What is Psychodynamic Psychotherapy?

Psychodynamic therapy is a type of talking therapy which helps you to understand how your current thoughts, feelings and behaviours are shaped by your early life and past experiences.

We all have our habitual ways of thinking, feeling, relating and behaving, which we may have developed from an early life, to deal with various difficult aspects at that time; and we may not be always aware of these habitual patterns. Continuing to use them without further thought or awareness, may be causing us various emotional and relationship problems in the present. Psychodynamic psychotherapy provides a space to explore and understand how the unhelpful patterns from our past may be affecting our present difficulties. Such understanding may help us to avoid repeating these unhelpful patterns, which consequently would facilitate more helpful relationships and better quality of life, alongside relieving troubling symptoms.

What is the difference between Psychoanalysis and Psychodynamic therapy?

Psychoanalysis, founded by Sigmund Freud, is based on the psychoanalytic theories that deal with unconscious mental processes. Traditional Psychoanalysis is performed three to five times per week, for several years, often with the patient lying on the couch, and might focus more on the analysis of the unconscious aspects, impulses and dreams.

Psychodynamic therapy is derived from psychoanalysis and the theories of Freud. While it is similar to psychoanalysis in many respects, it is often less frequent and shorter in duration. There is less direct and/or detailed analysis of the unconscious and more focus on exploring the impact of the past on the current life problems and relationships.

What kind of problems can psychodynamic therapy help with?

Psychodynamic therapy is an evidence-based therapy and can effectively help with a wide range of emotional problems and mental health conditions such as depression, anxiety, interpersonal problems, trauma, personality disorders and eating disorders.

At times, you may not be specifically looking for an ongoing treatment, but would like to understand yourself and your problems better. In that case, a limited number of Psychodynamic ‘consultation and formulation’ sessions, could help you to do this.

How do I know that psychodynamic therapy would be the right treatment for me?

You will have an initial assessment (usually 3-4 sessions) to help you and the therapist to evaluate whether psychodynamic therapy could be the right kind of therapy for you. If at the end of the assessment it is felt that it could be beneficial for you, you will be offered an ongoing treatment. This could be short-term (usually between six and 12 months) or longer-term (usually between 12 and 24 months). This is the usual offer, and you can accept or decline this offer.

On the other hand, if at the end of the assessment it is felt that this therapy may not be beneficial for you, an ‘assessment outcome letter’ with the formulation of your difficulties and possible alternative therapies/treatments will be provided, which could help you to consider the next steps of treatment.

What age groups is psychodynamic psychotherapy suitable for?

Psychodynamic psychotherapy usually has no specific age limit. However, psychodynamic therapy with Dr Swapna Kongara via PUK is available for patients aged 18 years and above.

Please see below for more information about Dr Kongara’s qualifications and experience.

What is available from PUK in relation to psychodynamic psychotherapy?

Currently one-to-one psychodynamic therapy sessions are available with Dr Swapna Kongara, as below.

If you are looking for ongoing therapy, you will need to undergo an initial assessment (over 3-4 sessions) to help you and the therapist evaluate whether psychodynamic therapy could be the right kind of therapy for you. At the end of the assessment, an outcome letter with a summary of the aspects discussed in the sessions and a ‘psychodynamic formulation’ of your difficulties is provided to you.

If at the end of the assessment, it is felt that psychodynamic therapy could be beneficial for you, you will be offered an ongoing treatment, usually a minimum of 6 months of weekly therapy. If psychodynamic psychotherapy is not recommended, or a different approach would be more suitable, the assessing therapist will discuss this with you and write to you (and your referrer) to confirm this.

On the other hand, if you are not  looking for an ongoing treatment, but would like to understand yourself and/or your problems better from a psychological perspective, you can request ‘Psychodynamic consultation and formulation’ sessions. This would involve meeting with the psychodynamic therapist for a limited number of sessions, following which, a ‘summary and formulation’ of your difficulties will be provided.

Please note, whether you are attending an assessment for ongoing treatment or only attending ‘consultation and formulation’ sessions, you will be asked to complete and send us a ‘patient questionnaire’ as an initial first step. This questionnaire will include questions about your past and current life aspects, difficulties and relationships. Completing the questionnaire in detail helps you to start reflecting on these aspects prior to the sessions and assists you in deciding what to focus on in the sessions. This will also enable the therapist to start focussing on the observed patterns and dynamics right from the beginning, as opposed to using the time available in the sessions simply for ‘information gathering’.

