Psychodynamic Therapy: Principles, Applications, Limitations, and Considerations

Introduction

 

Psychodynamic therapy (PDT) stands as the oldest of the modern therapeutic modalities, rooted in a highly developed and multifaceted theory of human development and interaction^[1]. Fundamentally, PDT focuses on the analysis of unconscious processes as they become observable in the client's current emotional state and manifest behavior^{[1, 2]}. The central therapeutic goals are achieving client self-awareness and developing a sophisticated understanding of how the influence of the past shapes present functioning^[1].

 

The psychodynamic model is predicated on the proposition that unconscious thoughts, desires, and memories—material often inaccessible to conscious awareness—still exert primary influence over human behavior^[2]. Over decades, this theoretical framework has undergone dramatic evolution, moving away from the rigid determinism of classical psychoanalysis. Contemporary PDT places strong emphasis on how unresolved conflicts originating from past dysfunctional relationships manifest themselves, actively shaping an individual's personality and current behavioral patterns^{[1, 2]}. This adaptation has demonstrated the richness of the underlying theory for evolution and contemporary application across a wide range of psychological disorders^[1].

 

A significant development in the application of psychoanalytic theory is the emergence of various approaches to Brief Psychodynamic Psychotherapy (BPDT). These short-term models are adaptations designed to enable clients to specifically examine unresolved conflicts and symptoms that arise from past relational issues. Research strongly supports the efficacy of BPDT approaches, indicating that they offer substantial therapeutic value. The success of these brief models is contingent upon their focus; they are often protocolized to address specific, circumscribed issues, highlighting the increasing relevance of the psychodynamic approach within modern, time-conscious healthcare systems^[1].

 

The continued clinical success of PDT relies on collaborative, multidisciplinary models. For instance, in the treatment of substance abuse disorders, BPDT is maximized when integrated with structured interventions like regular urinalysis and pharmacotherapy. Psychological insight alone is often insufficient for stabilizing biologically mediated or acutely severe conditions; thus, BPDT typically proves more helpful after initial abstinence is well established and may be more beneficial for clients exhibiting no greater than moderate severity of substance abuse^[1].

 

 

Principles of PDT

 

The central distinguishing feature of PDT is the unwavering premise that human behavior is profoundly influenced by the unconscious mind. This reservoir contains hidden thoughts, feelings, and memories that continue to influence present behaviors and emotions even when the individual is entirely unaware of its existence.

 

Therapy, therefore, aims to facilitate self-discovery by exploring and analyzing these hidden motivations and unresolved conflicts that contribute to current difficulties. This exploration is grounded in the dynamic interplay between different elements of the mind, traditionally conceptualized as the *id* (instinctual drives), the *ego* (reality testing and mediation), and the *superego* (moral and social conscience). The constant, dynamic interaction among these elements produces internal conflicts, anxiety, and the manifestation of symptoms.

 

Ego Psychology, Adaptation, and Defense Mechanisms

 

A crucial evolution within psychodynamic theory is the strong emphasis on Ego Psychology. This movement highlights the central role of the ego in functions critical to mental health, including adaptation, reality testing, and the management of internal and external conflicts. By focusing on the ego's capacities, modern PDT highlights an individual's capacity for resilience and effective problem-solving^[2].

 

To cope with internal anxiety and external threats, individuals utilize defense mechanisms, which are psychological strategies introduced by Freud to protect the ego. These mechanisms—such as projection, denial, or intellectualization—manifest in therapy as *resistance* . Analysis of these mechanisms is a core psychodynamic intervention, serving to strengthen the ego function, improve reality testing, and allow the individual to confront conflict more directly^[2].

 

Core Technical Tools and Interventions

 

Psychodynamic theory provides several techniques designed to aid the patient's self-discovery and facilitate healing, targeting different core principles:

 

• Free Association: This technique encourages clients to express their thoughts and feelings without internal censorship . The therapist monitors the spontaneous manner in which the client censors or avoids certain topics, which reveals the active operation of defense mechanisms (resistance). This process, alongside Dream Analysis, allows the unconscious dynamic interplay to surface, providing insight into underlying conflicts .
   
• Dream Analysis: Dreams are regarded as a symbolic "window into the unconscious". Dream content is conceptualized as having two components: the manifest content (the surface narrative of the dream) and the latent content (the hidden meaning, desires, fears, or conflicts being resolved). While dream analysis should not be formally recommended as a reliably effective tool, it remains a discretionary tool utilized by the client and therapist to discuss deeply personal experiences^[2].
   

