Psychodynamic

The ancient Greek word 'Psyche', meaning Spirit/Soul, has commonly been limited in modern language to signify 'mind' and intellectual process.

In Psychodynamic concepts, the term Psyche connotes thoughts, emotions, instincts and feelings as well as 'soul'. Together they are understood to have a reciprocal influence and interaction; hence, the adjunct term 'Dynamic', to signify the activity and movement of diverse forces that in turn creates another movement.

Psychodynamic theories, therefore, explore the harmonious and disharmonious interaction of thoughts, emotions and feelings in the lifelong process of self-actualisation of the individual. The self-actualisation process may include, in this context, the 'soul/spirit' idea.

Psychological symptoms and problems are the expressions of inner conflicting forces over 'unacceptable' aspects of our selves, or of our relationships with others. These conflicts may give rise to anxiety or "psychic pains" rejected by unconscious 'defence mechanisms', that help us suppress what seems to be consciously unacceptable. Denied feelings, memories and wishes may re-emerge subconsciously as 'symptoms', revealing hidden dynamics contrary to harmonious development and self-actualisation.

The origin of Psychodynamic Psychotherapy can be traced to Freud's work and through Psychoanalysis. Many psychodynamic thinkers have developed Freud's ideas, some following his basic assumptions and others introducing some independent concepts. Therefore, while they have some shared attributes, many psychodynamic ideas and practices are not necessarily Freudian in origin.

Similarly, each therapist gradually develops his or her own style based on the theoretical model of choice and adjusted by their own personality and experience in response to their clients and the setting in which they work. It would follow then that not every Psychodynamic therapist works in the same way, and that the same therapist may not work in the same way with every client.

The products of unconscious motives and feelings, psychological conflicts are not responsive to mere reasoning and reassurance, and often appear as characterised by one opposing phenomenon. While on the one hand there is a desire to be free of distress, on the other hand a tendency that seems to emerge is a wish to give up the endeavour and to oppose change. The crucial aim of therapy is to understand the origin of this resistance to change, and to explore appropriate ways to overcome it. Part of the therapist's work is to expose these resistances. This may involve revisiting earlier life experiences, exploring the meaning of the problem, and what it may represent for the individual.

Psychodynamic psychotherapy is a collaborative work between client and therapist and cannot be imparted on a passive subject. Therefore, the individual embarking on this task has to share the responsibility for self-development in partnership with the therapist. In this endeavour, the therapist seeks to engage the clients in actively understanding their self and their problems. This process is fostered by the therapeutic relationship between the client and the therapist, as representation of the client's relationships with others, and reflected upon in terms that connect the therapy with present and past aspects of the client's life, in a way that is understandable to the client.

At times, the counselling relationship is prone to exerting a certain amount of stress upon both client and counsellor. In these situations, it is valuable if both parties have established a working alliance from the outset. This may mean that the client has agreed to sustain and tolerate the frustration arising from the therapeutic relationship, so the client can continue working with the counsellor to explore the underlying affects and their meaning 'from the inside out', not only through an exchange of ideas, but through the observation and experience of their relationship's dynamics.

Consultations generally consist of sessions of 50 to 60 minutes and scheduled from once to twice a week or fortnightly.

Depending on the presented issue, the client and therapist may jointly consider if the therapy's goal is achievable in a short period of time (e.g. 12 to 25 sessions in Brief Psychodynamic Psychotherapy) or in medium to longer term (e.g. from 6 months to a year or longer). Open-ended therapy has no defined ending time, and the client and therapist will have to decide when they see it as appropriate to discuss an ending. In all circumstances, regularity of attendance, client commitment and a well-planned ending are major contributing factors in the therapy outcomes.

Description provided by Eros Candusso, Counsellor and Psychotherapist, Sydney

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