Build Safety, Connection, and Confidence Within
My name is Micah Fleitman, LPC. I am a psychodynamic trauma therapist in Arlington, Virginia, and I work with people who understand their patterns clearly but still find themselves either living inside or stuck in them. By combining psychodynamic therapy with EMDR, somatic approaches, and IFS, I work at the root level where those patterns were formed, so you can begin relating to your life differently instead of repeating what no longer fits.
There is a particular kind of exhaustion that comes from seeing your own patterns clearly and still being unable to stop them. The self-criticism runs regardless of what is achieved. The anxiety that persists despite knowing exactly where it comes from. The same relational dynamics play out in different contexts, with different people, same result. The understanding is genuine. And yet nothing shifts.
This is not a failure of effort. It is a reflection of where the patterns actually live. Some of what shapes how we move through the world was formed long before there were words for it, in early relationships, in the nervous system learning what was safe and what was not, in protective conclusions drawn from experience and never revisited. Understanding those patterns is a real first step. It rarely changes them on its own.
Psychodynamic trauma therapy works by creating access to the emotional roots of those patterns, not just their surface expressions. The therapeutic relationship itself becomes part of the work, a place where old relational dynamics can surface, be noticed, and begin to shift. The goal is not another layer of insight. It is something actually changing.
Psychodynamic trauma therapy is often a good fit for people who are self-aware and have done real work on themselves, yet still feel like something underneath is running the show:
What this kind of therapy actually looks like
Psychodynamic trauma therapy is a conversation with depth. It is not structured around a fixed sequence of steps. It works by paying close attention to what comes up naturally in sessions, what gets avoided, what surfaces in the relationship between us, and what themes keep returning. That attention, over time, creates access to material that is harder to reach through direct questioning or cognitive work alone.
In my practice, I integrate psychodynamic work with EMDR, somatic therapy, and IFS. These approaches address overlapping territory from different angles. Some trauma is more accessible through the body. Some respond to bilateral processing. Some require the gradual relational trust that psychodynamic work is designed to build. Using these together tends to create more durable change than any single method alone.
You already know something needs to change. Start there.
For most of my adult life, I understood myself pretty well. I could trace my reactions back to where they came from. That understanding did not stop the reactions. It was not until I found approaches that worked at a different level that things began to actually shift. That experience shapes everything about how I practice now.
I am a licensed professional counselor working with trauma, attachment wounds, and the relational patterns that formed in response to early experience. My training includes psychodynamic therapy, EMDR, Internal Family Systems, and somatic approaches. I hold an Advanced Certification in Complex Trauma and Dissociative Disorders from ISSTD, which shapes how carefully and slowly I move through this work. Sessions are available via secure teletherapy throughout Virginia.
The people I work with are usually high-functioning and genuinely self-aware. They come because something internal is no longer responding to effort alone. That is exactly what this is for.
Hi, I’m Micah Fleitman, LPC
Understanding the patterns is not the same as changing them. Together, we can work towards changing them.
Working at the level where patterns were formed
Psychodynamic trauma therapy in my practice is not a scripted method or a fixed protocol. It is a sustained, collaborative process of paying attention to what history has left inside and how it shows up now.
One of the core ideas in psychodynamic therapy is that patterns formed in early relationships do not stay in the past. They get replicated in present relationships, including the one with your therapist. When we pay careful attention to what happens between us in sessions, what feels safe, what triggers guardedness, what pulls for a particular kind of response, we are working with live material, not memories.
This makes the therapeutic relationship itself a treatment tool. The goal is not for the relationship to be perfect, but for it to be honest enough that old patterns can surface and be examined. When something shifts in how the relationship is experienced, that shift tends to generalize. It is a corrective experience, not just a corrective understanding.
When psychodynamic therapy refers to unconscious patterns, it does not mean something buried beyond reach. It means the emotional conclusions and relational habits formed through experience, often before there were words for them, that now operate automatically.