• Transference and Countertransference: These processes are central to the relational template in PDT, and are utilized through techniques of Clarification, Confrontation, and Interpretation to examine dysfunctional interpersonal patterns. Transference is the unconscious redirection of feelings, attitudes, and emotional expectations, primarily rooted in past significant relationships, onto the clinician. Countertransference involves the clinician's unconscious emotional reactions to the patient, which is utilized in modern PDT as a key piece of diagnostic data that reveals the emotional environment the patient typically generates in external relationships.

 

Working Through: Translating Relational Insight into External Life Change

 

The process of translating newfound relational insight into durable life changes is known as "working through." This is the repetitive exploration and integration of interpretations of transference and resistance. It allows the patient to fully comprehend the implications of their pathological patterns and, critically, to integrate new, corrective emotional experiences that override the old templates. This relational experience is recognized as the essential corrective step because it permits the reactivation of old, maladaptive memories within a safe, new context, setting the stage for deep neurobiological modification.

 

 

Clinical Applications

 

The enduring power of the psychodynamic approach lies in its underlying structural focus, enabling it to address deeply entrenched, repetitive, and characterological problems that are otherwise resistant to conscious effort or behavioral modification. This capacity for deep change is increasingly understood through established neurobiological models.

 

Neurobiological Mechanisms of Therapeutic Change

 

Contemporary clinical psychology understands therapeutic change in PDT through the neurobiological process of memory reconsolidation. This model defines "insight" as an active, measurable process of neuroplasticity—the literal updating of past emotional learning. The essential ingredients of enduring therapeutic change follow a three-part neurobiological sequence: reactivating the old, maladaptive emotional memories; engaging in new emotional experiences (e.g., through the corrective transference relationship); and reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world^[3]. The corrective experience relies on the therapeutic environment to provide a new context, which is incorporated into the old memory trace during re-encoding^[4].

 

Change often occurs through implicit learning, where the changing emotional and physiological responses to particular stimuli during treatment may not be consciously accessible to the individual. The goal of effective psychodynamic intervention is to modulate the patient’s fear structure by breaking the specific bonds between an eliciting stimulus and a strong, often maladaptive, emotional response^[4]. This emphasizes that affective immediacy is crucial for achieving durable psychodynamic intervention, as the interpretation must be delivered when the old memory trace is reactivated to render it labile for modification.

 

Efficacy and Durability of Gains

 

Considerable research now supports the efficacy and effectiveness of contemporary PDT. Meta-analytic data demonstrates that the effect sizes reported for psychodynamic therapy are as large as those reported for other therapies actively promoted as "empirically supported" and "evidence-based". A key strength that distinguishes PDT from many other modalities is the durability of its effects. Patients who receive psychodynamic therapy not only maintain their therapeutic gains after treatment ends, but they also appear to continue to improve^[5]. This finding suggests that PDT initiates a self-sustaining process of psychological growth and maturation.

 

Quantitative meta-analytic studies confirm PDT's effectiveness for major depressive disorder. Analysis of the efficacy of PDT compared to control conditions found it to be superior in improving depressive symptoms, reporting a medium effect size (g=–0.58) . Compared specifically to passive controls (e.g., waiting list), the effect size was large (g=–1.14), and compared to active controls (other forms of therapy), the effect size remained medium (g=–0.51), confirming that PDT is generally non-inferior to other established treatments for depression .

 

Specialized Applications for Personality Disorders

 

Psychodynamic therapy’s ability to delve into emotional themes and relational patterns rooted in early experiences, makes it the fundamental intervention for complex characterological problems. The most compelling evidence for PDT’s structural efficacy lies in its application to Personality Disorders (PDs), particularly Borderline Personality Disorder (BPD)^[6]. BPD is a severe condition characterized by pervasive problems with interpersonal relationships, identity disturbance, difficulties with affect regulation, and impulsivity. Long-term follow-up studies underscore the necessity of effective treatment, and there is a broad clinical consensus that psychotherapy represents the fundamental intervention for BPD^[7].

 

The effectiveness of psychodynamic principles for BPD has been confirmed through the development of highly structured, protocolized treatment models:

 

• Mentalisation-Based Treatment (MBT): Founded on the premise that patients with BPD show a reduced capacity to mentalise—the ability to understand one’s own behavior, and that of others, in terms of underlying mental states^[7]. MBT structures its interventions specifically to promote and restore the patient's capacity to mentalise, improving the stability of their self-image and relationships.
   
