What is psychodynamic psychotherapy?

Individual psychodynamic psychotherapy is a talking therapy which helps people identify, explore and work through their difficulties. It involves talking with a therapist to treat emotional problems and mental health conditions by becoming more aware, gaining control, and making choices that work better for us.

Psychodynamic psychotherapy looks at the psychological influences behind our behaviours, feelings, and relationships, and how these might relate to earlier life experiences.

Psychodynamic psychotherapy sees problems as a result of the links between present and past events or relationships, and intense unmanageable feelings associated with these that have been pushed out of awareness in order to manage life.

It aims to help you understand these intense, unmanageable feelings of which you may not even be aware.

Psychodynamic psychotherapy is aimed at helping you to talk about your present problems and how to look at and make sense of them through becoming more aware of the processes behind them, the links between present and past experience.

Even though feelings related to past experiences may be unconscious, they can continue to have a powerful influence over our thoughts, feelings, and behaviour in the present.

For example, if you suffered serious loss in your childhood, this might make you especially sensitive to further experiences of loss.

If you were hurt as a child, you may have hidden your anger about this, but it may emerge as depression or as aggression towards yourself or others in later years.

It is important to recognise and make sense of these patterns of feelings, behaviour, and relationships in order to improve how you see yourself and how you relate to others.

Why might I need psychodynamic psychotherapy?

You may have been coping for some time with chronic depression, anxiety, difficulties in your relationship with yourself or others, low self-esteem, harmful behaviour towards yourself or others, or complex psychological problems.

You may have experienced emotional, physical, or sexual abuse which has affected how you relate to yourself and others.  Your emotions might be overwhelming, or even making you think about ending your life.

Psychotherapy can be helpful if you want to work on understanding some underlying reasons for your problems and to change how you manage your difficulties.

It is not a short cut to solving problems and requires hard work, commitment, and a preparedness to face uncomfortable awareness about yourself.

Structure of therapy

Treatment is time-limited, usually conducted over a period of six months. Sessions are every week and last for fifty minutes.

The sessions will be at the same time every week, and in the same place, and you will not usually have any contact with your therapist between sessions.

It is important that you are able and willing to maintain this commitment.

You will be expected to avoid behaviours such as using drugs or drinking too much alcohol.

What can I expect when I’m in therapy?

Psychodynamic psychotherapy sessions may seem to have no special structure. Your therapist will not suggest an agenda or theme to talk about in sessions and will not be giving you advice or instructions about how to manage your symptoms or difficulties.

You will be encouraged to talk about whatever comes into your mind, even if it might not obviously seem to be related to your problems.

Once you are established in therapy, your therapist will probably not say anything at the start of the session and will let you start the session with whatever comes into your mind.

You may find that the therapist says less than you would expect in conversations in ordinary life, and there may be periods of silence in sessions.

Your therapist takes an enabling role, perhaps trying to clarify what you say, sometimes offering ideas about the meaning of an event.

Your past experiences will be addressed when it casts light on present events, but the main focus will be on helping you to understand present experience.

You and your therapist will work closely together to focus on what you might find painful or shameful subjects. Patterns of conflict, blocks to personal growth, and unresolved difficulties that may cause you distress will be thought about in depth.

The therapist may help you to notice and identify emotions and thoughts which are out of reach and may think with you about how these may relate to the effects of the environment in which you grew up, your childhood and adolescent experiences.

As part of this process, you may be encouraged to think about strong feelings positive or negative that you might experience towards the therapist.

It is a vital part of the treatment to be open about these feelings and together with your therapist to explore their possible meanings and their links to other relationships, present or past.

Psychodynamic psychotherapy is hard work and can feel challenging. Focusing on difficult and uncomfortable aspects of yourself and your experiences that you normally avoid thinking about can bring up painful and distressing emotions and memories.

You may find that you have strong emotional reactions after the end of sessions, and this is a usual part of the process, but important to talk with your therapist about.

The end of therapy

A planned ending is a key part of the process. Thinking about the ending of therapy, and the feelings that this brings up for you, is an important part of the therapeutic process, and you may find that your therapist focusses on this towards the end of your treatment.

It is important to remember that many people see the benefits of treatment some weeks or months after it finishes. We would not usually recommend having any other therapy at the same time as psychodynamic psychotherapy, or within six months after the end of therapy.

Patient Feedback

“Thank you – I’m very grateful to the NHS + psychological services for providing this treatment for me which I’ve found life affirming.”

“I wish this was more widely available and promoted. I don’t think I’ve met anyone who wouldn’t benefit from it.”

How can I contact Psychological Therapies?

Email

Oxon.psychologicaltherapies@oxfordhealth.nhs.uk

Telephone

01865 902 005.

Address

Oxford Health NHS Foundation Trust

Adult Mental Health Team

Psychological Therapies

May Davidson Building,

Warneford Hospital, Warneford Lane,

Headington, Oxford OX3 7JX