Depth Psychology Explained Using an Example

Thinking in terms of depth psychology means examining the unconscious aspects of behavior in today's relationships: its motive, function, and meaning—for example, what it protects against.

Someone never says no at work, takes on every task, and is so exhausted by evening that they can’t function at home. This hypothetical example illustrates a possible psychodynamic interpretation. It does not provide a general explanation of how exhaustion or other symptoms arise.

Two Possible Interpretations

The first interpretation seems obvious: The exhaustion is initially a result of high stress. Perhaps the demands are indeed unreasonable; perhaps saying “no” would have real professional consequences. These possibilities are not diagnoses; they highlight the information that the hypothetical case does not provide.

The second interpretation asks what purpose the constant “yes” serves. One might assume that saying “no” triggers a fear of rejection. A conversation would have to reveal whether the person recognizes this and whether this explanation fits their current situation.

One possible explanation dates back to childhood: People who, as children, received recognition primarily for their achievements and criticism for their mistakes may only feel valuable when everything is perfect, and hearing “no” then feels like a failure. In depth psychology-based psychotherapy, however, one’s life story serves only as background; the focus is on current relationships.

According to the Patient Information (PDF) According to the German Society for Psychoanalysis, Psychotherapy, Psychosomatics, and Depth Psychology, this approach begins with one or more specific current conflicts and relates the emotions experienced in those situations to significant past experiences and relationship patterns.

Michael Ermann’s textbook (*Psychotherapy and Psychosomatics*, 7th edition, 2020) describes symptoms for a specific group of disorders as the result of a compromise between defense mechanisms and the repressed experience. In this context, defense refers to a predominantly unconscious process that excludes a problem from conscious perception. That exhaustion is part of this process in the example would be a further assumption. Another model for this, How Symptoms Develop, the page discusses psychotherapy based on depth psychology; there, too, it does not apply to every symptom.

How the hypothesis is tested collaboratively

In this approach, such an assumption is often presented as a question or conjecture intended to stimulate reflection. Interpretations that might come across as definitive judgments lack the very intense therapeutic relationship that would support them; this approach does not aim to establish such a relationship.

The following excerpt from a conversation is fictional.

Therapist: How are things going at work right now? How long has it been like this, and what changed back then?

Patient: Since two of my coworkers left, their work has been spread out among the rest of us. It's a lot.

Therapist: I think so. Could it be that saying “no” also triggers a fear of rejection for you?

Patient: I know what it's like to fear rejection. But I don't think that's the only reason.

Therapist: Both could be true. Shall we look at the next situation in which you say “yes” together?

What the patient recognizes supports the hypothesis. The real reason only argues against it as the sole explanation. This could be tested in the following situation: If he says “yes” even when saying “no” would cost him nothing, this tends to support the hypothesis; otherwise, it tends to point to psychological distress. If the hypothesis holds, the procedure continues: The patient is familiar with the fear; the focus is on its unconscious aspect. The textbook describes, for example, a patient who cannot set boundaries with his partner because he unconsciously experiences his own desires as an attack on her.

What the example can and cannot show

The example illustrates a way of thinking; it does not prove that a treatment is effective. According to Ermann’s textbook, insight is only one of several factors contributing to the effectiveness of this approach; relational factors such as care and interest also play a role. The Methods.

I offer online psychological counseling. This does not include diagnoses or the treatment of mental health conditions. This counseling is not a substitute for necessary psychotherapy. My approach is rooted in psychodynamic psychotherapy. Time and again, I find that the solution to a problem lies within the problem itself—that we must recognize and integrate whatever we are currently in conflict with. However, change also requires new experiences and a different way of dealing with real-life stresses.