Psychodynamic therapy - anyone had this?

[Keepingwithitjustabout]

Just had first session of 'psychodynamic' therapy. As far as I know it's a more flexible/less intensive version of psychotherapy.

Wondered if anyone has had it - how it helped you? How much interaction with the therapist did you have?

She asked me to talk through a few things, and then prompted me to carry on when I ran out of steam... wondering how it will progress - are therapists usually prompting you to draw your own conclusions or will there be any guidance or even any opinions expressed by the therapist? I've no opinion either way at the moment but interested if it has helped you?

Am now on Prozac and have already had CBT for anxiety but I'm ready to address what's driving these feelings now, I hope

I like the psychodynamic way of working. It's something of an acquired taste though. Has the therapist explained to you the theory behind what happens in psychodynamics psychotherapy? If I am looking for a psychodynamic psychotherapist I look for someone with a lot of experience, in part because it can be intense and, particularly with an inexperienced practitioner, can be somewhat damaging for the client if it goes wrong. I would not want to work with a trainee, for example.

It would be more accurate to describe psychodynamic psychotherapy as a less intensive version of psychoanalysis. Psychotherapy is a broad umbrella term covering all sorts of therapies including CBT.

If you have questions about the therapeutic process, the most appropriate person to address these to is your psychotherapist. If you still do not understand what is happening, my suggestion would be to look for a different psychotherapist, which may or may not be possible depending on your physical location and how your sessions are funded - privately, insurance or NHS.

You might find this pdf aimed at clients helpful. You could discuss it with your psychotherapist, for example.

I have experience of psychotherapy some of which is psychodynamic, but is integrative meaning integrating several different methods.
She does offer advice and opinions and direction, problem solving etc. the psychodynamic part is to do with the deep therapeutic relationship and the dynamics between the two of us. For example, sometimes a dynamic might be played out with the therapist which is similar to your relationships in real life, or from childhood, which could be quite intense. The idea is that the therapist addresses this and it helps you to see what went wrong in the past etc.

Good advice here and the distinction between psychodynamic and psychoanalytically is therapy very valid. Psychodynamic is very different to CBT and, as said, much more focused on the relationship between you and the therapist. It has a very different feel to it and can be feel quite intimidating initially for that reason. I have found it really helpful though and much more helpful than CBT. Each to their own though. You should note that it takes time to build up the mutual trust with your thearapist with psychodynamic therapy so don't rush it and do expect it to take longer than with other forms of therapy.

I have been having psychodynamic psychotherapy for a year. I'm really torn over it.

My therapist is intelligent and kind which I guess is what they are pitching for. She is really well qualified and experienced. She gives a lot of feedback and shares ideas which I've found very valuable. But I think that takes time.

I've learnt a lot about myself and there has been a lot of reflection.

I do feel a little like either my head or emotions have been messed with. I feel incredibly vulnerable in terms of dependency and therapy ending. I think the idea is that this is revealing your feelings about other relationships in your life and we work through this, including concluding therapy when it's time.

I'm not completely convinced about building an attachment that then ends as a learning process. Just seems like more sadness.

Maybe I'll have better feedback in a year!

It's been interesting to read the replies to your post OP.

Thank you for your insights.

Had second session today and felt like we started a journey.

Interested to know more on the theory too now

paranoiaparanoia I can relate to and agree with some of what you have said. Somewhere I came across the notion of the client emerging from psychodynamic psychotherapy "sadder but wiser" which sounds about right to me.

My current therapist draws on a range of influences and I tend to get all squeamish when she does the psychodynamic bit. I have less of an attachment and dependency problem this time around than I have had in the past with a therapist who was both somewhat inexperienced and working psychodynamically, a combination that I cannot recommend.

Keepingwithitjustabout If you are interested to know more on the theory, it is a good idea to discuss this with your therapist too, if you feel able to - maybe later on if you feel ready. I find the theory fascinating and at the same time it is only a theory. There are multiple ways of looking at the world and looking at relationships through a psychodynamic lens is only one way. My experience is that therapists can get wedded to one set of theories, and I tend to keep in mind that they bring their belief systems to the session, just as I bring mine.

Adam Phillips once wrote a piece that concluded: "But the one thing that psychoanalysis cannot cure, when it works, is the belief in psychoanalysis. And that is a problem." I believe he was being somewhat tongue-in-cheek, but I may be wrong. I found it funny but I have something of a line in therapy jokes.

Good luck with the journey. When therapy goes well it is like immersive theatre, in my experience, quite breathtaking.

I'm not completely convinced about building an attachment that then ends as a learning process. Just seems like more sadness.

I had seven years of psychodynamic psychotherapy. The decision and process to end it was sad. Endings are always part of therapy, and rightly so. I learned a great deal from the process and it was transformative for me.

One of the biggest lessons for me was experiencing an ongoing relationship despite absence and separation. I still see her occasionally and am reassured by my ability to internalise my experience of her. One of the most notable things for me was experiencing her holding me in mind.

The depth of emotion associated with the knowledge that she does think about me, and that I too, along with her other clients, am part of her was potent and dramatic. I still think about her, five years after ending therapy, and in times of crisis she, and my experience with her, spontaneously come to mind. This has saved my life more than once,

A really good introduction to the importance of attachment and its basis in biology is:
www.amazon.co.uk/Why-Love-Matters-affection-shapes/dp/0415870534/ref=sr_1_1?ie=UTF8&qid=1497680627&sr=8-1&keywords=why+love+matters+sue+gerhardt&tag=mumsnetforum-21

I also echo what other comtributors have said about talking about your concerns and interest to your therapist. Ask your therapist about reading too.

One of the most notable things for me was experiencing her holding me in mind.

