Psychotherapy: Psychodynamic

Because of the limited data in support of psychodynamic psychotherapy, it is best considered as an alternative to empirically-validated therapies that is useful when standard forms of treatment are not desired or not effective. Recent reports have noted that many PTSD patients cannot tolerate the approaches of CPT or PE. Psychodynamic psychotherapy is a valuable alternative because the development of the therapeutic alliance may be crucial for patients to participate actively in the treatment. The psychodynamic perspective focuses on what is unique and idiosyncratic about the individual rather than how that individual is similar to other groups of patients. The specific meanings of the trauma, the defenses brought to bear to deal with the trauma, and the way the traumatic experience affects the individual’s relationships are all major foci of the treatment. Attention to rupture and repair of the therapeutic alliance may be crucial for the success of the therapy. Much more systematic research is required to support the value of this modality.