The self-criticism that fires before a thought is finished. The guardedness that appears before a conscious decision to protect. The pull toward familiar relationship dynamics, even when they are clearly recognized.
Exploring these patterns means paying attention to what comes up naturally in conversation, what themes repeat, what reactions seem bigger than the moment warrants, and what gets avoided. Over time, that attention creates the conditions for those patterns to become more visible and, eventually, more flexible.
Early experiences are the context in which the nervous system learned what to expect. Developmental trauma, attachment wounds, and chronic relational stress from childhood do not require a single catastrophic event. They are formed through patterns, through the repeated experience of how relationships felt, what was available, what had to be managed alone. Those patterns become the template.
In psychodynamic trauma therapy, examining early childhood experiences is not about blame or excavation for its own sake. It is about understanding where the current patterns came from so they can be worked with at their roots. Understanding alone rarely changes them. But understanding, combined with the relational and emotional work this therapy provides, tends to create lasting shifts
Psychodynamic therapy provides the relational container and the exploratory depth. EMDR and somatic approaches provide direct access to the places where trauma is stored in the nervous system and body. These are not competing methods. They address the same material from different directions.
Some trauma is most accessible through the gradual relational trust that psychodynamic work builds over time. Some respond better to the bilateral processing of EMDR, which works with emotionally charged memories directly. Some is held in the body in ways that require somatic attention. I move between these approaches based on what a session calls for, not a fixed protocol.
Trauma work that moves faster than the nervous system can integrate tends to retraumatize rather than heal. Psychodynamic trauma therapy is designed to move at a pace that the relationship and the person can support. For some people, that means moving more quickly into deeper material. For others, it means spending significant time building safety before the more difficult work begins.
Pacing is not passive. It is an active clinical decision made in response to what is observed and reported. Nothing in this work happens faster than the foundation beneath it can support. That is not a preference. It is what makes deeper work possible.
Psychodynamic trauma therapy works with a range of experiences that share a common thread. They are things that have persisted despite real effort, things that are understood but not yet changed.
Trauma is not always a single recognizable event. For many people, it is the accumulated weight of chronic stress, developmental wounds, or relational experiences that left the nervous system in a state of protection it never fully released. Post-traumatic stress disorder, complex trauma, and the quieter forms of unresolved experience all share a common feature: the past is still present in a way the mind and body have not finished processing.
Psychodynamic trauma therapy creates access to the emotional roots of traumatic experience, not just its symptoms. Flashbacks, intrusive memories, hypervigilance, avoidance behaviors, and emotional numbness are the nervous system doing what it learned. The work is to help it learn something different, at the level where the original learning happened. Combined with EMDR and somatic approaches, this is one of the most durable trauma treatments available.
Complex trauma refers to the kind of harm that happens over time, in a relationship, often in childhood. Developmental trauma, attachment wounds, emotional neglect, and the chronic stress of growing up in an environment that was unpredictable or unsafe do not produce a single traumatic memory. They produce a template, a set of expectations about what relationships are like, what is deserved, and what is safe to want.
Psychodynamic trauma therapy is particularly well-suited to this kind of work because it addresses relational patterns directly. The therapeutic relationship itself becomes the context in which old relational conclusions can be examined and gently revised. This takes time, but the changes that result tend to be deep and lasting rather than symptomatic and temporary.
Attachment trauma forms when early caregiving relationships were inconsistent, frightening, or unavailable in important ways. The nervous system learns from those experiences, and it carries those lessons forward into adult relationships. Difficulty trusting others, fear of intimacy, people-pleasing patterns, chronic guardedness, or the pull toward relationships that replicate familiar pain are all ways attachment wounds show up later in life.
Psychodynamic therapy works directly with relational patterns. It pays attention to what happens between therapist and client, to the dynamics that emerge in the relationship, and to the assumptions about relationships that were formed long ago. That relational focus is what makes it effective for attachment trauma specifically.
