What Makes Psychodynamic/Psychoanalytic Therapy Different – and Worthwhile?

Psychoanalysis and psychodynamic psychotherapy are in need of a user’s manual, a translator and a tour guide. Through this series of writings, I’m hoping that I can fill all three roles, and translate the complex, vexing and yet important ideas in psychoanalytic theory and thought into accessible, ordinary language.

I believe strongly in this approach, because over time, I have seen what it can do. Psychodynamic therapy and psychoanalysis (terms I’ll use interchangeably, since the major difference between them has to do with session frequency) are powerful tools for reducing emotional pain and effecting profound and lasting change. But it’s not a simple or nimble process, there are no formulas, and it takes patience and the ability to reside, for a time, in ambiguity and uncertainty.

Take this picture: my undergraduate degree was in psychology, and in those many classes, I was introduced briefly to Freud and Jung, then we quickly moved on (the same for my graduate program). It wasn’t until the philosophy and religion classes (my minors) that I encountered the richness, variety, and complexity of psychoanalytic theory and thinking; it was also not until philosophy and religion that I encountered the wealth of voices that have contributed important ideas to contemporary analytic theory, which leans more toward open-system, relational approaches.

In other words, there are a lot of ways in which psychodynamic/analytic therapy is not the average psychotherapy. Our culture seems to have swapped a drive and desire for depth of understanding for symptom-focused, manualized approaches to everything. This is no doubt due in part to economics, but I believe it goes deeper than that. We live in a culture and a time in which reality TV and social media seem to be as “real” as we ever get, and in which emotions have been replaced by emoticons. We’ve forgotten how to linger.

But, if you’re still reading, then it’s probably safe to say that this does not apply to you.

Psychodynamic psychotherapy creates space, and an invitation to learn how to inhabit it. People often think they understand themselves – and that’s often true, in one sense. People often have a very solid cognitive understanding of their motivations, their likes and dislikes, and even their reasons for engaging in self-frustrating and repetitive behaviors. What is missing is a deep emotional self-understanding.

Feeling is so much scarier than thinking, and often we try to build our lives around minimizing or even vanquishing feelings about things – and many of the cognitive-focused psychotherapies encourage this. The problem is that without fully discovering and engaging our feelings, change cannot happen. Feelings are the fuel for everything that matters in life – relationships, creativity, being alive and connected. Without access to a full range of feelings, and the ability to tolerate and handle them, it’s impossible to have satisfying versions of any of those things.

What does this mean for the work we do in the therapy room? There are some key ideas that set this approach apart from the others. I will discuss each in future writings, but the key difference has to do with our emphasis on the unconscious and how so much of our behavior, feelings and thoughts originate far from our awareness. The psychodynamic therapist has a special way of listening for these hidden messages. When we work with someone, over time we learn their partiucular language, and we help translate it so they are able to hear the important parts of themselves that have been like faint echoes for so long. It often turns out that these echoes have been driving things from the backseat all along.