Psychodynamic Therapy for PTSD: How it Works and What to Expect

When you start looking for post-traumatic stress disorder (PTSD) treatment, most therapists mention exposure therapy, cognitive processing therapy, or eye movement desensitization and reprocessing (EMDR). These approaches help many people, but they're not your only choice.

Psychodynamic therapy takes a distinctly different approach. Rather than making you relive traumatic memories, it examines how trauma shaped the way you relate to people.

At Mind Space Wellness, LLC, Caroline Bjorkman, DO, works with patients who need alternatives to standard trauma therapy. This approach examines unconscious relationship patterns rather than requiring you to confront painful memories directly.

You work through patterns instead of reliving memories

Most trauma therapies want you to tell your story, face your fears, or restructure your thoughts about what happened. Psychodynamic therapy skips all that. Dr. Bjorkman watches how trauma shows up in your relationships right now, including the one you build with her.

Dr. Bjorkman explains how trauma often creates unconscious defensive patterns that show up in all your relationships, including the one with your therapist. Rather than trying to break through these defenses, psychodynamic therapy works with them to understand what they’re protecting you from.

Trauma changes your relationship blueprint

When trauma happens, especially repeatedly or early in life, it rewires how your brain handles relationships and safety. You might find yourself constantly scanning for danger or feeling like you need to earn love.

These changes operate largely outside your conscious awareness. You might notice that you:

Expect criticism even when someone is being supportive
Feel an overwhelming urge to please others
Become distant when people try to get close
Feel suspicious of kindness or assume it comes with conditions

The therapy helps you recognize these unconscious patterns as they unfold in real time during sessions. Dr. Bjorkman pays attention to how you relate to her, what triggers defensive responses, and what this reveals about your internal working models of relationships and safety.

Transference shows you how trauma lives in your nervous system

One of the most powerful tools in psychodynamic therapy is the concept of transference. This happens when you unconsciously transfer feelings and reactions from past relationships onto your therapist. Rather than being a problem to solve, transference is invaluable information about how trauma has affected your capacity for trust and connection.

Working through these patterns in the safety of the therapeutic relationship can gradually restore your capacity for healthy connection.

Your defensive patterns reveal survival strategies

Everyone develops psychological defenses to cope with overwhelming experiences. Defense mechanisms like denial, avoidance, or emotional numbing operate unconsciously to manage anxiety and protect you from further harm.

Psychodynamic therapy helps you understand your particular defensive style without judgment. Common patterns include:

Minimizing trauma’s impact while staying hyperalert to danger signs
Catering to others to avoid conflict or abandonment
Shutting down emotionally when conversations feel intense
Intellectualizing feelings instead of actually experiencing them
Staying busy or distracted to avoid sitting with difficult emotions

Dr. Bjorkman works with you to recognize when these defenses are helpful versus when they might be limiting your life.

You set the pace instead of following a preset timeline

Psychodynamic therapy doesn’t follow the structured protocols you might expect from other PTSD treatments. Sessions happen weekly, but the timeline depends entirely on your trauma history and how quickly trust develops in the therapeutic relationship.

What happens in sessions:

Building safety and noticing patterns as they emerge
No required trauma storytelling or homework assignments
Working with whatever material surfaces naturally
Attention to how you relate and what triggers defensive responses

The timeline varies widely. Single-incident trauma with good support systems might take several months, while complex trauma often requires more time.

Understanding your trauma through unconscious patterns and relationships offers a different path to healing than symptom-focused approaches. If you’re interested in exploring psychodynamic therapy for PTSD, contact our offices in Fort Lee, New Jersey, or the Upper West Side of Manhattan to schedule an appointment with Dr. Bjorkman and our team.