Psychodynamic psychotherapy (also known as dynamic psychotherapy or psychodynamic therapy) is a psychotherapy approach based on psychodynamic theory that focuses on understanding a person’s emotional difficulties, ways of relating, behavioral cycles and the relationship they have with themselves.
What is psychodynamic psychotherapy?
Psychodynamic psychotherapy is a psychotherapy approach based on psychodynamic theory that aims to understand in greater depth a person’s present-day emotional difficulties, ways of relating, behavioral cycles and the bond they have with themselves. In this approach, not only current symptoms but also the person’s past experiences, early relationships, emotional needs, defense styles and relationship patterns that are repeated without awareness are evaluated together.
Psychodynamic psychotherapy recognizes that the difficulties a person experiences are not made up only of “present-day problems”; past experiences, learned ways of coping and unconscious processes can influence present-day emotions, thoughts and relationships. For this reason, a person’s anxieties, anger, feelings of guilt, experiences of loss, way of becoming close, themes of separation and dependency, sense of self and recurring cycles in relationships can be addressed in the process.
Are dynamic psychotherapy and psychodynamic therapy the same thing?
In the sources, the terms “dynamic psychotherapy” and “psychodynamic psychotherapy” are mostly used interchangeably for the same approach; for example, both names appear on the Greater Manchester Mental Health NHS Foundation Trust page. The Royal College of Psychiatrists (RCPsych) describes the approach under the name “psychodynamic psychotherapy.” The use of the terms may vary from one institution and one professional to another. For an overview of psychotherapy types, see Which Approaches Can Be Used in the Psychotherapy Process?.
What are the basic principles of psychodynamic psychotherapy?
Psychodynamic psychotherapy takes its origin from psychoanalytic theory; over time it has been enriched by developments such as object relations, self psychology and attachment theory. Its basic principles can be summarized in broad terms as follows:
- Unconscious processes: It is assumed that emotions, thoughts and conflicts a person is not aware of can influence their behaviors and relationships.
- The effect of past experiences on the present: Early relationships and experiences can shape a person’s present-day ways of relating and their expectations.
- Recurring patterns: A person may repeat similar cycles in their relationships and life; the aim in therapy is for these patterns to be noticed.
- Defense mechanisms: These are ways a person develops without awareness to protect themselves from challenging emotions; in therapy, an effort is made to understand them.
What is done in psychodynamic psychotherapy sessions?
In sessions, the client is invited to express what passes through their mind as freely as possible. The therapist pays attention not only to the events described but also to how the person experiences these events, which emotions come to the fore, which topics recur and the emotional reactions that emerge within the therapeutic relationship. In this respect, psychodynamic psychotherapy is not a process of giving advice or offering ready-made solutions; it is work that makes room for the person to make sense of their own inner experience, relational patterns and emotional conflicts.
What concepts are commonly used in psychodynamic psychotherapy?
- Free expression (free association): The person voicing what comes to mind as freely as possible, without selecting.
- Transference: The person unconsciously carrying emotions and expectations belonging to important relationships from the past into the therapy relationship.
- Resistance: Forms of avoidance, such as changing the subject or falling silent, that a person shows when approaching topics that may be painful.
These concepts are used not to label the person but to make sense of the experience.
How can a person benefit from psychodynamic psychotherapy?
A person can benefit from this process by getting to know themselves more closely, noticing recurring relationship and behavior cycles, making sense of challenging emotions and beginning to develop more flexible ways of coping. The aim is not only to reduce symptoms but to be able to address, in a deeper and more integrated way, the bond a person has with themselves, their emotions and their relationships.
Who may psychodynamic psychotherapy be suitable for?
According to the Greater Manchester Mental Health NHS Foundation Trust, psychodynamic psychotherapy may be suitable for people who are curious about themselves and want to understand their problems at a deeper level. As examples, the page mentions an uncertain or fragile sense of self, conflicts in current relationships that may echo past ones, and difficulty coping with loss and bereavement. The NHS London Waiting Room page, for its part, notes that the approach is not for everyone, that it may require a long-term commitment and that it can be emotionally challenging; the Greater Manchester page adds that it may not be the first choice for people who want more structure or direction. Suitability is determined through an assessment; for selection criteria, see How Is the Suitable Way of Working Assessed?.
