When we think about therapy, most of us envision the classic scenario of a client laying out on a couch expressing their feelings and the therapist listening intently. This picture of therapy was established by Sigmund Freud and his findings. Freud, often revered as the “Father of Psychoanalysis” believed that treating mental disorders should not rely on hospitals and medication but rather tapping into our unconscious. Later on, some of Freud’s findings were discredited and his disciples went on to develop Psychodynamic theory – the foundation of Psychodynamic Therapy.
Psychodynamic Therapy is an in-depth form of talk therapy that focuses on resolving psychic tension that stems from unresolved conflicts from our past. It is based on the past work of Freud along with the integration of Ego Psychology, Self Psychology, and Object Relation Psychology.
What does Psychodynamic Therapy treat?
- Adjustment Disorder
- Post-Traumatic Stress Disorder (PTSD)
- Panic Disorder
- Depression
- Eating Disorders
Unlike symptom-based treatments such as Cognitive Behavioural Therapy (CBT), Psychodynamic Psychotherapy works underneath the surface to reveal unconscious issues. While CBT works by treating issues in the here and now through problem-solving and skills-based learning, Psychodynamic Therapy encourages us to look into our past to gain any insight to help us in the present. When we are facing an issue in the present we may not know that it is a resolved conflict of our past that is driving this behaviour. Psychodynamic Therapy brings that conflict to our present so we can deal with it.
The Unconscious
Most Psychodynamic Therapy works under the assumption that most of our thoughts and behaviours are driven by our past experiences. These experiences are buried deep within our unconscious and so often we are unaware of why we truly act in a certain way. Freud often used an analogy of an iceberg to describe the different levels of the mind.
✽ Consciousness
The very tip of the iceberg is our consciousness, the part of our cognition that we are aware of. Our thoughts, feelings and emotions that we can explain at any given moment lie within our consciousness.
✽ Pre-conscious
Then just below the surface of the water is our pre-conscious or subconscious; these are aspects of our minds that we could be aware of if we tried to. These thoughts can often manifest in our dreams. Another way to think of our preconscious is like our breathing or our heartbeats; we are not aware of these processes all the time however we can be if we focus on them
✽ Unconscious
Lastly there is the unconscious mind, the majority of the iceberg. These are thoughts, feelings and urges that are completely out of our awareness and inaccessible to us on our own. According to Psychodynamic theory, oftentimes this part of our brains hides our most unpleasant thoughts to keep us from experiencing pain or anxiety.
Defense Mechanisms
We are masters at blocking our painful memories and burying them deep within our unconsciousness through defense mechanisms. While effective in blocking out unwanted thoughts, these defense mechanisms take a toll on our daily functioning.
Examples of Defense Mechanisms
- Rationalization
- Denial
- Repression
- Displacement
- Regression
- Projection
Therapeutic Relationship
One of the most important processes in Psychodynamic Therapy is the therapeutic relationship between the client and the therapist. Any issue a client may have with a past relation – often with a primary caregiver – can manifest itself within the client/therapist relationship. This process is called transference and it is pivotal in understanding the unconscious workings of the mind. For example, if someone’s unhealthy attachment to their mothers is impeding their ability to properly function in their daily lives they might try Psychodynamic Therapy. During the process, while the client is freely speaking they place their hostility for their mother on their therapist.
What to Expect in a Session
A typical first session explores your history, current concerns, and goals. You and your therapist begin to notice repeating themes—familiar feelings, relationship patterns, or situations that seem to recreate earlier dynamics. The therapist may invite free association (saying whatever comes to mind), gently track shifts in emotion, and pay attention to the relationship in the room. This is not aimless talk: it is a structured curiosity about links between past and present, so that old tensions can be felt, named, and worked through safely.
Sessions often include brief reflections like, “I notice you apologise when you share anger—does that feel familiar elsewhere?” or “When I was late, it seemed especially upsetting—is that like something you’ve experienced?” These observations help surface implicit expectations and fears. Over time, you and your therapist collaborate on new ways of relating that feel less constrained by the past.
Core Ideas and Techniques
Free Association. Speaking without censoring reveals unexpected links between thoughts and feelings. It lowers the “editor” that usually hides uncomfortable material.
