Psychodynamic Psychotherapy and the Body

Psychodynamic psychotherapy is a therapeutic school derived from psychoanalytic theory. So, what is psychodynamic therapy, a modality based on psychoanalytic concepts and methods?As a psychotherapeutic technique, psychodynamic therapy works with the person’s past experiences and patterns of relating, especially around early childhood attachment, while simultaneously making sense of these through unconscious material such as dreams, slips, and daydreams. But what is the unconscious? We might briefly think of the unconscious as the attic of the mind. The unconscious consists of everything that does not appear at the level of conscious awareness or in the flow of thought—everything we have unknowingly repressed because it was too difficult to accept consciously, tucked away in a dusty attic, and yet still persisting even if we are unaware of it. We put objects into the attic that belong to us but are no longer needed—just in case we might one day retrieve them. Unconscious material is like those forgotten and dust-covered belongings in the attic: waiting to be picked up one day. All the difficulties a person encounters in daily life, all the situations they cannot cope with, are related to what is stored in that attic. For example, if at age five we repressed the negative feelings aroused by the birth of a sibling, what remained at the conscious level may be only the memory of happiness. Yet the negative experience itself still exists, and, though we may not realize it, continues to manifest in various ways until it emerges through different symptoms.

In psychodynamic therapy, the person relates the difficulties they encounter in daily life to all that is hidden in the unconscious about themselves and discovers its meaning. This discovery gives the person something invaluable: insight. Insight expands as the distance between the conscious and unconscious narrows. This process is also explored through the relationship with the therapist, which reflects the client’s past relational patterns. What does the therapeutic relationship itself reveal about the client, their early relationships, their desires, and their sense of self? In the palette of the person, which colors are more present, which less, which stand out, which fade into the background? Psychodynamic therapy is an accompaniment in which the whole of the relationship, and all of a person’s colors, are present in the therapy room, while the hidden colors of life find a way to be expressed—leading to harmony between inner reality and the outer world, and to mental freedom.

And all the dilemmas, conflicts, and compulsions born of the interplay between conscious and unconscious converge under one roof: the body. Every experience we have lived since childhood is also recorded in the body; even if the unconscious has sent an experience to the attic, its traces remain somatically. Van der Kolk (2014) notes: “The body remembers what the mind forgets; the score is kept in the body.” At this point, it is hardly a coincidence that psychoanalysis was born of an attempt to understand somatic symptoms not explained by organic causes. In Studies on Hysteria (1895), Freud and Breuer wrote: “Hysterical patients suffer mainly from reminiscences,” as if pointing to the body as the dwelling place of the unconscious. While psychoanalysis has always traced the movements of the conscious and unconscious mind, it has never ceased to investigate their expression in the body.

To interpret psychodynamic therapy, grounded in psychoanalytic theory, without addressing its history—and without mentioning Sigmund Freud, one of the pioneers who, under the name of “talking cure,” sought the psychological roots of mental suffering—would be impossible. This will be the subject of the next essay.

References:

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.

Freud, S., & Breuer, J. (1895/2000). Studies on hysteria (J. Strachey, Trans.). New York, NY: Basic Books.