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Psychodynamic Therapy for Personality Disorders – Exploring the Underlying Unconscious Processes and their Impact on Symptomatology

What is Psychodynamic Therapy?

Psychodynamic therapy is a form of talk therapy that draws from psychoanalytic principles and focuses on exploring the unconscious mind to gain insight into a person’s thoughts, feelings, and behaviors. Developed from Freudian theory, psychodynamic therapy emphasizes the influence of early life experiences, especially those from childhood, on the formation of one’s personality and emotional patterns.(1,2)

The therapeutic process involves exploring past experiences, unresolved conflicts, and unconscious motivations to understand how they impact current behaviors and relationships. Through this exploration, patients gain self-awareness, uncover hidden emotions, and work towards resolving inner conflicts, leading to personal growth and improved mental well-being. The therapeutic relationship between the patient and the therapist is considered crucial in psychodynamic therapy, as it provides a safe and supportive space for the patient to explore and process their thoughts and emotions.(3)

How does Psychodynamic Therapy help in Personality Disorders?

Psychodynamic therapy can be particularly beneficial in the treatment of personality disorders by addressing the underlying psychological factors that contribute to the development and maintenance of maladaptive personality traits and behaviors. Here are some ways in which psychodynamic therapy helps individuals with personality disorders:(4,5)

  • Exploration of Early Experiences: Psychodynamic therapy delves into a person’s early life experiences, including childhood relationships and traumas, which may have shaped their personality development. By understanding these early experiences, patients can gain insight into the roots of their personality patterns and how they affect their current functioning.
  • Uncovering Unconscious Conflicts: Personality disorders often involve unresolved conflicts and emotional struggles that reside in the unconscious mind. Psychodynamic therapy helps bring these unconscious conflicts to the surface, allowing patients to become aware of their hidden motivations, fears, and desires.
  • Insight into Defense Mechanisms: Individuals with personality disorders often rely on defense mechanisms to protect themselves from emotional pain and distress. Psychodynamic therapy helps patients recognize and understand their defense mechanisms, enabling them to explore healthier coping strategies.
  • Working through Transference and Countertransference: The therapeutic relationship in psychodynamic therapy provides a unique opportunity to explore and understand interpersonal dynamics. Patients may project unresolved feelings and patterns onto the therapist (transference), and therapists must examine their own emotional reactions (countertransference). Working through these dynamics can shed light on how individuals relate to others outside of therapy.(6)
  • Emotional Expression and Regulation: Psychodynamic therapy encourages patients to express their emotions freely, helping them process and manage intense feelings that may be contributing to their personality difficulties.
  • Promoting Self-Awareness and Empowerment: Through the therapeutic process, individuals with personality disorders gain self-awareness and insight into their thoughts, emotions, and behaviors. This self-awareness fosters a sense of empowerment and enables patients to make more conscious choices in their lives.
  • Addressing Core Beliefs: Psychodynamic therapy provides a platform for challenging and modifying deep-seated negative core beliefs that underlie maladaptive behavior and self-perception.

While psychodynamic therapy may not be the sole treatment for personality disorders, it can be a valuable and transformative component of a comprehensive treatment plan. The exploration of underlying psychological factors and the development of self-awareness can lead to significant improvements in managing and adapting to personality challenges, fostering growth, and facilitating healthier relationships. However, the duration of psychodynamic therapy may be longer than some other therapeutic approaches, given the complexity of personality disorders and the depth of exploration involved.(7,8)

What Other Conditions Can Psychodynamic Therapy Help Treat?

Psychodynamic therapy can be helpful in treating a wide range of mental health conditions and emotional difficulties. While it is particularly effective in addressing issues related to personality, emotions, and interpersonal relationships, it can also be beneficial for the following conditions:

  1. Depression: Psychodynamic therapy explores the underlying causes and unresolved emotional conflicts that contribute to depression, helping individuals gain insight into their feelings and thought patterns.(9)
  2. Anxiety Disorders: By examining unconscious fears and anxieties, psychodynamic therapy assists individuals in understanding the root causes of their anxiety and developing healthier coping mechanisms.(10)
  3. Trauma and Post-Traumatic Stress Disorder (PTSD): Psychodynamic therapy can help individuals process and integrate traumatic experiences, leading to healing and symptom reduction.(11)
  4. Eating Disorders: For those with eating disorders, psychodynamic therapy can help uncover and understand the underlying emotional issues and conflicts contributing to disordered eating behaviors.(12)
  5. Relationship Difficulties: This therapy is well-suited for addressing relationship challenges, as it focuses on interpersonal dynamics and how past experiences influence present interactions.
  6. Grief and Loss: Psychodynamic therapy allows individuals to explore and work through their grief, helping them come to terms with loss and find ways to cope with their emotions.(13)
  7. Chronic Pain Management: Psychodynamic therapy can be beneficial in addressing emotional responses to chronic pain and exploring how pain may be connected to emotional experiences.(14)

What does Psychodynamic Therapy Involve?

