Freud Enters the Chat: Psychodynamic Therapy

Margaret took the captain’s chair for this one, and I was just along for the ride—straight into the deep waters of psychodynamic and psychoanalytic therapy. We start with the basics: what do these words actually mean, and why do they still make some clinicians roll their eyes while others swear by them? From Freud’s infamous couch to modern relational therapy, we unpack the myths, the methods, and the mysteries that still define this approach. Along the way, we wrestle with big questions: What’s really happening in the therapeutic relationship? Why does transference matter? And is there value in a therapy that sometimes feels more like philosophy than science? And because talking about it wasn’t enough, we try it on for size—running a live role-play where I attempt a psychodynamic formulation in real time. (Spoiler: it’s as messy and awkward as you’d imagine, but also revealing in ways I didn’t expect.) This isn’t a lecture or a history lesson. It’s us exploring why psychodynamic therapy still sparks curiosity, skepticism, and maybe even wonder—and asking what it means for the future of how we help people heal. Takeaways: Therapy on the Couch: Why psychoanalysis still matters, even if we roll our eyes at Freud.The Mirror Effect: How transference and countertransference shape every session more than we realize. Cracks in the Foundation: Why psychodynamic work digs into the “basement” instead of just fixing surface problems.Between Science and Story: The tension between falsifiability and the lived experience of patients. Practice Makes Awkward: A live role-play that shows just how messy (and revealing) this approach can be. Citations: Kassaw K, Gabbard GO. Creating a psychodynamic formulation from a clinical evaluation. Am J Psychiatry. 2002 May;159(5):721-6. doi: 10.1176/appi.ajp.159.5.721. PMID: 11986123. Summers, R. F., Barber, J. P., & Zilcha-Mano, S. (2024). Psychodynamic therapy: A guide to evidence-based practice (2nd ed.). The Guilford Press. Chapter 1 cited -- Ready to take your exam prep to the next level? Go to http://www.NowYouKnowPsych.com and enter the code BEPATIENT at checkout for 20% off. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices