Life involves many twists and turns that cast lasting shadows on the human psyche. Since the first moment wherein we gather our wits and learn to identify, focus, recollect, recreate, imitate, hide or react, the shadows of past experiences accumulate in the human mind to design and dictate our behavior, speech, and thought. Many a time, startling impressions from any event in the past could end up as a trauma that cripples the victim’s behavior in everyday life. It could be as innocuous as an excessive compulsion to wash your hands too frequently or as violent as the tendency to inflict self-injury.

Treating a trauma rooted deep in the recesses of the psyche necessitates an in-depth analysis of the victim’s mind to locate and assuage the pain inflicted by the memory in the abyss of the unconscious. Unlike a book that can be thoroughly read as you sieve through each leaf, there is no easy way to gauge the psychic apparatus except for resorting to interactive counselling undertaken by a psychologist on a willing participant through in-depth talks and conversations.

What is the core concept underlying psychodynamic therapy?

The psychodynamic approach to analyzing and conditioning the unconscious was developed by Sigmund Freud and his disciples in the 1890s, founded on the notion that childhood experiences and associated memories have a formative influence of an individual’s behavior and personality in their adulthood. The approach involves an attempt to unveil the traces of emotion and memories that are hidden away in the unconscious mind. The memories available for the conscious mind are limited and incomplete, like what’s visible of an iceberg to the observer as the tip; the bulky mass which forms the foundation and body of the berg is hidden away like the unconscious. So, how does the psychodynamic approach help unveil the deep-seated traumas or impressions?

Psychodynamic therapy sessions are one-on-one interpersonal exchanges between the client and the therapist whereby the words, actions, behavior, reactions, aversions, etc are shared and observed by both the participants, respectively. Psychodynamic theory is characterized by a stubborn insistence on the concept that every minute gesture, action or word a person delivers are directly influenced by the hidden elements in the unconscious.

To study the conflicts within the mind that ultimately dictate the client’s actions or speech, the counsellor places an emphasis on moving at the former’s pace. If any activity during the session triggers the client to rear up their defences (refusing to divulge further, sudden abnormal reaction to a certain trigger, etc), the therapist doesn’t try to topple their defensive mechanism with an offensive force rather gives them room to open up on their own..

Psychodynamic therapy is an interpersonal activity that demands a foundation of mutual trust and a shared goal. Free association is a significant approach in psychodynamic therapy wherein the therapist encourages the client to open up their emotional state, thoughts and worries without inhibition by voluntarily disclosing them to the therapist. Each session is scheduled once or twice a week in order to gradually set the pace. By allowing the patient to talk whatever is of interest to them, the therapist solidifies the basic foundation of trust in their patient-therapist relationship.

Psychodynamic therapy sessions have their own rocky gutters and hurdles along the way that ought to be overcome by the therapist and client together. For instance, a patient suffering from childhood trauma induced by abuse from parents might show tenacity to transfer their fear, repulsion, rebellious tendencies, dependence or other manifestations that directly correspond to the patient’s trauma onto the therapist. The therapist strives to find a pattern in the broken and unhinged shreds of emotion in the patient’s unconscious that form the core of their idiosyncrasies. The disorganized narrative of a patient’s hidden and available memories and emotional influence is examined and logically rearranged by the therapist in order to locate the cause and analyze its impact. The psychodynamic theory attributes the root of all behavioural peculiarities and reactions of adults as the direct result of experiences from childhood.

The aim of psychodynamic therapy is to invoke self-awareness in the patient, i.e, identify the hidden childhood trauma that has resulted in subsequent behavioral abnormalities in the adulthood; that is to say, it adamantly attributes Obsessive Compulsive Disorder in adults as the result of any trauma incurred in the childhood which is concealed behind the defensive instinct to suppress, repress, transfer or alter them within the unconscious. In the therapy, various methodologies like projective tests (patients attributing imageries to originally ambiguous inkblots based on elements from their unconscious), dream analysis, hypnosis, analyzing parapraxes (peeking into the unconscious through slips of the tongue unknowingly made by the patient) and free association ( allowing the patient to take lead in the conversation with the therapist, rather than prompting them to respond to the cues given by the latter) are employed to drive the patient to self-realization.

The ideal result of the psychodynamic therapy is long-term or permanent, i.e, the patient identifies the cause and reasons, which helps them reconcile with their inner conflicts and recondition their obsessive behavioral symptoms. At the completion of the therapy, the patient is reinvigorated with self-confidence- their ego elevated from a state of distress and enervation to one of confidence and acceptance of the self. Psychodynamic therapy is recommended to those with social phobia and OCD to re-emerge into society with normalcy.

What are the weaknesses of the psychodynamic approach to individual therapy?

In spite of its long-standing in the field of psychological therapy, the psychodynamic theory has no empirical foundation. It is premised entirely on the therapist’s “insight” and intuition, or how he makes informed guesses on the patient’s trauma by applying the psychodynamic theory. It is therefore classified as a reductionist form of psychology that inflexibly ascribes the cause solely as a result of childhood trauma and discredits other possible causes such as genetics and cognition. Under the psychodynamic approach, the patient is reduced to an entity that lacks the reason and ability to exercise free will who is entirely controlled by the unconscious in the three-tier model of id-ego-superego.. The deterministic nature of psychodynamic theory with subjective explanations that have little scientific grip and deep sexist tendencies makes it a treatment methodology much debated, both for and against.