What is a Loss of Agency?

Girl in Sunflowers, Painting by Ernst Morgenthaler, 1928

Loss of agency refers to the painful experience of feeling disconnected from one’s own choices, desires, wants, and sense of personal direction. A patient may be in a state of passivity, confusion, indecisiveness, or helplessness and feel as though life is happening to them instead of through them. In psychodynamic psychotherapy, this experience is understood as having roots in early relationships, childhood, repeated emotional patterns, and unconscious conflicts that influence how a person comes to relate to themselves and others.

For some patients, loss of agency may develop in environments where their needs, feelings, wants, or boundaries were not consistently recognised. Over time, a person may learn to adapt by pleasing others, suppressing their own preferences, or disconnecting from parts of themselves that feel unsafe to express. These can later interfere with the patient’s ability to make choices that feel genuinely their own even though they may have once been protective.

Loss of agency can appear in many different ways. A patient may feel stuck in relationships, unable to make decisions, overly dependent on external approval, or unsure of what they truly want. They may repeat patterns that feel familiar but unsatisfying, even when they consciously wish to change, which can create a gap between what the patient intellectually understands and what they emotionally feel able to do.

Yellow Yarrow, White Umbellifer Flowers and Blackberries by a Field, Painting by Emma Auguste Løffle, 1896

Psychodynamic psychotherapy helps explore the underlying meanings behind this sense of stuckness. Therapy creates space to understand the patient’s fears, defences, relational patterns, and unconscious expectations instead of focusing only on behaviour at the surface. Through this process, the patient can begin to recognise how past experiences continue to influence present-day choices, relationships, friendships, and self-perception.

As insight deepens, patients may gradually develop a stronger sense of authorship over their lives. This does not mean eliminating uncertainty or conflict, but rather becoming more able to reflect, choose, decide, and respond from a place of greater emotional freedom. Psychodynamic psychotherapy can support patients in reconnecting with their own needs, strengthening their boundaries, making decisions, and developing a more integrated sense of agency in their relationships and daily life.