Depth-focused therapy for repeating patterns, relationship difficulties, self-criticism, anxiety and low mood
Psychodynamic therapy helps you make sense of the patterns that repeat in relationships, in how you manage feelings, and in how you relate to yourself under pressure. Many people come to therapy not because they lack insight, but because the same reactions keep showing up: anxiety, shutdown, people-pleasing, harsh self-criticism, or feeling stuck in the same relational roles.
I offer psychodynamic therapy in Central London (W1W) (Weymouth Street, near the Harley Street medical area) and online. In my practice, psychodynamic principles are often integrated within an ISTDP-led approach, especially when the aim is to understand and shift deeper, long-standing patterns.
When psychodynamic therapy is most helpful
Psychodynamic therapy can be especially helpful if you:
- keep repeating the same relationship difficulties (e.g., choosing similar dynamics, getting stuck in the same role)
- struggle with boundaries, assertiveness, closeness, or conflict
- feel driven by internal pressure, perfectionism, or self-attack
- experience anxiety or low mood that feels longstanding or hard to “think your way out of”
- notice emotional numbness, withdrawal, or a sense of disconnect
- want therapy that helps you understand why patterns formed and how they keep going
This approach is often valued by people who want therapy that is both reflective and practical, understanding that leads to change.
The psychodynamic view: why patterns repeat
Psychodynamic therapy starts from a simple idea: we develop ways of coping with feelings and relationships early on, and those strategies can become automatic, even when they no longer serve us.
A common maintaining cycle looks like this:
- A relational or internal trigger occurs (criticism, disappointment, expectation, closeness, pressure)
- Feelings rise (often quickly and outside awareness)
- A familiar strategy appears to manage discomfort, such as:
- people-pleasing / overfunctioning
- withdrawal / emotional shutdown
- overthinking / “staying in the head”
- self-criticism
- avoiding conflict or need
- Short-term stability is maintained
- Long-term cost builds (resentment, loneliness, anxiety, low mood, disconnection)
- The pattern repeats, with a different person, a different situation, but the same internal outcome
Therapy helps you recognise these patterns in real time, understand what they protect you from, and develop more flexible responses.
What psychodynamic therapy looks like in practice
Psychodynamic work is collaborative. Sessions often involve:
- noticing how your difficulties show up in everyday life and relationships
- exploring recurring themes (e.g., responsibility, fear of burdening others, fear of being “too much”, mistrust, shame)
- understanding the emotional logic behind coping strategies
- developing the capacity to experience feelings without automatically moving into old defences
- experimenting with new ways of relating (internally and interpersonally)
This is not about blaming the past. It’s about understanding how patterns formed and updating them.
How psychodynamic work fits with ISTDP (clear distinction)
Psychodynamic therapy is a broad tradition of therapy focused on emotions, patterns, and relationships.
In my practice:
- ISTDP is the primary framework and is often the most active, in-the-moment method I use.
- Psychodynamic principles support deeper understanding of patterns, attachment themes, and meaning, especially when difficulties feel longstanding or woven into identity.
If you want a sense of the overall hierarchy and how I decide what we use, see Therapy Approaches.
Best for (common presentations)
Psychodynamic work in my practice is commonly relevant for:
- relationship difficulties (repeating patterns, conflict avoidance, closeness/distance problems)
- low self-esteem and harsh self-criticism
- depression that feels chronic or tied to relational history
- anxiety linked to emotional inhibition (rather than simple “worry”)
- bereavement and loss, where feelings are complex or blocked
- family-of-origin patterns that still shape present reactions
When psychodynamic therapy may not be the whole answer
If your main difficulty is best addressed with a more specific tool, we may integrate or prioritise:
- EMDR when distress is strongly memory-driven (trauma/PTSD)
- CBT when avoidance/checking loops are central (panic/OCD/health anxiety behaviours)
- DIT when a structured, time-limited relational focus is the best fit
You don’t need to choose this in advance; we clarify it together early on.
What to expect
Early sessions
- clarify what you want to change
- map your repeating patterns and the costs they create
- identify what triggers anxiety/low mood and what coping strategies maintain it
Ongoing work
- recognising patterns as they arise
- increasing emotional capacity and self-understanding
- developing new, more flexible responses in relationships and daily life
Sessions are typically weekly initially and reviewed over time.
Related pages
Frequently asked questions
Is psychodynamic therapy “just talking about the past”?
No. The past may be explored where relevant, but the focus is on how patterns operate now, and what changes them.
Is this therapy practical?
Yes. Understanding is useful when it changes choices, relationships, boundaries, and self-treatment in daily life.
Do you offer psychodynamic therapy online?
Yes. Psychodynamic therapy can work very well online.
Do you offer psychodynamic therapy in Central London?
Yes, I work in Central London (W1W) and online.
Next step
If you’re tired of repeating the same patterns, in relationships, self-criticism, anxiety, or low mood, psychodynamic therapy can help you understand what’s happening and shift it.
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