Psychodynamic therapy has its roots in Sigmund Freud’s theory of psychoanalysis, focussing on unconscious mechanisms and childhood traumas. Psychoanalysis points out that the person’s behaviors and feelings are influenced by forces beyond her conscious control.
Understanding the unconscious processes by “insight”, is the way to recover from depression, anxiety and other psychiatric disorders.
When the person emotionally understands that her depression is fueled by aggression, she can deal with her aggressive forces in a more mature way and turn them outwards and away from herself.
Psychodynamic therapy to treat depression
Psychodynamic therapy is not structured, unlike CBT and IPT. The patient speaks freely, uncensored and the therapist is non-directive. Usually a depressed patient meets the therapist once a week, but it can be more often if necessary. One session takes about 50 minutes. Short-term psychodynamic therapies take months, while classical psychoanalysis takes years.
To understand how psychodynamic therapy works, it is important to know the theory behind it. Freud declared that the mind has three parts: Id, Ego and Superego. Id contains emotions, desires and biological instincts, like aggression and sexuality. Superego contains moral and social rules, it criticizes and judges. Ego works on the principle of reality. Ego is under constant fire from Id and Superego and tries to find ways through everyday reality that satisfy both of them.
But how can Ego deal with the conflicts between Id and Superego?
Egos most prominent instrument are the defense mechanism, such as:
- Repression (a traumatic event cannot be remembered);
- Projection (the person attributes his/her own unwanted impulses or feelings to someone else);
- Sublimation (aggressive and other unwanted impulses are expressed through behaviors that are socially accepted;
- Other mechanism of defense are Denial, Rationalization, Regression etc.
Access to the unconscious is facilitated by specific psychotherapeutic techniques, like free associations, interpreting dreams and analysis of slips of tongues and lapses. Important in psychodynamic is the concept of transference, which means that the patient starts to experience that the therapeut is someone else, f.eks a parent.