Intended for healthcare professionals

Student Education

How does psychodynamic psychotherapy work?

BMJ 2002; 324 doi: (Published 01 February 2002) Cite this as: BMJ 2002;324:020214
  1. Kirsty Passmore, specialist registrar in learning disability1,
  2. Wai-Ching Leung, honorary lecturer in public health medicine2
  1. 1Durham
  2. 2University of East Anglia, Norwich

Kirsty Passmore and Wai-Ching Leung explain what is involved in this form of “talk therapy” and why you should know about it

Psychoanalysis never ceases to fascinate people, particularly in America where there is a great demand for therapy. In traditional psychoanalysis, patients attend between twice to five times a week. As this is rarely feasible in the NHS, a similar though less intensive form of therapy, “psychodynamic psychotherapy,” is usually offered. Students almost never have the opportunity to observe psychodynamic psychotherapy in action, as observers are never allowed. However, as future doctors, it is important to have a basic understanding of how it works and to be able to make appropriate referrals.

There are many types of psychotherapies (“talking therapies”). At one extreme, some focus entirely on what we do and not what we feel--for example, behavioural therapy. Other therapies focus on what and how we think--for example, cognitive therapy. By contrast, psychodynamic psychotherapy focuses on how we feel and how our mind works. Although we sometimes jokingly claim to have analysed our friends, we know that we can do nothing of the sort.

Dr. Sigmund Freud (1856-1939) Austrian. Treated patients with neuroses. Became good friends with Carl Gustav Jung when they met in 1906. Went on to publish numerous books and develop theories behind dream interpretation. Famous for relating sexual habits and functions to personality development

Although psychodynamic psychotherapy is one of the commonest types of psychotherapy used in the NHS, it is important to remember that this is only one of many types of psychotherapy available (see box 1). Both of us received supervision in giving psychodynamic psychotherapy during our psychiatric training, but we are not experts in psychotherapy. However, we found psychodynamic psychotherapy interesting, and hope to explain the basic ideas behind this type of therapy …

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