What does research say about psychodynamic psychotherapy?
A 2017 meta-analysis by Steinert and colleagues, published in the American Journal of Psychiatry, pooled 23 randomized controlled trials (2,751 patients in total) that compared manual-guided psychodynamic psychotherapy with treatments already shown to be effective for the same problem. For target symptoms, equivalence was reported both at the end of treatment and at follow-up; that is, the finding shows similarity, not superiority, of one approach. The authors also note that future research should identify which patients benefit most from which treatment. A review by Shedler (2010) reports that effect sizes for psychodynamic psychotherapy are comparable to those of other therapies commonly described as evidence-based. These findings concern group averages; individual responses may vary with the problem and the person.
How does the psychodynamic psychotherapy process proceed?
The psychodynamic psychotherapy process is unique to the person. The length, frequency and focus of the sessions are evaluated in line with the person’s reason for seeking support, needs, life circumstances and therapeutic goals. The process is conducted on the basis of confidentiality, ethical principles, a regular session framework and the client’s active participation.
According to RCPsych, individual psychodynamic psychotherapy usually involves regular 50-minute meetings, held weekly or, if needed, more often. This information reflects general practice described in the sources; the professional’s own working framework is determined together in the first sessions. For the general way psychotherapy works, see What Is Psychotherapy?.
What is the difference between psychodynamic psychotherapy and Cognitive Behavioral Therapy?
The table below summarizes the general tendencies between the two approaches:
| Feature | Psychodynamic psychotherapy | Cognitive Behavioral Therapy |
|---|---|---|
| Focus | Relationship patterns, the effect of past experiences on the present, the person’s inner world | Cycles of thought and behavior that maintain present-day difficulties |
| Session structure | More flexible; the person’s free expression guides the process | More structured; an agenda and goals are generally set for sessions |
| Techniques | Interpretation; addressing transference and resistance | Techniques such as thought records, behavioral experiments and exposure |
| Work outside sessions | Structured homework is generally not given | Work outside sessions is frequently used |
This comparison reflects general tendencies; practice may vary according to the therapist’s training and the person’s needs. For detailed information about Cognitive Behavioral Therapy, see What Is Cognitive Behavioral Therapy?; for a more detailed comparison of the two approaches, see What Is the Difference Between CBT and Psychodynamic Psychotherapy?.
How many sessions does psychodynamic psychotherapy generally take?
In psychodynamic psychotherapy there is no single standard of therapy duration that applies to everyone. The duration varies according to the person’s reason for seeking support, how long the difficulties have lasted, the complexity of relationship patterns, therapy goals and the depth of the process. While some psychodynamic work can be conducted on a shorter, time-limited basis, in more in-depth work the process can continue for months; in some cases it can take a year or longer. Particularly for long-standing relationship problems, recurring emotional cycles, personality patterns and difficulties related to the sense of self, therapy may require longer-term work. For this reason, in psychodynamic psychotherapy the number of sessions is not fixed definitively at the outset; it is evaluated together in the first sessions in line with the person’s needs, expectations and therapy goals.
Are there time-limited (brief) forms?
Yes. RCPsych notes that for more straightforward problems a few weeks or months may be enough, while for more complicated or long-standing problems the process may continue longer. According to the NHS London Waiting Room page, brief psychodynamic work often focuses on a single emotional area, and dynamic interpersonal therapy is a specific brief form that is sometimes used in the NHS; longer-term work, on the other hand, can take a year or more.
Do the gains last after therapy ends?
Shedler’s (2010) review reports that people who benefit from psychodynamic psychotherapy keep their gains and that improvement can continue after therapy ends. This is not a result that holds for every person but a general finding drawn from studies; individual differences may occur.
