Orange flowers with dark green leaves — Image by Egor Komarov

Psychodynamic therapy offers a space to explore the deeper patterns and emotional experiences that shape how we relate to ourselves, others, and the world around us.

Have you ever found yourself repeating the same patterns in relationships, even when you don’t want to? Or felt overwhelmed by emotions that seem to come from nowhere?

Perhaps you’ve noticed that certain situations trigger reactions that feel out of proportion, or wondered why you keep making choices that don't align with what you truly want.

These experiences often point to deeper emotional patterns, ones that psychodynamic therapy is uniquely equipped to help you understand and transform.

Rather than simply managing symptoms or learning coping strategies, psychodynamic therapy helps you understand why these patterns exist. By exploring the connections between past experiences and present-day struggles, you can develop genuine insight that leads to lasting change. This isn’t about dwelling on the past for its own sake - it’s about understanding how early experiences continue to influence you now, so you can make more conscious choices about how you want to live and relate to others.

Key principles of psychodynamic therapy include:

The unconscious mind: Much of our emotional life operates outside conscious awareness. Therapy creates space to bring these patterns into the light, offering new understanding and choice.
Early experiences and relationships: Our formative relationships shape how we see ourselves and connect with others. Exploring these patterns can help us understand current difficulties and create healthier ways of relating.
The therapeutic relationship: The relationship between therapist and client becomes a valuable lens for understanding relational patterns. This collaboration offers a safe place to explore emotions, defences, and ways of being.

The Evolution of Psychodynamic Therapy

The practice of psychodynamic therapy has evolved significantly since its early foundations. Originally developed from the work of Sigmund Freud in the late 19th and early 20th centuries, psychodynamic therapy has been refined and expanded by many influential thinkers, including Carl Jung, Melanie Klein, and Donald Winnicott. Today’s psychodynamic therapy is far more relational, collaborative, and evidence-based than its historical origins, focusing on the present therapeutic relationship while exploring how past experiences continue to influence our lives.

The Role of Attachment in Psychodynamic Work

Attachment theory is integral to contemporary psychodynamic therapy. Developed by John Bowlby and later expanded by Mary Ainsworth, attachment theory explores how our early bonds with caregivers shape our capacity for connection throughout life. These early attachment experiences create internal working models—templates for how we expect relationships to unfold and how we regulate our emotions within them.

In psychodynamic therapy, understanding your attachment patterns can illuminate why certain relationship dynamics feel familiar or triggering, why intimacy might feel threatening or why you might struggle with trust or dependency. The therapeutic relationship itself becomes a space to experience and potentially reshape these attachment patterns, offering what Bowlby called a ‘secure base’ from which to explore difficult emotions and experiences.

By creating a thoughtful, empathetic space for exploration, psychodynamic therapy helps clients develop deeper self-awareness, process unresolved emotions, and develop more fulfilling relationships. This approach supports lasting change by addressing not just symptoms, but the underlying emotional patterns that contribute to distress.

Frequently Asked Questions About Psychodynamic Therapy

What is psychodynamic therapy, and how is it different from other types of therapy?

Psychodynamic therapy focuses on exploring the deeper emotional patterns and unconscious processes that influence how you think, feel, and behave. Unlike Cognitive Behavioural Therapy (CBT), which tends to focus on changing specific thoughts and behaviours in the present, psychodynamic therapy considers the underlying reasons for certain patterns. While person-centred therapy emphasises unconditional acceptance and following your lead, psychodynamic therapy actively explores how past experiences and relationships shape your current life. The aim is lasting change through insight and understanding, rather than simply managing symptoms.

Is psychodynamic therapy evidence-based?

Yes, there’s substantial research supporting the effectiveness of psychodynamic therapy. Studies show it’s as effective as other therapies for depression and anxiety, with some research suggesting its benefits continue to grow after therapy ends, possibly because the insights and self-understanding gained have lasting effects. There’s particularly strong evidence for its effectiveness with personality difficulties, relationship problems, and complex or longstanding issues. Contemporary psychodynamic therapy integrates research from attachment theory and neuroscience, making it a thoroughly modern, evidence-informed approach. That said, the subjective experience of feeling understood and the quality of the therapeutic relationship matter enormously, which is harder to capture in research but central to how therapy actually works.

How can psychodynamic therapy help me with my issues?

Psychodynamic therapy is particularly effective for issues rooted in relational patterns and emotional difficulties. It can help with anxiety and depression by exploring what maintains these feelings beneath the surface, rather than just addressing symptoms. It’s especially valuable for relationship difficulties, as it examines how early attachment experiences influence your current connections. If you struggle with self-esteem, psychodynamic work can help you understand the origins of self-criticism and develop a more compassionate relationship with yourself. This approach is also helpful for those who feel stuck or keep repeating unwanted patterns without understanding why.

