What is psychodynamic therapy?
Psychodynamic psychotherapy is a way to help people to understand the ways in which they deceive and hide from themselves; how doing so creates problems, and how to stop doing it, so they can lead more authentic and gratifying lives.
In other words, psychodynamic psychotherapy views self-deception over painful feelings and thoughts and conflicts with self and others as the source of nearly all psychological problems.
A common self-deception is when people believe the “should” or “ought” to live their lives according to specific, yet arbitrary rules; to have certain kinds of careers, to marry certain kinds of spouses, and have certain kinds of successes.
Shoulds and oughts nearly always hide what the person wants for themselves, which is at odds with what they think others want for them or what they believe society deems appropriate.
Helping people identify what they want, which always comes with identifying what they feel and think. Knowing our wishes, feelings, and thoughts, gives us choices in life; enables us to pursue or not to pursue certain paths. Living by “shoulds” and “oughts,” however, does not.
Getting rid of the “shoulds” and “oughts,” among other ways we deceive ourselves, gets rid of the lies we put on ourselves.
What is “empirically-supported treatment”?
Psychodynamic psychotherapy is an empirically-supported treatment. Empirically-supported means that a treatment has been found to efficaciously treat specific psychological problems when tested in randomized controlled clinical trials and controlled case-studies.
Empirically-supported treatments are part of what is called “evidenced-based practice.” Evidence-based practice is a complex approach to treating psychological problems that uses a bio-psycho-social model, which takes into account the contributions of a person’s neurological, psychological, and social aspects to the development of their psychological problems. Evidence-based practice requires that psychotherapists attempt to use treatments with good empirical-support; that the psychotherapist knows how to use or is learning how to use the specific treatment, and that the treatment fits with how the patient wants to approach resolving their problems, including that it fits with their cultural worldview.
Is it right for you?
The initial session helps the client and I get an understanding of the problem that brought them to seek therapy and what they hope life might be like without the problem. The best way to know if I might be a good fit for you as your therapist is to see if we work well together.
What is the process?
The first session is called a psychiatric evaluation and serves as an initial consultation. We would try to get a good understanding of why you want psychotherapy and what you hope to get out of it.
The initial sessions that follow will include a further understanding of who you are, the extent and severity of your problem, and what you have tried to do to resolve it, including what has worked and what has not.
Individual psychotherapy is often best if it occurs at least twice weekly, but some people need more frequent sessions and some less frequent sessions. Session frequency can depend on several factors, including the severity of the problem, scheduling possibilities, and what is affordable.
What to expect
People in ongoing psychotherapy will take the lead in starting sessions and will talk about whatever is on their minds, even if the topic seems unrelated to why they came to therapy. One truism of psychotherapy is that nearly everything that a person discusses is related in some way, even tangentially, to the problem they want to resolve.
Attending sessions regularly and on time helps to create continuity across sessions. More frequent sessions can facilitate therapeutic continuity, for some people.
People often want to know how long psychotherapy will last. There are two ways to conduct psychotherapy: One is called brief or time-limited therapy, which has a designated number of sessions, usually in the range of 24 sessions. The other way of conducting psychotherapy is open-ended without a predetermined session limit. I offer both types of psychotherapy, but primarily practice open-ended psychotherapy because it allows people to resolve their problems in a way that is best suited to their needs. Brief psychotherapies might end before an individual receives the full potential benefits of the treatment.
It is impossible to predict how long it will take to resolve your problems, which is why I prefer using open-ended psychotherapy. An open-ended psychotherapy could range from a few sessions to several years. It is important that both the patient and the therapist regularly monitor the treatment for progress and reassess the approach, if progress is stalled, or if the patient feels like the problem has gotten worse.
Integrating other services
In addition to psychotherapy, I work with psychiatrists who are skilled at providing psychopharmacology, if psychiatric medications might be useful. I also have a network of professional colleagues who offer a range of services including career counseling, couples therapy, and neuropsychological assessments.
Addictive disorder treatment
I have a specialization in addictive disorders. I treat patients using an approach that I developed called Assimilative Dynamic Addiction PsychoTherapy (ADAPT). This approach views individual psychodynamic psychotherapy as the core of the treatment, but it also integrates other treatments as needed and these might include self-help groups like Alcoholics Anonymous, psychiatric medications, and group therapy.
People might see me for a consultation to determine the type of addiction treatment they need. They might see me exclusively for treatment, if their addictive disorder is not dangerously severe, or they might see me to help them maintain abstinence, if abstinence is their goal. I take a compassionate approach to addiction treatment.
Coping with ADHD and other learning differences
ADHD and other learning differences can profoundly and negatively affect a person's self-esteem and self-worth in addition to their sense of identity. These differences can contribute to anxiety, depression, career difficulties, and relationship problems.
Psychodynamic psychotherapy can help people with ADHD and other learning differences to heal emotionally, improve their careers, and relationships, and value the positives that come from having ADHD and other learning differences.
Couples therapy
Couples therapy serves to help people in intimate relationships resolve problems they are having as a couple. Couples enter relationships implicitly and explicitly carrying the positive and negative experiences of their childhoods, their parents' relationships or those of other important adults, and their own past romances and friendships.
Couples often come to therapy when their wishes and needs aren't being met in their relationship. Sometimes people get into relationships not knowing exactly what they want from them and others have trouble saying what they want. At other times, people know what they want, can say it, and the relationship ultimately can't provide it, or at least it seems so. Some relationships start off great and people meet each others' needs, but sometimes those needs change subtly or dramatically and can't be articulated. Relationships change due to careers, children, friendships, psychological problems and so on. Sometimes couples who have a solid foundation, need help getting back on track.
Couples therapy can help you understand what you want from each other; whether you want to and can provide it to each other, and then how to go about doing so. Couples therapy can also help people conclude that their relationship might not be able to give them what they want, which might mean accepting it as it is or ending it. Couples therapy can help two people end their relationship with as little pain as possible, especially when children are involved.
A consultation can help a couple determine if therapy might be useful and if I might be the right therapist for you.
