Yoko Kirkpatrick – Practice Manager (Edited by Keith Mainland)
There are hundreds of psychotherapy models and schools of thought. In fact, there are over a thousand different named psychotherapies including minor variations. However, when it comes to ‘talking therapy’, there are two prevalent therapies;
Psychodynamic Psychotherapy – the general term for types of talking therapywhere underlying problems are identified, explored and addressed over time. Cognitive Behavioural Therapy (CBT)- the type of therapy generally offered by the NHS which focuses on removing the symptoms of the immediate problem using a time-limited process.
So, why does Koan provide Psychodynamic Psychotherapy rather than CBT?
Psychodynamic Psychotherapy vs CBT
A common assumption of most types of therapy, including Psychodynamic Psychotherapy and CBT is that our thoughts, feelings, physical sensations and actions are interconnected. So, what is going on in our mindoften manifests itself in our body and behaviour.
If you are suffering from anxiety, depression or an obsessive compulsive disorder (OCD), you are often trapped in a vicious circle of negative thoughts. Your thoughts and perceptions are distorted and overwhelming, in other wordsthere is a problem in your cognitive process.
The key difference between the two therapies is in how they address the resulting problem.
How does it work?
The basis of Psychodynamic Psychotherapy is Freudian psychoanalysis, but where the therapist and client are seated in view of each other and the therapist talks during the therapy as well as listening. Perhaps the best way to describe psychodynamic psychotherapy is “the archaeology of the human mind”, focusing on helping clients to explore and gain insight into the causes of their difficulties so that you become able to address your own issues as they arise. So, Psychodynamic Psychotherapy can be useful if you want are looking for a longer-term solution to the problems you are experiencing.
In contrast, CBT is a brief, time-limited treatment therapy between 6 and 12 sessions focusing on specific goals but not your historical experience. This means that CBTtends to be a highly structured process which is directive in order to achieve its goals. CBT aims to help the client ‘fix’ their cognitive process by breaking the overwhelming thoughts and feelings into smaller parts and implementing a copying mechanism in order to induce positive changes in their behaviour and emotional state. So, CBT can be very useful if you are looking for a quick fix to the problems you are experiencing.
In conclusion, we at the Koan Practice believe that we serve out clients best by seeking deeper, longer term solutions with our clients; putting you and the exploration of your particular issues at the centre of your therapy.
Two basic ideas
As well as believing that therapy is extremely personal, Psychodynamic Psychotherapy assumes that some of our insights from therapy will be as a result of uncovering patterns and behaviours we were not aware of. This means that these two ideas are central to therapy at Koan:
Each individual is unique – so, although many of us can have similar problems, how we react to them depends upon our historical experience including family upbringing, positive and negative experiences and internalised assumptions.
Our unconscious needs to be explored – we all have feelings and behaviours that we are not aware of which significantly influence how we operate on a daily basis. Understanding our unconscious gives us an opportunity to consider (or reconsider) our choices, making change a possibility.
Psychodynamic psychotherapy helps you get in touch with the unique thoughts and feelings hidden in your mind.
Renata Salecl writes in her book The Tyranny of Choice “The fact that a person is able to make choices opens up the possibility of change. The problem today is that we see our choice as entirely rational, and so our ideas about it tend to fall in line with economic theory and consumerism. We allow ourselves to be governed by those theories. In reality, we need a much broader of choice. The fact that psychoanalysis sees people as responsible for their symptoms does not mean that each of us has rationally chosen our suffering. However, it does mean that the person is a subject – someone who always creates an individual symptom (or neurosis). Change is possible, and we have the capacity to overcome individual suffering as well as create it.”
Research into the Long Term Effectiveness of Psychodynamic Psychotherapy
“The conclusion reached in this review is that there is strong support for the use of psychodynamic psychotherapy in the treatment of a broad range of psychological conditions. Moreover, the improvements gained through psychodynamic psychotherapy are typically maintained beyond the termination of treatment. Psychodynamic psychotherapy appears to be as effective as other psychotherapies, but more comparative trials are needed before firmer conclusions can be drawn.” (The effectiveness of psychodynamic psychotherapy ; a systematic review of recent international and Australian research, Dr Cadeyrn J. Gaskin, Gaskin Research, December 2012)
Often patients come to therapy with distinct goals : the alleviation of symptoms of one sort or another, and then go on to contemplate other changes in the way they live. This is a laudable goal, although, at that point, treatment no longer fits the medical model. Treatment is directed at the difficulties everyone has in living, and not just in ameliorating certain symptoms. (The effectiveness of Psycthotherapy : How do you measure growth in Pyschology Today 08 June 2013- Drawn in part from “Caring: Home Treatment for the Emotionally Disturbed.”) Dr. Fredric Neuman