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What is Psychodynamic Psychotherapy?

Prospective clients often ask how psychodynamic psychotherapy works. What will it be like to be in the room with my therapist? What do I have to do? Will it make me feel better? Is it suitable for me?

You may or may not have an idea about psychodynamic psychotherapy before you begin at WPF Therapy as a client, so here are some thoughts. The first answer is that no two therapies are alike, just as no two people are alike, so we cannot tell you how it will unfold. What we can do is give you an idea of what to expect.

Your therapist will not know either, how the therapy will unfold. There is no agenda. This may sound strange, but it is quite deliberate. Strategies, plans, expectations, are all put away. What matters is the unique person that you are: your wishes, your desires, your hopes. It is not about what the therapist wants or knows, but about who you are. In psychodynamic therapy, the two of you embark on a joint journey to discover this. The setting will be entirely confidential. If you are curious about yourself then therapy can be of benefit.

Your therapist will be listening out, all the time, for who you are. Some parts of you may be buried deep, underneath all the expectations that others have had for you, and you have come to have of yourself. There may be some aspects of yourself that you distrust, dislike, hate, or are even afraid of. You may constantly try to be someone else – bigger, better, or perhaps smaller, more helpless than you feel. You may try hard not to let others see through this. The therapist’s job is to help you recognise and understand these parts of yourself, so that they no longer seem so important or frightening, or necessary to hold on to.

Most of these are fears and feelings left over from when we were very young. This is because the mind works by making patterns. When we encounter something new, our immediate reaction is to link it to something we experienced before. The mind goes: ‘ah, that’s like what happened when….’ pattern making is very necessary. It is how we make links between things, and how we learn. But this pattern making can also have less useful effects. Some of these effects may include deep depression and anxiety, difficulties with relationships and many other issues. Very early patterning may for example mean that if someone had an early experience of being ignored, they may expect everyone, including the therapist, to ignore them, even when that is not true. When such situations arise in therapy, your therapist will pick this up and you may come to see that history does not always repeat itself and does not have to repeat itself.

Trust is key to this process. In any relationship trust takes time to build, and so in your therapy too. With trust, you can gradually come to understand yourself as a unique individual, and to understand each person in your life for who they are, as individuals. You can learn to relate to yourself and others in new ways. You may not be aware that problems in the present may be rooted in past experiences, nor that you are transferring past experiences and expectations onto the present. It is all happening deep in the mind, not consciously, often right out of your awareness. Neither you nor your therapist may be sure what is going on for some time. But your therapist will always be seeking to listen out for resonances in what you say. Your therapist will, where possible, share their observations with you by suggesting, when the time feels right, new possible meanings for you both to reflect on.

All of this is going on at the same time that you might be talking about your family, your past week, difficulties at work, someone else you know. Anything and everything you say is therefore useful because over time it may help you make sense of things that feel important to you. It’s not only what you say but the way in which you are in the room that may be important: you can be distant or warm, lively or disengaged, and all this can change in the course of a session as well as over time.

One purpose of therapy is to help you to live your own life more fully; a life that really feels your own, not shaped by others’ wants or needs. Your therapist is an experienced professional able to help you with this. The therapist’s skill lies in allowing and facilitating something new to emerge in you. So your therapist may seem to hold back, to wait. He or she will offer no strategies or advice, because it is not about what the therapist wants. It is not your therapist’s job to tell you what to do or how to think. Your therapist is there to enable you to make sense of your life and to live in a more fulfilled way. This means your therapist accepts your own understandings until such time as you are ready to see them in a new way. Your therapy may sometimes give way to painful feelings that you have perhaps been avoiding for a long while. But you will not be alone in experiencing these: your therapist will be there to help you work through your feelings. The therapeutic space is reliably there just for you, and you can experience difficult feelings safely, together. Therapy is a journey that leads to change, and the process of changing is always to some extent painful. The direction of change is towards yourself – and a fuller life.