Chronic anxiety and deep shame often have roots in early experience. The core beliefs formed around those experiences, that something is fundamentally wrong, that safety is never guaranteed, that worth must be earned, are not just thoughts. They are conclusions drawn from real experiences and stored in ways that make them feel like facts rather than interpretations.
Psychodynamic trauma therapy works with negative core beliefs at their emotional roots rather than trying to argue with them directly. Understanding where a belief came from is part of the work. But the bigger change happens when the emotional experience that formed the belief is processed and updated, which requires more than cognitive reframing alone.
Depression connected to unresolved trauma or loss looks different from other forms of low mood. It carries grief, often unacknowledged. It carries anger turned inward. It carries the weight of experiences that were never fully processed and the sense that something was taken that cannot be recovered. That kind of depression does not always respond to approaches that focus on the present without addressing what is underneath.
Psychodynamic therapy creates space for the grief and complexity beneath the depression. It does not rush toward resolution. It makes room for the full range of what a person is carrying, which is usually what was missing when the depression first took hold.
Trauma, especially when it happens in childhood or in close relationships, affects how a person understands themselves. Low self-worth, difficulty knowing what is wanted, a sense of not quite belonging in one’s own life, the feeling that who you are depends on how others see you, these are some of the identity-level effects of sustained wounding. They are often the last thing to shift, because they are the most deeply formed.
Psychodynamic trauma therapy moves slowly in this territory, not because the work is passive but because the kind of change that reaches identity requires real time and real trust. The goal is a more stable, honest, and compassionate relationship with oneself, built through a therapeutic relationship that models that possibility.
The patterns keeping people stuck have roots. Psychodynamic therapy reaches them.
It is completely normal to arrive at a first session uncertain about what psychodynamic therapy actually involves, or whether this is the right kind of help. Most people who reach out have already tried other things and are not sure if this will be different. That skepticism is reasonable, and it belongs in the room.
In our first session, we will:
Safety and trust come first. For some people, that is established quickly. For others, it takes longer, and that is fine. The work follows your rhythm; it’s not a predetermined sequence.
This is not therapy, and it is not something to get right. It is just a small way to experience the quality of attention that psychodynamic work asks of you.
Think of a situation that reliably pulls a strong reaction, something that consistently brings up more feeling than the moment seems to call for. Without trying to explain it or fix it, just notice: how long has that reaction been there? What does it remind you of? See if it is possible to stay with the question without rushing toward an answer. That patient, curious attention directed inward without an agenda, is the spirit of this work. Not analysis. Just honest noticing.
See If Psychodynamic Trauma Therapy in Arlington Is the Right Next Step
What is psychodynamic trauma therapy?
Psychodynamic trauma therapy is an approach that works with the emotional roots of traumatic experience, including the unconscious patterns, relational dynamics, and early childhood experiences that shape how a person moves through the present. Unlike approaches that focus primarily on symptom reduction, psychodynamic therapy is interested in the whole picture: where these patterns came from, how they developed, and how they are still operating now.
What trauma-focused psychodynamic therapy addresses
Trauma-focused psychodynamic therapy works with the full range of traumatic experiences, from single-incident trauma to complex trauma, childhood trauma, developmental trauma, relational trauma, and attachment wounds. It pays particular attention to how traumatic experience gets encoded in relational patterns, in the nervous system, and in the unconscious conclusions drawn about safety, relationships, and self-worth.
How it differs from other trauma treatments
Where approaches like cognitive behavioral therapy for trauma focus on restructuring specific thoughts and behaviors, psychodynamic trauma therapy is more concerned with the relational and emotional context in which those thoughts and behaviors formed. It tends to work more slowly and more deeply, using the therapeutic relationship as a primary tool. It does not assume that identifying a distorted thought and correcting it is sufficient. It asks what the thought is protecting against and what experience created it.
How the therapeutic process unfolds
Psychodynamic trauma therapy works through sustained, collaborative exploration of what comes up in sessions: what themes repeat, what gets avoided, what surfaces in the relationship between therapist and client, what emotional material the present keeps circling back to. Rather than working through a fixed protocol, the process follows what emerges. That responsiveness is one of the things that makes it effective for complex and relational trauma.
