In psychodynamic psychotherapy, great importance is given to the therapeutic relationship and ambience. Whereby from the outset, the therapist will endeavour to establish and maintain an empathic and accepting stance with you, to enable you to feel that your experience (particularly your emotional experience) is understood and valued. Thereby enabling you to talk more openly about your difficulties and issues, as well as to allow you to explore your experience more deeply (consciously and unconsciously).
Your presenting difficulties and issues will be discussed and explored in detail to help you to gain a deeper understanding of what is happening, to understand the significance or personal meaning it has for you (relevant to your past), as well as to help you to articulate and receive support for what you are experiencing and feeling. It may be important to discuss and explore your family background and personal history, so that you may fully appreciate and understand significant earlier influences on your current difficulties.
The therapist helps to identify any patterns in your thinking, feeling, and behaviour that may be contributing to your current difficulties. Having greater understanding and ‘insight’ enables you to then be more consciously aware and present, and open to considering alternative ways of thinking and/or behaving.
You may find that meeting the initial goal of reducing or alleviating troubling symptoms and difficulties is sufficient for you. Or subsequently, you may want to continue with the therapy in order to achieve deeper (more permanent) change and/or additional self-development. (For a more detailed account of what this involves, and how this is achieved, refer to Principles of psychodynamic psychotherapy.)
While initially the therapist may be more ‘directive’ in assisting to explore and understand the presenting problem or issue, as the therapy continues the therapist will endeavour to allow and to facilitate you to ‘free associate’ (where you feel safe enough to say whatever comes to your mind, without censoring yourself). This is to allow the expression and development of your ‘true self’.
With long-term therapy, the ongoing exploration and understanding of your experience helps you to develop a greater sense of self-knowledge, self-awareness, and self-understanding … which in turn enables you to develop the capacity for self-reflection. In addition, the therapist’s continuous empathic attunement to your emotional experience enables you to further develop emotionally. These ‘capacities’ contribute to the development of a more healthy and robust ‘sense of self’.
Further, the ongoing exploration and deeper understanding of your family background and personal history helps you to understand the earlier experience and relationships that have been internalized and are now influencing your current experience and relationships (including with the therapist … referred to as ‘transference’). These influences (previously unconscious, now being brought into the conscious) can be ‘worked through’ in the therapy so that a more adaptive and healthy relational experience and relationship can be experienced, can be internalized, and subsequently can be known and experienced in ‘the real world’.
For more information on the theory and principles of psychodynamic psychotherapy, refer to Principles of psychodynamic psychotherapy.