Therapy is often imagined as lying down on a chaise longue, endlessly talking about your childhood to an analyst who feels a bit distant and clinical cold. Modern day therapy on the other hand, is often pictured as a place to collect “tools” or life advice to manage problems or even push away difficult thoughts.

In reality, psychotherapy is not really either of these things (although I totally have a chaise longue in my office). At its heart, it is a deeply human process, a relationship, a science, but even more so an art! It provides a safe and confidential space where you can explore what feels confusing, painful, or stuck, with someone trained to listen in a way that friends and family simply cannot.

Psychotherapy helps people understand themselves, not just in terms of what they think and feel, but why and then finds new ways of being. Many people come to therapy noticing patterns they don’t want to repeat, like falling into the same kinds of relationships, criticising themselves harshly, or struggling with anxiety or depression that just doesn’t seem to shift. A good therapist won’t give you a list of solutions, but will help you explore the underlying meanings behind these struggles.

What Happens in Psychotherapy?

What Psychotherapy Is

A place where your experiences are taken seriously, without judgement & with compassion.
A place where someone truly listens and holds you through difficult feelings.
A space to explore repeating patterns in your thoughts, feelings, and relationships.
A way of understanding parts of yourself that may have been ignored, criticised, invalidated, or hidden.
A process that unfolds at your pace, guided by curiosity and compassion.
A relationship that can become a model for healthier, more authentic connections in your life.
An experience that can repair or replace what may have been missing in earlier relationships.

What Psychotherapy Is Not

It is not the same as chatting with a friend. While friends can be supportive, psychotherapy is a structured and thoughtful process.
It is not about advice or quick fixes. If the answers were simple, you would likely have found them already.
It is not about being judged, labelled, or told what to do. The focus is on you as a whole person, not a set of symptoms.
It is not always easy. Facing yourself can be challenging, but it is profoundly rewarding.
It is not just about techniques or tools. While techniques can be useful, therapy helps you develop self-awareness, emotional regulation, and relational skills that can only be formed through a human relationship and not through being taught or read about.

Psychotherapy vs Counselling

Many therapists use the terms counselling and psychotherapy almost interchangeably, and training programmes often do too. Both are spaces for support, healing, and understanding. Traditionally, counselling has been more short-term, addressing specific challenges like breakups, workplace stress, or grief. Psychotherapy, especially in psychodynamic or psychoanalytic traditions, is usually deeper, longer-term work.

In Ireland, this interchangeability is widely accepted. Both counselling and psychotherapy fall under a broader therapeutic umbrella, including Cognitive Behavioural Therapy, person-centred, Gestalt, psychodynamic approaches, and more. In other countries, the distinction may be stricter.

What is Psychoanalytic
& Psychodynamic Psychotherapy?

If it wasn’t already a lot to differentiate between psychology, psychiatry, psychotherapy, and counselling, there is now a whole world of approaches within psychotherapy. Today, I’ll focus on psychoanalytic and psychodynamic therapy, my preferred approaches for long-lasting change.

Within psychoanalysis there are many schools, from Freud’s classical analysis to Kleinian, Lacanian, object relations, self psychology, and contemporary relational approaches. Psychodynamic psychotherapy takes insights from these traditions and applies them in a more flexible way, often with a focus on present-day life. Meanwhile Jungian therapy is a related but distinct tradition that emphasises dreams, symbols, and individuation. Many therapists, myself included, weave some Jungian ideas into psychodynamic work.

Psychoanalytic Psychotherapy

Psychoanalytic psychotherapy originates from Freud’s classical psychoanalysis and has been expanded by theorists such as Klein, Winnicott, Bion, Kohut, and many contemporary analysts. At its heart, it attempts to uncover the unconscious parts of us that shape our thoughts, feelings, and behaviours, which are often rooted in early relationships with caregivers.

In practice, psychoanalytic therapy involves:

Exploring the unconscious mind: Clients share their thoughts freely through free association and dreams. Repetitive patterns, and even slips of the tongue, can reveal hidden conflicts.
Understanding object relations: Early experiences with our caregivers, aka our “objects” are internalised and influence how we relate to others today. These patterns of idealisation, dependence, or conflict are then often repeated in adult relationships.
Working through transference: The feelings you project onto your therapist become a mirror of past relational dynamics. The therapist’s awareness of their own reactions (countertransference) helps illuminate these patterns and allows them to be worked through in the room.

