As lockdown continues, and we face another few months of life without access to our traditional gym settings, I have been inundated with questions regarding fitness strategies that can be implemented at home.
In this piece I thought I would write a little about psychodynamic psychotherapy to try and unpick the myths, legends and facts that surround this therapy. It seems that in a lot of the general public’s mind therapy tends to all blur into a faceless mass. This isn’t surprising given the different therapies and treatments on offer now. All the abbreviations, types and styles of therapy are confusing to people in the profession let alone to someone who is trying to find the best form of treatment for them. CBT, DBT, MBT, PIT, Psychoanalysis, Psychodynamic, Hypnotherapy, counselling and the list seemingly never ends.
So where should we start? Well I thought we could look at what is the reality of what it is and how it is conducted. There is a cautionary label attached to this however, a warning of sorts, that no two journeys in psychodynamic psychotherapy are the same. How could they be, right? We all have different backgrounds, experiences, relationships, traumas and on top of all that perceptions of how the world is around us. How boring would it be if we didn’t? Or how dangerous perhaps? That means that your story and journey is unique and as yet not quite fully understood.
Let's stop for just one second and make this a little bit more digestible. After all we do not want a feast so large we feel more unwell. Perhaps then here we are simply trying to find a morsel to feed a hunger and satisfy a need inside of us that seems unfulfilled or malformed in some way. That this seems to make our life more complicated and difficult than it need be and causes us pain. That being said - let’s go deeper into the rabbit warren shall we?
Remember the last good series of books you read or a series on Netflix, or (I’m not ashamed to admit it) the Harry Potter series. The reader had hints as the series progressed as to what might be happening, what dark secrets or unknown facts might be uncovered but nothing concrete. The journey through which ever series you went through for full of twists and turns with each factor affecting the next. It may seem dramatic for me to say this but everyone’s life is full of these moments. Each lay the story down of their lives, perceptions, relationships, desires, mood and direction.
Perhaps it’s important to think back now to your first experience of a relationship, no not a romantic liaison behind the school bike sheds, but in your first relationship. That’s right, the one with your parents, or caregivers. This relationship has set the wheels in motions for the start of your journey and direction. Don’t get me wrong it doesn’t give you an ending or destination but a start and foundation of what is to come or what might come. Take Harry Potter for instance, he was born with love, lost love and when he did a piece of that dark tragedy and loss was placed inside of him. Like a little time marker of the tragedy of the loss. It wasn’t till near the end of the books that we see that he is able to be set free from this pain and find he is able to move on with his life, that he understands what has been haunting him since he was born.
I’m not sat here saying that each person’s life has a Harry Potter or Lord of the Rings storyline. What I am saying is that each of us has their own journey through life each with own list of damages that we feel have been committed against us, or that we sometimes commit against ourselves and this makes a difference to who we are and how we interact with others, how we feel and how we see things.
Some might say that I have made too much light of this journey using the Hollywood glow to glamorise the difficulty people (all people) face. That might well be true if we were to only look at the surface. So let’s dive a little deeper and look at things from a psychodynamic psychotherapy perspective.
We each have plans in our mind, plans and maps of how to navigate all of life’s difficulties, challenges and successes. These plans are written by us learning how to interact with the world and with those people in it. It starts at birth (some say even before this) and goes on till the day we die, and then who knows maybe further, but as no one has been kind enough to come back and tell me about it we can assume at death. The most important factor to psychodynamic psychotherapy is the people, the interactions and experiences you have had. It relies on how this has moulded, directed and captured your journey and in fact series. The therapist is then able to look at this with you over time and try to help you work out what happened, why and how it has led to now. Here and now.
Here and now is what I think people find most difficult to understand about psychodynamic psychotherapy and it is an odd one. Not something that you do every day in every relationship and thank goodness for that I say, as it would be pretty tough thing to do all the time. It really means that the therapist listens very carefully to what you are saying, the way in which it’s being said, in what context, with what emotions attached to it, to who the therapist may represent to the patient at any one time, to the communication that is often missed in conversation and relationships. This then gives the therapist a way of trying to work out what is going on for the person, why they might be feeling that way, what the need is and how they expect it to be met or not met.
This is complicated and really why it takes so long to train to be a psychodynamic psychotherapist. It also includes years of therapy for the therapist. Yes that’s right, your therapist has likely had more years on the couch than you to figure out what is inside them and how this interacts or not with what you bring and to be able to try and separate the two to see you as clearly as they can. This way of doing things allows the therapist to try and explore with you what is really going on for you. It allows for a deeper understanding of you as a person and what has brought you to this point in your life.
I won’t go into more complicated language of transference or counter-transference as I often find that this leads to a barrier in understanding and language with people about therapy (much like all the abbreviations that are banded around healthcare in general). I will say though that in psychodynamic psychotherapy you bring yourself and enter into a relationship with your therapist. One that doesn’t include you knowing very much at all about them.
This is an important factor, to allow you to project your film, journey, series onto the more blank but absorbent and communicating screen to see what’s happening, what’s gone on and what can be understood. People often comment that the therapist in psychodynamic therapy doesn’t say much, doesn’t direct you much to what to say or do, and pretty much at times feels like an observer and just that. For a good therapy this is not true, although at times might feel like this.
They may seem like a distant figure that leaves you feeling anxious, angry, happy, sad, excited at times feeling a little helpless but they are there to see, hold you and provide a safe space to work through these feelings. To make sense and be able to see things a little clearer. They are there to try and help you to see the difficult and often complicated messy nature of you as a human being and feel accepted that this is okay and normal for your journey. To be able to accept what is done, acknowledge what it did and feel that things can move on.
I hope this helps a little in understanding what psychodynamic psychotherapy is like but of course, as I said before, each journey is unique as the patient and as the patient and therapist involved. After all, especially at the moment, it’s the contact and relationship with others that truly makes us human.
Have you thought about how hard it is to admit that sometimes we need help to deal with stress, anxiety or unhappiness in relationships?