What Is Psychodynamic Therapy and How Does It Work?
Psychodynamic therapy helps you understand how your past shapes the way you feel today. Claire Smith, BACP accredited therapist in Worcester Park, explains what it is and how it works.
People sometimes ask me what psychodynamic therapy actually is, and I understand why. There are so many different types of therapy out there that it can be hard to know what each one involves, let alone which one might be right for you.
So I thought I'd try to explain it in plain English, the way I'd explain it if you were sitting across from me in a session.
It starts with a simple idea
Psychodynamic therapy is based on something that most of us already know instinctively: that our past shapes who we are today. The experiences we had growing up, the relationships we formed early on, the things we were told about ourselves, all of that leaves a mark. Sometimes those marks are helpful. Sometimes they're not.
What psychodynamic therapy does is help you notice those patterns. Not in a textbook way, but in a way that actually makes sense of what you're feeling right now. Why you react the way you do in certain situations. Why some relationships feel harder than others. Why you might keep ending up in the same place even when you're trying to do things differently.
What happens in the room
If you've seen therapy in films, you might be imagining someone lying on a couch while a therapist scribbles notes and says nothing. That's not what this looks like.
In practice, we sit together and talk. There's no script, no homework, no set agenda. You bring whatever is on your mind, and we explore it together. Sometimes that means talking about what happened this week. Sometimes it means going back to something from years ago. Often, the two are connected in ways that aren't immediately obvious.
My job isn't to tell you what to do or give you advice. It's to help you understand yourself better. To notice things you might not have noticed before, and to make connections between how you felt then and how you feel now.
It's not about blaming your parents
This is something I get asked about a lot, so it's worth saying clearly: psychodynamic therapy isn't about pointing the finger at anyone. It's not about deciding whose fault things are.
It's about understanding. When you can see where a pattern started, you're in a much better position to change it. That's not blame, it's freedom.
How is it different from CBT?
CBT, or cognitive behavioural therapy, is probably the type of therapy people have heard of most. It's a structured approach that focuses on changing unhelpful thought patterns and behaviours, usually over a set number of sessions.
Psychodynamic therapy works differently. Rather than focusing on symptoms and strategies, it looks at what's underneath. It asks why you think and feel the way you do, not just how to manage it. Both approaches have their place, but psychodynamic work tends to create deeper, longer-lasting change because it gets to the root of things rather than managing what's on the surface.
How long does it take?
There's no fixed number of sessions. Some people come for a few months and find what they need. Others stay longer because the work goes deeper. It depends entirely on you, what you're bringing, and what feels right.
What I can say is that most people start to notice shifts quite early on. Not dramatic overnight changes, but a growing sense of understanding. A feeling of things starting to make sense.
Is it right for you?
If you've ever found yourself thinking "why do I always do this?" or "why can't I just move on?", psychodynamic therapy might be a good fit. It's particularly helpful for people who feel stuck in patterns, who struggle with relationships, or who have a sense that something deeper is going on beneath the surface.
If you're curious about whether it could help, I offer an initial consultation where we can talk through what's going on for you and whether this approach feels right. There's no pressure and no obligation.
You can get in touch at help@counsellingwithclaire.uk or visit my contact page to find out more.
Claire Smith is a BACP accredited psychodynamic therapist (216379) based at Manor Drive Medical Centre, Worcester Park. She works with adults on a range of issues including anxiety, depression, relationship difficulties, and repeating patterns.