Psychodynamic therapy is a powerful, insight-oriented approach to treating mental health conditions, especially those rooted in unresolved emotional conflicts and complex interpersonal patterns. But what exactly is it and how does psychodynamic therapy work?
Rooted in psychoanalytic theory originally developed by Sigmund Freud, psychodynamic psychotherapy explores how unconscious processes, early childhood experiences, and interpersonal relationships shape present behavior. At Red Ribbon Recovery, we offer psychodynamic therapy as part of our comprehensive therapeutic model for individuals seeking lasting change and healing.
What is psychodynamic therapy?
Psychodynamic therapy, sometimes called talk therapy or psychodynamic psychotherapy, is based on the idea that current psychological struggles often stem from unresolved unconscious conflicts, repressed emotions, and painful feelings tied to past relationships, particularly with primary caregivers. This approach emphasizes the therapist-client relationship (also known as the therapeutic alliance) as a safe space to explore these deeper issues.
Unlike cognitive behavioral therapy, which often focuses on symptom management and present thoughts, psychodynamic therapy focuses on helping patients gain insight into the emotional roots of their mental health symptoms—insight that can lead to long-term relief and personal growth.
How does psychodynamic psychotherapy work?
So, how does psychodynamic therapy work in practice?
The process typically involves:
- Weekly therapy sessions where the patient and therapist build trust over time
- Open-ended dialogue that explores unconscious motivations, defense mechanisms, and interpersonal dynamics
- Techniques like free association to uncover hidden thoughts or patterns
- Analysis of the therapeutic relationship itself as a mirror for other relationships
- A focus on how early life experiences and childhood experiences influence current behavior
Through this therapeutic process, patients come to recognize patterns in their relationships, understand their defense mechanisms, and gain conscious awareness of behaviors or emotions that were previously automatic or confusing.
The role of the Therapeutic Alliance
One of the defining features of psychodynamic therapy is its emphasis on the therapeutic alliance. This patient-therapist relationship serves as both a container for emotional exploration and a vehicle for healing. As psychodynamic therapists build a supportive connection with their clients, the therapeutic relationship itself becomes a space where new ways of relating can emerge.
This alliance helps patients confront unconscious patterns, reflect on interpersonal relationships, and develop new coping mechanisms grounded in ego psychology, self psychology, and the psychodynamic perspective.
Is there empirical evidence supporting psychodynamic therapy?
Yes. A growing body of empirical evidence, including randomized controlled trials, supports the effectiveness of psychodynamic therapy in treating a variety of psychological disorders. While once seen as more abstract or time-consuming than cognitive therapy, recent research confirms that psychodynamic therapy is effective, particularly for complex or long-standing emotional difficulties.
A review published in the journal American Psychologist noted that psychodynamic therapy provides “benefits that increase over time” and is particularly well-suited for clients seeking to understand the deeper causes of their suffering.
When is brief psychodynamic therapy used?
Brief psychodynamic therapy is typically delivered in a shorter time frame, often 12 to 24 sessions, and focuses on a single issue or conflict. It is ideal for patients who may not require long-term psychodynamic therapy but still need support exploring a central emotional concern or psychological distress.
This therapeutic approach blends the core principles of psychodynamic theory with a more focused timeline, making it a versatile and accessible option for many.
What to expect in a therapy session with psychodynamic therapists
For many people, the idea of starting psychodynamic therapy can feel intimidating simply because they’re not sure what will happen in the room. At Red Ribbon Recovery, our goal is to create a safe, supportive, and collaborative experience for every session.
Typical therapy sessions last about 45–60 minutes and center on open conversation between the client and therapist. Guided by proven therapeutic techniques, the discussion may explore recent challenges, recurring relationship patterns, or early life experiences that continue to shape thoughts and feelings today. In this process, the patient–therapist relationship itself becomes a powerful tool for insight, as it can mirror dynamics from other relationships in the client’s life.
Because psychodynamic therapy focuses on uncovering unconscious processes, sessions often involve reflecting on feelings that arise in the moment, making connections to past events, and exploring how these patterns influence current behaviors. Clients may also integrate skills from other therapies, such as CBT or DBT, creating a more comprehensive approach to care.
Our clinicians adapt therapeutic approaches to meet the needs of each individual, whether they’re addressing mental health conditions like depression and anxiety, or complex psychological disorders such as personality disorders or trauma-related issues. The aim is to ensure that each session feels purposeful and safe, fostering trust while creating space for meaningful emotional growth.
Cognitive behavioral therapy vs psychodynamic therapy
While cognitive behavioral therapy can help manage present triggers, psychodynamic therapy aims to address the root causes, creating long-term resilience. At Red Ribbon Recovery, we often integrate both approaches, blending the practical skills of CBT with the deeper insight gained through the psychodynamic therapy offered. In some cases, we use brief psychodynamic formats to target specific emotional issues, while in others, long-term work provides the foundation for sustained recovery.
