Psychodynamic

Psychodynamic Therapy

Longer-term work on the patterns underneath a problem — where they came from, and what keeps them running.

Lineage: Freud, then Jung, Adler, Rank and Klein
Frequency: Usually once or twice per week
Length: In the trials Shedler reviewed, typically weekly for less than a year
Distinctive of: Interpretation and exploration rather than instruction

What it is

Psychodynamic therapy works to bring unconscious material into view, on the basis that what is out of sight is still steering things.

It is markedly shorter than traditional psychoanalysis, and the therapist's role is less directive than in CBT — more interpretive, following what emerges rather than setting the agenda.

Core methods include free association, working with resistance, attention to dreams, and transference: what gets projected onto the therapist, examined as it happens.

What it looks like in session

1Talking freely, without steering toward a tidy conclusion
2Noticing where you stop, change the subject, or go quiet
3Tracing a pattern back through the relationships that formed it
4Paying attention to what happens between you and the therapist
5Fewer worksheets, more room — the shape of a session is looser by design
6Working at a pace that assumes the material takes time to surface

What the evidence says

A meta-analysis by Jonathan Shedler, published in American Psychologist in 2010, covered 1,431 patients and found an effect size of 0.97 for overall symptom improvement — 0.80 is conventionally read as a large effect.

In that review the benefit grew after therapy ended: effect size rose by 50%, to 1.51, when patients were reassessed nine or more months later.

A 2020 meta-analysis found long-term psychoanalytic psychotherapy produced small but statistically significant benefits over other psychotherapies in complex disorders; short-term psychodynamic therapy shows effect sizes of 0.34–0.71 against no treatment.

Nothing here is a prediction about your own treatment.

Often used for

Recurring relationship patternsIdentityLong-standing low self-esteem

Wondering if Psychodynamic is right for you?

You do not have to decide in advance. We work that out together in the first session, and often use more than one method.

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Other methods we use

CBT