Psychodynamic therapy typically takes place in one-on-one sessions between the patient and the therapist. Here are some key features of what psychodynamic therapy involves:

  • Free Association: Patients are encouraged to freely express their thoughts, emotions, and associations without censorship. This allows the therapist to observe patterns and identify underlying themes.
  • Interpretation: The therapist interprets the patient’s thoughts, emotions, and behaviors to reveal unconscious conflicts and motivations.
  • Exploration of Past Experiences: Psychodynamic therapy delves into early life experiences, particularly childhood relationships with caregivers and significant events, to understand how they shape the individual’s personality and emotional patterns.
  • Unconscious Processes: The therapy focuses on exploring unconscious thoughts, feelings, and defense mechanisms that may be influencing the patient’s emotional reactions and behaviors.
  • Transference and Countertransference: The therapeutic relationship plays a vital role in psychodynamic therapy. Patients may project unresolved feelings and attitudes onto the therapist (transference), and therapists may experience their own emotional reactions towards the patient (countertransference).(15)
  • Emotional Expression and Regulation: Patients are encouraged to express and explore their emotions openly, which facilitates emotional processing and regulation.
  • Focus on Childhood Development: Understanding early childhood experiences is essential in psychodynamic therapy, as it helps shed light on the formation of the patient’s personality and emotional patterns.

Psychodynamic therapy aims to provide a safe and supportive environment for patients to explore their emotions, thoughts, and experiences, leading to personal growth, improved coping strategies, and healthier relationships.


Psychodynamic therapy is fast emerging as a valuable and insightful approach in the treatment of personality disorders. By delving into unconscious conflicts, early life experiences, and defense mechanisms, this therapeutic modality offers a deeper understanding of the roots of maladaptive personality traits and behaviors. Through the therapeutic alliance and exploration of transference and countertransference, clients gain self-awareness, insight, and empowerment, fostering personal growth and improved interpersonal relationships.

Psychodynamic therapy’s focus on emotional expression, regulation, and the development of healthier coping strategies proves particularly beneficial for individuals with personality disorders seeking transformative change. While it may require a longer-term commitment, the depth and effectiveness of psychodynamic therapy make it a vital resource in helping individuals navigate the complexities of their personalities, leading to enhanced emotional well-being and a more fulfilling life.


  1. Warren, C.S., 1998. Models of brief psychodynamic therapy: A comparative approach.
  2. Strupp, H.H., Butler, S.F. and Rosser, C.L., 1988. Training in psychodynamic therapy. Journal of Consulting and Clinical Psychology, 56(5), p.689.
  3. Summers, R.F. and Barber, J.P., 2010. Psychodynamic therapy: A guide to evidence-based practice. Guilford Press.
  4. Messer, S.B. and Abbass, A.A., 2010. Evidence-based psychodynamic therapy with personality disorders.
  5. Leichsenring, F. and Leibing, E., 2003. The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis. American journal of psychiatry, 160(7), pp.1223-1232.
  6. Parth, K., Datz, F., Seidman, C. and Löffler-Stastka, H., 2017. Transference and countertransference: A review. Bulletin of the Menninger Clinic, 81(2), pp.167-211.
  7. Caligor, E., Kernberg, O.F., Clarkin, J.F. and Yeomans, F.E., 2018. Psychodynamic therapy for personality pathology: Treating self and interpersonal functioning. American Psychiatric Pub.
  8. Haskayne, D., Hirschfeld, R. and Larkin, M., 2014. The outcome of psychodynamic psychotherapies with individuals diagnosed with personality disorders: a systematic review. Psychoanalytic Psychotherapy, 28(2), pp.115-138.
  9. Huber, D., Henrich, G., Clarkin, J. and Klug, G., 2013. Psychoanalytic versus psychodynamic therapy for depression: A three-year follow-up study. Psychiatry: Interpersonal & Biological Processes, 76(2), pp.132-149.
  10. Keefe, J.R., McCarthy, K.S., Dinger, U., Zilcha-Mano, S. and Barber, J.P., 2014. A meta-analytic review of psychodynamic therapies for anxiety disorders. Clinical Psychology Review, 34(4), pp.309-323.
  11. Levi, O., 2020. The role of hope in psychodynamic therapy (PDT) for complex PTSD (C-PTSD). Journal of Social Work Practice, 34(3), pp.237-248.
  12. Zerbe, K.J., 2010. Psychodynamic therapy for eating disorders. The treatment of eating disorders: A clinical handbook, pp.339-358.
  13. Berzoff, J., 2003. Psychodynamic theories in grief and bereavement. Smith College Studies in Social Work, 73(3), pp.273-298.
  14. Bassett, D.L. and Pilowsky, I., 1985. A study of brief psychotherapy for chronic pain. Journal of Psychosomatic Research, 29(3), pp.259-264.
  15. Orr, D.W., 1954. Transference and countertransference: A historical survey. Journal of the American Psychoanalytic Association, 2(4), pp.621-670.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 12, 2023

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