Common misconceptions about psychodynamic psychotherapy
- “Psychodynamic psychotherapy focuses only on childhood.” Past experiences have an important place; however, the aim is less to retell the past than to understand how those experiences affect present-day emotions, relationships and patterns of behavior.
- “Psychodynamic psychotherapy always lasts for years.” Duration varies with the form of the approach and the person’s needs. There are brief, time-limited forms; longer-term work can take a year or more.
- “The therapist analyzes everything and hands over ready-made interpretations.” The therapist’s role is not to give advice or suggest a course of action; it is to try to understand the person and to make the conversation helpful. Meaning is built together, starting from the person’s own experience.
- “Sessions have no structure; it is just chatting.” Although sessions leave room for free expression, the work takes place within a frame: a regular, agreed meeting time, an agreed length of work and a focus that becomes clear during the assessment.
- “Psychodynamic psychotherapy has no research support.” Randomized controlled trials and meta-analyses exist for psychodynamic psychotherapy as well; the findings are summarized above.
Expert note
In clinical work, psychodynamic psychotherapy is used not to place a person into a list of concepts but to help them make sense of their own story, relationships and recurring patterns. Concepts such as transference, resistance and defense are valuable only to the extent that they serve this sense-making.
From a perspective that draws on both cognitive behavioral and psychodynamic theory, working with the cycles that maintain present-day symptoms and understanding their roots in relationships and in the past do not exclude each other. Which approach, or which combination of approaches, is suitable usually becomes clear only after an assessment; the information in this article does not replace that assessment.
Clinical Psychologist Özgün Emre Yaylacı
Frequently asked questions
What is the difference between psychodynamic psychotherapy and CBT?
Psychodynamic psychotherapy gives more room to the person’s relationship patterns, the effect of past experiences on the present and their understanding of their inner world. Cognitive Behavioral Therapy, on the other hand, focuses more on the cycles of thought and behavior that maintain present-day difficulties and on structured techniques.
Why is free expression requested in psychodynamic psychotherapy sessions?
Free expression aims to make room for the person to notice their thoughts, emotions and recurring patterns and to make sense of them.
Is psychodynamic psychotherapy suitable for everyone?
The suitability of a psychotherapy approach is determined according to the person’s needs, reason for seeking support and clinical assessment. For this reason, it cannot be said that a single approach is suitable for everyone.
Does the therapist give advice in psychodynamic psychotherapy?
In psychodynamic psychotherapy, the therapist’s role is generally not to give advice or suggest a course of action. The therapist tries to understand what the person says and keeps the conversation going in a way that helps the person make sense of their own experience.
Is psychodynamic psychotherapy the same as psychoanalysis?
Psychoanalysis is the classical method from which psychodynamic approaches originate. Psychodynamic psychotherapy comes from this tradition, but it is generally a way of working with less frequent meetings and within a more limited period. The use of the terms can vary from person to person and from institution to institution.
Is psychodynamic psychotherapy more effective than CBT?
The relevant meta-analysis finding points to equivalence, not superiority: a 2017 study reported that, for target symptoms, psychodynamic psychotherapy was equivalent to treatments already shown to be effective. Results may vary with the problem and the person.
Sources
This article was prepared for general information; the following sources were used in preparing it (in English):
- NHS London Waiting Room: Psychodynamic psychotherapy
- Greater Manchester Mental Health NHS Foundation Trust: Psychodynamic Psychotherapy
- NHS (UK National Health Service): Cognitive behavioural therapy (CBT)
- Royal College of Psychiatrists: Psychotherapies and psychological treatments
- Steinert et al. (2017), American Journal of Psychiatry: Psychodynamic Therapy: As Efficacious as Other Empirically Supported Treatments? A Meta-Analysis Testing Equivalence of Outcomes
- Shedler (2010), American Psychologist: The efficacy of psychodynamic psychotherapy
This article was prepared by Clinical Psychologist Özgün Emre Yaylacı. Last updated: October 23, 2026. The content is for general information only and does not constitute diagnosis, treatment or personal guidance.