I find the thought of my therapist having any sort of concern for me almost unbearably painful, which is of itself informative, if you see what I mean. I am more or less continually on the verge of quitting due to my chronic fear of emotional intimacy. This is what I mean about psychodynamic psychotherapy being powerful. I come up against facets of myself which never occurred to me as being particularly different to how other people experience the world.

My current therapist is containing, and good with boundaries. I haven't quit yet. I am somewhat in the thick of it though which is all quite disorienting.

Yes it is disorientating. I too am in the thick of it.
I didn't go this week.
I've been somewhat haphazardly reading everything from self help, through psychology to existential philosophy. Not sure I've helped myself!

I feel like for a long time I didn't question going. It was (literally I think, not sure) about survival. It's more difficult now.

OP, I repeatedly, especially early on, wanted to talk about how therapy works when with my therapist. Your therapist will, I think, welcome those conversations.

I'm currently not convinced tbh!

I think I have little to learn intellectually about myself I have a huge clash between logic and emotion. We have had several discussions around that the outcome should be - is it just about accepting this is as good as my life will ever be and how do I live with the reality that I will always be alone, unsupported and lonely.

I've been somewhat haphazardly reading everything from self help, through psychology to existential philosophy. Not sure I've helped myself!

Ha! I thought I was the only person who did this! I did a number on myself trying to second-guess what was going on. Now, I talk with my therapist. She is transparent unlike the previous one who did not seem to understand what it was that I did not understand.

I never did not turn up, but I have felt relieved when I have had to miss a week for whatever reason, and cannot wait for August when mine goes away. Therapy can be grueling, and simultaneously enormous fun. On balance I find it helpful. Not everybody does.

OP I hope I have not put you off. It is early days for you and your therapist. Generally speaking, if you have concerns the best person to talk to with about them is your therapist.

Random I'm sorry to read that. I've posted elsewhere as Yoshimi and have seen some of your posts. You give lots of support. (I NC a lot due to previous privacy issues). Lonely is difficult.

Thank you paranoia, I think very few people have it "easy" in life. Perhaps all I am having to accept is that you can change childhood brain damage, it's there, it's done and hoping for things to be different is futile.

Better to accept this in my 40's than my 60's? If people would just stop trotting out the meaningless and untrue platitudes it would be better "have more gratitude", "be glass is half full" and so on!

I am also sorry to hear that RandomMess.

A big part of psychotherapy for me has been finding my own philosophy. I do not have to accept other people's aphorisms if they do not resonate with me. Some people find truth in the platitudes you find meaningless and untrue.

I feel less alone, unsupported and lonely due to MN. I feel supported here, especially on the MH board but on other boards as well.

I read a blog post which I thought you might find helpful OP. It's a very good website.

www.goodtherapy.org/blog/how-psychotherapy-retrains-brain-to-expect-feel-better-0605175

Erinaceus Somewhere I came across the notion of the client emerging from psychodynamic psychotherapy "sadder but wiser" which sounds about right to me.

How interesting. This also basically describes my emotional journey over the past 5ish years. I'm not sure what the solution is if one is still struggling in daily life, now due to the immense sadness...

Random If people would just stop trotting out the meaningless and untrue platitudes it would be better grin "have more gratitude", "be glass is half full" and so on!

I know what you mean. I find it especially hard that people assume my mindset must be wildly and obviously wrong, and massively oversimplify things. (Especially if they do daft/apparently emotionally immature things themselves, skipping merrily through situations that seem precarious to those of us who constantly overthink everything to avoid "danger"!) Actually I confuse people if they get to know me a bit before finding out about my mental health... they just cannot understand I have problems if I'm not thick or obviously bonkers. They hit a wall of confusion when the simple platitudes don't work (...which I am now singing to the tune of "the drugs don't work"..!)

I'm interested in the idea of relationship issues coming into play/coming to light in your relationship with the therapist. (I've had some therapy that integrated different approaches.) Surely the relationship with the therapist is different because you're paying them? And just... totally different to usual interpersonal relationships. I'm thinking of my experiences with NHS services. They seemed to make the mistake of assuming all my relationships must be like my relationship with them (frankly if they were a person I should have LTB! ) and therefore decided I had a bunch of relationship problems. But obviously it's completely different, for example, I wouldn't show up on a friend's doorstep at 4am injured and bleeding, but I might go to A&E - and expect them to do something about it! Whereas in mental health they seem to ignore the professional/patient service provider/service user dynamic. So it makes me wonder about the relationship in (private) psychotherapy?

Surely the relationship with the therapist is different because you're paying them?

Indeed this is the case. This is not the only reason that the therapeutic relationship is different to other relationships. This does not mean that the way that you relate to other people never comes up in the relationship with the therapist. The situation is not either/or.

And just... totally different to usual interpersonal relationships.

Indeed. This is one criticism of the psychodynamic approach.

decided I had a bunch of relationship problems

Has this been said to you, that you have a bunch of relationship problems, or is this what you think they think?

So it makes me wonder about the relationship in (private) psychotherapy?

You would either have to try it to find out, or perhaps do some research and draw your own conclusions. The relationship between a client and a psychotherapist who works in private practice is different to the relationship between a service user and an NHS employee, in various ways.

I struggled for a long time with the relationship being 'fake' . And not being in control of it, also being more vulnerable than the therapist as some / all my information was revealed but hers wasn't.
In time, various difficult things emerged such as me being unwilling or withdrawing from trusting her, me becoming angry with her and feeling she had let me down, me feeling dependent on her and hating that. Those difficult emotions made me experience aspects of relationships that I've experienced with others in my life , parents, friends etc and this helped me to see where some powerful negative feelings and losses had been in my life.