What are Psychodynamic Psychotherapy and Psychoanalysis?
Psychodynamic Psychotherapy (also called Psychoanalytic Psychotherapy) and Psychoanalysis have the same theoretical grounding and therefore essentially similar approaches to therapy. For the purposes of this article I will use the terms interchangeably. You can read the FAQ “In what ways are psychoanalysis and psychodynamic psychotherapy different” to get some flavor of the difference between them, but this article focuses on their commonalities.
The Roots of Psychoanalysis
If the term psychoanalysis conjures up images of Viennese capes, monocles and Freudian consulting rooms replete with figurines and carpeted chaise, you are not far off, at least as far as the beginning of the school of psychoanalysis currently certified by the International and American Psychoanalytic Associations. But that beginning was before motor cars, and in 150 years psychoanalysis has evolved and diversifiedto a quantum degree, integrating many complex facets of human development as those facets and their underlying theories came to be understood through scientific research.
Psychoanalysis has come a full circle because Sigmund Freud was a neurologist before he developed psychoanalysis, and started with research on the brain. One hundred years later, brain science is what accounts for some of the most important breakthroughs in the practice of psychoanalysis today. Specifically, if not surprisingly, we now have incontrovertible proof that mind, unconscious psyche, personality, brain, andrelationships are inextricably tied.
How does brain science inform contemporary psychotherapy?
Sometimes clients seeking therapy feel strongly that past-orientation, such as talking about childhood or background, is a waste of time, and they’d rather focus on skills and techniques to improve the situation for the now. Yet brain science has demonstrated to us that relationships hard-wire our brains from womb onwards. Early relationships are form our brains and personalities, leaving ample room for adaptive adjustments. Being human means we are both flexible and susceptible to literally millions of forms of input from childhood to death. Individual variations include the myriad permutations of what, how and where it stores memories and feelings and experiences; the habits (neural pathways) of interactive stimulus and response in relationships; and the feedback loops of emotion and behavior.
What are the goals of Psychodynamic Psychotherapy and Psychoanalysis?
This approach aims at nothing less than the personal fulfillment of the individual. It aims to help people realize their potential – whether that is to best utilize their gifts and abilities; to feel happy and good about themselves; to make and sustain positive and fulfilling relationships; to seek and find what is meaningful to their lives; and to be free of the suffering and symptoms that drove them into therapy in the first place.
Specific goals and skills that lead to these aims include:
- Improving self-awareness about one’s own inner life, one’s feelings and motivations
- Achieving insight into the kind of unconscious forces and dynamics that may be driving unhelpful behavior in ways that are not evident to the conscious mind
- Acquiring Insight into the particular problems and symptoms the patient may be suffering
- Developing skills and inner resources to handle psychological problems
What are the main processes and tools of Psychoanalysis and Psychoanalytic Psychotherapy?
The patient-therapist relationship is the key aspect to an effective treatment
The single most important aspect of this approach is the view that the patient-therapist relationship is core to the change process. This rather simple-appearing perspective is actually based on layers of research and discovery over a century and a half, including research on the foundations of human development, attachment, brain and neuroscience research, and the psychoanalytic concept of transference. Psychoanalysis is a complex and sophisticated model of therapy with a very detailed and intentional set of guidelines. This includes a close observation of how the relationship unfolds within the therapy, as well as how relationships for the patient are shifting outside the therapy. It includes the therapist sharing real-time observations about how they experience the patient, with the view of exploring patterns relevant to other relationships in their lives.
Exploring the Unconscious Mind
A core principle of psychoanalysis is the concept of the unconscious mind — aspects of personal functioning that are automatic – like the operating system on a computer. Such aspects can include hidden drivers of the personality, such as habits of relating to people or ideas and feelings about the self. For example, a highly talented and bright individual may persistently sabotage themselves, feel underserving of success, or feel like an imposter.
Change at this level requires understanding oneself at a deeper level, having insight that requires reaching for the unconscious roots of these habits. Intellectual insight is not sufficient, however. To be effective psychoanalysis must touch the emotionally meaningful roots of these psychic grooves: grooves – or neural circuitry – that were laid down early in a person’s life and thereafter put a stamp on what came thereafter into adulthood.
Free association is a key tool of psychodynamic psychotherapy. The purpose of it is to allow the unfettered action of the unconscious mind to come forth. The assumption is that a structured agenda may fulfill the intended aims, but not really reach anything deeper. In a psychoanalytic session, the patient is asked to share what comes to mind in order, eventually, to follow the authentic chain of associations in their mind as well as to allow them to gradually become more spontaneous and free in their sharing. In this way the sessions can gradually reveal deeper concerns, wishes, fears and inner conflicts.
Free association is not limited to thoughts, but also to emotions, sensations, and perceptions that may arise during a session. To allow free association its full potential psychotherapy sessions are often open-ended and non-structured. This sometimes gives people coming from busy, pressured lives the feeling the sessions are “unproductive,” but more likely, entering a psychoanalytic session itself subtly activates the different reaches of mind in the direction of change.
Dream analysis or dream interpretation is quite important in psychoanalysis because it can be a window into the unconscious mind. Worries, fears, concerns, or wishes that do not break the surface of conscious awareness may nevertheless be influencing a person’s thoughts or behaviors in a significant way. At times these themes may show up in dreams in the myriad forms of expression that only dreams can have. In psychoanalysis these expressions are not mapped to a “dictionary” of symbolism, but interpreted together between client and analyst, in the context of what is meaningful in the individual’s specific psyche.
Is Dr. Wu a Psychoanalyst?
Dr. Wu is a certified psychoanalyst having graduated from the Boston Psychoanalytic Society and Institute, an affiliate of the American and International Psychoanalytic Societies. She practices psychoanalysis for patients strictly in her Boston office, but psychoanalytic principles and approach imbue all aspects of her work, including her executive coaching and organizational clients in Greater Boston and abroad. Read more about Dr. Wu.
Psychoanalysis Areas of Focus
Learn more about the types of referral problems that Dr. Wu treats and inform yourself about some of their common symptoms and underlying causes.
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