If we think about psychotherapy, the image that probably comes to mind is that of an individual lying on a couch explaining his problems to a psychologist sitting behind him while he takes notes and asks questions. However, this image does not necessarily correspond to reality: there are multiple schools and currents of thought in psychology , some being more appropriate than others depending on the specific case being treated.

One of the first great currents of thought to emerge was Freud’s psychoanalysis. But Freud’s students and those followers who decided to break with him due to discrepancies in some elements of his theory also continued to generate content and add new theories and aspects to psychoanalytic therapy. These are the so-called psychodynamic approaches. And with them, different therapies emerged. In this article we will see the main models and psychodynamic theories .

Psychodynamic theories

The concept of psychodynamic theory may seem unique and unitary, but the truth is that it encompasses a wide number of ways of understanding the human mind. When we talk about psychodynamic theories we are talking about a heterogeneous set of perspectives that have their origin in conceptions of mental processes derived from psychoanalysis .

In this sense, all of them share with the Freudian theory the idea that there are intrapsychic conflicts between the conscious and the unconscious , being one of the main objectives of the therapy to contribute to make the patient capable of understanding and managing the unconscious content (bringing it to consciousness).

Furthermore, psychodynamic theories also consider the existence of strategies and defense mechanisms used by the psyche to minimize the suffering generated by such conflicts, and agree that the psychic structure and personality are formed during childhood from the satisfaction or dissatisfaction of needs. The childhood experience is very relevant for this current , as well as the interpretation of these experiences and the transfers. They also consider that the interaction with the therapist will make the patient relive the repressed experiences and representations, turning to the professional.

These psychodynamic models and theories differ from psychoanalysis, among other things, in that they focus more on the reason for consultation identified by the patient and not on a complete personality restructuring. The therapies are not so long and more spaced out, and they are open to a large number of mental disorders and problems and not only neuroses and hysteria. There are other differences, but these will depend largely on the specific psychodynamic model being observed.

Some of the main therapies and models

As we have mentioned, there are multiple theories and psychodynamic therapies. Below are some of the best known.

Adler’s individual psychology

One of the main neo-Freudian models is that of Adler, one of the authors who separated from Freud due to multiple discrepancies with some aspects of psychoanalytic theory.

This author considered that the libido was not the main engine of the psyche, but the search for acceptance and belonging, which will generate anxieties that if not replaced will cause feelings of inferiority. He also considered the human being a unitary being, understandable at a holistic level , who is not a passive being but has the capacity to choose. This author considers the lifestyle as one of the most relevant aspects to work with, together with the eagerness for power derived from the feeling of inferiority and the objectives and goals of the subject.

His psychotherapy is understood as a process that seeks to confront and change the way the subject faces the vital tasks, trying to make explicit the guideline of the subject’s performance to favor his self-efficacy and self-confidence.

From this psychodynamic theory, the first proposal is the establishment of a relationship of trust and recognition between therapist and patient , trying to bring the objectives of both towards the achievement of the recovery of the latter. Subsequently, the problems in question are explored and the observation of the strengths and competences of the patient is encouraged, which will end up being used to solve them.

The lifestyle and the decisions made are analyzed, after which the focus is shifted to working on the beliefs, goals and vital objectives of the subject so that he can understand his own internal logic. Finally, we work together with the patient to develop habits and behaviors that allow the reorientation of behavior towards the tasks and objectives of the subject.

Jungian Analytical Theory

Jung’s model is another of the main neo-Freudian models, being one of Freud’s followers who decided to break with him due to several discrepancies. From this model we work with aspects such as dreams, artistic expressions, complexes (unconscious organizations of unrecognized emotional experiences) and archetypes (inherited images that make up our collective unconscious).

The aim of this therapy is to achieve the development of an integrated identity, trying to help the subject to take into account what Jung interpreted as unconscious forces . Firstly, the subject is confronted with his person (the part of himself that he recognizes as his own and that expresses the outside world) and with his shadow (the part of our being that we do not express and that we usually project on others), trying to achieve this through the treatment.

After that, we work on the anima and animus archetypes, the archetypes that represent the feminine and the masculine and how they are worked and projected in social relations. Later in a third stage we look for to work the archetypes corresponding to the wisdom and synchronicity with the universe by means of the analysis of dreams and artistic elaborations (that are analyzed, among other methods, by means of the use of the association in particular elements of the dreams). We work collaboratively with the patient and try to integrate the different facets of being.