What can I expect within psychodynamic psychotherapy sessions?

Your therapist will encourage you to talk freely about whatever comes to mind. This is known as free association, which often helps to bring out the aspects that you may have forgotten or not previously been consciously aware of.

You can talk openly and honestly about your difficulties, childhood experiences, current and past relationships, and anything else that comes to your mind. The therapist will listen carefully, and make some observations as appropriate, but they may speak less than other therapists. They might seem more neutral and less openly reassuring, but they will be empathetic. The therapist will also be interested in your feelings about them, and how these feelings might relate to other relationships in your life, past and present.

Sometimes there may be silences in the session and the therapist will not usually interrupt these silences. This could feel awkward, but the idea is that such silences and your experience/interpretation of these silences could help to understand some important aspects about yourself.  Psychodynamic psychotherapy does not involve the therapist giving advice. The therapist may share observations, ideas or interpretation of the issues you discuss, but they will not give specific directions, advice, techniques or coping strategies to practice. Instead, you are supported to reflect on and come to your own conclusions about your difficulties over the course of the therapy.

All these aspects/techniques help you to understand yourself and your difficulties better and feel able to make the changes that could improve your relationships and quality of life.

The sessions will be 50 mins long, at the same time, every week. The sessions start on time and finish on time. The therapist will give you adequate notice of their anticipated absences and they would ask you to do the same. They may not share personal aspects about themselves. Usually, a clear end date for therapy is agreed at the beginning stages of therapy, and the therapy will end on that date. You will not usually have contact with your therapist between the therapy sessions. If you require immediate help with your mental health during this time, you may need to contact your GP and/or local mental health services. These ‘rules’ that are used to maintain a consistent therapy setting are also sometimes referred to as ‘boundaries’ in psychotherapy language.

The assessment sessions are conducted similarly to the ongoing therapy sessions, as above, to give you a flavour of what to expect in ongoing therapy.

What possible benefits can I expect from psychodynamic psychotherapy?

Psychodynamic therapy can help you to understand yourself, your difficulties and your relationships better, which can result in self-acceptance, better relationships and better quality of life. The research evidence (see resources below) suggests that the benefits of psychodynamic psychotherapy continue to grow even after the therapy has ended.

How private are my psychotherapy sessions?

Your sessions are confidential. However, as with any other medical appointments, your therapist writes detailed session notes on your medical records. The assessment outcome letters, formulation letters and end-of-therapy letters will have a summary of the aspects that were discussed in the sessions and the agreed plan. They may discuss your sessions with their psychotherapy supervisor.

If the therapist feels that you have become a danger to yourself or (rarely) other people, they have to tell others – although they would usually discuss this with you first.

Will I have contact with my therapist between the psychotherapy sessions?

You will not usually have contact with your therapist between the therapy sessions. If you require support with your mental health between the sessions, you may need to contact your GP and/or local mental health services.

What if the psychodynamic sessions make me feel worse and I require urgent help between therapy sessions? What if the sessions cause increased risks to myself or others?

Very often people feel validated and understood within psychodynamic therapy sessions. However, it is possible, especially at the early stages of therapy, during therapy breaks and towards the ending of therapy that you may experience difficult thoughts and feelings. You can discuss in your next session with your therapist to make sense of such thoughts and feelings. Often tolerating and reflecting until next session could help as a ‘practice’ of helpfully containing your thoughts and emotions. However, if you need immediate help, you might need to contact your GP and in urgent cases, you can approach A&E for help from local mental health teams. It is helpful to discuss and agree with your therapist, what sources of support you might use between the therapy sessions.

This is another reason why you will be offered assessment prior to ongoing therapy, as it helps to evaluate if you are able to maintain your wellbeing and safety between the therapy sessions and during the times when your therapist is away. But if the assessment itself causes some difficult thoughts, the sessions might lead to providing some support and grounding techniques – which need to be followed up by your GP, local Home Treatment Teams and in urgent cases, you can approach A&E for help from local mental health teams.

How much do sessions cost?

Assessment Sessions:

Each assessment session costs £180 and lasts 50 minutes. Usually, it takes 3 to 4 sessions to complete the assessment. You are not committed to completing the assessment and can choose to discontinue after one or two sessions.

