Within the depth-psychology corpus, psychodynamic psychotherapy occupies a contested yet increasingly vindicated position as both a clinically effective modality and a theoretically rich framework for understanding unconscious processes, relational dynamics, and character change. The empirical literature, represented most forcefully by Shedler (2010) and Leichsenring and Rabung (2008), mounts a sustained argument that effect sizes for psychodynamic treatment rival those of any 'empirically supported' approach, and that uniquely, gains appear to consolidate and grow after treatment termination—suggesting that the therapy catalyzes ongoing intrapsychic processes rather than merely suppressing symptoms. A further tension runs through the corpus between short-term and long-term formats: Abbass and colleagues demonstrate efficacy for brief psychodynamic work across common mental disorders, while Leichsenring's meta-analyses reserve the strongest claims for long-term treatment of complex, chronic, and personality-disordered presentations. De Maat's systematic review situates psychodynamic therapy on a continuum with formal psychoanalysis, raising questions about where the boundary lies. Jung's own writings introduce a philosophically distinct strand, framing psychotherapy as a dialectical encounter between two psychic systems rather than a technique. Across all these voices, the defining tensions concern duration, empirical legitimacy, the relationship to cognitivism, and whether symptom relief or character transformation constitutes the proper therapeutic telos.
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Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as 'empirically supported' and 'evidence based.'
Shedler's central claim is that psychodynamic therapy possesses robust empirical support comparable to any promoted evidence-based treatment, and that the contrary belief reflects selective dissemination rather than scientific fact.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010thesis
The effect size increased to 1.51 when the patients were assessed at long-term follow-up. The consistent trend toward larger effect sizes at follow-up suggests that psychodynamic therapy sets in motion psychological processes that lead to ongoing change.
Meta-analytic data show psychodynamic therapy's effect sizes growing post-treatment, indicating it activates enduring intrapsychic change mechanisms rather than producing only immediate symptom suppression.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010thesis
Evidence suggests that short-term treatments are insufficient for a considerable proportion of patients with complex mental disorders, ie, patients with multiple or chronic mental disorders or personality disorders.
Leichsenring argues that the evidence base must distinguish short-term from long-term psychodynamic psychotherapy, with the latter uniquely suited to complex, chronic, and personality-disordered presentations inadequately served by brief formats.
Leichsenring, Falk, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis, 2008thesis
The goals of psychodynamic therapy include, but extend beyond, symptom remission. Successful treatment should not only relieve symptoms but also foster the positive presence of psychological capacities and resources.
Shedler articulates psychodynamic therapy's distinctive therapeutic aim as the development of inner capacities—fulfilling relationships, effective use of talents, realistic self-esteem—beyond mere symptom elimination.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010thesis
Focus on affect and expression of emotion. Psychodynamic therapy encourages exploration and discussion of the full range of a patient's emotions… There is also a recognition that intellectual insight is not the same as emotional insight, which resonates at a deep level and leads to change.
Shedler enumerates the defining technical features of psychodynamic therapy—affective exploration, attention to avoidance, use of the therapeutic relationship—distinguishing it procedurally from cognitive-behavioral approaches.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
These intrapsychic changes occurred in patients who received psychodynamic therapy but not in patients who received dialectical behavior therapy… At five-year follow-up, 87% of patients who received 'treatment as usual' continued to meet diagnostic criteria for borderline personality disorder, compared with 13% of patients who received psychodynamic therapy.
Evidence from borderline personality disorder trials demonstrates that psychodynamic therapy produces unique intrapsychic structural changes—in reflective function and attachment—with markedly superior long-term outcomes compared to other active treatments.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
In complex mental disorders, therefore, the differences in effect size between LTPP and other forms of psychotherapy for overall outcome, target problems, and personality functioning were between 1.8 and 6.9 standard deviations.
Leichsenring's meta-analysis reports that long-term psychodynamic psychotherapy yields substantial between-group advantages over comparison treatments in complex mental disorders, particularly for personality functioning.
Leichsenring, Falk, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis, 2008supporting
Psychodynamic therapy may not only alleviate symptoms but also develop inner capacities and resources that allow a richer and more fulfilling life… psychotherapists, irrespective of their own theoretical orientations, tend to choose psychodynamic psychotherapy for themselves.
Shedler notes that practitioners across orientations preferentially select psychodynamic therapy for their own personal treatment, a convergent validity indicator for its distinctive capacity to foster character development beyond symptom relief.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
Therapist adherence to the psychodynamic prototype predicted successful outcome in both psychodynamic… treatments, suggesting that psychodynamic techniques contribute to positive outcomes across orientations.
