Psychodynamic therapy is the kind of talk therapy many people imagine when they think of psychological treatment for depression. That's because the image of the psychiatrist and patient probing the past is a staple of our popular culture. It can be found on sitcoms or in jokes. And psychodynamic therapy has been a major element in movies like Good Will Hunting and Ordinary People and on the stage in plays like Equus.
Psychodynamic therapy is designed to help patients explore the full range of their emotions, including feelings they may not be aware of. By making the unconscious elements of their life a part of their present experience, psychodynamic therapy helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings.
Seeking help for depression -- and following through with antidepressant medication -- is a courageous and important first step on the road to recovery. But too often, those who take that step find themselves faced with another troubling problem: weight gain.
Experts say that for up to 25% of people, most antidepressant medications -- including the popular SSRI (selective serotonin reuptake inhibitor) drugs like Lexapro, Paxil, Prozac, and Zoloft -- can cause a weight gain of 10 pounds or more.
What Distinguishes Psychodynamic Therapy From Other Therapies for Depression?
Psychodynamic therapy is one of three main types of therapy used to treat depression. The other two are cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). What distinguishes them is the nature of their focus.
Both CBT and IPT are focused on understanding and modifying certain processes or behaviors. For CBT, the focus is on how a person thinks. Thoughts shape what a person does and how a person feels and reacts; CBT focuses on identifying and changing dysfunctional patterns of thought.
With IPT the emphasis is on identifying issues and problems in interpersonal relationships and learning ways to address and improve them. Both CBT and IPT are also time-limited, short-term therapies. The emphasis is on learning new patterns rather than analyzing why the dysfunctional patterns are there.
Psychodynamic therapy, on the other hand, grew out of the theories and practices of Freudian psychoanalysis. Psychoanalysis is based on the idea that a person's behavior is affected by the unconscious mind and by past experiences. Psychoanalysis involves an intense, open-ended exploration of a patient's feelings, often with multiple sessions in a week. The sessions include an examination of the feelings the patient is aware of and those the patient is unaware of before therapy begins.
Psychodynamic therapy is less intense. Sessions usually occur once a week and are typically 50 minutes each. But unlike IPT and CBT, both of which have sessions that adhere to a formal, outlined structure and that set specific learning agendas, psychodynamic therapy sessions are open-ended and based on a process of free association.
In psychodynamic therapy, the patient is encouraged to talk freely about whatever happens to be on his or her mind. As the patient does this, patterns of behavior and feelings that stem from past experiences and unrecognized feelings become apparent. The focus is put then on those patterns so the patient can become more aware of how past experience and the unconscious mind are affecting his or her present life.
Another distinction between the types of therapies is that psychodynamic therapy is not necessarily a short-term, time-limited treatment. While some courses of therapy may end after 16 to 20 weeks, other instances may go on for more than a year.