Evidence-based approach in psychotherapy

Updated: Sep 26, 2020

Psychodynamic or psychoanalytical psychotherapy and psychoanalysis



The terms “psychodynamic” and “psychoanalytical” mean the same thing. They refer to an in-depth form of therapy – in fact, the oldest type of psychotherapy. The difference between psychodynamic therapy (or other kind of psychotherapy) and psychoanalysis is only in the frequencies of the weekly sessions. If there are more than two sessions per week then the treatment is called psychoanalysis. If the treatment is once per week then it is psychotherapy. This approach is used to treat anxiety, depression, adjustment disorders, compulsions and OCD, trauma and PTSD and many others.

The core of this approach is uncovering what has been covered, bringing to awareness what’s is not in touch with consciousness. The different schools of thought have theoretical arguments and might use different words to explain the technique, but the essence of the approach is the same: to bring what is inside out, to find its meaning and to work it through the therapeutic relationship between a therapist and a patient.


Efficiency of psychodynamic therapy and psychoanalysis


It is a wide-spared opinion in society (both among professionals and non-professionals in the field of psychotherapy) that “evidence-based” approach means a cognitive behavioral (CBT) approach and its derivatives (techniques and sub-approaches). They are meant to offer a structured treatment that is limited in time, and that promise the quick resolution of the problem within only 15 sessions or less. Sounds too good to be true. We would all like to have just 10 sessions within which to get rid of all our symptoms. Unfortunately, this is not realistic and not possible. We, as humans, unfortunately, are far more complex than that. We carry our inner people (imaginary or not) and our inner dysfunctional relationships with ourselves/parts of ourselves and others. We tend to repeat patters of behaviors and elicit people to treat us in a certain way. We carry our past with us. We bring our inner someone’s in each and every relationship we enter, and our inner families in each and every group we enter (day care, school, work, society). While it is unquestionable that the CBT approach can help manage the symptom, it does not heal the reason for the symptom. Learning how to cope can definitely help you cope, but it will not erase your past or eliminate the real nature of the cause of the symptom. In order to fully treat a problem, the problem has to be explored. When it is explored therapy become psychodynamic. The symptom and the disease have a meaning. In a way, they are there to alarm that something is wrong and action has to be taken. In many ways, they are a survival strategy.


“Psychodynamic Psychotherapy Brings Lasting Benefits through Self-Knowledge”

Article:The Efficacy of Psychodynamic Psychotherapy,” Jonathan K. Shedler, PhD, University of Colorado Denver School of Medicine; American Psychologist, Vol. 65. No.2.; Quote: American Psychological Association




Evidence-based approach

Empirical studies


There are several empirical studies that provide evidence on the efficacy if the psychoanalytic/psychodynamic therapy. They are gathered together in the article “The efficacy of psychodynamic psychotherapy” by Johnathan Sheller. Unlike CBT techniques that help manage, the psychodynamic approach have the advantage of bringing lasting benefits to the patient long after they have terminated the treatment. The same study finds that patients continue to Improve after the treatment has ended. It has been discovered* and proven that what heels in psychotherapy, what helps the patient recover, is not the technique, but the therapeutic relationship. The therapeutic relationship is a psychoanalytical paradigm. It has been defined long ago by Sigmund Freud who discovered the transference. Since then the concept and the technique have been enriched and have changed a lot and many new aspects of them have been discovered. For example, it was once believed* that all the patient feels in the therapy room is a replication of his childhood feelings. Now it is accepted that what the patient feels towards the therapist is always a combination of what the patient has felt in their childhood and what has been co-created between the therapist and the patient. Thus our past personal story can be changed all the time. And this is what helps. But nevertheless the nuances the fundamental principle remains: what helps in psychotherapy is the relationship, that is to say, the analytical component. This means that even in a cognitive-behavioral therapy it is the analytical component that helps. This makes the psychodynamic, psychoanalytical psychotherapy the only really effective form of psychotherapy.


There are different techniques within the psychodynamic/psychoanalytical psychotherapy and many different schools of thought. There is no right or wrong answer to the question what type pf psychoanalytical therapy, or what therapist reflects the needs of the different patients, because this is something very individual. And it does not mean that the analytically orientated therapist does not use CBT approaches. On the contrary - many do.

Psychodynamic psychotherapy/ psychoanalysis is something very individual, very personal, intimate and meaningful. It is a subjective experience that helps the person reach insight and personal growth. It is also an encounter with someone else. A co-creating of an art piece produced by two people – a therapist and a patient. An art-piece that heals.


Irina Simidchieva, Licenced Clinical Social Worker/Therapist



References:

Shedler, J. (2012). The efficacy of psychodynamic psychotherapy.

Gabbard, G.(2017). Psychodynamic Psychiatry in Clinical Practice. CBS Publishers&Distributirs Pvt Ltd

Recourses:

Psychodynamic Therapy, An interview with Dr. Jonathan Shedler

What is a cognitive behavioral therapy?

Cognitive behavioral therapy



#Psychodynamic#Psychotherapy#Psychoanalysis#Psychotherapy NYC#Psychotherapy of NYC

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