How psychodynamic therapy addresses unconscious trauma patterns
Unconscious trauma patterns are not buried beyond reach. They are the emotional conclusions and relational habits that operate automatically, formed through experience before they can be examined consciously. Psychodynamic therapy brings attention to where these patterns show up in present life, in relationships, in reactions, in what feels unavoidable, and creates the conditions for them to become more visible and more flexible over time.
The role of the therapeutic relationship
The therapeutic relationship is not just a backdrop in psychodynamic therapy. It is one of the primary mechanisms of change. Old relational patterns tend to emerge in the therapy relationship itself. When those patterns can be noticed, named, and worked with in real time, the change that results is experiential, not just intellectual. That kind of corrective experience is what creates lasting shifts in how a person relates to themselves and others.
Trauma types this approach addresses
Psychodynamic trauma therapy is effective for the full range of traumatic experiences, including post-traumatic stress disorder (PTSD), complex PTSD, childhood trauma, developmental trauma, relational trauma, attachment trauma, acute traumatic events, and the long-term impact of chronic stress. It is particularly well-suited to complex and relational trauma, where the wound was interpersonal in nature and where the effects show up most clearly in relationships and in the sense of self.
Trauma symptoms, this therapy works with
Common trauma symptoms addressed in psychodynamic trauma treatment include flashbacks, intrusive memories, nightmares, hypervigilance, dissociation, emotional numbness, avoidance behaviors, irritability, anxiety and panic related to trauma, depression linked to traumatic experience, difficulty trusting others, shame and self-blame, negative core beliefs, boundary challenges, people-pleasing patterns, and nervous system dysregulation including fight, flight, and freeze responses.
Can psychodynamic therapy help with complex PTSD?
Yes. Complex PTSD, which develops in response to prolonged or repeated traumatic experiences rather than a single incident, is an area where psychodynamic trauma therapy has particular depth. Because complex PTSD affects identity, self-worth, and relational patterns at a foundational level, approaches that work with those areas directly tend to be more effective than symptom-focused methods alone. I hold an Advanced Certification in Complex Trauma and Dissociative Disorders from ISSTD, which shapes how carefully I approach this work.
What the research shows
Psychodynamic psychotherapy has a substantial research base supporting its effectiveness for trauma, depression, anxiety, and personality-level difficulties. Studies consistently show that the gains from psychodynamic therapy tend to continue growing after treatment ends, a phenomenon sometimes called the sleeper effect. The depth of change tends to produce durable results rather than symptomatic relief that diminishes over time.
How psychodynamic therapy compares to CBT for trauma
Psychodynamic trauma therapy and trauma-focused CBT are different tools suited to different presentations. CBT tends to work more efficiently for specific, identifiable symptoms with clear cognitive components. Psychodynamic therapy tends to work more effectively for complex trauma, relational wounds, and the deeper patterns that persist even after symptom-focused work. My practice uses both, along with EMDR and somatic approaches, depending on what the work calls for.
What actually produces change
The mechanism of change in psychodynamic trauma therapy is primarily relational and experiential. The therapeutic relationship provides a context in which old patterns can surface and be worked with in real time. The depth of the exploratory process creates access to emotional material that more structured approaches often cannot reach. Integrating EMDR and somatic work alongside psychodynamic exploration addresses the same material from multiple directions, which tends to produce more lasting change than any single approach alone.
Who benefits from this approach
Psychodynamic trauma therapy tends to be a strong fit for self-aware adults who have done some prior personal or therapeutic work and feel like something is still not shifting despite that effort. It is particularly effective for people working through childhood trauma, complex trauma, relational wounds, attachment difficulties, or patterns of self-criticism and shame that have persisted across many contexts. High-functioning professionals who carry significant internal weight alongside strong external performance often find this approach resonates with how they process their inner world.
Is it only for people with a PTSD diagnosis?
