By Gerald Schoenewolf, Ph.D. Psychodynamic therapy—that is, therapy that is based on the psychoanalytic model—is the oldest form of therapy and most probably the deepest. While many therapies today are symptom oriented, psychoanalysis is oriented towards relieving a client from the unconscious blocks that prevent healthy functioning. Psychoanalysts believe that if you help a client to overcome a symptom, another one will appear to replace it.
Because it is a therapy that probes deep into the unconscious, it takes more time, but once you go through it, all of your symptoms will diminish. Below I have delineated four stages of psychodynamic psychotherapy.
Stage 1: Intellectual Awareness. The first few months–sometimes lasting up to a year–are spent obtaining an intellectual understanding of your issues. You learn all about yourself: why you are anxious, depressed or angry; how you got that way (linking present habits with traumatic events during childhood); and what kind of situations in your present life are problematic. You become aware of what things trigger you and what people you are vulnerable to.
During this stage you start off feeling that you are making a lot of progress, as you become quickly aware of the various aspects of your psychological functioning. However after a while you have the feeling that you are not making progress. It seems to you that you have learned everything you need to know, but you are still getting into the same situations you always have.
Stage 2: Emotional Awareness. The second stage involves the most difficult part of therapy. In this stage you have to understand your feelings and what you do with them. This is the part of therapy where you learn to really “know yourself”–something many wise people have written about. The hardest part about knowing yourself is recognizing your own faults. It is easy to look at the faults of others and how others are making you miserable; but looking objectively at yourself is perhaps the hardest thing any person can do.
The main thing that stops people from looking at themselves is their unconscious emotional blocks. For example, a person may be aware that he is angry at another person and critical of them. But he will not want to be aware of the deeper jealousy that causes him to want to put down the other person. Getting in touch with all your feelings and how you express them is a long term project that may last years.
The second-stage process involves taking yourself apart and studying each aspect of your psychological functioning. This can be the most painful part of the process, but also the most rewarding.
Stage 3: Reconstruction. Now that you have taken yourself apart, you will need to rebuild yourself. Taking yourself apart involves individuation–separating yourself from the self you were programmed to be by your upbringing. Perhaps you were programmed to feel afraid of opening up to people and have deep-seated fears of doing so because in your family whenever you opened up you ended up feeling misunderstood and belittled. Reconstruction involves learning how to open up and developing your own confidence in yourself. It has to do with building a new you from the ground up.
Once you have erected this new you, you will begin to relate to people in a different way. Family members and friends who are used to looking down on you and feeling superior to you will have to process their own feelings. After your emotional separation from them, you will no longer tolerate bad treatment from them, and they will think you have gotten uppity. There will follow a period of adjustment.
Stage 4: Mastery. Toward the end of the third stage you reach a point where you feel more balanced and more grounded. You have gone through individuation and have developed a new personality that is more adept at taking care of yourself and your feelings. The new self has learned to handle people and situation that used to cause you stress.
As you practice handling the various situations that come up, you develop mastery. The things that used to trigger you diminish, but not completely. You are more able to handle them, but still have occasional relapses. Eventually you develop a new you that not only handles things better, but thinks about them better. For example, whereas you might have been convinced that the only way to make yourself feel good would be to tell off all your enemies, now you understand that the way you feel better is to forgive them and move on.
These four stages can last a couple or years or a lifetime, depending on how disturbed you are at the beginning of therapy. But research has shown that psychodynamic therapy does work, and like all good things, you get out of it what you put into it. Last Update: 4/13/2023
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