• Transference-Focused Psychotherapy (TFP): Based on object relations theory, TFP specifically leverages the intense, often chaotic, transference dynamics that immediately manifest in the therapeutic relationship . TFP helps patients recognize their unhealthy interpersonal patterns—which are rooted in internalized, split object relations—by offering consistent clarification and feedback on these patterns as they unfold.
   

Research has established that the patient’s underlying psychological maturity, or reflective functioning, is a critical predictor for optimal treatment selection. Patients assessed with low reflective functioning benefit significantly more from therapies specifically focused on relational and emotional understanding, such as TFP or Supportive Psychodynamic Therapy (SPT) . Conversely, patients with high reflective functioning—those possessing a greater capacity for self-awareness—respond better to skills-building models like Dialectical Behavior Therapy (DBT).

 

 

Limitations

 

The central limitation of PDT stems directly from its greatest strength—the depth of its work. Achieving structural change through insight and the "working through" of complex relational patterns^[3] is inherently a time-intensive process. This necessary duration translates directly into higher initial costs, creating significant accessibility barriers within resource-constrained public and private healthcare systems^[6].

 

Research Gaps and Allegiance Effects

 

The research base demonstrates clear areas where evidence is limited, underscoring the need for judicious application of PDT. Defined areas where evidence does not support the broad implementation of PDT include Post-Traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder (OCD), bulimia nervosa, cocaine dependence, or psychosis. A commitment to evidence-based practice mandates that policy analysts and practitioners recognize these limitations and avoid deploying PDT where protocolized, exposure-based treatments are known to be superior^[6].

 

The outcome research field remains subject to methodological challenges. Reviews of comparative efficacy often suffer from allegiance effects, where researchers unconsciously or consciously favor the modality they practice or prefer, which can skew reported findings. Furthermore, the traditional methodology of comparing heterogeneous "families" of therapies (e.g., all psychodynamic approaches) against other broad categories (e.g., all cognitive approaches) is inherently conservative and statistically flawed^[6].

 

 

Potential Damages and Ethical Considerations

 

The complexity and relational focus of PDT introduce unique ethical considerations, particularly regarding clinical competence and the management of transference.

 

The specialized nature of psychodynamic intervention, especially for complex conditions, requires that the psychodynamic therapist possess specialized knowledge beyond general training. For instance, treating substance abuse demands knowledge of the pharmacology of abused drugs, the subculture of substance abuse, and relevant complementary programs like 12-Step models^[1]. The failure to possess specialized knowledge can lead to inadequate preparation for stabilization and treatment.

 

The powerful utilization of transference in TFP requires that the clinician exercise extreme care. Successfully utilizing countertransference demands a high degree of emotional self-regulation and theoretical precision from the clinician; the failure to distinguish countertransference from the therapist's own pathology renders the tool unusable and potentially damaging. Ethical practice requires adherence to professional development that transcends basic competence and reaches toward mastery, characterized by the ability to recognize and acknowledge the limits of one's knowledge and navigate complex situations flexibly and pragmatically^[8].

 

Structural and Policy Barriers

 

The greatest barriers to the future success of PDT now reside less in scientific proof and more in policy and implementation. Fragmented and insufficient insurance coverage—in both the US and Europe—remains a major impediment, increasing costs and limiting access. If technology is to effectively disseminate high-fidelity, complex treatments like TFP and MBT, insurance systems must evolve alongside technological developments to reduce financial barriers^[9].

 

A lack of knowledge among healthcare professionals regarding the prescription and integration of digital health apps into practice further hinders adoption, despite the potential of Digital Therapeutics (DTx) to increase accessibility and reduce costs^[9].

 

 

Conclusion

 

Contemporary Psychodynamic Therapy (PDT) is confirmed as an empirically supported intervention distinguished by its focus on deep structural change. Its mechanism is increasingly understood through the neurobiological process of memory reconsolidation, which allows for the updating of maladaptive emotional memories through corrective experiences, primarily enacted via the transference relationship.

 

PDT is the treatment of choice for complex characterological disorders, evidenced by the efficacy of specialized, protocolized models like Transference-Focused Psychotherapy (TFP) and Mentalisation-Based Treatment (MBT) for Borderline Personality Disorder. Clinical decision-making for these conditions should be personalized, requiring assessment of the patient’s reflective functioning to match the complexity of the intervention to their capacity for insight.

 

The primary limitations of PDT are structural, revolving around the necessary duration and associated cost, and clinical, requiring judicious application; it is generally not recommended for disorders where exposure-based protocols, such as for OCD or PTSD, demonstrate superior efficacy.

