There is a particular kind of frustration that brings people to therapy in New York — not confusion about what the pattern is, but the inability to stop it despite knowing exactly what it is. The relationship dynamic that keeps returning in different configurations. The self-defeating move made clearly enough to be named, and made anyway. The sense of watching yourself do the thing you said you wouldn't do again.
The explanation that circulates most often — that this is a failure of willpower, or insight, or commitment to change — is almost always wrong.
The British psychoanalyst Ronald Fairbairn spent much of his career asking why people remain attached to ways of being that cause them pain. His answer was not that they are weak or self-destructive. It was that the patterns were formed in relationship — with early caregivers, with the people who mattered most at the moments when the self was still being assembled — and that changing them carries a cost that has nothing to do with willpower.
The internal world we carry into adult life was built with other people in it. To dismantle a pattern formed in that world is not simply to choose a new behavior. It is, at some level below conscious awareness, to leave behind the relationship in which the pattern was first learned. Stuckness, in this framing, is not weakness. It is a form of fidelity — to people, to moments, to a version of the self that was shaped by both.
This is why insight alone rarely moves the needle. A person can understand the pattern completely and still find themselves inside it the following Tuesday. Understanding what something is and releasing your loyalty to it are two different kinds of work.
Psychodynamic therapy takes this seriously. Rather than targeting the pattern directly — identifying it, challenging it, replacing it with a better one — it works to notice when the pattern is present and operating — in the room, in a conversation, in a dynamic that keeps recurring — and to use the lens of the past not to assign cause but to understand how it moves in the present, and what it has meant to carry it. The loyalty underneath the stuckness, once it becomes visible, often shifts on its own. Not immediately, and not without difficulty. But differently than it does when treated as a bad habit to be corrected.
New York is full of people who have done the intellectual work and are still stuck in the same place. If that gap — between what you know and what you keep doing — is something you're navigating, this may be the kind of therapy worth considering.
I work with adults throughout New York via telehealth. Prospective clients are welcome to reach out at jonathanwalsh@hushmail.com or to request a complimentary 15-minute consultation through this site.
Frequently Asked Questions about Psychodynamic Therapy
What is psychodynamic therapy?
Psychodynamic therapy explores how early relationships and unconscious patterns shape the way we think, feel, and behave in the present. It focuses less on specific symptoms and more on understanding the deeper dynamics that keep them in place.
What does psychodynamic therapy help with?
It is well-suited for recurring relationship patterns, persistent feelings of stuckness, anxiety, depression, and the gap between knowing what you want to change and actually changing it.
How is psychodynamic therapy different from CBT?
CBT works directly on thoughts and behaviors in the present. Psychodynamic therapy uses the lens of the past to understand how patterns move in the present, treating insight into their origins as part of what makes change possible.
Who is a good fit for psychodynamic therapy?
It tends to work well for people who have tried other approaches and remain stuck, or who are drawn to understanding themselves at a deeper level rather than managing symptoms alone.
Jonathan Walsh, LMHC, LCMHC, LPC is a licensed therapist offering psychodynamic and object relations therapy via telehealth in New York and several other states. Learn more about Jonathan.