Guides
Psychodynamic Therapy
Making sense of the patterns that keep repeating—by looking at where they started, what goes unsaid, and how they show up between us.
Approaches I draw on
If “psychodynamic” makes you picture a silent analyst behind a couch, murmuring “hmm” while you talk to the ceiling, I understand—that image has had a long run. It isn’t what this looks like with me. For one thing, we meet by video, so the only couch involved is yours, if you happen to be on one.
Psychodynamic theory is part of the ground I stand on as a therapist, along with attachment theory and mindfulness. Underneath it is a hopeful idea: the past isn’t finished with us, and the strategies you built to get through earlier chapters of your life are often still running, whether or not anyone asked them to.
What psychodynamic therapy pays attention to
Psychodynamic therapy grew out of psychoanalysis and kept its most useful idea: much of what drives us happens outside our awareness. Not in a spooky way—more like driving a familiar route and arriving with no memory of the turns. In our sessions, I’m listening on a few levels at once:
- History: what earlier relationships taught you to expect from people, and from yourself
- What goes unsaid: the pause before an answer, the subject that keeps changing, the joke that arrives right as something gets tender
- Patterns that repeat: the same role, the same argument, or the same ending turning up with different people
- What happens between us, which deserves its own section
What a session actually looks like
I’m an active therapist, so our sessions are a conversation rather than a monologue. Expect questions from me, connections pointed out as they appear, and the occasional return to something you mentioned in passing that I suspect mattered more than you let on.
If you’ve ever had a therapist who mostly listened and nodded, you might like my answer to that exact complaint on the FAQ page—it starts with two words and an exclamation point. I’ll engage with you and challenge you when it’s useful, while remembering that you are the expert of your own life. The hope is that you leave each session knowing something about yourself you didn’t know when you logged on.
The relationship as part of the work
The relationships where your patterns repeat include the one with me. Patterns don’t take a day off just because you’re in therapy. You might catch yourself apologizing for crying, worrying that you’re boring me, swallowing a disagreement, or bracing for criticism when you log on a few minutes late.
In session, we can get curious about those reactions while they’re happening, which can teach us more than describing them afterward. If something between us echoes an older pattern, we’ll name it kindly and look at it together, and you’re welcome to push back on me, too.
How it fits with the rest of my approach
I use several traditions deliberately rather than interchangeably, as I explain on my approach page, and psychodynamic thinking is the one that keeps asking where something came from. Attachment-focused work narrows that question to closeness and distance, mindfulness brings it back to what your body is doing right now, and Internal Family Systems, my primary lens, lets us talk with the part of you that’s still running an old strategy.
That might mean noticing that you go quiet whenever someone raises their voice, tracing the quiet back to a household where it kept the peace, feeling where it lives in your body, and getting to know the part of you that still believes silence is the safest option.
Who it can suit
Psychodynamic work can be a good fit if you understand your patterns perfectly well in your head and they keep happening anyway, if the same argument keeps turning up with different people, or if you’re simply curious about your inner world. If you’d rather have something short and tightly structured, a different approach may serve you better, and I’ll say so honestly.
If it does sound like a fit, this work usually happens in individual therapy: 45 minutes by video, wherever you are in California or Massachusetts, weekly at least to begin with, because consistency is what makes it hold.
If you’d like to see how it feels with your own material, send me a short note through the contact form and we’ll find a time for a free 15-minute video consultation—no paperwork and no pressure.
A few common questions
Is psychodynamic therapy the same as psychoanalysis?
They’re related, but not the same. Classical psychoanalysis usually means several sessions a week, often on a couch, for years. Psychodynamic therapy keeps the core ideas—unconscious patterns, the past alive in the present, the relationship as a place to learn—and works with them in a more conversational way, face to face, or in our case screen to screen.
Do we just talk about my childhood?
No, though it will probably come up, because childhood has a way of doing that. We can start with what’s happening now and look back only as far as it helps make sense of the present. Some sessions may never leave this week, and that’s fine. You decide how much history to share, and when.
How is it different from skills-focused therapy?
Skills-focused approaches tend to work directly on thoughts and behaviors, often with structured exercises between sessions, and they can be genuinely helpful. Psychodynamic work spends more time on why a pattern formed and what it protects. The two aren’t rivals, and our sessions include practical pieces too, like meditation and breathwork.