A History of Psychodynamic Therapy and Why It Works

psychodynamic therapy

There are many different therapeutic techniques used to treat mental health disorders, but psychodynamic therapy is one of the oldest and most well-known theories still used today. It dates back to the founding father of psychology, Sigmund Freud, and is used today in numerous settings including substance abuse rehab programs, individual counseling, marriage counseling, family therapy, group therapy and more.

What Is Psychodynamic Therapy?

Psychodynamic therapy is a technique used by therapists and counselors to help patients overcome mental health disorders. Psychodynamic therapy is based on the idea that there are unconscious processes (such as thoughts and emotions that you may not be aware of) that drive human behavior. According to psychodynamic theory, if a patient is engaging in unhealthy behaviors, he or she needs to uncover the unconscious processes that are causing those behaviors. Most commonly, psychodynamic therapists help patients examine and understand unresolved conflicts, experiences and emotions from the past that might still be affecting them today.

What Is the History of Psychodynamic Therapy?

Psychodynamic therapy originated based on the theories set forth by Freud, who believed that individuals behaved based on a combination of unconscious sexual and aggressive drives, defense mechanisms and guilt. His theory and practice were known as psychoanalytic therapy. Freud’s psychoanalytic therapy involved a great deal of sexual exploration, especially with regard to identifying any sexual frustrations towards one’s parents. Though they have similar names and both originated with Freud, psychodynamic therapy is different from psychoanalytic therapy.

Like Freud’s psychoanalytic theory, psychodynamic therapy assumes that there are unconscious thoughts and emotions that drive human behavior. However, the similarities between the two therapies stop there. Psychodynamic therapy also assumes that human beings are complex creatures who are driven by more than just sex and aggression. Rather, psychodynamic therapy focuses on problem resolution and developing personal insight.

How Well Does Psychodynamic Therapy Work?

Psychodynamic therapy requires a patient to recall past events, which may be painful for some people. In cases of substance abuse, many patients may have originally turned to drugs or alcohol as a way to escape these painful events and residual memories. Returning to these memories during psychodynamic therapy may be difficult for many patients. Therefore, researchers suggest that psychodynamic therapy should only be used when a patient is in a controlled environment such as a drug rehab center or once the patient has been able to abstain from drugs or alcohol for a significant amount of time.

However, if a patient is ready to work through his or her past events, psychodynamic therapy can be an excellent tool. During psychodynamic therapy, a patient will be guided by a therapist to examine the way he or she expresses emotions. Oftentimes this means analyzing why the patient tries to avoid uncomfortable thoughts and feelings. For individuals struggling with substance use disorders, this may involve examining the root causes of substance abuse behaviors and why substances are used as an escape.

Psychodynamic therapists also encourage their patients to identify recurring themes or patterns in their thoughts and behaviors. By discussing past experiences, examining existing relationships and talking through fantasies, pretend situations or role-playing, a psychodynamic therapist can help a patient overcome past hurt and create a fresh foundation for a healthy future.



Center for Substance Abuse Treatment. (1999). Brief Interventions and Brief Therapies for Substance Abuse: Chapter 7—Brief Psychodynamic Therapy. https://www.ncbi.nlm.nih.gov/books/NBK64952/

Gaskin, C. J. (2012). The effectiveness of psychodynamic psychotherapy: A systematic review of recent international and Australian research. Psychotherapy & Counseling Federation of Australia. https://www.health.gov.au/internet/main/publishing.nsf/Content/phi-natural-therapies-submissions-containerpage/$file/PACFA%20Psychodynamic%20Psychotherapy%20Lit%20Review.pdf

Shedler, J. (2010). The Efficacy of Psychodynamic Therapy. American Psychologist, 65(2), 98-109. https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf

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