What Is Psychodynamic Therapy?
- Hannah McCann, MSW, LADC I, LCSW
- Mar 26
- 3 min read
Many people come to therapy with a sense that something deeper is going on, even if they cannot fully explain it.
They may notice patterns in their relationships, emotional reactions that feel stronger than expected, or behaviors that seem to repeat even when they are trying to change.
Sometimes the thought is, “I understand what I’m doing, but I don’t understand why I keep doing it.”
Psychodynamic therapy focuses on helping people understand those deeper patterns.
It examines how past experiences, underlying emotions, and less-conscious processes may still influence how someone thinks, feels, and relates in the present.
Looking beyond surface-level patterns
Some therapy approaches focus primarily on current thoughts and behaviors.
Psychodynamic therapy takes a different approach. It looks at what may be underneath those patterns.
This includes exploring:
recurring emotional themes
relationship dynamics
internal conflicts
beliefs about self and others
reactions that feel automatic or difficult to control
The goal is not just to identify what is happening, but to understand the underlying reasons those patterns developed and why they continue.
How past experiences continue to show up
Many current struggles are connected to earlier experiences, even when the connection is not immediately obvious.
This does not mean everything comes directly from childhood, but early relationships and emotional experiences often shape how people:
interpret situations
respond to stress
experience connection
regulate emotions
develop expectations of others
Over time, these patterns can become automatic.
Psychodynamic therapy helps bring awareness to these connections so that patterns feel less confusing and more understandable.
The role of awareness and insight
A core part of psychodynamic therapy is developing insight.
Insight means understanding not just what you are doing, but why.
For example, someone might begin to notice:
why certain situations trigger strong emotional reactions
why they tend to repeat specific relationship patterns
why they struggle with boundaries or self-worth
why certain thoughts or beliefs feel deeply ingrained
This type of awareness can reduce self-blame and increase clarity.
When patterns are understood more fully, they become easier to shift over time.
What psychodynamic therapy focuses on
Psychodynamic therapy often focuses on:
identifying recurring patterns
exploring emotional experiences in more depth
understanding internal conflicts
recognizing unconscious or automatic responses
connecting past experiences to present behavior
It is less about quick fixes and more about developing a deeper understanding that leads to lasting change.
What this looks like in therapy
Sessions are typically conversational and exploratory.
The focus is on noticing patterns as they come up, both in current life and sometimes within the therapeutic relationship itself.
Over time, therapy may involve:
identifying themes that show up across situations
exploring emotional reactions in real time
understanding how past experiences influence present responses
building awareness of internal patterns
The pace is often more gradual, but the goal is to create changes that are meaningful and long-lasting.
How I use psychodynamic therapy
In my practice, I use psychodynamic principles to help clients understand the underlying patterns that continue to influence their thoughts, emotions, and behaviors.
This is especially helpful for clients who:
feel stuck in repeating patterns
have insight but struggle to create change
experience strong emotional reactions without clear explanation
want to understand themselves at a deeper level
I often integrate psychodynamic work with CBT, DBT, ACT, trauma-informed care, attachment-informed approaches, and somatic strategies depending on the individual.
The focus is on combining insight with practical change.
When psychodynamic therapy may be a good fit
Psychodynamic therapy may be a good fit if you:
notice patterns repeating in your life or relationships
want to understand the deeper reasons behind your reactions
feel like your responses are automatic or difficult to change
are interested in gaining more self-awareness
want therapy that focuses on long-term change rather than quick solutions
This approach can be especially helpful when surface-level strategies have not fully addressed the underlying issue.
Closing
If you are in Massachusetts and looking for therapy support for trauma, anxiety, depression, addiction, or long-standing patterns that feel difficult to change, you can learn more about my services or reach out to schedule a consultation.
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