PSYCHOANALYTIC PSYCHOTHERAPY

 

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WHAT IS PSYCHOANALYTIC PSYCHOTHERAPY?

  • In Psychoanalytic Psychotherapy, the focus is on the person’s conscious and unconscious assumptions about relationships and how these are played out with the therapist. So past experiences resurface and can be thought about in a live way.

  • Psychodynamic psychotherapy is an exploratory psychotherapy which seeks to go beyond short term support or symptom relief to a deeper understanding of the whole person.

  • The therapist listens and lets the person in therapy set the agenda.

  • The therapist avoids imposing his / her own view, and the person is asked in turn to live with the uncertainty this can bring.

  • Outcome studies of different therapeutic modalities support the claim that the crucial factor differentiating sucessful from unsucessful therapy is not the particular therapeutic model as such but the quality of the therapeutic relationship between patient and therapist, an issue of central focus in psychodynamic psychotherapy.

 

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WHAT SORT OF ISSUES CAN PSYCHOANALYTIC PSYCHOTHERAPY HELP WITH?

  • Psychoanalytic/psychodynamic psychotherapy can be used in a wide variety of conditions in which people have emotional or relationship difficulties and is not aimed at specific disorders.

  • The wish for self-understanding, the willingness to tolerate uncertainty, and the readiness to consider another point of view, are some of the necessary ingredients.

  • People benefiting from this form of therapy often have difficulties in relationships or in handling the pressures of everyday living.

  • Some people also have disorders such as depression, eating disorders, and psychotic conditions or are struggling with self-harm.

  • Many have additionally been affected by psychological, physical or sexual abuse.

  • Outpatient psychotherapy is not appropriate for people who are habitually violent, actively psychotic, actively suicidal or highly addicted to alcohol or other substances

  • For patients with more focussed therapeutic needs and less interest in the exploratory aspects of psychoanalytic psychotherapy, cognitive behavioural therapy (CBT) might be more suitable.

 

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IS THERE RESEARCH EVIDENCE THAT IT WORKS?

  • There is an increasing body of evidence that psychoanalytic psychotherapy is effective in the treatment of a wide range of disorders.

  • These include the treatment of depression, anxiety disorders, eating disorders, borderline personality disorders and a range of other mental health issues.

  • Roth A & Fonagy R (2004) What Works for Whom? 2nd Edition. Guilford Press

  • Fonagy R (2006) Evidence-Based Psychodynamic Psychotherapies, in PDM Task Force (2006) Psychodynamic Diagnostic Manual (PDM)

  • Dekker et al. (2014) Growing Evidence for Psychodynamic Therapy for Depression. Contemporary Psychoanalysis. Vol.50, 1-2, 2014

  • Westen D, Novotny CM, Thompson-Brenner H (2004) The Empirical Status of Empirically Supported Psychotherapies: Assumptions, Findings, and Reporting in Controlled Clinical Trial, Psychological Bulletin, vol 130, no. 4, 631-663

 

HOW LONG DOES THERAPY LAST AND HOW MUCH DOES IT COST?

  • The frequency and duration of therapy varies according to clinical need and availability of resources.

  • Individual therapy usually lasts from 6 months to 3 years. Depending on the nature of the problem and the needs of the client, individual therapy can last many years.

  • Group therapy typically lasts between for 18 months to 3 years.

  • Therapy can take place between 1 and 5 times a week. Therapy held 4 times a week or more is usually called psychoanalysis as opposed to psychoanalytic (or psychodynamic) psychotherapy.

  • Individual sessions last for 50 minutes, and group sessions for 1.5 hours

  • Sessions can vary in frequency from once a week psychotherapy to four times a week psychoanalysis.

  • Fees for a session are usually 1500 CZK per 50 minute session.

 

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WHAT QUALIFICATIONS CAN I EXPECT THE THERAPIST TO HAVE?

  • Trained mental health professionals from a variety of professions provide psychoanalytic psychotherapy.

  • They will typically have at least a masters level training or be under supervision as a trainee therapist.

 

ONCE I START THERAPY, WHAT HAPPENS AT THE APPOINTMENTS?

  • Before starting therapy you will meet with your psychotherapist to discuss a regular time for your sessions and other practicalities such as arrangements in case of illness, cancellation, holidays etc.

  • Typically a 3-5 session assessment period is initiated to assist in diagnosis, to assess the suitable 'fit' between client and therapist, and to decide on the best form of treatment for the specific patient and their problems.

  • Sessions are held in the same room, at the same time each week.

  • In psychoanalytic therapy, the therapist does not generally structure or direct the sessions but allows the person to talk about whatever comes to their mind. This is known as free association. This may feel uncomfortable at first as most people are used to being given advice or led in encounters with health professionals.

  • The therapist does not disclose personal information or make any physical contact with their patient.

  • These factors allow a person’s most important underlying issues and emotions to surface and the ways they relate to others to be revealed most clearly in the therapy.

  • Some people experience some intensification of their anxieties and symptoms during therapy, especially at the start and around holiday breaks. This is also a sign of increased involvement with the therapeutic process.

  • Work in therapy on these areas can help the individual better understand his emotions and relationships and feel freer to lead a more fulfilling, creative life.

 

For more information on psychoanalysis and psychoanalytic psychotherapy, see this useful summary by the British Psychoanalytic Council: Making sense of psychotherapy and psychoanalysis

 


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