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Psychodynamic Therapy

How Does Psychotherapy Help?

Psychotherapy can help gain an awareness of how your beliefs and actions hurt you and keep you addicted. Your therapist will work with you to understand your emotions, change negative thinking and substance-abuse promoting patterns, alter your behaviors, and find and develop your inner motivation to stay sober.

Each experience you have in life makes a tiny mark on your personality. Over time, these tiny marks can build up into habits or patterns, and those patterns might be hard for you to see or break on your own. Sometimes, these patterns are helpful as they allow you to avoid making the same types of mistakes over and over again. But, there are times when these patterns trap you into a behavior, and that behavior isn’t always helpful. If you’re recovering from an addiction, for example, the way that you’ve always responded to stress or criticism or anger may be deeply influenced by your past, and only through breaking down the past can you move forward. Psychodynamic therapy may be a useful way to help you do just that.

*Therapy in the Movies

The actor and writer Woody Allen has made a career out of making fun of psychodynamic forms of therapy. He believes, however, that the therapy has merit, no matter what he might say in his movies. He was quoted as saying, “People always tease me. They say, look at you, you went for so much psychoanalysis and you’re so neurotic, you wind up marrying a girl so much younger than you. You don’t like to go through tunnels. You don’t like to stand near the drain in the shower. But I could also say to them, I’ve had a very productive life. I’ve worked very hard, I’ve never fallen prey to depression. I’m not sure I could have done all of that without being in psychoanalysis.”

Source: IMDB

A Deep Conversation

At its core, psychodynamic therapy is much like other forms of therapy. A counselor and a patient sit down in a room together, and they work hard to help the patient understand what has happened in the past, and what will need to change in the future. Psychodynamic therapy does have a few differences, however, when compared to other forms of therapy. For example, other forms of therapy may be complete in just a few weeks, but psychodynamic therapy can last for months or even for years, depending on the issues you’re facing. Deeply complex issues that have their roots within childhood trauma might be hard for you to reveal or to even understand right away. Your therapy might be a bit like peeling an onion. Each session pulls away another layer of hurt or dysfunction, but another layer is just beneath the surface, waiting to be exposed. It can take time to remove all these layers.

In addition, psychodynamic therapy relies on a strong, deep connection between the therapist and the patient. Some forms of therapy, such as cognitive behavioral therapy, ask the therapist to remain distant and professional, revealing very little and focusing on solutions and behavior rather than emotions. In psychodynamic therapy, it’s considered acceptable for the therapist to connect to the patient on an emotional level. While the relationship might never leave the therapy room, you might form a deep and lasting attachment to your therapist if you use psychodynamic therapy.

*How to Open Up in Therapy

No matter what form of therapy you use, you’ll need to spend time sharing your thoughts and feelings with your therapist. After years of addiction issues, you might find it difficult to connect like this. These tips might help you as you learn how to share once more:

  1. Be honest. If you are tempted to lie in a session, choose silence and gather your courage to tell the truth. The therapist won’t rush you as you think.
  2. Focus on work. Your sessions are designed to help you solve the problem of addiction. You’re not required to be funny, smart or charming. You’re there to do hard work and get better.
  3. Take direction. Allow your therapist to set the pace, ask questions and provide you with homework. While ceding control like this might be uncomfortable, it can be the best way to progress in your sessions. You won’t be fighting for control.
  4. Rest up. Therapy will be easier for you if you’re relaxed and rested. Try to sleep well before you walk into your therapy session.
  5. Trust the education. Your therapist has specific training that allows him/her to help you to spot trends and make changes. The therapist also knows how to keep secrets, and is lawfully obliged to do so. Reminding yourself of these facts might allow you to share your thoughts more openly.