 

The future vitality of the psychodynamic field depends on continued rigorous adherence to component-based research (moving beyond comparing "families" of therapy) and successfully overcoming systemic policy barriers. Advocacy for equitable insurance coverage and the proper integration of Digital Therapeutics are essential to ensure that this efficacious, structural model of therapy is accessible to the populations who stand to benefit most from its durable, self-sustaining effects.

 

 

References

 

1. Gopalakrishna, G., Wicherts, J. M., Bouter, L., Sara, & Van den Akker, O. (2024). National Survey on Research Integrity. OSF. Retrieved from https://doi.org/10.17605/OSF.IO/DP6ZF
2. Hayes, S. C., et al. (2017). ACT is an empirically supported psychotherapy: Addressing challenges and gaps in the field. Psychology, Health & Medicine, 22(sup1), 1-28. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5509623/
3. Hayes, S. C. (n.d.). The Six Core Processes of ACT: Acceptance, Defusion, Present Moment, Self-as-Context, Values, Committed Action. Contextual Behavioral Science. Retrieved from https://contextualscience.org/six_core_processes_act
4. Dixon, M. R., et al. (2020). Acceptance and commitment therapy and relational density theory. Behavior Analysis in Practice, 14(1), 140-155. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8854599/
5. Dixon, M. R., et al. (2020). Relational density theory and the ACT Hexaflex. Behavior Analysis in Practice. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8854599/
6. The meta-analysis revealed that the EMDR treatments significantly reduced the symptoms of PTSD (g = −0.662), depression (g = −0.643), anxiety (g = −0.640), and subjective distress (g = −0.956) in PTSD patients. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103676
7. Zhou, Y., et al. (2025). Cross-cultural adaptation for Internet-based ACT protocols. Journal of Contextual Behavioral Science. Retrieved from https://contextualscience.org/act_randomized_controlled_trials_1986_to_present

8. Hayes, S. C., et al. (n.d.). Functional Groupings of Hexaflex Processes. Contextual Behavioral Science. Retrieved from https://contextualscience.org/six_core_processes_act

