Psychodynamic therapy
Making sense of how past experiences can affect feelings and relationships in the present.
By Richard Mann · 15 October 2026
← Integrative therapy and the different approaches
Do you find yourself having the same argument, feeling responsible for everyone or expecting people to leave? You might be frustrated that a pattern keeps returning even though you can see it happening. Psychodynamic therapy offers time to understand why the pattern has such a strong hold.
It explores how earlier experiences and feelings outside immediate awareness influence the present. It shares its roots with psychoanalysis, but the arrangement is often less intensive. The focus is on understanding your particular experience, including how you relate to yourself and other people.
How can understanding the past change the present?
Recognising where a response comes from can reduce the sense that there is something wrong with you. If disagreement once led to rejection or hostility, it makes sense that you might avoid it now. What once protected you may also make it hard to express an opinion or ask for something you need.
Insight is a beginning rather than the whole task. The work also involves feeling and thinking about situations differently as they arise. You may need to experience a disagreement that does not end a relationship, rather than simply be told that disagreement is safe.
What happens in the room?
You might begin with something that happened that week. The therapist helps you explore the feelings around it and notices connections with other experiences. A conversation about feeling overlooked at work might lead to a familiar sense that you have to earn attention by being useful.
Attention may also turn to the relationship with the therapist. If you worry that you have said too much, or feel disappointed by a response, that can be talked about. These moments can reveal expectations that are difficult to see elsewhere. The therapist should remain open to having misunderstood you; not every difficulty is a repetition of the past.
Who might find this way of working useful?
It may be worth considering when relationship difficulties repeat, feelings seem hard to understand or self-criticism persists despite reassurance. Some people want to explore grief, low mood or the impact of earlier experiences in greater depth. You can ask how the approach relates to the particular difficulty you are bringing.
Psychodynamic work can be time-limited or open-ended. It does not require spending every session discussing childhood. Present circumstances, identity, discrimination and practical pressures also matter. If you need help with something urgent or want specific strategies, that should be part of the conversation about what support fits.
When feedback feels like rejection
Imagine that a manager asks you to revise a piece of work and you spend the evening feeling ashamed. Exploring the experience might reveal an old belief that being valued depends on getting everything right. Therapy could help you recognise that belief, understand the hurt beneath it and try asking for clarification rather than apologising repeatedly. Feedback may remain uncomfortable, but it need not become a verdict on your worth.
What might change?
Less automatic self-blame
You may understand your reaction before deciding that you are the problem.
More freedom in relationships
It may become easier to express a need or tolerate a difference.
Earlier recognition of triggers
A familiar feeling can become a signal to pause and reflect.
These are possible signs of progress, not promises. What matters is whether the work is making a useful difference to your life. You and your therapist can review that together.
How this fits with integrative therapy
In integrative counselling we can explore the history of a pattern alongside what keeps it going now. Understanding why criticism hurts, for example, can sit alongside practical work on boundaries, self-criticism or how to respond to feedback.
Read about integrative therapy and explore the other approaches →Sources and further reading
- BACP: Psychodynamic therapy
- British Psychoanalytical Society: Psychoanalysis and psychotherapy
- NHS: Treatment for depression
This article explains an approach in general terms. The right support depends on your needs, preferences and the practitioner’s training.
We can begin with a conversation.
You do not need to work out which approach you need before getting in touch. I offer a free 15-minute consultation to talk about what is troubling you and whether working together feels right.
Sessions are available in North London and online across the UK.
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