Psychodynamic Therapy in Edinburgh

What psychodynamic therapy is

Psychodynamic therapy is a type of therapy that begins from a particular conviction — that much of what shapes your present life happens outside your conscious awareness, and that lasting change usually requires bringing some of that hidden material into view. In this sense it is a depth psychology, one that believes we cannot fundamentally change without looking deep into ourselves, rather than dealing solely with symptoms.

The phrase “psychodynamic” sounds medical and forbidding, a bit like psychiatry. It carries the linguistic baggage of the psychoanalytic tradition it was born out of, yet in practice, it describes something quite ordinary — an understanding of psychology built on dynamics: tensions between different parts of ourselves, contrasting desires, and the opposition between ourselves and the world. None of us are just one thing; we are different people at different times depending on where we are, what we are doing, and especially who we are with. None of our actions, thoughts, or feelings can be understood outside of this essential context, and yet to reach a sustained view on this context is notoriously difficult. None of us can have an unbiased perspective on our own lives.

Psychodynamic therapy tries to correct for this bias, and to accept it. It is a way of gaining more insight into our current behaviour and its significance within the context of our rich and infinitely meaningful pasts. We all carry patterns — ways of relating to other people, ways of managing difficult feelings, expectations about what life will give and take from us — that we didn’t choose and don’t fully see. These patterns were once useful, often essential. They protected us from things that felt unbearable, and helped us secure the love and approval we needed to survive. But the strategies that served the child rarely serve the adult quite so well. What once kept you safe can become what now keeps you stuck.

Psychodynamic therapy is the slow, careful work of seeing these patterns more clearly — and, in seeing them, beginning to be free of them.

How psychodynamic therapy works

The therapy itself is conversational. There’s no homework, no worksheets, no agenda set out in advance. We meet weekly for fifty minutes, and you say what comes to mind. I listen — not only to the content of what you say, but to its shape. What you return to, what you skirt around, what feelings rise as you speak. Over time, this attention itself becomes a kind of mirror. You begin to notice things about yourself that have been there all along, but were difficult to see alone. Hopefully, by the end of our work together, this kind of perspective on your own life is something you can sustain on your own.

A psychodynamic psychotherapist pays particular attention to three things. First, the patterns I’ve described above — how you relate to authority, to intimacy, to your own desires and limits — and where these patterns might have come from. Second, the ways you defend against feelings that are difficult to bear. We all have defences and we need them. But sometimes the defences calcify, leaving us cut off from parts of ourselves we’d be better served by reclaiming. Third, the relationship between us. The way you experience me — what you assume, what you hope, what you fear — is rarely just about me. It often echoes earlier relationships in a way that, once we can speak about it openly, becomes one of the most useful places for the work to happen.

I trained at the University of Edinburgh in an integrative tradition that combines the psychodynamic approach with the person-centred work of Carl Rogers and others. In practice this means that I won’t talk to you from a position of clinical distance, pronouncing on what’s wrong with you. I’ll meet you with honesty and without judgement, trying to be as genuine as possible in the room, and I’ll trust that you know your own life better than I do. The psychodynamic tradition offers a way of thinking about what we are looking to discover together — but the process of discovery is driven by you.

When psychodynamic therapy might help

People come to psychodynamic therapy for many different reasons. Some have tried more structured approaches — CBT, coaching, self-help — and found that the relief, though it may have been real, didn’t last, or that something deeper asserted itself. Others arrive simply curious, wanting to understand why their lives have taken the shape they have. Others still are in real distress — anxious, depressed, grieving, lost — and looking for something more than symptom management in dealing with their problems.

It may be worth considering psychodynamic therapy if:

• You’ve noticed patterns in your relationships, your work, or your moods that keep recurring despite your best efforts to change them
• You sense that something from your past — explicit or only half-remembered — continues to affect your present life
• You’re drawn to understanding why you feel and behave as you do, not only how to feel differently
• You’re at a juncture — a loss, a transition, a decision — and want to understand yourself more fully before moving on
• You’ve had therapy before that helped at the time, but feel there’s more to be explored
• You value the depth of an open-ended process over a fixed-session protocol

Psychodynamic therapy isn’t the right approach for everyone. If you’re looking for tools to manage a specific symptom in the short term, a CBT or solution-focused approach may serve you better. If you need crisis support or are in acute risk, please contact your GP or NHS 24 on 111.

What a course of psychodynamic therapy looks like

Psychodynamic therapy is typically open-ended. We usually won’t agree a fixed number of sessions in advance — instead we’ll begin and review together as we go. Some people come for several months to work through something specific. Others stay for a year or more, finding the process itself becomes a place where they continue to grow.

The early sessions are usually about getting your bearings. You’ll talk about what’s brought you here, and we’ll begin to find a rhythm. There’s no expectation that you’ll arrive knowing what to say, or be able to articulate what’s wrong from the outset. Often, simply giving voice to things you’ve kept to yourself is the work of these first weeks.

As trust deepens, the conversation tends to widen. The work problem you came in with may turn out to connect to your earlier life at school. The difficulty in your current relationship may bear traces of much older patterns — something absorbed from your parents’ marriage, perhaps, or from a friendship that ended badly when you were young. We won’t excavate the past for its own sake. We turn to it for the light that it sheds on the present, and only at a pace which seems right for you.