9. Hofmann, S. G., & Asmundson, G. J. G. (2020). Caution: The Differences Between CT and ACT. Cognitive Therapy and Research. Retrieved from https://drexel.edu/~/media/Files/psychology/labs/innovation/Caution%20-%20The%20Differences%20Between%20CT%20and%20ACT.ashx
10. Wood, S., & Turner, M. J. (2025). ACT dominance in sport psychology in Scandinavia. Scandinavian Journal of Sport and Exercise Psychology. Retrieved from https://www.researchgate.net/publication/389089569_Using_Acceptance_and_Commitment_Therapy_with_Athletes
11. Hayes, S. C., et al. (2017). ACT application across diverse settings and delivery formats. Psychology, Health & Medicine. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5509623/
12. A-Tjak, J. G. L., et al. (2015). A Meta-Analysis on the Efficacy of Acceptance and Commitment Therapy for Mental Disorders and Somatic Health Problems. Psychotherapy and Psychosomatics. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25547522/
13. Strosahl, K. D., et al. (2021). Technology-Mediated Interventions (TMI) and FACE COVID for Healthcare Providers. Psychol Health Med. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9359768/
14. Hayes, S. C., et al. (n.d.). Functional Groupings of Hexaflex Processes. Contextual Behavioral Science. Retrieved from https://contextualscience.org/six_core_processes_act
15. SimplePractice. (2022). Cognitive Defusion Techniques: Labeling and Visualization. SimplePractice Resources. Retrieved from https://www.simplepractice.com/resource/cognitive-defusion-techniques/
16. Lindahl, J. R., et al. (2017). Trauma History as a Risk Factor for Meditation-Related Challenges. PLoS One. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6575147/
17. Zhou, Y., et al. (2025). Cross-cultural adaptation for Internet-based ACT protocols. Journal of Contextual Behavioral Science. Retrieved from https://contextualscience.org/act_randomized_controlled_trials_1986_to_present
18. Wicksell, R. K., et al. (2023). Meta-analysis of ACT for chronic pain. The Clinical Journal of Pain. Retrieved from https://pubmed.ncbi.nlm.nih.gov/37043967/
19. Zero Suicide. (2024). Acute Crisis Stabilization vs. Longer-Term Treatment Modalities. Zero Suicide Toolkit. Retrieved from https://zerosuicide.edc.org/toolkit/treat
20. Oliver, J. (2017). The “Leaves on the stream” exercise. Contextual Consulting. Retrieved from https://contextualconsulting.co.uk/resources/leaves-on-the-stream-exercise
21. Hayes, S. C., et al. (2024). ACT Model and Principles: The Hexaflex Explained. PositivePsychology.com. Retrieved from https://positivepsychology.com/act-model/
22. Wood, S., & Turner, M. J. (2025). ACT in sports: concentration, self-talk, goal setting. Scandinavian Journal of Sport and Exercise Psychology. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC12341456/
23. Hayes, S. C., et al. (2016). Psychological acceptance is the willingness to experience thoughts, feelings, and physiological sensations without controlling them. The Clinical Psychologist. Retrieved from https://www.researchgate.net/publication/316360613_Acceptance_and_Commitment_Therapy
24. Psychodynamic therapy focuses on unconscious processes. NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64952/
25. Oliver, J. (2017). Leaves on the Stream: Observing thoughts for detachment. Contextual Consulting. Retrieved from https://contextualconsulting.co.uk/resources/leaves-on-the-stream-exercise
26. Gopalakrishna, G., et al. (2024). ACT measurement limitations: AAQ, AAQ-II, AFQY treat PF as a single factor. BMC Psychology. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10797814/
27. Tyndall, I. (2024). Assessment of Psychological Flexibility and Inflexibility: Conceptual Foundations. ResearchGate. Retrieved from https://www.researchgate.net/publication/392760708_Assessment_of_Psychological_Flexibility_and_Inflexibility_Conceptual_Foundations_Psychometric_Evidence_and_Clinical_Considerations
28. Strosahl, K. D., & Wilson, K. G. (2018). ACT: Third Wave Focus on Context and Function. Guilford Press. https://www.guilford.com/books/Acceptance-and-Commitment-Therapy/Hayes-Strosahl-Wilson/9781462528943
29. Hayes, S. C., et al. (1999). Acceptance and Commitment Therapy. Guilford Press. https://www.guilford.com/books/Acceptance-and-Commitment-Therapy/Hayes-Strosahl-Wilson/9781462528943
30. The Adaptive Information Processing (AIP) model posits that traumatic or highly disturbing experiences are stored in memory networks in a fragmented, maladaptive state. Retrieved from https://www.psychologytoday.com/us/blog/relationship-and-trauma-insights/202012/the-eight-magical-phases-emdr-therapy-demystified
31. Regulators are often reluctant to approve PDTs due to their cautious stance toward this emerging technology. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC12087680/
32. Hayes, S. C., et al. (2017). ACT: Identifying novel treatment delivery methods. Psychology, Health & Medicine. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5509623/
33. The Stream: Symbolizes the flow of life. Sweet Institute. Retrieved from https://sweetinstitute.com/the-power-of-leaves-on-the-stream-metaphor-for-personal-growth/
34. The newer forms of CBT, especially ACT, have added an emphasis on chosen values as a key mediator of change. Behavior Therapy. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8429332/
35. Thought bubbles Just as bubbles float by. SimplePractice Resources. Retrieved from https://www.simplepractice.com/resource/cognitive-defusion-techniques/
36. Clinicians are also more likely to practice within the usual and customary standard of care when they are connected to their peers. EMDRIA. Retrieved from https://www.emdria.org/blog/ethics-and-emdr-therapy/
37. Lindahl, J. R., et al. (2017). Trauma History as a Risk Factor for Meditation-Related Challenges. PLoS One. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6575147/

38. The meta-analysis revealed that the EMDR treatments significantly reduced the symptoms of PTSD. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103676