Benefits of Psychodynamic Therapy

While almost any form of therapy might help you to learn more about your past, and how your addiction might have its roots in your past, the Harvard Mental Health Letter reports that psychodynamic therapy might have specific benefits that aren’t typically found in other forms of therapy, such as providing you with tools that can help you to:

  • Understand emotion. Some forms of addiction treatment focus exclusively on how you act. Psychodynamic therapy allows you to focus on how you feel. This sort of insight might help you to understand why you behave the way you do, and that knowledge might allow you to change your behavior.
  • Deal with avoidance. You might spend time avoiding specific thoughts or feelings by turning to substance abuse. In therapy, you might become more aware of these habits, and you might learn more effective coping skills.
  • Identify patterns in relationships. During your life, you might associate with the same types of people or become embroiled in the same types of relationships. In therapy, you’ll learn how to spot and break destructive patterns like this.
  • Find your inner voice. The format of the sessions encourages you to speak freely, even if your thoughts don’t quite make sense to you quite yet. Over time, you might learn to tap into that voice, speaking openly with those you care about, instead of suppressing your thoughts, feelings and opinions.

In order to determine the true benefit of therapy, researchers often conduct experiments in which one set of people receives one type of therapy and another set of people receives a different type of therapy. In these experiments, people who receive psychodynamic therapy often receive the most benefit months after their therapy is complete. For example, according to the American Psychological Association, a study compared the effect size, or the amount of change produced by a treatment, of psychodynamic therapy and other forms of treatment. The effect size for psychodynamic psychotherapy was 0.97 for symptom improvement, but that effect size increased by 50 percent nine or more months later. Those who received medication treatment had an effect size of 0.31. This seems to indicate that psychodynamic therapy is the superior treatment, and that the true benefit of the therapy is really felt months after the therapy is complete.

While it’s impossible to prove why people benefit more months after therapy is over, as there are many reasons why people might get better in time, it’s possible that the lessons learned in psychodynamic therapy need time in order to take hold. In therapy, you’re learning more about the way you’ve thought and the way you’ve behaved throughout your life. You might be addressing years and years of entrenched ways of thinking and acting and feeling. You might not be able to turn on a dime and become a new person in a minute, but months down the road, as you apply these lessons, you truly might become a new person with an entirely new way of behaving in the world.

*Understanding Motivation

Psychodynamic therapists believe that all behavior is rooted in the unconscious. Every step you take, every sentence you speak and every relationship you enter has its motivation located deep within your past experiences. This could be a revolutionary insight as you work with your addiction. Relapses won’t “just happen,” as you’ll have an understanding of what motivates you to behave the way you do, and you’ll know more about what you need to change to keep those relapses from happening again.

Varied Format

Therapists who use psychodynamic therapy often believe in asking their patients to speak freely, naming the ideas that come into their consciousness and working with their ideas as they arise. For this reason, your therapy sessions may be free form and relaxed. Your therapist will have goals for you to reach, of course, and you will be expected to work and stay engaged in each and every session, but you may not have a specific format that you follow in your sessions. You likely won’t start each session in the same way, and you may not end your sessions in the same way, either.

As you talk, your therapist might interrupt you with questions such as:

  • What does that remind you of?
  • How does that make you feel?
  • What else did you think?
  • Who does that person remind you of?

These questions can be irritating, especially if you’ve become accustomed to speaking at length with no one stopping you for any reason, but each question is designed to encourage you to probe a little deeper and think a little harder about your past and your inner thoughts. Each question should be answered as honestly and as completely as possible.

There is no agreed-upon length for psychodynamic therapy. Some therapists utilize a brief form of the therapy that is focused on goals and designed to end when those goals are met. Other therapists allow the patient to dictate when the therapy is over, depending on how the patient feels at the time and whether or not the patient feels as though the therapy is continuing to help. Either method can be helpful.

Psychodynamic Therapy and Mental Illness

Psychodynamic therapy might be helpful for addiction, but it can also be quite helpful for people who have a mental illness. For example, according to an article published in the American Journal of Psychiatry, this form of therapy has been proven helpful in treating both depression and personality disorders. If you have one of these mental illnesses as well as addiction, your therapist might opt to use psychodynamic therapy as part of your treatment program.

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