Psychodynamic meaning / Psychodynamic definition
The American Psychological Association Defines psychodynamic theory as:
“a constellation of theories of human functioning that are based on the interplay of drives and other forces within the person, especially (and originating in) the psychoanalytic theories developed by Sigmund Freud and his colleagues and successors, such as Anna Freud, Carl Jung, and Melanie Klein. Later psychodynamic theories, while retaining concepts of the interworking of drives and motives to some degree, emphasize the process of change and incorporate interpersonal and transactional perspectives of personality development.”
APA Dictionary
Characteristics of Psychodynamic theory
- There is an unconscious
As much as we want to be self-governing, rational beings, we mostly are not. Starting from this assumption allows for a coherent understanding of why people act either irrationally and/or in ways that hurt us more than help us.
Most of the time we don’t have good reasons why we act the way we do. The unconscious mind helps to explain this. Consciousness has influence over things. In fact, the subjective experience of consciousness does an excellent job of convincing itself of its own power.
Underneath the conscious mind though, there is a reservoir of instinct, memory, experience, and evolutionary history. It’s a dark, vast, and mysterious place. There are ways we can learn more about it, and psychodynamic clinicians are trained to use certain tools to decode its cryptic messages.
Psychodynamic therapists use tools like dreams and fantasy life, free association, slips of the tongue, hypnosis, and transference as ways to better understand what our unconscious mind is inclined to make us do.
- What’s in our unconscious determines us
The unconscious contains all of our evolutionary history. We are capable of expressing profoundly sophisticated behaviors. Spend a few days on a psychiatric ward, and you’ll also see the exact opposite.
When it comes to life and death matters, the older parts of our brains are primary. Instincts, feelings, drives, and reflexes bear the brunt of keeping us alive. Neocortex is quite a bit more advanced and sophisticated. We can do some incredible things with that hardware. At the end of the day though, our brains are like lizards with a macbook pro.
- What we don’t know can hurt us
The less we know about the instincts, wishes, and pressures arising from our unconscious minds, the more governed we are by these forces. That is, to be unconscious of something means we are determined by it.
Sex and aggression are the most animalistic of our urges. In humans, connections to others is also a basic drive. In my psychodynamic formulations, I also consider more humanistic aspirations such as acceptance, self-esteem, productivity/utility, freedom, and emotional validation. These humanistic, relational desires flow out of the attachment system.
In fact, the necessity of a healthy connection to other individuals, groups, and social systems is the reason we have such complex brains to begin with.
Developmental deprivations of any, some, or all of these needs often leads to powerful unconscious insistence on getting them met. If we don’t know what’s driving us, then we are more likely to take destructive paths to attain it.
Working with someone who offers an empathic understanding of what we want and need calms impulsive and compulsive action. It also opens up the possibility that what we need and desire can be achieved within the confines of what society can tolerate.
Insight and awareness is key to minimizing damage to ourselves and others as our unconscious minds insist on getting their way. As G.I. Joe said, “knowledge is half the battle.”
- Origins of “pathology” or maladaptive (or insufficiently adaptive defenses) arise out of experiences during sensitive developmental periods
Our minds are open and, for the most part, trusting during early years. This is by design, as our complex, social brains need time and input in order to grow. This is literally a mechanical problem, since if fetal brains developed any further than they already do, vaginal childbirth would not be able to occur at all.
Openness, flexibility, and trust are all essential preconditions for optimal learning. They are also tremendous vulnerabilities when it comes to toxicity in a developmental environment. Researchers can now trace many emotional impairments back to mundane interactions between mother and child at 4 months of age. The implications of this are as fascinating as they are sobering.
The depth, continuity, intimacy, and trust inherent to a good psychodynamic treatment environment are the way to heal early developmental disruptions, say psychodynamic therapists. Merely changing thoughts and behaviors are insufficient.
- Change occurs at the level of personality
Psychologists and other mental health professionals like to separate disorders into acute and chronic conditions–which is to say, stress-induced vs. personality-based pathology. The psychodynamic model assumes that acute flare-ups, of anxiety and depression, let’s say, are rooted in personality organization. That is, something about the general adaptations made by a person during formative years have both strengths and weaknesses.
Change in therapy means reshuffling and retooling the personality so weaknesses are a little less weak, and vulnerabilities are a little less vulnerable. One reason psychodynamic models have fallen out of favor is that individuals (and insurance companies) prefer to believe that a problem can be “fixed” without messing with the rest of the system.
Psychodynamic theorists say this is not the case.
- The mind is like a hydraulic, thermodynamic system
Like a game of whack-a-mole, when an individual inhibits animalistic drives with frontal lobe energy, then the energy pops up somewhere else. It has been argued that Freud’s theory of the mind is an expression of the leading technologies of his era. Subsequently, more computational, information processing models of the mind have been posited.
While it’s possible to find merit in both computational and hydraulic system models, proponents of psychodynamic theory argue that the hydraulic/thermodynamic analog has more points of comparison.
- For meaningful change to happen, the individual must become more aware of unconscious motivations
The oft-cited wisdom from Freud “making the unconscious conscious” is indeed the way for individuals to shape their futures. However, being aware of something does not mean it is controlled by the ego–it merely provides opportunities for better compromises, defenses, and adaptations to take hold.
The more awareness that builds and time that elapses in a psychodynamic treatment, the more opportunity a person has to create improved communications and more seamless integration. And obviously, the more stress an individual is under, the more challenging a healthy dialogue between the conscious mind and unconscious mind is to foster.
Psychodynamic perspective
Now that we have a definition and basic characteristics of the term “psychodynamic” in mind, how might we describe what it means to have a “psychodynamic perspective”?
The psychodynamic perspective on the human mind and personality is one that considers systems, contingencies, interconnectedness, and finding equilibrium. In other models of human psychology, researchers and clinicians treat symptoms as isolated phenomena that need to be removed with surgical precision. What is unique about a psychodynamic perspective is the assumption that removing a symptom likely creates a new problem.
Systems seek equilibrium, and the human mind and personality are no different. Symptoms serve a function–and even though there probably are more empowering and efficient ways of solving a problem than an annoying symptom, psychological problems are not mostly not like appendixes that can be removed without consequence.
The psychodynamic perspective is not one where an omniscient clinician provides expert advice on how to create more equilibrium. Psychodynamic clinicians place their faith in the unconscious of the patient as patient and therapist collaborate in identifying problems and finding their meaning and purpose.
Psychodynamic vs. psychoanalytic
Increasingly, the terms psychodynamic and psychoanalytic are used interchangeably. Most experts believe that differences between the terms are largely academic. Historically, psychodynamic refers to rules governing the flow of psychic energy (i.e., libido) and how these principles can explain human psychology–especially the neuroses. Psychoanalytic traditionally has been applied in a more narrow way; it mostly has been used to mean of or related to psychoanalysis. Psychoanalysis refers to the orthodox practices of Freud and his most faithful adherents–practices built around psychodynamic assumptions. As fewer psychoanalysts remain strict adherents to Freud’s more doctrinaire techniques, the two terms are treated more and more as synonyms.
The term “psychodynamic” captures the characteristics of the human mind that are analogous to the laws of thermodynamics–especially the notion that energy can neither be created nor destroyed. Ernst von Brücke first popularized this assumption about the human mind. It eventually became a core component of Freud’s theories about the mind and psychotherapeutic change.
The term “psychoanalysis” includes not only psychodynamic theories about the mind, but also aspects of Freud’s theories and practices specifically. For example, some (but not all!) modern psychoanalysts believe in a “death drive”, use an analytic couch, insist on a minimum number of sessions per week (e.g., 4), etc. The term psychodynamic is thus more broad and inclusive, capturing both orthodox classical Freudian analysts and therapists who make use of shared theoretical underpinnings in a once-weekly therapy context.
Psychodynamic examples
The vignettes below provide some examples of psychodynamic psychology and principles. Notice how crises arise out of both/either unawareness of powerful feelings and/or a feeling of conflict around how to express these feelings.
Little Johnny
Little Johnny is angry at his mother for telling him he can’t have waffles for breakfast. He is afraid of expressing this anger directly to his mom because in the past she starts to cry and accuses Little Johnny of not loving and respecting her. Because he must do something with his emotion of anger, Little Johnny sneaks into his mother’s room and hides her favorite slippers (passive-aggression).
Sarah
Sarah doesn’t have many friends, but she does have a very best friend named Becky. Sarah has been seeing less of Becky lately because recently the most popular boy in school has taken an interest in Becky. Not only has Sarah been seeing less of Becky, but also when they do spend time together, Becky wants to talk exclusively about her new love interest. Sarah feels both envy and anger towards Becky. However, Sarah already feels lonely and does not believe she has the right to be upset about Becky’s excitement and happiness. Sarah begins to manage her guilt, envy, and anger by restricting her food intake. When Sarah is able to control and restrict her food intake, she feels a greater mastery over her emotions and feels less guilty about being selfish (masochism).
Timmy
Timmy lives in a single-parent home where money, attention, and consideration for his feelings are scarce. The most attention he gets occurs when he acts out. Screaming, throwing tantrums, making a mess, refusing to do what he’s asked are win-win situations for him. If someone pays attention to him and makes him stop, then great! If he gets to have fun making a mess and doing fun things, then great! Of course, this is not all great. What Timmy would much prefer is attention, healthy limit-setting, and help understanding why he feels so restless and out-of-control. The biggest problem for Timmy is that he’s in 1st grade and has already had tons of problems at school. He can’t sit still, he gets sent out of the classroom, and his teachers have sent him to be evaluated for ADHD. His already-overwhelmed caregiver is losing patience and has even less empathy for Timmy’s antics at home. While Timmy appears to be a wild, but fun-loving kid, his deeper problems don’t get seen because HE doesn’t even understand them. His family, community, and even school psychologist doesn’t get him. What’s worse, he is developing a sense of himself that’s quite painful (not that he has any conscious understanding of this at all). He feels like a nuisance, he can’t do things other kids can do (like sit still), he’s out of control, he’s profoundly anxious (again, he has no idea what this means), and he doesn’t have the slightest sense of how this could be any different.
Psychodynamic therapy
Distinguishing one form of psychotherapy from another can be challenging since even very different brands of therapy share common factors (Rosenzweig, 1936). Leading researcher on psychodynamic psychotherapy, Jonathan Shedler, argues that psychodynamic psychotherapy can be distilled down to 7 essential shared qualities. These characteristics of psychodynamic psychotherapy per Shedler, 2010 are the following:
- Focus on affect and expression of emotion
- Exploration attempts to avoid distressing thoughts and emotions
- Identification of recurring themes and patterns
- Discussion of past experience (developmental focus)
- Focus on interpersonal relations
- Focus on the therapy relationship
- Exploration of fantasy life
Efficacy of psychodynamic psychotherapy
In addition to providing a basic list of defining features of psychodynamic psychotherapy, Jonathan Shedler also summarized an impressive track-record of therapeutic outcomes when psychodynamic psychotherapy has been studied.
In particular, Shedler focuses on Meta-analyses of psychodynamic psychotherapy research; that is, studies that evaluate pooled results from a wide variety of strong individual studies on psychodynamic psychotherapy.
Some of the key findings are the following:
- Large effect sizes in general symptom improvement, anxiety ratings, and somatic symptoms. Moderate effect size improvements in depressive symptoms. Long-term follow-up showed that these effect size improvements continued to increase over time.
- Compared to a control group, one meta-analysis showed large effect sizes that increased at long-term follow up; the effect sizes showed that recipients of psychodynamic psychotherapy were better off with regard to their symptoms than 92% of patients prior to treatment
- Moderate effect sizes were found among patients experiencing unexplained somatic symptoms, both in terms of reduction of somatic symptoms and general psychiatric symptoms
- In a study comparing Cognitive Behavior Therapy and Psychodynamic Psychotherapy, Effect sizes of CBT and Psychodynamic Psychotherapy were both found to have large effect sizes
- Short-term psychodynamic psychotherapy was found to have large effect sizes for both general psychiatric symptoms and interpersonal functioning
- Two individual studies on long-term psychodynamic treatments (more than a year) showed large effect sizes at the end of the trial, with effect sizes increasing at long-term follow up
Shedler points out that one especially intriguing potential advantage to long-term psychodynamic psychotherapies is that the benefits appear to increase over time. In contrast, non-psychodynamic treatments largely show decay in benefits over time.
Confirmation of the compounding benefits of psychodynamic psychotherapy over time could support the theorized mode of therapeutic change in psychodynamic treatment; that is, that the patient internalizes the voice of the therapist and becomes one’s own therapist over time.
APA psychodynamic division
The APA division devoted to psychoanalysis as well as psychodynamic theory, psychodynamic therapy, and psychodynamic practices is Division 39: Society for Psychoanalysis and Psychoanalytic Psychology.
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References
The American Psychological Association
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American psychologist, 65(2), 98.
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