Sullivan’s interpersonal perspective

Sullivan considered that the main element that explains our psychic structure are the interpersonal relationships and how these are lived, configuring our personality based on personifications (ways of interpreting the world), dynamisms (energies and needs) and the elaboration of a system of the self.

At the therapy level, this is understood as a form of interpersonal relationship that allows for security and facilitates learning. It should generate changes in the person and situation, with the therapist working in an active and directive way without increasing the distress of the subject .

It mainly proposes to work from obtaining information and correcting that which is erroneous, modify dysfunctional evaluation systems, work on the personal distance of the subject from people and situations, correct phenomena such as the fact of interacting with others believing that they will relate to us just like other significant people before them, seek and reintegrate the inhibited elements of the patient and seek that the patient is capable of communicating and expressing logical thoughts and the search for satisfaction while reducing the need for security and experiential avoidance.

The theory of object relations

Melanie Klein is perhaps one of the greatest figures of the psychoanalytic tradition of the self , followers of Freud who followed his theoretical line by adding new contents and fields of study. In his case, the study and focus on minors.

One of its most relevant theories is the theory of object relations, in which it is proposed that individuals relate to the environment according to the link they make between subject and object, with the unconscious fantasy generated by the object being especially relevant when explaining behaviour.

When working with children, special importance is given to symbolic play as a method for working on and externalising unconscious fantasies, to later try to clarify the anxieties that arise from them and to introduce modifications both through play and by other means such as creative visualisation, narrative, drawing, dance or role-playing.

Other more recent psychodynamic theories

There are many approaches, models and theories that have been developed throughout history from the psychodynamic approach. In addition to the above, there are some relatively recent psychodynamic therapies and theories, very focused on the practice and day-to-day of therapy, and not so much on systematic explanations of the structure of mental processes.

Theory of Brief Dynamic Psychotherapy

This perspective is based on the idea that the therapeutic work should be focused on a specific area that generates the greatest difficulties and that best explains the patient’s specific problem. Its main characteristics are its brevity and the high level of definition of the element to be worked on and the objectives to be achieved.

In addition to this a high level of directivity of the therapist and the expression of optimism regarding the patient’s improvement is also common. The aim is to attack the resistances in order to later work on the anxiety generated by the attack and subsequently make the patient aware of the feelings that have generated these defences and discomfort.

Within this type of psychotherapy we can find different techniques, such as brief psychotherapy with provocation of anguish or deactivation of the unconscious.

Transference-based therapy

Proposed by Kernberg, it is a type of therapy of great importance in the treatment of subjects with personality disorders as the limit. The theory behind it is based on the theory of object relations to propose a model in which there is a focus on both the internal and external world of the patient and which focuses on working from the transfer of internal difficulties to the therapist. In people with severe personality disorders, the experience of frustration and the inability to regulate it prevails, with which the psyche finally splits up in such a way that a diffusion of identity is produced.

It seeks to promote the integration of the mental structures of patients, reorganizing them and seeking to generate modifications that allow a stable mental functioning in which the subjective experience, perception and behavior go hand in hand. The context, the therapeutic relationship and the analysis of the object relations are fundamental , analysing the feelings generated by the relationship with them (including the therapeutic relationship) and the unconscious fantasy generated by this relationship, helping to understand them.

Mind-Based Therapy

Bateman and Fonagy developed a model and a type of therapy that is based on the concept of mentalization. This is understood as the capacity to interpret one’s own and others’ actions and reactions based on the existence of emotions and thoughts, recognizing these as a state of mind.

Very influential and based largely on Bowlby’s attachment theory, it attempts to explain mental disorder (especially borderline personality disorder) as a result of difficulty in attributing mental states to what they do or feel. The therapy linked to this model seeks to achieve congruence, favour the connection between feeling and thinking , develop the capacity to mentalize and try to understand one’s own emotions and those of others, improving in turn interpersonal relationships.

Bibliographic references:

  • Almond tree, M.T. (2012). Psychotherapies. Manual CEDE de Preparación PIR, 06.
  • Bateman, A. W., & Fonagy, P. (2004). Psychotherapy for Borderline Personality Disorder: Mentalization Based Treatment. Oxford: Oxford University Press.