What you might bring

Psychodynamic therapy can be useful for a wide range of concerns. People I see come to talk about:

• Anxiety, depression, or persistent low mood
• Difficulty in relationships — with partners, family members, friends, or colleagues
• Patterns of behaviour that they find puzzling or self-defeating
• Bereavement and other significant losses
• The aftermath of a difficult childhood, including emotionally absent or unpredictable caregivers
• Questions about identity, purpose, and what kind of life they want to live
• A sense of being stuck — in a relationship, a career, or a way of being in the world
• The wish to understand themselves more fully, without a particular crisis to address

You don’t need a diagnosis or a clear formulation of the problem. You only need a willingness to be curious about your own life.

What to expect

I work weekly for fifty minutes, in person at 22 Drumsheugh Gardens in Edinburgh’s New Town — a few minutes from Princes Street and the West End — or online across the UK. Sessions are £70.

I offer a free 20-minute online consultation so we can talk briefly about what’s brought you here and whether psychodynamic therapy with me feels like a good fit. There’s no obligation, and no pressure. If I’m not the right therapist for you, I’ll do my best to help you find someone who is.

Frequently asked questions

• What’s the difference between psychodynamic therapy and CBT?

  The two approaches share a goal — to help you live a fuller life with less suffering — but they go about it differently. CBT (cognitive behavioural therapy) typically focuses on the present: identifying unhelpful patterns of thought and behaviour, and using structured techniques to modify them. It’s often time-limited and protocol-driven, and there’s good evidence for its effectiveness with specific conditions like phobia and OCD.

  Psychodynamic therapy is interested in how present difficulties have come about — what they mean, what they’re protecting, and where they began. It’s less structured, generally longer, and works through the relationship between therapist and client as much as through any technique. Neither is universally better. They suit different temperaments and different problems. If you’ve found CBT unhelpful, or felt that it didn’t quite reach what was bothering you, psychodynamic therapy may give you something different.

• What happens in a psychodynamic therapy session?

  In practical terms, we sit facing each other in a quiet room (or across a video call), and you talk. There’s no fixed structure — no worksheets, no questions I run through. You might begin with something that’s been on your mind that week, or something you noticed in our last session, or something that surfaced between sessions. I’ll listen, and at times I’ll reflect something back, ask a question, or offer a thought about what I’m hearing. Silences are allowed. Sessions last fifty minutes, and over time they develop their own rhythm. Some weeks feel productive in an obvious way; others feel less so at the time, and the significance only becomes clear later.

• How long does psychodynamic therapy take?

  There’s no fixed answer, which can feel frustrating to people who’d like a clear estimate. Some find that twelve to twenty sessions are enough to address what brought them. Others come for a year or more — and a smaller number stay for longer. What’s right for you depends on what you bring, how readily you take to the work, and what you’re hoping to gain from it. We’ll review regularly as we go, so the question of when to end is something we think about together rather than something I impose. I may advise you on the timing of our ending, but it will always be your space and your decision.

• Do I have to talk about my childhood?

  Not in any prescribed way. The work usually moves between present and past, but I won’t ask you to recount your early life as a kind of biographical exercise. We turn to the past when something in the present invites us to — when a current pattern echoes an older one, when a feeling about something happening now seems to draw on something that happened long ago. Some clients spend a great deal of time on early experience. Others barely touch it. There’s no template.

• What if I don’t remember much from my childhood?

  That’s common, and it’s not an obstacle. Memory is rarely a complete or reliable record. What matters more in psychodynamic work is the residue — the patterns, expectations, and ways of feeling that early experience leaves behind, even when the events themselves are vague. Sometimes, talking about the present reveals more about the past than trying to remember the past directly. Sometimes the fragments of memory around the gaps are uniquely illuminating.

• Will we talk about my dreams?

  If you want to. Dreams can be useful material — they sometimes give voice to things the conscious mind has been working hard not to see. But there’s no obligation. Some clients bring dreams regularly and find it useful. Others rarely mention them. I don’t have a fixed system for “interpreting” dreams — when we work with them, we do so in the same spirit as the rest of the therapy, listening for what they might be telling you about your life now.

• What’s the difference between psychodynamic therapy and psychoanalysis?

  Psychoanalysis is the older and more intensive parent of psychodynamic therapy — typically four or five sessions a week, often using the couch, and usually lasting several years. Psychodynamic therapy emerged from the same intellectual tradition but is more flexible: weekly (occasionally twice-weekly) sessions, face-to-face, and adapted to the realities of contemporary life. The shared assumption is that the unconscious matters and that careful attention over time can help loosen its grip. Psychodynamic therapy makes that approach available to people who can’t or don’t want to commit to full analysis.

• Is psychodynamic therapy evidence-based?

  Yes — though the evidence base looks somewhat different from that of more structured therapies. A substantial research literature shows psychodynamic therapy to be effective for depression, anxiety, personality difficulties, and a range of other concerns, with effects that often continue to develop after therapy has ended. The picture isn’t simple, partly because the work doesn’t lend itself to short-term measurement in the same way as more focused approaches. But the evidence is there, and it has grown considerably over the last two decades. For a fuller picture, Jonathan Shedler’s 2010 paper The Efficacy of Psychodynamic Psychotherapy, published in American Psychologist, is a good place to start.

About this page

Written by Tom Wells, MBACP, COSCA. Last reviewed April 2026.

Trained at the University of Edinburgh (PGDip Counselling and Psychotherapy). Registered with the British Association for Counselling and Psychotherapy (profile on the BACP register) and with Counselling and Psychotherapy in Scotland (COSCA).

Scope of practice: adults aged 18 and over; individual therapy only. I do not offer couples therapy, EMDR, formal diagnosis, or medication; where any of these would serve you better, I am glad to point you towards them.