Counselling vs Therapy vs Psychotherapy: What’s the Difference?
Counselling, therapy and psychotherapy overlap, but they are not identical. What each involves, who provides it in the UK and how to choose what suits you.
Psychodynamic Therapy Explained: What to Expect
What psychodynamic therapy is, how it explores patterns from the past, short-term and long-term options, what sessions are like and how to find a UK therapist.
Key takeaways
- Psychodynamic therapy explores how feelings, relationships and patterns from the past shape the present.
- It can be short-term and focused or longer and open-ended; NICE lists short-term psychodynamic psychotherapy as an option for depression.
- Look for a therapist registered with a recognised body such as the BPC, UKCP or BACP.
On this page
Psychodynamic therapy is a talking therapy that helps you understand how your feelings, relationships and past experiences shape the way you think and behave now. Rather than teaching specific techniques, it explores patterns you may not be fully aware of, such as why you keep ending up in similar relationships or react strongly in certain situations. It can be short and focused or longer and open-ended, and it’s available on the NHS for some problems as well as privately.
Where it comes from
Psychodynamic therapy grew out of psychoanalysis, the approach developed by Sigmund Freud more than a century ago. Modern psychodynamic therapy is quite different from the stereotype: most sessions are face to face in chairs rather than on a couch, therapists are more active, and many courses are time-limited.
Key ideas
| Idea | In plain English |
|---|---|
| The unconscious | Some feelings, memories and wishes influence us without our full awareness |
| Early relationships | Experiences with parents and carers can shape how we relate to others as adults |
| Repeating patterns | We may repeat familiar ways of relating, even when they hurt us |
| Defences | Ways of protecting ourselves from painful feelings, such as avoidance or denial |
| The therapy relationship | Feelings that come up towards the therapist can shed light on other relationships |
What sessions are like
Sessions usually last 50 minutes, at the same time each week. You’re encouraged to talk about whatever is on your mind, even if it seems unimportant. The therapist listens closely, notices themes and links between past and present, and offers reflections or interpretations for you to consider.
Psychodynamic therapists often say less than in other approaches and don’t usually set homework. Some people find this freeing; others find it uncomfortable at first. It’s fine to talk about how the therapy feels; that’s part of the work.
Short-term and long-term options
| Type | Length | Often used for |
|---|---|---|
| Short-term psychodynamic psychotherapy | Around 16 to 20 sessions | Depression, anxiety, relationship difficulties |
| Dynamic interpersonal therapy (DIT) | Around 16 sessions | Depression; offered within some NHS Talking Therapies services |
| Longer-term psychodynamic therapy | Months to years | Long-standing difficulties with relationships, identity or emotions |
| Psychoanalysis | Several sessions a week, often for years | Deep, long-term personal change |
What the evidence says
NICE’s guideline on depression in adults includes short-term psychodynamic psychotherapy among the treatment options for depression, alongside approaches such as CBT, counselling and interpersonal therapy. Research on psychodynamic therapy for other problems is growing but less extensive than for CBT. As with any therapy, the relationship between you and your therapist is an important part of whether it helps.
Who it might suit
Psychodynamic therapy may appeal if you:
- want to understand why you feel or act the way you do, not just manage symptoms
- notice repeating patterns in relationships or work
- have tried structured therapies and want something more exploratory
- are curious about how your history affects you now
It may be less suitable if you want quick, practical strategies for a specific problem, in which case CBT might fit better, or if you’re in crisis and need immediate support.
Psychodynamic, person-centred and CBT compared
| Psychodynamic | Person-centred | CBT | |
|---|---|---|---|
| Main focus | Unconscious patterns and the past | Your experience and feelings now | Thoughts and behaviours now |
| Therapist’s style | Reflective, interpretive | Warm, non-directive | Active, structured |
| Homework | Rarely | Rarely | Usually |
| Length | Short or long-term | Flexible | Usually short-term |
Our guides to person-centred therapy and counselling vs therapy vs psychotherapy explain the differences further.
Finding a psychodynamic therapist in the UK
- On the NHS: some services offer short-term psychodynamic therapy or DIT; ask your GP or local NHS Talking Therapies service.
- Privately: look for a therapist registered with the British Psychoanalytic Council (BPC), UKCP or BACP, which hold registers accredited by the Professional Standards Authority.
- Low-cost options: some training institutes offer reduced-fee therapy with supervised trainees.
Our guides to finding a counsellor and counselling costs in the UK help you compare. You can also read about counselling for depression, where psychodynamic approaches are one of several options.
Questions to ask
- What is your training, and which register are you on?
- Do you offer short-term or open-ended work?
- How will we review whether therapy is helping?
- What happens during breaks and holidays?
If you need help now
If you feel unable to keep yourself safe, call 999 or go to A&E. You can call Samaritans free on 116 123, any time, or text SHOUT to 85258. In England, call NHS 111 and choose the mental health option.
Frequently asked questions
Will I have to lie on a couch?
Almost certainly not. Most psychodynamic therapy happens face to face in chairs. Some psychoanalysts use a couch, but you can discuss what feels comfortable.
Is psychodynamic therapy all about my childhood?
No. Childhood can come up, but the focus is on how patterns show up in your life now, including in current relationships.
How long does psychodynamic therapy take?
Short-term courses are often around 16 to 20 sessions. Longer-term therapy can continue for months or years, depending on your goals.
Sources
Every article is edited by a human and checked against our editorial policy. Spotted a mistake? Tell us.
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