Psychodynamic theory is based on the idea that individuals are often unaware of the reasons why they behave in certain ways. It is common for those who fall into alcohol and drug abuse to struggle when trying to justify their actions; in fact, addiction is often described as a compulsion to engage in behaviours despite the obvious negative consequences of doing so. The goal of psychodynamic theory is to help the person develop a better understanding of the driving forces behind his or her behaviour.
Psychodynamic therapy originated from the work of Sigmund Freud. The name refers to the fact that there is a dynamic relationship between different parts of the mind and in particular the unconscious and conscious. This form of treatment is also referred to as insight-orientated therapy because the goal is to help individuals discover important information about themselves.
According to psychodynamic theory, the reason many fall into substance abuse is that they have unresolved conflicts in their mind. The person may be completely unaware of this, but this past trauma may be having a profound impact on his or her behaviour. The key, then, is to help the client delve down into their unconscious mind to identify and resolve the conflict. Once this goal has been achieved then the need to abuse alcohol or drugs falls away.
Psychodynamic therapy involves a relationship between a therapist and a client, based on an interactive process. The therapist is not there to tell the clients what to do about their drinking, but to listen and gently encourage them to delve down into their psyche. This work can take some time to accomplish. It typically means committing to therapy for at least a year (sometimes several years), and it may involve up to three sessions per week. It can also take time for the patient to develop trust in the therapist, which is crucial for the process to be effective. Short-term psychodynamic therapy can bring some benefits to a client, which is why it is often offered in rehab or as part of standard therapy.
One of the reasons why psychodynamic therapy can be so effective is that it allows the individual to get right down to the roots of their problem. This is importance because it may be that the substance abuse is just a symptom of an underlying issue. If this is not dealt with, the person may very well break free of alcohol or drugs, but they are likely to turn to new maladaptive behaviours. By getting to the source of the issue, it greatly decreases the risk of relapse, which means the person can be completely free.
As well as helping individuals understand the driving force behind their addiction, psychodynamic therapy also leads to deep insights into personal values and aspirations. This means that the person can become much better at deciding which path to take in life. It can also mean that the individual feels far more in control of his or her life, which is something that can be very empowering.
Psychodynamic therapy is not something that will work for everyone dealing with a substance abuse. It takes a significant commitment to get the most out of this form of treatment – possibly years of going to therapy sessions. It can also be prohibitively expensive. Some people just do not feel comfortable with this type of intense relationship with a therapist; many of those who begin psychodynamic therapy give up after a couple of sessions.