psychodynamic psychotherapy has
developed as a less intensiveand less expensiveform of psychological
treatment than psychoanalysis, but its premises
derive just the same from Sigmund Freuds ideas about the role of insight in
psychological healing. Unlike the cognitive-behavioral
treatments, which perceive the individual as a consequence of many
stimuli from the environment, psychodynamic psychotherapy perceives
the individual as an agent in his or her own behavior and seeks to help the
individual understand the unconscious meaningthat
is, the dynamicsof troubling symptoms.
Thus, insight into the symptoms is valued as a far more helpful and lasting
cure than merely getting rid of the symptoms.
As a person grows
and develops through childhood into adulthood, many environmental stimuli,
of course, contribute to shaping that persons attitudes and behaviors.
Although quite a bit of this shaping takes place unconsciously, the outward
manifestation of it all is called
Now, when the
goal of psychological treatment is to change long-standing personality qualities,
long-term psychodynamic psychotherapy is called for. Treatment is called
long-term because it can take more than just a few visitsin
fact, it sometimes takes several yearsto change patterns of behavior
that in themselves took years to develop.
But when a person
is functioning well in society and has no deep personality deficits to correct,
and yet develops psychiatric symptoms, brief psychodynamic psychotherapy
can be used to help the person understand what he or she has been through
emotionally that brought about the
A college student
was referred by a professor when the student made some angry and sarcastic
statements in class that gave the professor cause to be concerned about
depression and possible suicidal ideation in the student. So, rather than
discipline the student for his disrespectful and disruptive behavior, the
professor recommended psychotherapy.
On meeting with
the student, I learned that there had been no obvious family dysfunction
in his childhood, but there had been a time in pre-adolescence when he was
hit by a car while riding a bicycle and very nearly died. In fact, he heard
the medical staff say that he would likely not make it. I also
learned that the students remarks in class had been provoked by something
the professor had said, something very similar to comments that the
students father used to make to him. Sometimes the student would feel
enraged by his fathers comments, and one night he got so
that he took off on his bike. And, as it happened, he got hit by a car that
ran a stop sign.
two sessions. It involved some education about how a near-death experience
can cause a trauma that lingers in the
unconscious even after the event is survived. It involved
some discussion about how the professors comments could have triggered
painful memories of childhood events. It involved some
hypnosis to give the student a new perspective
on the unconscious meaning of his past and to help create a new perspective
on his future. And it involved some cognitive-behavioral instruction in changing
In the example
above, treatment took two sessions. Brief psychotherapy sometimes can take
only one session, as in hypnosis for smoking
cessation. Or it can take 12 sessions, as in a focused treatment protocol
for a traumatic event, such as a rape, or an accident, or an act of terrorism.
There is no specified time length, really. In the proper circumstances, however,
it can be a short and valuable investment in ones
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