39. Psychological flexibility (PF), and its psychopathological reflection psychological inflexibility (PI), are the main purported processes of change within acceptance and commitment therapy (ACT). Retrieved from https://www.researchgate.net/publication/392760708_Assessment_of_Psychological_Flexibility_and_Inflexibility_Conceptual_Foundations_Psychometric_Evidence_and_Clinical_Considerations
40. Interventions are typically briefer (e.g., one session encounter) and focus on acute crisis stabilization. Zero Suicide Toolkit. Retrieved from https://zerosuicide.edc.org/toolkit/treat
41. ACT outperformed control conditions (Hedges' g = 0.57) at posttreatment and follow-up assessments. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25547522/
42. Review findings suggest that EMDR may be considered an effective treatment for improving symptoms of depression. Retrieved from https://www.tandfonline.com/doi/full/10.1080/20008198.2021.1894736
43. Research indicates that EMDR could be a promising treatment for mental health issues other than PTSD. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7839656/
44. We propose that the essential ingredients of therapeutic change include: (1) reactivating old memories. NCBI Bookshelf. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24827452/
45. The corrective experience occurs within a new context, the context of therapy itself, which can also be incorporated into the old memory via the processes of reactivation, re-encoding, and reconsolidation. Retrieved from https://boris-portal.unibe.ch/bitstreams/c1d13754-28c8-40a2-8fdf-913f192eb743/download
46. What Is ACT? The Hexaflex Model and Principles Explained. PositivePsychology.com. Retrieved from https://positivepsychology.com/act-model/
47. Contact with the Present Moment – In the face of distress and overwhelm, mindfully reconnecting with one's present moment experience can be both grounding and empowering. Mindfulness Alliance. Retrieved from https://mindfulness-alliance.org/2018/04/29/mindfulness-in-action-trauma-informed-practices-and-social-justice-an-act-based-perspective/

48. Psychodynamic models propose that unconscious thoughts, desires, and memories inaccessible to conscious awareness still primarily influence human behavior. NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK606117/

49. Wood, S., & Turner, M. J. (2025). ACT in sports: concentration, self-talk, goal setting. Scandinavian Journal of Sport and Exercise Psychology. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC12341456/
50. Participants with chronic headache and fibromyalgia showed greater benefit from ACT compared to those with non-specific pain or mixed pain. Retrieved from https://pubmed.ncbi.nlm.nih.gov/37043967/
51. This paper provides a comprehensive review of outcome studies and meta-analyses of effectiveness studies of psychodynamic therapy (PDT) for the major categories of mental disorders. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4471961/
52. Among the studies comparing EMDR to TAU, a recent study found EMDR to be significantly more effective on Quality of Life in a group of 70 patients suffering from Major Depressive Disorder. Retrieved from https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.644369/full
53. Empirical evidence supports the efficacy of psychodynamic therapy. American Psychologist. Retrieved from https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf
54. This article summarises the current position of evidence-based psychodynamic psychotherapies aimed at the treatment of borderline personality disorder – mentalisation-based treatment and transference-focused psychotherapy. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6020925/
55. The meta-analysis of RCTs evaluated the effectiveness of EMDR in anxiety disorder, in a total of 17 trials with 647 patients. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8488430/
56. Unconscious Mind: Psychodynamic therapy posits that much of human behavior is influenced by unconscious thoughts and desires. ICSW Blog. Retrieved from https://www.icsw.edu/icsw_blog/what-is-psychodynamic-therapy
57. Psychological acceptance is one of the psychosocial factors most strongly associated with psychological resilience. The Clinical Psychologist. Retrieved from https://www.researchgate.net/publication/316360613_Acceptance_and_Commitment_Therapy
58. Dreams are considered a window into the unconscious. NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK606117/
59. Most widely used psychological flexibility measures, such as the Acceptance and Action Questionnaire (AAQ), the Acceptance and Action Questionnaire-II (AAQ-II), and the Avoidance and Fusion Questionnaire for Adolescents (AFQY), treat PF as a single factor. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10797814/
60. Transference-focused psychotherapy (TFP) leverages the patient-therapist relationship to help patients recognize unhealthy interpersonal patterns, and the therapist offers clarification and feedback. Retrieved from https://www.apa.org/monitor/2025/04-05/treating-borderline-personality
61. Since its emergence in the 1980s, acceptance and commitment therapy (ACT) has become a reputable evidence-based psychological therapy for certain disorders. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6037942/
62. Efficacy of PDT vs. control conditions. PDT was found to be superior to all control conditions in improving depressive symptoms, with a medium effect size (g=–0.58, 95% CI: –0.33 to –0.83, n=12, I2=63%, N=1,017) and no evidence for publication bias (see Table 1). Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10168167/
63. This is where psychodynamic therapy shines by delving into emotional themes and patterns rooted in early experiences. Retrieved from https://counselingcentergroup.com/psychodynamic-psychotherapy-vs-cbt/
64. The article reviews the current state and future of psychodynamic psychotherapies. In the past few decades psychodynamic psychotherapies have fallen into disrepute due to the fractious and dogmatic nature of different psychodynamic schools of thought and the lack of interest in validating some of its major premises or its effectiveness in comparison with other psychotherapy modalities. Retrieved from https://www.researchgate.net/publication/42253679_The_Future_of_Psychodynamic_Psychotherapy