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How psychodynamic therapy can help you unpack past ordeals to treat anxiety, depression and more


Psychodyanmic therapy can help you explore past events in your childhood to help identify and treat conditions like depression or anxiety.

If you feel perpetually hopeless, anxious, insecure, or angry but don't know why, psychodynamic therapy may prove helpful. 

This approach aims to help you identify the roots of your emotional distress so you can learn how to better cope with present challenges.

Psychodynamic therapy evolved out of Sigmund Freud's psychoanalysis as a way to help improve mental health, according to Dr. Steven Reidbord, a board-certified psychiatrist in private practice who specializes in psychodynamic therapy. 

Though less time-intensive than psychoanalysis, which can take years, psychodynamic therapy is based on some of the same principles:

Reidbord notes that originally, psychodynamic therapy aimed to treat what doctors once called "neuroses" — which today, mental health professionals would diagnose as depression or anxiety disorders.

Read on to find out more about the many potential benefits of psychodynamic therapy, and learn whether it might be a good fit for you.

Who it helps

Psychodynamic therapy can help treat a wide range of mental health conditions and symptoms, including:


Evidence suggests psychodynamic therapy can help reduce symptoms of depression — and these benefits not only last but can actually increase with time, even after the treatment ends. 

In fact, psychodynamic therapy may treat depression just as effectively as cognitive behavioral therapy (CBT), which many experts consider the "gold standard" approach to treating depression and other mental health concerns.

According to Mike Dow, a licensed psychotherapist at Field Trip Health, psychodynamic therapy works because it can help you recognize and understand deep-seated negative beliefs you developed over your past that may fuel or worsen your depression. 

For example, if you developed the belief that you're unlovable due to how a parent treated you during childhood, a psychodynamic therapist could help you explore the possible origins of that belief and challenge it to develop a more realistic mindset.


Psychodynamic therapy can help you identify past experiences that may drive or reinforce your anxiety — for example, instability or neglect from caregivers — so you can work on healing those old wounds, Dow says.

If you've already tried other approaches, like CBT, and found them unhelpful, psychodynamic therapy could offer another option to consider: Evidence suggests psychodynamic therapy is more effective for improving anxiety disorders than no treatment at all. 

This approach may also be worth considering if you live with social anxiety. A 2022 review found that psychodynamic therapy may prove particularly helpful for reducing intense fear in social settings and other symptoms of social anxiety.

Interpersonal difficulties

Research on psychodynamic therapy for relationship issues remains limited, but Reidbord says this approach may help you uncover any unhelpful unconscious beliefs negatively affecting your relationships. 

For example, he says a psychodynamic therapist may help you realize that your passive-aggressive tendencies serve as a defense mechanism that helps you avoid confrontation. From there, your therapist might help you untangle where your fear of confrontation comes from and build more productive coping mechanisms.

A small 2021 case study found that psychodynamic therapy helped treat couples' unresolved grief after losing a child. 

Before participating in therapy, the participants blamed themselves and their partners for their child's death. They also projected their own self-loathing onto their partners, which led to feelings of alienation and isolation. Through therapy, researchers reported these couples were able to let go of self-reproach and work on forgiving themselves and each other.

Eating disorders

Psychodynamic therapy considers disordered eating behaviors one method of expressing underlying distress. The goal of therapy involves identifying these concerns and guiding you toward more helpful ways of dealing with them.

One review found strong evidence that psychodynamic therapy can support recovery from anorexia nervosa. 

The review authors noted that available studies on psychodynamic therapy for bulimia nervosa are mostly small, with conflicting findings. However, one of the included studies did find evidence to suggest that 16 weeks of group psychodynamic psychotherapy helped:

Personality disorders

If you live with a personality disorder, you may find yourself using unhelpful defense mechanisms to handle unwanted or painful emotions. Examples include:

But psychodynamic therapy can help you identify and shift those patterns.

A 2020 review found psychodynamic therapy can help treat symptoms of:

Researchers noted that psychodynamic therapy appeared especially helpful for reducing suicide attempts and self-harm among people living with personality disorders.

Theory and techniques

Psychodynamic therapy has three goals, according to Dr. Steven M. Sultanoff, a former clinical psychologist and current psychology professor at Pepperdine University. These goals include:

Common techniques used in psychodynamic therapy include:

"With psychodynamic therapy, the therapist maintains the position of being the 'curious observer' in guiding the discussion,'" Sultanoff says.

"For example, the therapist might say, 'You said you feel angry. What happens when you are angry?' and "As you feel angry here in the room with me, does that remind you of feeling angry at earlier times in your life?"

What to expect from treatment

The duration of psychodynamic therapy can vary widely, depending on the severity of your symptoms, Reidbord says.

Dow says short-term psychodynamic therapy usually lasts for 25-30 sessions, while long-term psychodynamic therapy can last for 50 sessions or more. 

Sessions usually last 45 minutes to an hour and happen once or twice a week.

While your sessions won't follow any specific arc or format, Reidbord says early sessions typically focus on gathering information about your personal history. After that, your therapist may work with you to identify the pressing issues or goals you'd like to focus on during sessions.

"Unlike CBT models of therapy that can be highly structured, psychodynamic therapy tends to be more fluid," Dow says.

According to Dow, the psychodynamic approach can also work well in a group therapy setting. 

Sultanoff says a skilled therapist can draw parallels between everyone's experiences and help them relate to and project onto other members of the group. 

Also, since the group serves as a miniature version of the outside world, members may become more aware of unhelpful habits and patterns. For example, through your interactions with other group members, you might realize you have a tendency to project your own insecurities onto other people and take everything very personally.

Can it work as online therapy?

While you can try psychodynamic therapy via teletherapy, evidence has yet to determine whether an online approach offers the same benefits as in-person therapy. 

A small 2022 study found when people with depression and anxiety conditions participated in online group psychodynamic therapy, their symptoms improved, and so did their self-esteem.

Sultanoff and Reidbord agree, however, that in-person therapy tends to be more effective in terms of developing transference and ensuring both you and your therapist remain present and engaged.

How to try it

To find a therapist who offers psychodynamic therapy, Reidbord recommends using online directories or asking your primary care doctor for referrals. 

You can try the following searchable databases and filter for therapists trained in this approach:

According to Dow, insurance covers psychodynamic therapy as long as your therapist accepts your insurance.

Insider's takeaway

In psychodynamic therapy, your therapist will help you connect the dots between your past experiences and your current mental health symptoms and other difficulties.

"Instead of focusing on what you have — in other words, your symptoms — psychodynamic therapy focuses on why you're experiencing distress," Dow says.

In addition to exploring those past events and their impact on you, your therapist can also help you develop positive coping techniques for distressing situations.

Read the original article on Insider


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