Psychoanalytic psychotherapy is usually long-term and intensive. Its goal is not just symptom relief, but deep personality change, greater self-understanding, and the ability to form authentic, fulfilling relationships.

Example: A client who constantly fears rejection may explore how this pattern echoes early experiences with a critical parent, learning to tolerate vulnerability in current relationships.

Psychodynamic Psychotherapy

Psychodynamic psychotherapy developed from psychoanalysis into a more flexible and accessible way of practising. While it shares a focus on unconscious processes and early relational experiences, psychodynamic therapy is often more adaptable to our current life challenges.

Key features include:

Exploring recurring patterns: Clients identify emotional and relational patterns that interfere with daily life.
Balancing past and present: Childhood experiences are explored, with an emphasis on how they shape present relationships, work life, and emotional wellbeing.
Relational focus: The therapeutic relationship itself provides a “corrective experience,” helping clients internalise healthier ways of relating.
Creative and symbolic exploration: Some therapists also integrate Jungian ideas, exploring dreams, symbols, or creative expression to access unconscious aspects of the self.

Research, including meta-analyses by Jonathan Shedler, shows that psychodynamic therapy produces lasting improvements not only in symptoms like anxiety and depression but in overall personality functioning and relational capacities.

How the Therapeutic Relationship Works

between client and therapist. As Nancy McWilliams emphasises, this relationship is more than a container; it is a living arena where change occurs.

Transference and countertransference: Clients experience and reflect on relational patterns in real time.
Corrective emotional experiences: Therapy allows clients to internalise new ways of relating, promoting resilience and healthier connections outside therapy.
Collaborative exploration: Therapy is a safe, supportive partnership, not a distant analysis.

Example:

A client struggling with chronic self-criticism may discover that this inner voice echoes a critical parent from childhood. Therapy helps the client recognise this, separate the past from the present, and develop a more compassionate internal dialogue.
Someone with recurring anxiety in romantic relationships might see how fear and withdrawal replicate early attachment experiences. Psychodynamic exploration helps break these patterns and build trust.

Why Choose Psychoanalytic or Psychodynamic Therapy?

Both approaches offer depth, insight, and lasting change.
They both:

Address the roots of emotional struggles, not just symptoms.
Strengthen self-awareness, emotional regulation, and relational capacity.
Are supported by research demonstrating enduring benefits, especially for personality development and relational functioning.

Modern psychodynamic therapy is flexible and practical while preserving the richness of psychoanalytic insight. Whether you’re dealing with anxiety, depression, relationship difficulties, or self-critical patterns, these approaches provide a pathway to understanding yourself more deeply and creating meaningful, lasting change.

How Psychotherapy Helps With Anxiety, Depression, and Relationships

Struggles such as anxiety, low mood, relationship difficulties, or low self-esteem often reflect earlier experiences that left their mark.

A critical parent may shape a harsh inner voice.
Early loss may make later separations feel overwhelming.
Lack of emotional attunement in childhood may lead to difficulty trusting others as an adult.

Psychodynamic and psychoanalytic therapies don’t just manage symptoms; they aim to understand the roots of struggles so change happens at a deeper level. This doesn’t mean living in the past; it means recognising how the past still influences the present and finding new ways of relating to yourself and others.

Therapy as Growth, Not Just Symptom Relief

One of the most meaningful aspects of psychotherapy is that it supports growth. As therapy progresses, people often feel not just less anxious or depressed, but more creative, more loving, and more alive.

The goal is not simply to “fix” what feels broken, but to enlarge your capacity for love, work, play, and a fuller, authentic life.

Thinking About Starting Psychotherapy?

If you’re curious whether psychotherapy is right for you, I offer a safe and supportive space to explore what you need. Even if you’re unsure what you want or need, simply exploring your thoughts and feelings in a confidential space can be the first step toward meaningful change. Feel free to get in touch to arrange an initial session or any queries you may have.

What is Psychotherapy? A Beginner’s Guide