Some of our responses originate in attempts to manage internal conflicts during early stages of development. These ingrained ways of functioning can be stubborn and persistent, and can hamper our efforts to manage family life, get on with people, derive satisfaction from our work, or achieve emotional or sexual fulfilment. The psychoanalytic therapies seek to cast light on such processes, helping to bring more flexibility and decisiveness to life and relationships.
Psychoanalytic and psychodynamic psychotherapy are derived from psychoanalysis, a discipline founded by Sigmund Freud in Vienna in the early twentieth century. Psychoanalysis proper is usually understood as comprising four or five sessions per week, psychoanalytic psychotherapy has a frequency of three sessions per week, and psychodynamic psychotherapy is conducted in one or two sessions per week. All these analytic psychotherapies are based on the principle that much of the activity of the mind is unconscious.
Psychoanalytic and psychodynamic psychotherapy have been shown to be effective and to bring lasting gains. The Tavistock Adult Depression Study (2015) demonstrated the long-term efficacy of psychoanalytic psychotherapy; Jonathan Shedler of the University of Colorado Denver School of Medicine has made a strong case for psychodynamic psychotherapy (2010); and Ann Halsell Appelbaum (2006) adduces Joseph Masling's studies, writing 'each one supported, instead of casting doubt on, the psychodynamic hypothesis he was testing.'
Nevertheless, other forms of talking treatment are equally useful, and many people do not feel the need of what Freud called 'depth psychology', so the best approach is to come for an exploratory consultation to get an idea of what analytic work feels like. This is a good way to judge whether it has something of value to offer you.
Fonagy et. al. (2015) Pragmatic Randomised Controlled Trial of Long-Term Psychoanalytic Psychotherapy for Treatment-Resistant Depression: the Tavistock Adult Depression Study (TADS). World Psychiatry, Vol 14.
Halsell Appelbaum, A. (2006) Supportive Psychoanalytic Psychotherapy for Borderline Patients: An Empirical Approach. American Journal of Psychoanalysis, Vol 66 (4).
Shedler, J. (2010) The Efficacy of Psychodynamic Psychotherapy. American Psychologist.
This practice is derived from the origins of the profession with Freud, who was a physician. But he himself believed that the profession should be open to non-medical practitioners, and today many or perhaps most analytic psychotherapists are not doctors.
In psychoanalytic or psychodynamic therapy, the therapist and patient meet for a regular appointment once a week, twice a week, or three times a week.
The therapist asks the patient to say whatever comes into his or her mind, while the therapist's task is to listen and wait. The therapist will speak from time to time to clarify some element of what the patient is communicating, or to offer a new way of understanding it.
The couch is useful in helping the patient to speak spontaneously. The patient lies on the couch while the therapist is seated out of view. However, this arrangement does not suit everybody. Useful analytic work is often carried out with patient and therapist sitting in armchairs at a slight angle from one another.
When such problems come to the attention of patient and therapist, there is an immediate 'live' opportunity for the problems to be considered anew.
The psychotherapist and the patient share a mutual task of trying to pay attention to hidden or ignored mental activity, so that it can be thought about in a systematic and creative way. As a result, the tendencies towards curiosity and development can grow in strength, while habits which work against the best interests of the patient can be understood and mastered.
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The first step is that we meet for a consultation session to think about what you are looking for, and whether or not I might be helpful to you. This meeting can be useful in itself, even if we do not decide upon a course of therapy.
If we arrange for you to come into therapy, we will decide on a session time which you can observe consistently, and a starting date. Then I will write you a formal letter putting our agreement in writing, and the therapy can begin.
It is best to come to Ducie House no earlier than five minutes before your appointment, to avoid waiting outside. Press the bell for Unit 111, and I will release the door remotely to admit you to the building.
Please wait in the entrance area with the yellow seats, and I will come and bring you to the consulting room.
It might be useful to know that toilets are plentiful and easily accessible in Ducie House.