Psychodynamic Therapy

Teresa Foley, M.D., Everett Siegel, M.D., Julie Newman-Toker, M.D.


  • Psychodynamic, also called "insight-oriented," psychotherapy is an umbrella term encompassing long- and short-term treatments based on theories of normal and abnormal development.
  • Psychodynamic therapy is distinct from psychoanalysis, which requires more frequent sessions, a different set of techniques, and an extensive training period for its practitioners. Psychodynamic therapy is based on theories developed over the last century of how character structure, interpersonal relationships, and psychological symptoms are related to psychological forces that are dynamic (versus static), often stem from early experiences, and may be out of one’s awareness.
  • There are four main schools of thought:
    • Freudian structural theory: Based on Sigmund Freud’s structural map of the psyche into id, ego, and superego; understands anxiety as a result of inner conflicts between doing what one wants to do (id) and what one needs to do (ego) or should do (superego). Interpretation of unconscious conflicts can lead to resolution of anxiety[1].
    • Ego psychology: Developed by Anna Freud; focuses on healthy or unhealthy mechanisms (defenses) to cope with overwhelming emotions[1].
    • Object relations: First proposed by Melanie Klein; focuses on the importance of early relationships (internalized representations) and how they influence adult relationships[1]. Otto Kernberg elaborated the theory to help understand the pathology and subsequent treatment of borderline personality disorder.
    • Self-psychology: Founded by Heinz Kohut; emphasizes the development of healthy self-esteem and development of a cohesive self; particularly useful for treatment of narcissistic personality disorder.

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Last updated: April 3, 2022