What can I expect in a typical session?

Sessions are conversational and collaborative. You’ll have space to talk about whatever feels most pressing - whether that’s something that happened during the week, a dream, or a relationship concern. I’ll listen carefully and may offer observations about patterns, connections between past and present, or dynamics that emerge in our relationship. There’s no fixed agenda or structured exercises. Some sessions might focus on current concerns, whilst others naturally move towards exploring earlier experiences. The pace and direction are guided by what’s most meaningful and useful for you.

How long does psychodynamic therapy usually take?

This varies considerably depending on your goals and what you’re working through. Some clients find meaningful change within a few months of weekly sessions, whilst others benefit from longer-term work spanning a year or more. Psychodynamic therapy can be open-ended, allowing the work to unfold naturally, or we can agree on a specific timeframe. During our initial consultation and early sessions, we’ll discuss what feels right for you, and we can revisit this as therapy progresses. The time you invest often reflects the depth of change you’re seeking. Working on longstanding patterns typically takes longer than addressing a specific situational challenge.

Do I need to talk about my childhood?

Not necessarily, and certainly not immediately. Whilst psychodynamic therapy values understanding how early experiences shape us, this isn’t about forcing yourself to revisit memories. Many clients find that childhood naturally comes up as we explore current patterns. You might notice similarities between how you felt as a child and how you feel now, or recognise that certain relationship dynamics feel familiar. If exploring the past feels too difficult or irrelevant, we focus on what’s happening in your life now. The aim is understanding, not excavation for its own sake.

Will I have homework or exercises to do outside of sessions?

Generally, no. Psychodynamic therapy typically does not involve structured homework or worksheets. The therapeutic work happens primarily within the session itself, through our conversations and the relationship we build. That said, you might naturally reflect on what we’ve discussed between sessions, notice patterns in your daily life, or become more aware of your emotional responses. Some clients keep journals if that feels helpful, but it's not required. The focus is on what emerges naturally rather than completing tasks.

Is psychodynamic therapy suitable for couples or only individuals?

Psychodynamic therapy works beautifully with couples. In couples therapy, we explore the unconscious patterns and attachment dynamics that both partners bring to the relationship. This might include examining how early experiences of love and connection influence expectations and behaviours in your partnership, or understanding the defensive patterns that create distance. The focus is on deepening understanding of yourselves and each other, rather than simply resolving surface-level conflicts. Many couples find this approach helps them break cycles of blame and reactivity, creating a more secure and compassionate connection.

How do I know if psychodynamic therapy is working?

Progress in psychodynamic therapy can be subtle and cumulative. You might notice you’re responding differently to situations that used to trigger you, feeling more choice in how you react, or finding relationships less fraught. Some clients report feeling more like themselves, or describe a sense of internal spaciousness where there was once rigidity. We’ll check in regularly on how therapy is going and whether it’s meeting your needs. It’s also normal for things to feel harder before they feel better, as bringing unconscious material into awareness can be temporarily uncomfortable.

What if I feel worse before I feel better?

It’s quite common to feel temporarily worse since therapy brings difficult and complicated feelings or realisations into awareness. What was unconscious often stayed that way because it was painful, so bringing it into the light can feel challenging. This is actually often a sign that meaningful work is happening. I’ll be with you through these difficult moments, helping you make sense of what’s emerging. Therapy is a collaborative process, and if something isn't working, we adjust our approach. Your well-being and sense of safety in the process are paramount.

What’s the difference between psychodynamic therapy and psychoanalysis?

Psychoanalysis is the more intensive, traditional form developed by Freud, typically involving multiple sessions per week and often lasting several years. Psychodynamic therapy evolved from psychoanalysis in the 20th century, but is more flexible and accessible. Sessions are usually once a week. You sit facing your therapist rather than lying on a couch, and the approach is more conversational and relational. Modern psychodynamic therapy incorporates contemporary understandings from attachment theory, neuroscience, and relational psychology, whilst retaining the depth and insight-focused nature of the psychoanalytic tradition. Think of psychodynamic therapy as the practical, evolved descendant of psychoanalysis.

How I can help

I’m Francesca, an integrative therapist offering individual therapy and couples therapy. I draw on psychodynamic principles alongside other approaches to create a therapeutic space tailored to your unique needs and goals. If you’re curious whether this approach is right for you, I’d be happy to discuss how we might work together.

Book your consultation

You may also enjoy …

Featured

Is Psychodynamic Therapy Right For You? Everything You Need To Know

Have you ever found yourself repeating the same patterns in relationships, even when you don’t want to? Or felt overwhelmed by emotions that seem to come from nowhere? Psychodynamic therapy offers a space to explore the deeper patterns and emotional experiences that shape how we relate to ourselves, others, and the world around us.