By Jessica Parkes, Aspiring Clinical Psych Content Assistant
Wondering about theory-practice links?
You’ve come to the right place!
This blog will be thinking about psychodynamic theory, the history behind it and how it might be applied in practice during psychodynamic therapy.
As an aspiring psychologist you may have come across some psychodynamic concepts, such as “transference” and “countertransference” within your work with service users. You are likely to have also covered psychodynamic theory during your undergraduate or postgraduate conversion degree.
What is psychodynamic theory?
Psychodynamic theory is a psychological framework that emphasises the influence of the unconscious mind on behaviour, thoughts and emotions. Central to psychodynamic theory is the idea that much of our mental activity occurs outside of conscious awareness, with the “unconscious mind” housing desires, fears, and memories that impact our conscious behaviour. The concept of psychosexual development also came from psychodynamic theory, which suggests that early childhood experiences shape personality, with fixations or conflicts during these stages leading to psychological issues in adulthood.
Furthermore, the theory introduces the structural model of the mind: the id (representing primal desires), ego (rational thinking) and superego (moral conscience). Under psychodynamic theory, conflict between these states causes anxiety, which may be dealt with through defence mechanisms such as “repression” and “denial”, contributing to psychological distress. Modern psychodynamic theory also highlights the importance of early relationships and emphasises how these early experiences shape future interactions.
Modern adaptations of the theory focus on exploring the unconscious mind, early life experiences and interpersonal relationships. Psychodynamic therapists aim to uncover and address internal conflicts to enable the service user to understand themselves better and resolve any difficulties.
The history behind psychodynamic theory
The most well-known contributor to psychodynamic theory is Sigmund Freud, who originally developed the theory in the late 19th and early 20th century. Freud developed psychoanalysis, the first form of psychodynamic therapy, based on his work with service users presenting with symptoms without clear physical causes. Since then, psychodynamic theory has evolved through the contributions of various psychologists and psychoanalysts. Carl Jung built on Freud’s theory with the concept of the collective unconscious (universal symbols and themes present in the unconscious mind) and Alfred Adler founded individual psychology, which shifted Freud’s emphasis on sexuality to concepts such as feelings of inferiority and the importance of social connections.
Psychodynamic theory was further built on throughout the 20th century when it recognised the importance of early relationships, particularly with primary caregivers, in shaping an individual’s psychological development. Further evolutions included self psychology, which focused on the development of the self and the need for empathy in therapeutic relationships, and Bowlby’s attachment theory, which is rooted in psychodynamic principles but moved away from Freud’s concept of psychosexual development.
Freud’s theories and methods are considered somewhat controversial in the modern day due to a lack of scientific testing, but importantly, they laid a foundation for the development of many later psychological theories.
How does psychodynamic therapy compare to other talking therapies?
In contrast to other therapies where we might work collaboratively with a service user and place them as an expert in their own experience, traditional psychoanalysis places the therapist as the expert who interprets what the service user is speaking about. However, therapy that draws from psychodynamic theory values the quality of the relationship between the therapist and service user alongside this element of interpretation.
Psychodynamic therapy also tends to be longer than other therapies and can last months and even years. This is in direct contrast to talking therapies such as CBT, which tend to be strictly time-limited with a set number of sessions.
How does psychodynamic therapy work?
Freud practiced psychoanalysis, which required “patients” to come to his office multiple times a week for sessions where they laid on a sofa and spoke aloud. Although some therapists still practice psychoanalysis, others may simply draw on these techniques through psychodynamic therapy and help a service user work through unconscious thoughts, feelings and past experiences that influence their current behaviour. This might include using strategies such as dream interpretation and free association (where a service user says whatever comes to mind). Building a strong relationship between the therapist and “patient” is the initial focus to allow the service user to explore deep-seated emotions and experiences in a safe place.
Many studies have been conducted into psychodynamic therapy and the impact it can have on the brain via neuroimages of the brain being taken before and after a service user completes treatment. Abbass and colleagues (2014) reviewed eleven of these studies and found an increase in brain activity in various key areas of the brain, which resulted in a reduction in psychological symptoms of distress. Although the authors could not know for sure why this might have occurred, they suggested that high activity in emotion-related brain areas may indicate unprocessed emotions that therapy helped to bring to the surface.
Conclusion
This blog presented a brief overview of psychodynamic theory and how we might apply it to our work with service users. Psychodynamic theory has come a long way since the work of Freud, and as an aspiring psychologist you will see how many modern psychological theories derive from Freud’s work. This blog explained how psychodynamic therapy works in practice beyond the theory you learned at university.
As with any therapeutic modality, make sure to discuss your cases in supervision and consider the most appropriate approach depending on your service, your skills and your supervisor’s specialities.
Want to learn more? Check out this blog on Narrative Therapy.
Are you an aspiring clinical psychologist wondering how to prepare for DClinPsy? Click here to find out more about how we support aspiring clinical psychologists.
References
Abbass, A. A., Nowoweiski, S. J., Bernier, D., Tarzwell, R. & Beutel, M. E. (2014). Review of psychodynamic psychotherapy neuroimaging studies. Psychotherapy and Psychosomatics, 83, 142-147. https://doi.org/10.1159/000358841
