Psychodynamic psychotherapy (PDP) originated in psychoanalytic thought and evolved over the years into three major schools: ego psychology, object relations and self-psychology. Although PDP is not a single entity, there are common factors that differentiate the method from other therapeutic approaches. Firstly, it explores the clients’ past in order to gain some insights into their current problems. It looks closely at the individual’s formative years in order to identify recurring feelings, thoughts, behaviours and relationship patterns that are indicative of underlying wounds inflicted at a young age.
Additionally, psychodynamic therapists pay close attention to the emotional expression of their clients. Clients are encouraged to embrace the variety of emotions, including the ones that are disturbing, contradictory or shameful. Furthermore, this approach acknowledges the difference between the intellectual insight and the emotional insight. Knowing oneself intellectually is valuable, as it provides the language to talk about and make sense of one’s story. However, for the lasting change to occur, there is a need to re-experience the pain of the past and re-live those moments of abandonment, rejection, or neglect as if they were happening today.
Finally, psychodynamic therapists attend to dreams, wishes and fantasies – the various ways by which the subconscious communicates with the conscious mind. They also work with the clients’ tendency to avoid certain topics or feelings. This resistance to therapy is acknowledged, normalised and worked through in the course of treatment. Moreover, the approach recognises that the client’s patterns of relating to others in the world will eventually enter the relationship between the therapist and the client. When it happens, it is no longer the story that the client brings about their interpersonal struggles but an immediate reality in the room that is hard to ignore or deny and can be successfully worked through.