Psychodynamic Therapy and Approach to Psychotherapy
OPC prepares students with the required knowledge and competencies for entry to practice as a psychotherapist. The OPC program has a particular focus on preparing students to practice within a coherent model of practice related to the psychodynamic psychotherapy model of practice (PPMP).
Psychodynamic refers to both a theory and a dynamic approach to therapy. The theory suggests that all behaviour, feelings and conflicts as an adult are rooted in childhood experiences that shape the unconscious. Psychodynamic psychotherapy (PP) focuses on uncovering the unconscious processes as they are manifested in the client’s present behaviours and revealing and resolving unconscious conflicts that may be driving present symptoms. The goals of PP are client self-awareness and understanding the influence in the past on present behaviour. It is predicated upon the conviction that understanding one’s interpersonal patterns is critical to self-awareness and to developing mutually satisfying interpersonal relationships.
Psychodynamic psychotherapy is a relational psychotherapy that developed from psychoanalytic traditions and life span development with a focus on unconscious feelings, thoughts, and conflicts, which give rise to present emotions and behaviours.
Psychodynamic psychotherapy originated in and is informed by 4 early schools of psychoanalytic theory: Freud’s drive theory, ego psychology, object relations and self-psychology. It is also informed by relational therapy and the intersubjective approach to therapy because of its focus on the therapeutic alliance and the relationship as central to the therapy. Lifespan development and broader biopsychosocial and cultural approaches are increasingly seen as significant in psychodynamic therapy. Gabbard (2010) states: “regardless of the theoretical model of development, the psychodynamic view is consistent in approaching the adult patient as a product of important early experiences that continue to be repeated in the present with others, including the therapist” (p. 13).
Psychodynamic theory views human functioning and malfunctioning as based on the interaction between drives and forces from within. It does not just focus on the resultant behaviour, but on what is perceived and understood in the mind of the client that may drive the behaviour. Techniques and approaches used in psychodynamic therapy help individuals to talk about what is happening in their thoughts and feelings and what in their unconscious may have shaped their personality and behaviours. Such understanding and new awareness is intended to empower the individual through an increased level of conscious understanding of feelings and actions to make positive change possible. The task of a psychodynamic therapist is to help the client to pursue, uncover, reveal and express their true self and to support growth and authenticity.
Berzoff, Flanagan and Hertz (2008) postulate that psychodynamic psychotherapy goes beyond a psychoanalytic focus of uncovering the unconscious and they “believe strongly in holding a balanced, comprehensive biopsychosocial view of assessment and treatment” (p. 4) in this approach to therapy. In their broader, more inclusive view psychodynamic refers to working with “both internal and external forces that have an impact on mental and emotional development” (p. 5). OPC guides therapists to also explore biopsychosocial influences in working with clients.
Psychodynamic therapy is often not a short or a time-limited therapy. It allows time to uncover, express, interpret, understand, support and integrate the insights, learning and changes acquired through the therapeutic communication process and a relationship alliance developed with the therapist. Long-term therapy uses techniques of free association, listening, reflecting and thoughtfully timed recognition and interpretation of resistance, transference, counter-transference and working through painful and meaningful memories and present experiences in the context of a therapeutic relationship. It is “a therapy that involves careful attention to the therapist-patient interaction, with thoughtfully timed interpretation of transference and resistance embedded in a sophisticated appreciation of the therapist’s contribution to the two-person field” (Gunderson & Gabbard, 1999, p. 685).
As the client talks about experiences and thoughts, patterns of behaviours and feelings that stem from past experiences and unrecognized feelings are uncovered and become more apparent.
Rodolfa et al. (2005) stated that these competencies of professional psychology are key for the psychodynamic psychotherapist: relationship, self-reflection, assessment, case conceptualization, and intervention The relationship is seen as the heart of what is understood to be curative about this approach to therapy.
The basic principles of Psychodynamic Psychotherapy according to Gabbard (2005 in Gabbard, 2010, p. 4) are:
- Much of mental life is unconscious.
- Childhood experiences in concert with genetic factors shape the adult.
- The client’s transference to the therapist is a primary source of understanding.
- The therapist’s counter-transference provides valuable understanding about what the client induces in others.
- The client’s resistance to the therapy process is a major focus of the therapy.
- Symptoms and behaviors serve multiple functions and are determined by complex and often unconscious forces.
- A psychodynamic therapist assists the client in achieving a sense of authenticity and uniqueness.
According to Blagys and Hilsenroth (2000 in Gabbard, 2010) the distinctive features of techniques used in Psychodynamic Psychotherapy involve:
- Focus on affect and expression of emotion.
- Exploration of attempts to avoid aspects of experience.
- Identification of recurring themes and patterns.
- Discussion of past experiences.
- Focus on interpersonal relations.
- Focus on the therapeutic relationship.
- Exploration of wishes, dreams and fantasies.
The OPC curriculum studies and practice opportunities prepare the student to develop an in-depth understanding of psychodynamic therapy and how to use the skills in a coherent model of practice. Opportunities for case discussion, simulation, practice, reflection, debriefing and feedback are abundant in the program.
- Berzoff, J., Flanagan L. M., & Hertz, P., (Eds.). (2008). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (2nd Ed.). Lantham, Maryland: Jason Aronson.
- Blagys, M. D. & Hilsenroth, M. J. (2000). Distinctive features of short-term psychotherapy interpersonal psychotherapy: A review of the comparative psychotherapy process literature. Clinical Psychology, 167-188.
- Gabbard, G. (2010). Long-term psychodynamic psychotherapy: A basic text (2nd Ed.). Washington, DC: American Psychiatric Publishing, Inc.
- Gunderson, J.G.,& Gabbard, G.O.(1999).Making the case for psychoanalytictherapiesinthecurrentpsychiatricenvironment.Journal of the American Psychoanalytic Association, 47, 679-704.
- Rudolfa, E, Russ, B, Eisman, E, Nelson, P., Rehm, L., and Ritchie, P. (2005). A cube model for competency development: Implications for psychology educators and regulators. Professional Psychology: Research and practice. Vol. 36. No 4, 347-354