Psychodynamic psychotherapy
Psychodynamic therapy is an effective approach to change.

Australia Counselling member Eros Candusso is a Sydney psychotherapist who uses a psychodynamic approach with his clients.

Psychoanalysis and psychodynamic therapies are often surrounded by many myths and misconceptions about what they are and how they work.

However, they have been shown to be effective approaches that bring about long-term change.

So we asked Eros a few questions about psychodynamic psychotherapy; what it is and what are the benefits.

Here’s what he had to say in answer to our questions:

How would you describe psychodynamic therapy to the layperson who knows nothing about therapy?

Psychodynamic therapy is a process towards personal change from the inside out.

As Insight-Oriented therapy it can transform the way we respond to our present experiences of the outside world by connecting with our inner emotional responses and by reframing our value systems that we have created in response to past experiences.

How is psychodynamic therapy different from psychoanalysis? Is there an overlap?

There is a difference between Therapy and Analysis. Therapy aims to ameliorate a condition, an emotional distress that appears to be caused by events or situations. Analysis, on the other hand, aims to foster changes in the personality by self-awareness.

However, some psychodynamic therapies are closer, in fact, to psychoanalysis and vice versa. The two approaches do overlap in various methods and techniques.

While as in most of other counselling therapies they implement empathic listening, reflecting feelings, reframing content and so on, Psychodynamic therapy and Psychoanalysis share the fundamental theory (and not so much theory anymore) of unconscious dynamics processes and motivations.

The acknowledgement of the unconscious in itself may not be exclusive to Psychodynamic therapy and Psychoanalysis; however it is unique to these two systems the “working through” these unconscious dynamics by ways of Transference and Countertransference and interpretations focusing on the client/therapist relationship. In these modalities, the unconscious becomes the “place” for working toward self-awareness.

What can a client expect to experience in a session with you using a psychodynamic approach?

In the beginning, there may be what we can call a process of “attuning” between my client and me, building what is also known as “therapeutic alliance”. Then, when a sufficient sense of trust and connection is established, there will be an improvement in modulating emotions and an understanding around the issues presented and that will form a reassuring self-knowledge in the client providing a framework for new thinking about personal circumstances and emotions.

For some individuals, this could be all they seek out of therapy. Others will enter into a next stage in a progressive exploration of unconscious dynamics and believes or motivations the have contributed to shape their life experiences in what appeared as the presented problem and toward a new self-awareness.

Actual “problems” and emotional experiences do not happen in a vacuum. They arise in the midst of  “reality states” of mind co-created within a split (or conflict) between our intellectual knowledge (conscious) and our intuitive knowledge (unconscious) as we have constructed from earlier life experiences by means of beliefs, meanings and “revised” memories. In psychodynamic therapy, the client is helped to re-integrate this spitted duality and toward an expanded self-awareness so to better master his or her life.

What are some of the issues that can be effectively treated with a psychodynamic approach?

The key word here is “effective” and it all depends in what we understand for “issue” and the time and means we have to address it.

Various alternative psychotherapy models developed in the past 20 years or so, by influential personalities in the field, have sold their treatment modalities through professional circles and through marketing and media appearances. Each new method is claiming the best results for some mental health affliction under the banner “evidence-based”, often by results of clinical research trials against a “Do-Nothing” approach of the control group.

It is fine to have case studies supporting particular claims, but they could be seen as misleading biases if are not supported by randomized controlled clinical trials. There has been a drove in health insurances and Medicare providers looking for cost cut towards those therapies claiming results with evidence based time-cost-effectiveness.

Consequently, the general public has largely bought into this business model by thinking that certain therapies are and should be faster and tailored treatments for specific disorders. From cross studies, what seems to be “effective” in psychotherapy are the commonalities between the methods more than their particularities regardless of the presented “problem”. However, if one individual understand his or her “issue” as an abnormality intruding in an otherwise satisfying life and just seeks to feel better, than a particular methods focusing on the symptom reduction may be more appropriate.

If the individual sees the “issue” as merging from lack of self-awareness and understanding of the influences of the past experiences on present behaviours, then Psychodynamic therapy can be an effective treatment or a component in a combined treatment for a very broad range of emotional and psychological difficulties.

Is a psychodynamic approach not suited to some people or some issues?

We can address this question for any individual only after a careful assessment. After that, Psychodynamic psychotherapy can be suited in all ages and many diagnostic categories; the range of indications is significantly wider than that for psychoanalysis: mood disorders, anxiety disorders, substance abuse disorders, eating disorders, sexual dysfunctions, adjustment disorders, personality disorders and relational, family or professional problems amongst others.

What do you see are the benefits of a psychodynamic approach to working with people?

In psychodynamic psychotherapy, clients are drawn into discuss in a unique mode of thinking about themselves and in a collaborative role. This will facilitate innovative ideas and explore ways to create and promote quality in their immediate life’s “issues” and elsewhere.

This model of therapy can truly bring personal development through reflecting on present and historical issues and personal attitudes towards life’s circumstances and emotions, in private and social contexts.

Psychodynamic counselling is intended to formulate new ideas of existential change about personal challenges, help achieving centeredness and self-control in emotionally defying situations and cultivate the focus and tranquillity needed to deal with inner conflict, challenging thoughts, desired ideals, and the will to identify and express personal resources and power. That may clarify how to change circumstances and inspire new visions on the value of change for life’s future while participating in the transformative dynamics that are happening today in a changing world.

Eros Candusso is a Sydney psychotherapist and counsellor. Visit his Australia Counselling profile or website. 


photo credit: qthomasbower

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