No. Psychodynamic trauma therapy does not require a PTSD diagnosis and is not limited to people with a formal trauma history in the clinical sense. Many people who benefit most from this work would not describe themselves as trauma survivors. They come because of persistent patterns, relational difficulties, chronic anxiety, a sense that something is unresolved, or a feeling that they are not living as fully as they could. If the past is shaping the present in ways that are limiting, this work is relevant.
Session length and frequency
Individual sessions are 53 minutes, typically once per week. Some people find that meeting more frequently, particularly during intensive periods of work, supports deeper progress. Frequency is discussed based on what is being worked on and what is sustainable.
Number of sessions
Psychodynamic trauma therapy is not a fixed-length program. How long the work takes depends on the nature and complexity of what is being worked on, how long it has been present, and how the nervous system responds to the process. Some people notice meaningful shifts within a few months. Others are doing work that calls for a longer, more gradual process. There is no predetermined sequence and no pressure to move faster than the work can support.
Long-term outcomes of psychodynamic therapy
Research on psychodynamic therapy consistently shows that gains continue to develop after treatment ends. The depth of exploration and the relational foundation built during the work tend to continue producing change even without ongoing sessions. Many people return for additional work at different life stages, not because the first round failed but because the same depth of engagement is useful again when new challenges arise.
Session fees
My fee is $300 for a 53-minute session, due at the time of service.
Insurance
I am out-of-network with all insurance plans. Your plan may have out-of-network benefits that reimburse between 50% and 80% of the session cost. I provide a monthly superbill you can submit directly to your insurance, or through a claims service like Mentaya or Reimbursify for an additional small fee. A HIPAA-secure estimate of out-of-network benefits is available through the link on my fees page.
Online psychodynamic trauma therapy throughout Virginia
I offer teletherapy only. All sessions are conducted online via a secure, HIPAA-compliant video platform. You must be located in Virginia at the time of your session, in a private space with a reliable internet connection and both audio and video. The Wilson Blvd address is my registered mailing address, not a clinical office.
Online psychodynamic trauma therapy sessions provide the same depth and quality of work as in-person therapy. For the kind of internally directed, relational work that psychodynamic therapy involves, many people find the privacy and comfort of their own space actually supports rather than limits the process.
About the Arlington mailing address
My registered address is 1550 Wilson Blvd, Ste. 700 #226, Arlington, VA 22209, in the Radnor/Fort Myer Heights neighborhood near Key Bridge, close to the Wilson Blvd and N Lynn Street intersection. If you need to send mail or documents, that address can be used for correspondence. There is no in-person reception at this location.
How do I find a psychodynamic trauma therapist near me in Arlington?
If you are in Arlington or the surrounding Northern Virginia area, including Rosslyn, Courthouse, and Clarendon, the most important criteria are clinical licensure, specific training in psychodynamic and trauma-informed approaches, and a clear explanation of how the therapist actually works. A free consultation is available to talk through your situation and whether this approach is the right fit.
Online psychodynamic trauma therapy serving Virginia
Psychodynamic trauma therapy is available via secure teletherapy to clients in Arlington and throughout Virginia. Communities served include Arlington, Alexandria, Fairfax, Loudoun County, Richmond, Hampton Roads, Charlottesville, and surrounding areas. Teletherapy requires a private space, a reliable internet connection, and both audio and video. You must be located in Virginia at the time of your session.
Online psychodynamic trauma therapy is the only format I offer
Yes. Psychodynamic trauma therapy is available to clients throughout Virginia through my secure teletherapy platform. All sessions are conducted online. The depth and relational quality of psychodynamic work are fully accessible remotely, and many people find that working from a familiar, private space supports the kind of inward focus this therapy requires.
What you need for online sessions
To work together online, you will need to be located in Virginia at the time of your session. A private space where you will not be interrupted, a reliable internet connection, and a device with both audio and video are all that is required. Sessions are conducted through a HIPAA-compliant platform.
