Psychodynamic Therapy
You might have read the books, listened to the podcasts, even had therapy before. You know your patterns well. And yet you still find yourself in the same argument, the same kind of relationship, the same 3am feeling.
Psychodynamic therapy is a space to go underneath. It explores the feelings, memories and relationships that shape you, often in ways that are hard to see on your own, so those patterns have less say over your life.
What is it?
01Have you ever reacted to something and thought, “Where did that come from?”
Psychodynamic therapy is a talking therapy that explores how your past experiences, your relationships and feelings you may not be fully aware of shape the way you think, feel and relate to people today.
It grew out of psychoanalysis, the tradition that began with Sigmund Freud. But modern psychodynamic therapy looks very different from the couch-and-cigar image many people picture. Today it usually looks like a conversation, face to face, with a therapist who is genuinely curious about you.
Where skills-based therapies focus on what to do differently, psychodynamic therapy is more interested in understanding why. Why does criticism cut so deep? Why do you hold back what you really feel? Why do you keep being drawn to what hurts?
It can be short term, with a set number of sessions, or longer term, continuing for many months or more.
You don’t need to arrive with a neat story or a clear goal. Following whatever is on your mind is part of the process.
What may it help with?
02People are often drawn to psychodynamic therapy when the same difficulties keep returning, when they want to understand themselves more deeply, or when they feel lost without quite knowing why.
Why do I end up in the same kind of relationship? Why do I feel empty when life looks good on paper? Why can’t I let anyone see the real me? Why do old feelings show up in situations that have nothing to do with them?
It’s commonly explored for depression, grief and loss, low self-worth and feeling lost.
It can suit people who have found that symptom-focused approaches helped on the surface, but didn’t reach what was underneath.
How does it work?
03The idea is that much of what drives us sits outside our everyday awareness. Old hurts, early relationships and feelings we learnt to push away don’t simply disappear. They tend to show up in our patterns.
Psychodynamic therapy works by bringing those patterns into the light, gently and over time.
- Noticing patterns. You and your therapist look for themes that repeat across your relationships, choices and feelings.
- Making room for emotion. Including mixed feelings, and the ones you learnt weren’t safe to have. Grief, anger, longing, love. All of it is welcome here.
- Understanding defences. These are the ways we protect ourselves from pain, such as keeping busy, joking, withdrawing, people-pleasing or staying in control. They made sense once, and may have helped you get through. Now they might be getting in the way.
- Using the relationship. Patterns from other relationships often show up with your therapist too. Perhaps you worry about disappointing them, or find yourself holding back. Exploring that safely, in the moment, is part of the work.
- Connecting past and present. Understanding where a pattern began can loosen its hold, so you have more choice about how you respond now.
This isn’t about blaming your parents or reliving every painful memory. It’s about understanding yourself well enough that the past stops quietly running the show.
Insight can be a powerful beginning. Change often comes from feeling something differently, not just understanding it, and that takes time.
“The psychological rule says that when an inner situation is not made conscious, it happens outside, as fate.”
Carl Jung, Aion
What does the evidence say?
04Psychodynamic therapy is an established approach, used by psychologists, psychiatrists and psychotherapists around the world, with a growing body of research behind it.
A 2023 review of reviews found high-quality evidence that it reduces symptoms more than comparison conditions for depression, and for physical symptoms linked to emotional distress. It found moderate-quality evidence for anxiety and personality difficulties, and that it works about as well as other established therapies. The authors are researchers in psychodynamic therapy [1].
Longer-term therapy has been studied too. A 2026 review of 16 trials looked at psychodynamic therapy lasting nine months or more. It found high-certainty evidence that it reduced depression symptoms more than comparison conditions, and the benefits generally lasted after therapy ended. The review was funded by the Royal Australian and New Zealand College of Psychiatrists, and its authors work in psychodynamic research [2].
None of this means it suits everyone. Some people love the space to go deep. Others want more structure and practical tools. Both are reasonable, and many people draw on more than one approach over time.
What does a session look like?
05Sessions are usually one-on-one, often weekly and sometimes more often.
They’re generally less structured than CBT. You’re encouraged to talk about whatever is on your mind, even if it seems unrelated or unimportant. Your therapist listens for patterns, links and feelings, and sometimes offers an observation for you to consider together. You’re always free to disagree.
There’s usually less set practice between sessions than in skills-based therapies, although many people find the work carries on in their thoughts and relationships during the week.
Frequency, time and cost
Short-term psychodynamic therapy runs for a set number of sessions. Longer-term therapy can continue for many months or years. That can be a significant investment, so talk about length, frequency and cost at the start, and revisit them as you go.
Finding the right person
The relationship is at the heart of this work. Qualifications and training matter. So does whether you feel safe enough to be honest. You’re allowed to look for someone else if the fit doesn’t feel right.
Something to try
When a reaction surprises you, pause and get curious rather than critical. Ask yourself: “When have I felt like this before? Who does this remind me of?” You don’t need an answer straight away. Sometimes noticing the question is enough.
Risks and considerations
06It can feel slower and less directive than skills-based therapies. That suits some people and frustrates others. If you’d like more practical tools, say so. Some therapists blend approaches.
Your story remains yours. A good therapist offers observations for you to consider, not explanations you have to accept. If an interpretation doesn’t fit, it’s okay to say so.
Questions to ask a practitioner
07- What psychodynamic training have you completed, and are you a registered psychologist or a member of a professional body?
- Would you recommend short-term or longer-term therapy for me, and why?
- How will we review whether therapy is helping?
- If I’d like some practical tools too, do you blend approaches?
You’ve read about it. Now what can you actually do?
You don’t need to have the perfect plan. Choose the next step that feels most useful for where you are right now.
Always speak with a qualified health professional before starting something new. If you are struggling right now, find immediate support.
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This is educational information. It is not a recommendation that this approach is right for you. Always speak with a qualified health professional.