Process research demonstrates that adherence to psychodynamic therapeutic techniques predicts good outcome regardless of the nominal treatment model applied, suggesting psychodynamic methods are active ingredients in effective therapy generally.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
These models can be used with a broad range of people with personality disorder including borderline personality disorder, and a range of depressive and somatic disorders.
Abbass maps the principal short-term psychodynamic models—including Davanloo's intensive STDP and Hobson's psychodynamic interpersonal therapy—showing their applicability across personality, depressive, and somatic presentations.
Abbass, Allan A, Short-term psychodynamic psychotherapies for common mental disorders, 2014supporting
Common treatment options in these settings include psychotherapy (e.g. psychodynamic psychotherapy, cognitive behavioural therapies), medications and, in certain situations such as severe depression, procedures such as electroconvulsive therapy.
Abbass situates psychodynamic psychotherapy within the standard treatment landscape for common mental disorders, positioning it alongside cognitive-behavioral therapy and pharmacotherapy as a front-line option.
Abbass, Allan A, Short-term psychodynamic psychotherapies for common mental disorders, 2014supporting
The review of Leichsenring dealt with short-term psychodynamic psychotherapy and long-term psychoanalytic therapy. He identified 22 randomized, controlled trials (RCTs), all of which dealt with short-term psychotherapy.
De Maat situates the psychodynamic outcome literature by noting that RCT evidence is concentrated in short-term formats, with long-term psychoanalytic therapy relying more heavily on observational designs—a critical methodological asymmetry.
de Maat, Saskia, The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies, 2009supporting
LTPP alone yielded significant effect sizes for overall outcome, target problems, general psychiatric symptoms, and social functioning at posttest time points. All these effect sizes were more than 0.80 indicating large effects.
For patients with personality disorders specifically, long-term psychodynamic psychotherapy demonstrates large pre-to-post effect sizes across all major outcome domains, including social functioning and personality structure.
Leichsenring, Falk, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis, 2008supporting
Many psychodynamic clinicians and educators seem ill-prepared to respond to challenges from evidence-oriented colleagues, students, utilization reviewers, or policymakers, despite the accumulation of high-quality empirical evidence supporting psychodynamic concepts and treatments.
Shedler identifies a dissemination failure within the psychodynamic community itself, whereby practitioners' distrust of academic research has left the field poorly positioned to advocate for its own well-documented empirical base.
Shedler, Jonathan, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
Sensorimotor psychotherapy draws heavily from the Hakomi method… and incorporates theory and technique from psychodynamic psychotherapy, cognitive-behavioral therapy, neuroscience, and theories of attachment and dissociation.
Ogden positions psychodynamic psychotherapy as a foundational theoretical source for sensorimotor approaches, acknowledging its concepts as necessary but insufficient alone for body-oriented trauma treatment.
Ogden, Pat, Trauma and the Body: A Sensorimotor Approach to Psychotherapy, 2006supporting
Psychotherapy is… a kind of dialectical process, a dialogue or discussion between two persons… A person is a psychic system which, when it affects another person, enters into reciprocal reaction with another psychic system.
Jung frames psychotherapy not as a technical procedure but as a mutual dialectical encounter between two psychic systems, a position that subtly critiques technique-focused models and anticipates relational perspectives in depth psychology.
Jung, C.G., Collected Works Volume 16: The Practice of Psychotherapy, 1954supporting
Freud's demand that the causes be made conscious has become the leitmotiv or basic postulate of all the more recent forms of psychotherapy. The most important aetiological processes in neurosis are essentially unconscious.
Jung identifies the making-conscious of unconscious etiological factors as the common ground uniting the diverse schools of psychotherapy, grounding the psychodynamic enterprise in a shared epistemological claim about the pathogenic role of the unconscious.
Jung, Carl Gustav, The Practice of Psychotherapy: Essays on the Psychology of the Transference and Other Subjects, 1954supporting
Psychotherapy was at first simply an auxiliary method; only gradually did it free itself from the world of ideas represented by medical therapeutics and come to understand that its concern lay not merely with physiological but primarily with psychological principles.
Jung traces the historical emancipation of psychotherapy from a subsidiary medical technique into an independent discipline governed by psychological rather than physiological principles—a genealogical point relevant to understanding psychodynamic therapy's intellectual autonomy.
Jung, C.G., Collected Works Volume 16: The Practice of Psychotherapy, 1954aside
Jungian psychotherapy does not involve an indoctrination or training in Jungian thought, but an engagement with the patient's psychology.
Sedgwick distinguishes Jungian psychotherapy from didactic or theory-driven models, implicitly positioning it as a relational-exploratory practice within the broader psychodynamic tradition rather than a dogmatic application of analytical constructs.
Sedgwick, David, An Introduction to Jungian Psychotherapy: The Therapeutic Relationship, 2001aside