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How to Start Dynamic Psychotherapy for Psychosis

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28.03.2026

Find a therapist to treat psychosis

Psychodynamic therapy can be transformative for people with psychosis.

Many therapists don't know where to start when engaging in dynamic therapy to treat psychosis.

It's important to stay curious with a person with psychosis and both encourage and model mentalization.

When I’m teaching psychiatry residents, medical students, or psychotherapy trainees about psychodynamic therapy for psychosis, I frequently hear the same refrain. They very much see the need for the work and want to do it, but are intimidated by the idea that therapy with psychotic people is very different than it is with other patient populations, and that they would have no idea how to begin.

What makes a therapy psychodynamic? Three core principles that define a psychodynamic therapy are:

Attention to unconscious conflicts and fantasies Fantasies in analytic terms, meaning stories about themselves and others; they can be pleasant or unpleasant fantasies

Fantasies in analytic terms, meaning stories about themselves and others; they can be pleasant or unpleasant fantasies

Genetic interpretations

Fantasies in analytic terms, meaning stories about themselves and others; they can be pleasant or unpleasant fantasies

“Genetic” in analytic terms, meaning regarding early childhood and family relationships

Attention to........

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