What Is Psychodynamic Therapy?

The word psychodynamic gives us a clue about how this therapy works. “Psyche” means mind or self, and “dynamic” means movement or change. Psychodynamic therapy is based on the idea that our inner world is always moving and shaping how we feel and behave, often in ways we are not fully aware of — these are unconscious processes.
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Sometimes we experience different parts of ourselves in conflict. For example, we may want closeness but also feel afraid of it, or want change but feel held back. When these inner tensions are not fully understood, they can contribute to anxiety, low mood, withdrawal, relationship difficulties, or feeling stuck.
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Psychodynamic therapy recognises that we do not always fully understand our own thoughts and feelings. Many of our emotional patterns begin early in life, particularly in our relationships with our primary caregiver. These early experiences can influence how we see ourselves, how we relate to others, and how we manage emotions in the present. In this way, aspects of the past can continue to play out in the present.
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While the past does not determine everything, it can shape us in subtle ways. Psychodynamic therapy helps you explore these patterns, make connections between past and present, and develop greater self-understanding. Over time, this can support meaningful and lasting change.
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How Does Psychodynamic Therapy Work?
​​During sessions, you are encouraged to speak freely without censoring yourself. Together with your therapist, you will begin to notice recurring patterns that are not immediately obvious.
A central part of psychodynamic therapy is making connections between the past and present-day life. Early relationships and experiences can shape how we think, feel, and relate to others today. By exploring these links, you can gain a deeper understanding of current difficulties.
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What Is a Typical Psychodynamic Therapy Session Like?
Sessions are held weekly and can take place either in person or online. Both formats can be effective.
In person, the therapy room provides a confidential space that the therapist is responsible for holding.
Online sessions can offer greater convenience and flexibility, although you would need to ensure you have privacy and unlikely to be interrupted. The most important factor is that you feel able to speak openly.
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If you have never had counselling before, the process can seem strange. You are encouraged to talk about yourself freely, while the therapist does not reveal much about themselves.
People can experience sessions in very different ways. Some may feel unsure what to say, others may feel conflicted about attending, but some look forward to the opportunity to be heard and understood. It is also common to think about the session beforehand or imagine conversations in advance, only to find that once the session begins your mind goes blank.
Whatever your experience is, it is all useful. How you feel about therapy can offer important insight into your patterns, relationships, and inner conflicts.​
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What Issues Can Psychodynamic Therapy Help With?
Psychodynamic therapy can help with a wide range of emotional and relationship difficulties. Experiences such as anxiety, depression, or feeling overwhelmed are often signs that something deeper may need attention.
These symptoms can be thought of like a fever — a fever tells us that the body is responding to something underneath. In the same way, emotional difficulties can point to unresolved feelings, past experiences, or inner conflicts.
Psychodynamic therapy does not ignore symptoms, but helps you understand what may be contributing to them.
It can also support you if you feel stuck in emotions such as guilt, sadness, anger, or shame. Rather than only managing these feelings, therapy explores where they come from and why they may repeat.
psychosomatic illness can be unconscious attempt to repeat or repair a psychological conflict, for example its very common to get IBS before meeting someone or overly fatigued after socialising. Psychodynamic therapy can help uncover the true cause of these physical struggles.
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Psychodynamic therapy is especially focused on relationship patterns. This may include fear of closeness, worry about abandonment, repeated conflict, or similar difficulties across different relationships. These patterns can sometimes appear in the therapy relationship as well, and noticing them is an important part of the work.
By understanding these patterns and their roots, it becomes possible to reduce self-criticism, increase awareness, and feel more free to be yourself.
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Frequently Asked Questions​
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Q: Who is psychodynamic therapy for and how do I know if it is right for me?
A: Psychodynamic therapy is for anyone who would like to better understand themselves and explore the deeper roots of their difficulties.
It can be helpful if you are open to reflecting on your thoughts, feelings, relationships, and inner conflicts. If you are ready to explore beneath the surface and are willing to engage in a process of self-reflection, its a suitable approach for you.
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Q: How long does psychodynamic therapy take?​
A: Sessions are weekly and last for 50 minutes. In terms of how long it takes to get better is harder to answer. Client and therapist will decide on a goal and tasks to work through. It takes as long as it takes, however progress creeps up on you. My suggestion is to give it six months before deciding to continue; this gives plenty of time to get settled in the process and is usually when real, lasting changes start to emerge.
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Q: Is psychodynamic therapy evidence-based?​
A: Yes. Modern psychodynamic therapy is supported by a strong body of research and is recognised as an evidence-based approach. It has been shown to be effective for difficulties such as anxiety, depression, and relationship problems. Not to mention the early child development and attachment theory research that interweaves with modern psychotherapy.
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Q: Do I have to talk about my childhood?​
A: While exploring the past is a core part of the process, you are not pressured to talk about anything. We explore what needs to be explored when it is the right time to explore it.
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Q: How is psychodynamic therapy different from CBT?​
A: CBT tends to focus on outward behaviour and conscious thoughts. By altering behaviour and reframing conscious thoughts, you eventually change how you feel. Therapy tends to be more directive and planned on action steps. This can be helpful if done well. But with psychodynamic therapy, there is a recognition that conscious thoughts and behaviours are downstream from unconscious internal conflict. Changing behaviour or reframing thoughts only gets you so far from the root cause.
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Q: How is psychodynamic therapy different from person-centred therapy?
A: Person-centred and psychodynamic do share some similarities, insofar as offering a warm space for the client to speak freely, empathic reflection, and not being as directive as CBT. Person-centred therapy is based on the idea that if the right empathic environment is provided, the client will, over time, grow like a plant in a greenhouse. There is truth to this, but psychodynamic therapy recognises that despite having a good environment, we still get in our own way and that there is a part of ourselves conflicting outside of our awareness.
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Q: What if I find it hard to talk in sessions?​
A: Therapy is a weird set-up. You share with a stranger all your thoughts and feelings, who does not share much back. The fact that it is hard to talk in sessions is itself something to be explored. It is not a performance, and your therapist will help you speak in a way that makes sense for you.
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Taking the Next Step
​If you would like to explore whether psychodynamic therapy might be right for you, you can find more information about starting therapy on my First Session page, or learn more about my approach on the About Me page.
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If you feel ready to arrange an appointment, please visit the Contact page.