Understanding Psychodynamic Psychotherapy: A Comprehensive Overview

What the Research Shows

Shedler (2010) reviewed a wide range of empirical studies, meta-analyses, and outcome research on psychodynamic therapy. The major conclusion of this review is clear: psychodynamic psychotherapy produces substantial and lasting benefits for clients.

Studies supporting the efficacy of psychodynamic psychotherapy span a range of conditions and populations. Randomized controlled trials support the efficacy of psychodynamic psychotherapy for depression, anxiety, panic, somatoform disorders, eating disorders, substance-related disorders, and personality disorders.

Enduring Benefits of Psychodynamic Therapy

Especially interesting is the recurring finding that the benefits of psychodynamic psychotherapy not only endure but increase with time. In contrast, the benefits of other (non-psychodynamic) empirically supported therapies tend to decay over time for the most common disorders (e.g., depression, generalized anxiety). Noteworthy findings include:

• Symptom reduction: Patients receiving psychodynamic therapy show significant improvements in mental health symptoms, including depression, anxiety, somatic complaints, and personality disorders.

• Enduring change: Unlike some treatments where gains diminish after therapy ends, psychodynamic therapy often leads to continued improvement after the conclusion of treatment. This suggests that clients experience change in deeper psychological structures, leading to continued growth.

• Comparability with CBT: Meta-analyses indicate that psychodynamic therapy is at least as effective as cognitive-behavioral therapy (CBT), the most widely promoted evidence-based treatment. In certain studies, psychodynamic approaches demonstrated larger and more sustained effects.

  
  

Why Might Psychodynamic Therapy Be Effective?

Shedler (2010) also identified key therapeutic processes that make psychodynamic therapy unique and effective. These processes may contribute to its unique and enduring effects:

• Focus on emotion: Exploring and working through the full range of a client’s feelings, including those outside conscious awareness.

• Exploration of avoidance: Helping clients recognize and work through defenses that limit self-understanding and growth.

• Attention to recurring patterns: Identifying repeated relational themes in a person’s life and fostering new ways of relating.

• Past and present integration: Connecting early experiences with current struggles to promote insight and healing.

• Relationship as a catalyst: Using the therapeutic relationship itself as a vehicle for change, providing both a mirror and a new relational experience.

  
  

The Role of Therapeutic Relationships

The therapeutic relationship plays a crucial role in psychodynamic therapy. It serves as a space where clients can explore their feelings and patterns in a safe environment. This relationship can help clients develop new ways of relating to themselves and others. By understanding their past and how it influences their present, clients can achieve deeper insights.

Psychodynamic Therapy vs. Other Approaches

When comparing psychodynamic therapy to other therapeutic approaches, it becomes clear that each has its strengths. Cognitive-behavioral therapy (CBT) focuses on changing negative thought patterns and behaviors. While CBT is effective for many, it may not address the underlying emotional issues that psychodynamic therapy targets.

Psychodynamic therapy delves into the root causes of emotional distress. This can lead to more profound and lasting changes. Clients often find that understanding their emotions and past experiences helps them navigate their current challenges more effectively.

Conclusion

The myth that psychodynamic therapy lacks scientific support is simply not true. Shedler’s review has helped to shift the conversation, showing unequivocally that psychodynamic psychotherapy is an evidence-based practice. Moreover, its emphasis on depth, meaning, and long-term growth makes psychodynamic psychotherapy particularly valuable for individuals facing complex and recurring difficulties stemming from early childhood and attachment disruptions.

For clients considering therapy, the takeaway is encouraging: psychodynamic psychotherapy is a proven, evidence-based option that fosters not only symptom relief but also enduring personal growth. If you are looking for a therapeutic approach that offers depth and lasting change, consider exploring psychodynamic therapy.

References

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109.