Interpretation. The therapist offers tentative meanings about patterns (“When closeness increases, you pull away—perhaps to avoid disappointment”), which you test against your experience.
Transference & Countertransference. Transference is how feelings from earlier relationships get replayed with the therapist (e.g., expecting criticism). Countertransference is the therapist’s emotional response, used thoughtfully to understand relational patterns rather than to act them out.
Resistance. Avoidance (arriving late, changing topics, joking) is understood compassionately as protection. Naming resistance makes room for choice: proceed, pause, or approach differently.
Dreams and Symbols. Dreams, slips of the tongue, and recurring images can illuminate conflicts and wishes that are hard to voice directly.
Working Through. Insight is a start; repetition consolidates change. You revisit a theme across contexts until new responses feel natural.
Psychodynamic vs. CBT: How They Can Complement Each Other
CBT targets specific symptoms with skills in the “here and now”—very useful for panic, insomnia, or habits. Psychodynamic work asks why those symptoms cling—what meanings and relationships keep them in place. Many clients use both: skills to stabilise, depth work to shift the roots. For example, learning a breathing technique may reduce immediate anxiety, while exploring how anger was discouraged in childhood helps you assert needs without panic.
Who May Benefit
Psychodynamic Therapy can help if your difficulties seem to recur across jobs or relationships, if you feel “stuck” despite trying short-term strategies, or if identity, self-worth, or intimacy remain confusing. It is also helpful when emotions feel disproportionate to current events—often a sign that older experiences are being stirred. Treatment length varies: some people engage briefly around a focused theme; others prefer longer work for broader personality patterns.
Evidence and Outcomes
Research suggests that psychodynamic approaches can lead to improvements that continue after Psychodynamic Therapy ends, as insights translate into more flexible ways of thinking, feeling, and relating. Gains are often seen in self-understanding, relationship satisfaction, symptom relief, and the capacity to manage complex feelings. The aim is not to remove all conflict—life will still present challenges—but to reduce suffering linked to old patterns and to expand your range of choices.
Common Myths
“It’s just talking about the past.” The past matters only insofar as it shapes the present. Sessions connect old dynamics to what is happening today, including in the Psychodynamic Therapy relationship.
“It never ends.” Duration is collaborative. Many people work in time-limited formats; others choose to continue because the process remains helpful.
“It’s not practical.” Insight and emotional processing lead to concrete shifts: clearer boundaries, less reactivity, more satisfying connections, and choices aligned with values.
Your Role in the Process
Bring curiosity, honesty, and patience. Notice when strong feelings arise during the week and how you respond. Share dreams or interactions that linger in your mind. Ask your therapist about anything that puzzles or frustrates you—including aspects of Psychodynamic Therapy itself. This collaboration helps tailor the work to you and strengthens the therapeutic alliance, which is the best predictor of outcome across modalities.
Safety, Boundaries, and Suitability
A psychodynamic therapist maintains clear boundaries and an ethically grounded frame (time, confidentiality, roles). If you are in immediate crisis or experiencing symptoms that require medical management, Psychodynamic Therapy can coordinate with other supports. The pace should feel manageable; difficult material is approached with care, not forced. You are always free to slow down, clarify goals, or adjust the plan.
Signs of Progress
You may notice a kinder inner voice, less compulsive repetition of old patterns, and an ability to stay present during conflict without shutting down or lashing out. Relationships feel more mutual; you recognise needs sooner and express them more directly. Even when stress rises, you recover faster. These are markers that the “iceberg” is shifting—more of your mind is available to you in conscious, flexible ways.
Putting Insight into Action
Between sessions, small experiments help consolidate change: pausing before replying to a triggering message, trying one new boundary, or allowing a trusted friend to see a vulnerable feeling. Reflect afterward—what was different from the old pattern? What did you learn about your fears and strengths? These loops of insight-and-practice gradually rewire expectation and choice.
Starting Psychodynamic Therapy with Us
At Psychology Blossom, therapists integrate depth understanding with a warm, collaborative style. We focus on what matters most to you now and trace its threads with care—always at a pace that respects safety and autonomy. If you are curious about how earlier experiences may be shaping today’s challenges, this approach offers a thoughtful path forward.
We recommend This Video to those who wants to learn more about Psychodynamic Therapy.
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