Listening beneath the surface: How psychodynamic therapists hear what others cannot?
Most people imagine therapy as a conversation between two people in a quiet room. For a psychodynamic therapist, listening is not passive. It is an immersion into another person’s emotional world. It involves tuning in to stories, silences, hesitations, and internal conflicts that may never have been spoken aloud.
After more than fifteen years in clinical practice, I have learned something fundamental. Change rarely begins with advice. It starts when someone finally feels heard, fully and without judgment.
Psychodynamic listening
Many assume therapists simply listen kindly and offer empathy. Empathy matters, but psychodynamic listening requires something more. It demands attention to several layers at once. These include what is spoken, what is left out, how the body expresses itself, and how old relational wounds suddenly appear in the room.
Writers like Glen Gabbard and Nancy McWilliams emphasize that psychological suffering is rarely about events alone. It’s about how those events are experienced, defended against, or woven into a person’s sense of self. To understand a story, we must understand the person carrying it.
Eight ways a psychodynamic therapist listens
To clarify this, below is a simple framework often used in training. It outlines eight channels that psychodynamic listening may include. They aren’t strict rules but helpful ways to describe where a therapist’s attention is directed.
- The story itself
What happened, who was involved, and what is unfolding now.
- Emotional expression
Tears that don’t fall, laughter that hides pain, anger that appears only in the eyes.
- Bodily signals
A held breath, a tightened jaw, a smile that fades before reaching the eyes. The body often speaks when words cannot.
- Protective defenses
Joking, minimizing, intellectualizing, or changing the subject. These aren’t flaws. They are strategies that once protected a person from harm.
- Unconscious symbols
Dreams, recurring images, or metaphors. Sometimes the psyche communicates long before the mind understands why.
- Transference in the room
A person may expect the therapist to judge them, abandon them, or rescue them because someone once did. Old emotional realities often become active in the therapy space.
- The therapist’s inner response
Sometimes I feel protective. Sometimes heaviness settles in my chest. These reactions aren’t interruptions. They are info that helps me understand what the patient is carrying.
- Repeating patterns
The same heartbreak, the same ending, the same relationship dynamic. Noticing repetition can often lead to transformation.
Listening across all these levels is like tuning a delicate instrument. The therapist uses intellect, intuition, emotional attunement, and reactions to create understanding.
What this sounds like
Imagine someone sitting down and quietly saying:
“It does not matter. People always leave. You will too.”
A casual listener might hear pessimism. A psychodynamic listener notices more. There might be a whisper in tone, a collapsed posture, a quick move away from hope. I may feel an urge to reassure, which shows me how sensitive abandonment is for this person.
A sympathetic response could be:
“I am sorry you have been hurt.”
A psychodynamic response could be:
“It sounds painful to expect me to leave you. I imagine you’ve had to prepare for that many times before. Can we stay with that feeling for a moment instead of moving past it?”
In that moment, listening becomes a bridge from fear into connection.
Why this listening matters
People come to therapy carrying stories they’ve never shared. Often, it’s not because they refuse to speak but because they’ve never had a safe space where speaking was possible.
Psychodynamic listening helps:
Emotions become understandable and nameable.e
Unconscious fears and patterns become visible.
Defenses are respected instead of criticized.
A new relational experience can begin, where wounds may be rewritten.n
In a world that pushes us to move quickly and solve problems immediately, this type of listening offers something rare. It offers time, depth, and presence.
A gentle invitation
You can practice a softer version of this listening in your daily life.
Notice how someone speaks, rather than only what they say.
Notice the pauses. Notice how you feel while they speak.
If you are the one speaking, notice which parts of your story are hardest to share.
Sometimes healing starts simply because someone stayed long enough to hear you.
Psychodynamic listening is a clinical craft. It is shaped by theory, strengthened by practice, and grounded in genuine human presence. It asks the therapist to bear witness to another person’s pain and stay aware of what stirs inside themselves.
Whether you are a clinician, a client, or someone curious about emotional life, I hope this provides a clear window into what happens in the quiet and brave space called therapy.
References
Psychodynamic psychotherapy (Cambridge University Press). https://www.cambridge.org/core/books/essential-psychiatry/psychodynamic-psychotherapy/BA3FC5063EAFCDF433F39B66A83E78B1
Gabbard, Glen O. “A Contemporary Psychoanalytic Model of Countertransference” (PubMed). https://pubmed.ncbi.nlm.nih.gov/11449380/
What Is Transference and Countertransference? (Psychiatry Podcast). https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/strongepisode-041-strongtherapeutic-alliance-part-4-what-is-transference-and-countertransference
Countertransference in therapy (Verywell Mind). https://www.verywellmind.com/counter-transference-2671577
Psychodynamic psychotherapy comprehensive reading list (American Psychoanalytic Association). https://apsa.org/wp-content/uploads/2023/04/Psychodynmaic-Psychotherapy-Comprehensive-Reading.pdf
Psychodynamic therapy explained (Olympic Behavioral Health). https://olympicbehavioralhealth.com/rehab-blog/psychodynamic-therapy/
© 2025 by Shabnam Sadigova
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