And
in this approach, the client therapist relationship reveals all those
unconscious or maybe it's better to say, unrecognized patterns that

(05:36):
the client carries inside without even realizing how much they
shape their life and behavior. So contrary to the stereotype,
the therapist isn't just sitting there nodding and occasionally going.
They're more like a mirror reflecting back to the client
their emotions, patterns or coping mechanisms, behaviors, habits or fears

(06:03):
that the client may not even be aware of. And
beyond or simply listening, the therapists can actively confront the
client with what they're noticing in that moment and then
work together with them to explore and give meaning to
those emotions and to make it easier to picture. Imagine

(06:24):
a client, the client who grew up in a home
where the parents were emotionally unavailable and had very high
expectations of their kids. And this client might come to
therapy struggling with relationships, may be feeling unappreciated, avoiding closeness

(06:46):
because they're afraid of rejection, and yet deep down wishing
they could form a closer bond because they feel lonely
and in the relationship with the therapist, this pattern starts
to play out again. The client might, for example, react
to a completely neutral comment from the therapist as if

(07:09):
it were criticism. Here we can see that the client
feels insecure in the relationship, going on the defensive even
though there was no attack. They might feel misunderstood and
even experience anger or frustration, even though the therapist hasn't
actually done anything wrong in any objective sense. And this

(07:32):
is where we see one of the key mechanism in
psychodynamic therapy. It's called transference, where the client projects onto
the therapist emotions that were originally directed toward their parents,
and in this case, parents who were critical, emotionally distant,
and who didn't show curiosity or openness toward their child,

(07:57):
and the therapist in this situation doesn't respet onto these
emotions in the way the client expects or is used to.
They don't meet anger with anger, they don't get into
a fight. Instead of rejecting or criticizing those emotions, the

(08:17):
therapists approach them with openness and curiosity, and they help
the client understand where those feelings come from, accept them,
and explore them together in enough detail that they can
eventually recognize that these reactions are in fact their eCos

(08:38):
of past experiences. And here's another example. A client might
say to the therapist during a session, I feel like
you're not really listening to me, like my problems do
not matter to you. And in reality, the therapist was
listening closely, but the client could have inter predate a

(09:00):
moment of silence or a neutral look as a sign
of indifference. So from there, the work happens around that feeling,
that emotion. The therapist explores whether the client has experienced
neglect or maybe was punished with silence when they did
something wrong. And this kind of response from the therapist,

(09:23):
genuine curiosity and interest in that emotion opens the door
to deeper inside, and the therapist helps the client not
only notice where that feeling came from, but also creates
space for a different perspective on the situation, and in
this case, the therapist shows that it's possible to be

(09:45):
truly heard and understood without judgment or rejection, something the
client couldn't experience on their own because they only had
their own perspective. And well, let's be honest, it's not
easy to step out of your comfort zone, ask yourself
through other people's eyes, and even harder, admit you might

(10:09):
be wrong. That's super difficult, even for a therapist, even
for us, it's not easy to admit that we were wrong.
An important part of psychodynamic therapy is also something that's
called counter transference, which is basically the opposite of what

(10:30):
I was just talking about earlier. In counter transference, the
focus is on the therapist's emotions toward the client. For example,
if a client keeps withdrawing, avoiding eye contact, and seems
emotionally frozen or answering questions with just one word responses

(10:52):
like they don't really want to be there at all,
the therapists might start to feel frustrated or helpless, and
if the therapist reacts automatically to that frustration, may be
becoming cold or distant or impatient. That can disrupt the

(11:14):
therapy process. But if the therapist becomes aware of those
feelings and reflects on where they come from, those feelings
can actually become a valuable source of insight and help
in therapy. So it might turn out that the frustration
isn't just the therapist's own feeling, but actually reflects emotions

(11:38):
that client tends to evoke in other people, maybe in
their family, at work, or in relationships. Or it could
be that the feeling is kind of transferred by the client,
meaning that client themselves feel frustrated but can't express it,
so they communicate it nonverbally to the therapist, who then

(11:58):
starts to feel it for them, And in that sense,
the therapist's emotions become an additional source of information about
the clients inner world, giving a lot of insight beyond
what the client actually says about their emotional and day
to day functioning. And to sum it up, the relationship

(12:21):
with the therapist is a space where the client has
a chance to experience closeness in a different way than before,
so under different conditions, without fear of rejections. And in
this relationship, the therapist is open to every emotion the
client feels, even the negative ones. Whether they don't criticize, lecture,

(12:43):
or correct the client and instead they receive all emotional
states with curiosity and acceptance, and together with the client,
they give those emotions meaning. And as you might guess,
psychodynamic therapy isn't a quick fix. It's often described as
a slow process of uncovering layers and digging deep to

(13:06):
understand where certain feelings and reactions come from. And sometimes
over many sessions, a client might wonder why for the
past several years they kept repeating the same pattern of
getting involved with dominant or emotionally called partners, And through
therapy it becomes clear that this pattern comes from their childhood,

(13:31):
from the relationship with their parents or significant person. And
only when they see this pattern playing out in the
relationship with the therapies and can look at their life
from the outside a bit, they they start to feel
like it all makes sense, They understand where it came from,

(13:52):
and that's when the choice appears. They realize they don't
have to keep following old patterns. They can break free
and move forward. So what does this therapy actually look like?
Psychodynamic therapy is based almost entirely on conversation. The client

(14:12):
doesn't lie on a couch like you sometimes seen movies.
Usually the client just sits in the chair, the therapist
sits in the chair and they talk. There aren't cognitive
exercises or visualization tasks, no homework assignments or anything like
that like in cognitive behavioral therapy, and there aren't usually

(14:39):
not always, but usually techniques like psychodrama or touch based
contact or relaxation methods. They're not employed unless the therapist
blends other approaches into their practice. But in its purest form,
psychodynamic therapy is all about talking. And are there specific

(15:02):
types of problems it's best suited for. Generally No, You
can work through pretty much any individual issue or couple's
problem using the psychodynamic approach. Maybe classical behavioral issues like
specific phobias are better handled strictly with behavioral therapy rather

(15:25):
than psychodynamic, but by and large, you can come to
a psychodynamic therapiest with any problem, and psychodynamic therapy should
or should be appropriate for you. And well, that's a
very brief summary of psychodynamic therapy. That's basically all I

(15:49):
wanted to tell you about it in today's episode, And
thank you for listening, and until next time, Bye bye.