Depression and Psychodynamic Therapy
Psychodynamic Therapy has roots in psychoanalysis as developed by Sigmund Freud in the early 1900s. Similar to psychoanalysis, individuals meet face-to-face with the therapist and treatment is an interactive process between client and therapist. Both work together to address the unconscious motivation behind many of the emotions, behaviors and life-patterns that contribute to the client's depression or other emotional disorder.
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Effect of Psychodynamic Therapy on Depression
Clients generally meet with a psychotherapist one time per week, and discuss whatever comes to mind while in the therapy session.1 It is the role of the therapist to hone in on central concepts that may underly the client's unconscious patterns and together address these motivations.
The major difference between CBT and psychodynamic therapy is the emphasis on insight into unconscious motivation in psychodynamic therapy.2Central to the psychodynamic approach with depressed patients is the establishment of the interpersonal meaning and context of their depression but unfortunately, patients often resist these interpersonal implications. Instead, they view their depression and sometimes accompanying suicidal wishes as occurring in a vacuum, insisting that no one is to blame but themselves. The psychodynamic therapist's task is to help the patient conceive of new ways of living and to examine the impact of his or her condition on others.
While cognitive behavioral therapy has been studied extensively with depressed patients, brief psychodynamic therapy of depression has less of a research base. Randomized controlled studies of long-term psychodynamic therapy and psychoanalysis with depressed patients are not available. More recently, however, rigorous controlled studies have shown promising results of brief dynamic therapy of depressed patients.
Research Evidence on Psychodynamic Therapy
Unlike cognitive behavioral therapy, which has been studied extensively with depressed patients, brief psychodynamic therapy for depression has less of a research base. Psychodynamic therapy is considered nondirective and the majority of empirically supported treatments for emotional disorders including depression, have been done on guided therapies like CBT.2Therefore, randomized controlled studies of long-term psychodynamic therapy and psychoanalysis with depressed patients are not available.
However, more recently, rigorous controlled studies have shown promising results of brief dynamic therapy of depressed patients. The Journal of the American Medical Association recently analyzed 23 studies and found that long-term psychodynamic psychotherapy was more effective in treating individuals with complex mental disorders (particularly anxiety and depression) than other forms of psychotherapy.3 Additionally, a one meta-analysis found that psychodynamic therapy and CBT were equally effective treatments for depression.4
As with other forms of psychotherapy, psychodynamic therapy in particular can be used in a treatment regime for many personality and emotional disorders. There are no known side effects to using psychotherapy to treat depression.
1 Types of Psychological Treatment. A Guide to Psychology and its Practice. Retrieved from http://www.guidetopsychology.com/txtypes.htm#Psychodynamic
2 Seligman, L.D., Wuyek, L.A., Geers, A.L., Hovey, J.D., & Motley, R.L. (2009). The Effects of Inaccurate Expectations on Experiences with Psychotherapy. Cognitive Therapy Research 33, 139-49. doi: 10.1007/s10608-005-9174-6
3 The Benefits of Long-Term Therapy(2009). Therapy, Today 20(1).
4 Leichsenrig, F. (2001). Comparative Effects of Short-Term Psychodynamic Therapy and Cognitive-Behavioral Therapy in Depression: A Meta-Analysis. Clinical Psychology Review 21, 401-19.