Your therapist will write an assessment report regardless of how many assessment sessions you have attended. However, if you discontinue before the assessment process is complete, the assessment report will only include the aspects discussed in the sessions that you have attended, and hence may not be very detailed or comprehensive.

‘Psychodynamic consultation and formulation’ sessions cost £180 and last for 50 mins, usually 3-4 sessions. If you discontinue before the consultation process is complete, the report will only include the aspects discussed in the sessions that you have attended and hence may not be very detailed or comprehensive.

Therapy Sessions:

Each therapy session costs £120 and lasts 50 minutes. This is usually once a week, for a minimum of 6 months. You are not committed to completing the therapy.

Your therapist will write an ‘end of therapy’ report/ letter regardless of how many therapy sessions you have attended, which will include the aspects discussed in the sessions you have attended.

Reports/ letters will be shared with your GP. Please discuss with your therapist if there is anything you do not want to be shared.

How do I book an assessment?

Bookings can be made using our online booking form or you can call 0330 124 1980 and speak to one of our trained advisors (8am-8pm weekdays) who will arrange an appointment for you (lines are normally very busy so there may be a wait)

Alternatively, to find out more information about this service please complete our initial enquiry form.

What are Dr Swapna Kongara’s qualifications and experience?

Dr Swapna Kongara is a Medical Psychotherapist with a Dual CCT (Certificate of Completion of Training) in General Psychiatry and Psychotherapy. This means, after completing her medical degree (MBBS), she completed specialist training in General Psychiatry and Psychotherapy.  This Dual training has helped her to more efficiently integrate the biological, psychological and social aspects of the mental health care. She has been working as a Consultant in the NHS since 2017. She obtained MRCPsych in 2011 and was awarded the Fellowship of the Royal College of Psychiatrists (FRCPsych) in 2022 as a mark of distinction and recognition of her contributions to psychiatry.

As part of her General Psychiatry training, she has worked in diverse mental health settings, including Primary care Mental Health Team (PCMHT), Early Intervention Services (EIS), Eating Disorder services, Substance Misuse Services and inpatient units, which has enabled her to acquire extensive range of skills to manage a broad array of mental health conditions

Dr Kongara’s principal Psychotherapy training is in Psychodynamic therapy and she has the experience of assessing and delivering therapies for patients with a wide range of diagnoses, traumas and psychosocial issues, including, depression, anxiety, OCD, Bipolar disorder, psychosis, PTSD and personality difficulties. She also had training in other modalities of therapies including CBT, Family Therapy, and Group therapy skills. She is also trained in Compassion Focussed Therapy (CFT).

In addition to this, she has acquired training in Mentalization Based therapy (MBT) and Dialectic Behavioural therapy (DBT), which are recognized as Evidence Based Therapies for people diagnosed with Personality Disorders and trauma histories.

She feels very passionate about providing a safe and helpful space to enable the patients to share their stories, make sense of their mental health difficulties and diagnoses and learn the required skills to manage such difficulties, for a better quality of life.

She has a keen interest in Medical education, and obtained Post Graduate Certificate (PGCE) in Workplace-based Medical Education from Edgehill University. She is currently the Psychotherapy Tutor in her Trust and also the Training Programme Director (TPD) for Higher Psychotherapy training in the North West. She was awarded the Membership of the Academy of the Medical Educators (MAcadMEd) by the Academy of Medical Educators (AOME) in recognition of her commitment to Medical Education.

Dr Kongara can speak English and Telugu languages.

What can I do if I do not like my therapy/therapist?

Psychodynamic therapy sessions could evoke difficult feelings about your therapy and/or therapist. This is termed as ‘transference’ in psychotherapy language, and this could be linked to your thoughts and feelings about significant others in your present or past life. It is helpful to share these with your therapist in the sessions, to enable a discussion and understanding about what could be causing these thoughts and feelings. This would in turn also help you to understand your relationships outside the therapy.  However, if the issues remain unresolved, you can refer to our complaints policy by clicking on ‘Complaints and Disputes’ at the foot of this page.

Where can I find further information regarding Psychodynamic Psychotherapy?

Royal College of Psychiatry

“The Efficacy of Psychodynamic Psychotherapy,” Jonathan K. Shedler, PhD, University of Colorado Denver School of Medicine; American Psychologist, Vol. 65. No.2