What is Psychodynamic/Psychoanalytic Treatment

As a therapy, Psychodynamic/Psychoanalytic treatment is based on the fact that people are usually not conscious of the reasons why they are having trouble in their love life or in their work. These unconscious issues may create unhappiness and trouble for people in their lives. Sometimes people are aware of some of the difficulties they are experiencing but often they  keep repeating the same patterns over and over again, not understanding what the reasons are. Because  most of these issues are unconscious, getting advice, from therapists who do not have the proper training, from books, from friends or relatives, does not help with alleviating the problems that a person is struggling with.

There is a concept that as psychodynamic/psychoanalytic therapists, we need to deal with on a daily basis. All of us — you, we, your friends, everybody repeats their past. We internalize what went on when we are young and then merely repeat symbolically, if not literally what happened when we were growing up. If it was a good past — then no problem, we are repeating a good past. However, when the past was not good or there were problems, we repeat that too. We call that Repetition Compulsion. We do not have the capacity to not repeat the past. So, one might ask, what should I do? None of us is capable of changing how our past influences the present. One needs someone who has the in-depth training to help them change their past so that they don’t keep repeating it.  All of us try to change the problems we have experienced as children but low and behold, we merely repeat the past over and over with the hope of changing things but nothing ever changes. Only psychodynamically/psychoanalytically oriented treatment can help someone change the past.

Psychodynamic/Psychoanalytic treatment helps one understand how these unconscious factors affect one’s relationships in work and in love. The first step in this kind of therapy is getting a family history so that first the therapist can learn what happened in the past and from there help the patient see what they are repeating in the present is a repetition of their past.

This kind of treatment is a close relationship between the therapist and the patient. As mentioned, the goal, initially, of the therapist is to help the patient become aware of the issues that are creating the problems. Together they work on making what was unconscious, conscious. The therapist continually points out these issues that the patient is repeating in their lives. Eventually the patient arrives at a point where they, themselves, can see what it is that they were about to do and then stop themselves. During the time that the treatment takes place, the patient struggles with these insights, repeating them again and again with the therapist and experiencing them in their relationships, with friends, in phantasies, and in dreams.  When the patient repeats these issues with the therapist, the therapist has the benefit of pointing this out to the patient as it is happening. We call this interpreting the transference. This continues, until the patient themselves, because they have been made so aware of this behaviour, stops this acting out. The patient and therapist  join together to stop the repetition of dysfunctional behaviour. As the transference gets interpreted, the patient is able to see in the "here and now" what they are doing. Over and over again, in dreams, in the transference the therapist makes the interpretations so that the patient becomes consciously aware of their behaviour. Eventually the patient’s life – his or her behaviour, friend and love relationships, work, sense of self – changes in dramatic ways.

In working with people in individually oriented therapy, marital or couples therapy, or any setting whether it be in business consulting, or schools, the psychodynamic approach influences the work that we do with our clients. That is, what happened in anyone’s past life influences their present life so no matter what type of treatment the client is seeking — individual, marital, etc., in working with adults, what happened in their past needs to be dealt with to help them work through their conflicts. In working with children and adolescents it is very important to understand the child’s relationships with their parents to enable the therapist to help the child or adolescent to work through their problems. So consulting with the parents is crucial in one’s therapeutic work with children and adolescents.

 


Read the latest research on PsychodynamicTreatment.

"The Efficacy of Psychodynamic Psychotherapy"

Jonathan Shedler, PhD

"Empirical evidence supports the efficacy of psychodynamic psychotherapy. Effect sizes for psychodynamic psychotherapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” Additionally, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends."
http://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf

 


MEDICATION:

As a psychiatrist, I have seen quite a few patients for whom a diagnosis of ADD had not been made in childhood or adolescence, resulting in poor school and job performance.

After having treatment with medication it is always heartwarming to have a patient returning gratefully, saying, “ if only they had this medication years ago."

That doesn’t, of course, mean that the person cannot also benefit from psychodynamic/psychoanalytic psychotherapy.  You might want to take a look at what we have entered about Elyn Saks.

Elyn Saks JD has schizophrenia and is a law professor. Her story is inspiring. Whereas, medication is a must, we think, to treat schizophrenia, having the benefit of psychodynamic/ psychoanalytic treatment changed Elyn Saks’ life — with the medication, of course.

Take a look at this YOU TUBE VIDEO.

This is an excerpt from a panel discussion at the FPR-UCLA 2010 conference on the biological and cultural contexts of psychiatric disorder. Elyn Saks and Kay Redfield Jamison spoke about their experiences living with a psychiatric disorder, including the highly effective combination of medication and psychodynamic therapy.