Psychodynamic Psychotherapy

[Trev57]

Many of the discussions here are related to a cognitive approach to psychotherapy, Has anyone experienced a psychodynamic approach to psychotherapy/counselling? If so how did it help you, or not help you as the case may be?

Psychodynamic counselling relies heavily on the quality of the relationship created between the client and counsellor. In a true helping relationship the client is able to experience the full range of feelings in complete safety. Unconditional positive regard for the client, as in the Rogerian concept of Person Centered Counselling, provides the framework for creating trusting relationships where the client can talk without fear of being judged for any prejudices or views that the client may hold. In relation to cognitive therapies psychodynamic therapies tend to be longer term, but there is evidence to suggest that the gains made by the client also tend to be long term.

Any thoughts, experiences to share?

[confuzzed]

That's an interesting question, Trev57.

If I understand what psychodynamic psychotherapy really is it seems to me that there aren't too many folks engaged in that type of therapy these days because of the length of time it takes and the fact that since most people are on insurance benefits for therapy, insurance just isn't going to pay for it.

These days insurance companies want to limit their expenses for everything, and unfortunately it can be detrimental to the person/community. (I won't get on my insurance rant here....)

[Guest ASchwartz]

Hi Confuzzed and Trev,

I agree with both of you. In my opinion, psychodynamic therapy (which I practised before my retirement) is very powerful when the patient is open and motivated and the therapist is skillful (I was skillful ). Confuzzed, insurance companies do not want to pay. You are quite correct. But, what they do, is set a short time for therapy, the client and therapist have to stop because the "goals of therapy" are achieved and that is that. Then, two years later, problems come back and a new course of therapy starts. Silly. In my mind, there is nothing like a long term, in depth, psychodynamic psychotherapy based on the here and now relationship between patient and therapist. Why? Because the therapeutic relationship repeats all of the patient issues right there, in the office, where the two can work them out. That is the treatment I had and it was wonderful and life changing.

Allan

[paula]

Hi All

I don't know whether mine is Psycho dynamic counseling or not? I am supposed to have Therapy on a weekly basis but... my councilor has been off for 2 months and is off for a further 6 wks so... But when I do see her she will sit there and ask me what bothers/upsets me, and do I feel the need to talk about this to her?

Would this be classed as Psycho dynamic counseling or not?

[Guest ASchwartz]

Hi Paula,

Well, it would be good if you talked things over with your therapist, including how you really feel about her being away for so long. If it was me and she was my therapist I would be very angry about that and I would let her know. I don't mean that I would yell or shout. I mean that I would tell her that I feel real angry, and I would tell her in a calm voice. I know, I did that when I was in therapy and it helped a lot and gave me and my therapist a real chance to learn and work things through.

What do others think?

Allan

[David O]

I think the question could be phrased differently: Which therapy is most effective for which client at which time? Few of us are purists: most of us now integrate what is best given the client and situation. Many of us incorporate psychodynamic, client-centered, behavioral cognitive, family therapy, etc. since each approach provides a partial explanation of behavior and each is enhanced when selectively integrated with other aspects of the therapist's approach and the client’s situation.

I tend to lean very heavily (use) towards the cognitive behavioral and brief therapies (BT); however, I find them fairly counterproductive with me (a minority) and frequently with other racio-ethnically/culturally different populations, especially 1st generation immigrants (of which I am one). The psycho-dynamic approach fits my world view and that of cultures who place great value on the problems of people removed from their cultural roots and the consequent culture shock, problems as a result of migration, sojourn, or involuntary displacement, and problems connected by being a "minority" in the US-- African American, Hispanic, Native American, etc. Also, a good psycho-dynamic therapist can easily integrate indigenous approaches, a much harder approach with purer CBT, behavior therapies and BT's.

Hope this adds to the discussion.

Edited July 11, 2009 by David O

[David O]

Hi All

... But when I do see her she will sit there and ask me what bothers/upsets me, and do I feel the need to talk about this to her?

Would this be classed as Psycho dynamic counseling or not?

Paula,

It sounds less like an issue of whether the therapist is using one approach vs another, and more about a clinician who is directionless and lacks goal orientation. If she is at this point and you've seen her >3 times, you may have a issue: if this is session 1-3, this "might" be where therapy is, although for me, even this would be far to directionless.

My suggestion , like Allan's, is to discuss not so much what approach she's taking, but which direction she's going and what is the expected outcome. She should turn to you at this point and direct the inquiry there. This is your therapy time, you may need to take greater ownership of where you want this to go: the therapist may need to use greater effort in ensuring you don't languish in each session.

David O.