Secure Teletherapy for Arlington and All of Virginia
My registered office is at 1550 Wilson Blvd, Ste. 700 #226, in the Radnor/Fort Myer Heights neighborhood near Key Bridge. All sessions are conducted online, which means this work is accessible from wherever is most comfortable and private in Virginia.
How the two approaches differ
Cognitive behavioral therapy for trauma, including trauma-focused CBT, focuses primarily on identifying and restructuring the specific thoughts, beliefs, and behaviors that maintain trauma symptoms. It tends to be more structured and shorter-term, and it is particularly effective for specific, identifiable symptoms. Psychodynamic trauma therapy is more concerned with the emotional and relational context in which those symptoms formed. It tends to work at greater depth and over a longer timeframe, addressing the roots rather than the presenting expressions.
Is psychodynamic therapy the same as talk therapy?
Psychodynamic therapy is a form of talk therapy, but not all talk therapy is psychodynamic. What distinguishes psychodynamic therapy is its attention to unconscious patterns, early experience, the therapeutic relationship, and the emotional roots of present difficulties. Many forms of talk therapy focus on conscious problem-solving, behavioral change, or skill-building. Psychodynamic therapy is primarily interested in depth of understanding and the kind of change that comes from working with emotional experience directly.
Can it be combined with EMDR or somatic therapy?
Yes, and in my practice it routinely is. EMDR and somatic therapy address the same material as psychodynamic therapy, but through different pathways. EMDR works directly with emotionally charged memories through bilateral processing. Somatic approaches work with how trauma is held in the body. Integrating these with psychodynamic work allows the same material to be addressed from several directions simultaneously, which tends to produce more durable and comprehensive change than any single method alone.
Why previous therapy may not have produced lasting change
This is one of the most common things people bring to a first consultation. Previous therapy helped with understanding. It gave tools. It produced some relief. And something still did not shift. That gap is often not a failure of the therapy or the person. It is a signal that the work was operating at one level and the patterns are rooted at another. Psychodynamic trauma therapy is specifically designed for that gap.
What if talking about trauma makes things worse?
This is a real concern and one worth taking seriously. Psychodynamic trauma therapy does not require retelling trauma in detail or moving into difficult material before a foundation of safety and trust has been established. The pacing is careful and deliberate. Some sessions will touch difficult territory. Others will focus on regulation and the relationship itself. Nothing moves faster than the foundation beneath it can support.
How to know if a psychodynamic trauma therapist is the right fit
What to look for in a psychodynamic trauma clinician: clinical licensure, specific training in trauma-informed psychodynamic approaches, and a clear sense from the first conversation that the clinician understands what is being dealt with and can work with it competently. I hold an Advanced Certification in Complex Trauma and Dissociative Disorders from ISSTD, and I offer a free consultation so we can assess the fit together without pressure.
What this therapy is designed to accomplish
The goals of psychodynamic trauma treatment vary by person but generally include: reducing the grip of trauma symptoms, understanding and shifting the unconscious patterns that trauma formed, improving the quality of relationships and attachment, building a more stable and compassionate relationship with oneself, integrating traumatic experiences so they become part of the past rather than the ongoing present, and developing greater emotional regulation and resilience. The aim is not just symptom reduction but a genuine and lasting change in how a person experiences themselves and their life.
Why understanding childhood experiences matters
Early experience is not just history. It is the context in which the nervous system learned what to expect, what is safe, what relationships are like, and what is worth wanting. Examining early childhood experiences in psychodynamic trauma therapy is not about revisiting pain for its own sake. It is about understanding where current patterns came from so they can be worked with at their roots rather than managed at their surface.
Building safety and long-term healing and integration
Long-term healing and integration means reaching a place where what happened has been processed enough that it belongs fully to the past. Intrusive symptoms have diminished. Relational patterns have shifted. The sense of self is more stable. Emotional regulation is more reliable. That kind of integration does not happen quickly, but it is durable. It changes the underlying structure rather than managing the surface.
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