Chapter 25. Psychodynamic Psychotherapy of Depression

Glen O. Gabbard, M.D.; Tanya J. Bennett, M.D.
DOI: 10.1176/appi.books.9781585622986.257181



Psychodynamic psychotherapy is based on a set of time-honored principles (Gabbard 2005). These principles include the notion that unconscious meanings, conflicts, and desires create distress. Developmental emphasis is also characteristic of psychodynamic psychotherapy in that adult relationships are seen as growing out of ingrained and largely unconscious patterns from childhood. Indeed, these patterns emerge in the therapeutic relationship; they are referred to as transference, and the therapist pays close attention to the way the patient relates to the therapist and brings it to the patient's attention. Countertransference involves those issues from the therapist's past that may influence the therapeutic relationship as well as feelings directly induced in the therapist by the patient's behavior. A systematic understanding of the countertransference is regarded as useful information in discerning characteristic relationship problems the patient encounters in outside interactions. Finally, resistance is a reflection of the patient's ambivalence about getting better, and the therapist makes a concerted effort to understand the multiple meanings of the way the patient resists the therapist's efforts to help. A succinct definition of psychodynamic psychotherapy is "a therapy that involves careful attention to the therapist–patient interaction, with thoughtfully timed interpretation of transference and resistance embedded in a sophisticated appreciation of the therapist's contribution to the two-person field" (Gunderson and Gabbard 1999, p. 685).

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Table Reference Number
Table 25–1. Indications and contraindications for psychodynamic psychotherapy


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