Last Updated:

January 30th, 2026

Psychodynamic therapy

Psychodynamic therapy for addiction focuses on the causes of drug, alcohol and behavioural addiction, not just how to stop. It considers your childhood, important relationships, and the ways you react to life’s challenges, without knowing why. The idea is that understanding these deeper reasons will help you resolve them so you don’t need substances or behaviours like gambling, shopping or sex to cope. Psychodynamic therapy is a key part of all top rehab programmes, so it is crucial to understand how it works.

Psychodynamic group therapy

What is psychodynamic therapy for addiction?

Psychodynamic therapy is therapy that looks at the unconscious feelings and past experiences that are often the hidden drivers of drug and alcohol addiction. Sessions are spent discussing your history and feelings, so your therapist can show you the hidden connections. Perhaps you drink when you feel abandoned because of childhood experiences, or you use stimulants to feel confident because of some deep-seated anxiety.

These patterns can develop without you knowing, and they can keep you stuck in addiction unless you work through them. Many people spend years in psychodynamic therapy, even after rehab, because it helps them stay sober and benefits every other area of their life.

What does the psychodynamic model of addiction address?

The psychodynamic model sees alcohol and drug addiction as meeting an emotional need. The belief is that people are not just physically dependent, but are using substances to fight inner battles. These may include:

Emotional voids
Substances might fill voids from childhood. If you lacked emotional warmth growing up, drugs might provide temporary comfort. If you felt invisible, alcohol might make you feel noticed. The substance replaces what you lacked.
Trauma and painful emotions
Many people use drugs or drink to avoid emotions they can’t bear. Strong feelings like rage or shame can be overwhelming, but substances can numb them. Psychodynamic therapy shows you where these feelings come from so you can face them without escaping through substances.
Old behaviour patterns
Behaviour patterns can be incredibly hard to break. If you have been drinking every day since you were very young, it can become so normalised that sobriety is a scary prospect. Psychotherapy brings these patterns to light, so you can start to break them.
Unhealthy defences
Your mind creates shields like rationalisation or denial to protect you from psychological pain. Psychodynamic therapy looks at these defences, why you need them, and how you can resolve that pain instead of avoiding it..

How does psychodynamic therapy work for addiction?

Drug and alcohol rehab programmes provide psychodynamic therapy in both individual and group sessions. Some of the most important aspects of the therapy include:

Free association
This is when you are encouraged to say whatever comes to mind, rather than the therapist directing you. You go wherever your thoughts take you, with the connections often exposing hidden feelings or struggles. Your therapist will ask open-ended questions that encourage exploration so you can arrive at your own insights instead of being told what to think.
Working with silence
Quiet moments are important in psychodynamic therapy because they give you a chance to reflect and connect the dots. This is different to lots of other alcohol and drug rehab therapies, where the focus is often on talking constantly to see what comes up.
Exploring dreams
Some psychodynamic therapists use dream analysis, believing that dreams can reveal hidden desires and fears that you’re not consciously aware of.
Examining resistance
Resistance can mean avoiding certain topics, becoming defensive, or sometimes even getting angry when challenged on your behaviours. Exploring this resistance is very important because it is often the things that you don’t want to discuss which are the biggest reasons for addiction.
Spotting patterns across your life
Your therapist can also help you identify the important patterns that you always repeat. These can be patterns in behaviours, substance use, relationships, or thoughts. Understanding the patterns can give you fresh perspectives on your habits and what needs to change.
Linking past experiences to present behaviour
Your therapist will also help tie your past to your present. This can help show you why you usually act or respond in a certain way, which is very important for breaking down defences and changing drinking or drug use habits.

young woman doing psychodynamic Therapy

Who benefits from psychodynamic therapy?

Psychodynamic therapy can help many people, which is why it is part of the best rehab plans. However, it is particularly useful for people who:

Have trauma histories
If trauma has contributed to your addiction, psychodynamic therapy can address these experiences and help you find closure. Hopefully, you will be able to resolve the issues altogether, but if not, you will learn better ways of coping with them.
Are struggling in relationships
Psychodynamic therapy can teach you how past relationships shape current ones and why drugs and alcohol may have become your way to cope with loneliness.
Have tried other therapies unsuccessfully
If other approaches haven’t worked, psychodynamic therapy can offer another route to recovery. Some people need to understand the reasons for their addiction before they can change, and psychodynamic therapy can help you unpack everything.
Are willing to commit long-term
Psychodynamic therapy requires patience and commitment, but if you’re prepared to spend time understanding yourself better, it can transform your life.
Struggling with mental health alongside addiction
Psychodynamic therapy addresses various co-occurring mental health and addiction issues, including depression and anxiety.

Finding psychodynamic therapy for addiction

Not all rehab centres offer psychodynamic therapy, but it is a really beneficial part of treatment. Even when programmes do include it, you need to ask whether the therapists are trained in psychodynamic therapy specifically. This is important because specialist training and experience treating people with addiction can make a huge difference to the outcomes.

You should also ask whether psychodynamic therapy continues after leaving residential care. The best results often require extended work, so ongoing outpatient psychodynamic therapy as part of an aftercare programme can be a major plus.

You should also check whether the programme combines psychodynamic therapy with other treatments. For example, some provide psychodynamic individual therapy with CBT groups or 12-step meetings. These approaches can work brilliantly together, so find out how psychodynamic therapy is integrated into the wider treatment plan.

Next steps

If you are interested in understanding the deeper reasons behind your addiction, psychodynamic therapy can be a life-changing experience. Contact us today for expert advice and to talk about your options.

Frequently Asked Questions

How does psychodynamic therapy support recovery from addiction?
Psychodynamic therapy helps you understand the unconscious reasons for using drugs or drinking. This understanding helps you address underlying needs in a healthy way rather than medicating or drinking them away. Psychodynamic therapy also improves relationships and stops you from blaming yourself, both of which are crucial for lasting recovery.
What is the psychodynamic model of alcohol and other drug use?
The psychodynamic model sees addiction as filling psychological needs or avoiding painful feelings. It sees substance use as a substitute for unfulfilled emotional needs, a coping mechanism for trauma, or an unconscious form of self-harm. The model emphasises how past experiences drive current behaviour, so you can break the link between them.
Can psychodynamic therapy assist with managing cravings?
Yes, but indirectly. Psychodynamic therapy doesn’t teach specific craving management techniques, but it can help you understand what triggers cravings emotionally. This can help you address the underlying feeling rather than just struggling through urges.