Psychodynamic therapy & how it helps with depression

A person in therapy session. Photo by Christopher Lemercier

Psychodynamic therapy & how it helps with depression

It is estimated that 1 in 4 people will experience a mental health problem of some variety each year in the UK. Perhaps more alarmingly, 1 in 6 people report experiencing poor mental health in any given week.

From anxiety, depression, phobias, post-traumatic stress to obsessive-compulsive disorder, we are in the midst of a global mental health crisis. So much so, in 2022 the World Health Organization released its largest review of the state of the world’s mental health since the turn of the century. Its report was damning and highlighted an urgent need to transform our approach to mental health.

The good news is that although there are growing numbers of mental health issues, there are also growing ways in which professionals can support those struggling.

One of those is psychodynamic therapy – a type of counselling which helps clients to understand how their current feelings and behaviours are shaped by the past and their unconscious mind. Here’s a breakdown of psychodynamic theory and how it can help treat depression.

The origins of psychodynamic theory

Psychodynamic theory encompasses elements from many different types of therapy. Its roots can be found predominantly in the work of Sigmund Freud, but other theories and practitioners like Carl Jung, Otto Rank, Melanie Klein, and Alfred Adler have also been commended for their efforts in developing the field.

Propositioned by Freud, psychodynamic therapy is all about making the unconscious mind, conscious. The theory is that our unconscious holds our painful memories and feelings from our past, ones that our conscious mind would find too difficult to process without the help of a professional.

To ensure these experiences stay hidden, we may develop defences, denials, and projections to protect ourselves, when in actuality we’re doing more harm than good. The aim of psychodynamic therapy is to help people recognise, process, and understand these deep-rooted feelings in order to resolve them.

How does psychodynamic therapy work in practice?

Therapists or counsellors need to gain a better understanding of their clients’ lives in order to apply psychodynamic theory. This usually involves conversations about beliefs, current thoughts, emotional responses, and early life experiences. Professionals work with clients to help identify the recurring patterns which are usually resulting in destructive (or at least self-destructive) behaviours.

A key component of psychodynamic therapy is a strong and trusting relationship between the client and the therapist. The client should feel able to talk freely and openly about sensitive subjects without fear of judgement.

In practice, clients are encouraged to talk freely – known as free association. This process – talking about whatever comes to your mind – is essential to allowing your unconscious to come through and show itself in the conversation. Transference is another key concept – the practice of redirecting feelings clients have experienced in other significant relationships onto the professional. It may sound odd, but transference is a useful tool which helps clients to understand why they are treated in a certain way, or the type of behaviours they unconsciously attract.

Psychodynamic therapeutic conversations should always be had in a safe space with a trusted professional. If you are a practitioner, ensure that your client has the necessary privacy to open up about their potentially painful experiences. Self-employed therapists should look into therapy rooms to rent if they’re eyeing up a space of their own.

Psychodynamic therapy and depression

Mental health practitioners use psychodynamic therapy to help with a host of different problems, including anxiety, addiction, and eating disorders. However, it is a particularly useful theory when it comes to supporting those suffering from depression.

Depression has tended to be treated by either cognitive behavioural therapy (CBT), interpersonal therapy (IPT), or indeed psychodynamic therapy. They tend to be different in their focus: CBT is about how a person a person thinks and how dysfunctional thought patterns can be altered, and IPT emphasises the role of interpersonal relationships and how issues within them can be addressed. Both of these approaches are short-term and rely heavily on learning new patterns, rather than unpacking older, harmful, and dysfunctional patterns deep within us.

Psychodynamic therapy delves into the past and helps people to realise unconscious thoughts and behaviours. Sessions with therapists can be informal, whereas with CBT and IPT, there are specific learning agendas and an outlined structure.

For those with depression, psychodynamic therapy has been found to have longer lasting effects. These courses of therapy are usually longer, more detailed, more fluid, and evidently provide better outcomes for those struggling.

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