Because addiction frequently coexists with mental health conditions such as depression, anxiety, or PTSD, this insight-oriented approach can also help improve emotional stability, strengthen relationships, and reduce the risk of relapse—supporting both sobriety and overall well-being.
Who can benefit from psychodynamic therapy?
Psychodynamic therapy is considered effective for a wide range of mental health conditions, particularly those involving deep-seated emotional struggles. Common issues treated with psychodynamic treatment include:
Personality disorders (such as borderline personality disorder)
For people with personality disorders, psychodynamic therapy explores underlying relationship patterns, attachment styles, and self-image. This approach can help patients better understand their emotional triggers, improve interpersonal skills, and develop more stable ways of relating to others.
Panic disorder and social anxiety disorder
Psychodynamic therapy can uncover the deeper emotional conflicts that fuel panic attacks or social anxiety—such as unresolved fears, self-esteem issues, or early relational experiences. By identifying these root causes, individuals can reduce symptom intensity and learn healthier responses to anxiety.
Post-traumatic stress disorder (PTSD)
By providing a safe space to process traumatic memories, psychodynamic therapy helps individuals recognize how trauma impacts current behaviors, relationships, and emotional regulation. This process can support healing from the lingering psychological effects of trauma.
Eating disorders
Psychodynamic therapy addresses the underlying emotional distress, identity struggles, or relational dynamics that can contribute to disordered eating. It helps clients understand the symbolic meaning of food and body image, promoting healthier self-perception and coping strategies.
Depression and mood instability
This therapy approach explores unresolved grief, internalized guilt, or self-critical thought patterns that may be contributing to depression. By bringing unconscious feelings into awareness, individuals can shift long-standing emotional patterns and build more emotional stability.
Complicated grief, relationship issues, and trauma
For those coping with loss, relationship breakdowns, or ongoing trauma, psychodynamic therapy provides a supportive framework to work through unresolved emotions. It fosters greater self-awareness, emotional resilience, and the ability to form healthier future connections.
Whether offered as short-term psychodynamic psychotherapy (also known as brief psychodynamic therapy) or as long-term psychodynamic therapy, the treatment can be adapted to meet different clinical needs.
Is psychodynamic therapy effective for addiction recovery?
Substance use disorders often have deep emotional roots, tied to unresolved conflicts, past trauma, and unconscious patterns that influence present-day behavior. For many clients, understanding how psychodynamic therapy works can be the missing piece in breaking the cycle of relapse.
In psychodynamic psychotherapy, clients explore the underlying emotional and relational patterns that may have fueled their substance use. This process goes beyond surface symptoms to uncover the core issues—such as feelings of abandonment, unresolved grief, or chronic self-doubt—that drive harmful coping mechanisms. Through consistent therapy sessions, the therapeutic relationship becomes a safe space to examine these patterns and begin changing them.
The long-term benefits of insight-oriented therapy
One of the unique strengths of psychodynamic therapy, rooted in psychoanalytic theory, is that its benefits often continue to expand long after the final session. By exploring unconscious processes and connecting them to past experiences, clients gain a deeper understanding of why they think, feel, and act the way they do. This self-awareness becomes a lasting tool for navigating life’s challenges.
When psychodynamic therapists work with clients, the focus isn’t only on symptom relief in the present, but also on building the emotional resilience to handle future stressors. Over time, these therapeutic approaches can strengthen personal relationships, improve communication, and foster healthier boundaries. This insight-oriented growth also supports better decision-making, reducing the likelihood of returning to old patterns or harmful coping mechanisms.
The Red Ribbon Recovery approach
At Red Ribbon Recovery, our licensed clinicians integrate psychodynamic therapy with other evidence-based modalities, including cognitive behavioral therapy and trauma-informed care. Whether you’re facing addiction, a mental health diagnosis, or unresolved emotional pain, our goal is to provide personalized, compassionate treatment that addresses the whole person.
We help clients uncover and resolve the unconscious conflicts that fuel self-sabotage, addiction, or emotional dysfunction—creating a foundation for lasting transformation. Contact us today to speak with one of our psychodynamic therapists and begin your healing journey.
Sources
- National Library of Medicine (US). Treating Stimulant Use Disorders. NCBI Bookshelf, 2022.
- Stubbe, Dorothy E. “The Therapeutic Alliance: The Fundamental Element of Psychotherapy.” Focus (American Psychiatric Publishing), vol. 16, no. 4, Fall 2018.
- American Psychological Association. “Psychodynamic Therapy: What It Is and How It Works.” APA Public Interest Directorate, Jan. 2010.
