How ready are you to work with a counsellor or psychotherapist? When you decide to use talk therapy there could still be some unanswered questions about which approach suits you. In this blog, I look at how the strengths and weaknesses of the psychodynamic approach may be of benefit for someone working from the past to know themselves better.

When did the psychodynamic approach begin? Is it still relevant today? 

As a practitioner, I cite Sigmund Freud in his late nineteenth and early twentieth-century work to whom this approach can be mostly linked with. He started to investigate how his patients – a clinical term of the time – were experiencing historic relational difficulties. This realisation is a strength because it acknowledges that what might be causing us difficulties could have links to our conscious and unconscious selves. But, more on that later. 

He was not alone. Other professionals have worked on this theory from his discoveries making it an evidence-based approach to support anxiety, depression, addiction and relationship difficulties. What I do as a talk therapist is build up a description of what it means to be you. This means working with what is in your mind in the present moment as a conscious thought, or it may be that you present unconscious facts about yourself which highlight how you have unanswered questions about the problems you face. 

Since his work others have built upon the unconscious, resistance, transference, countertransference, defence mechanisms, free associations and repetition compulsion which people face. I work from the theory of Petruska Clarkson in helping to define these clinical terms to be clearer. It could be argued that these complicated terms are what make psychodynamic work more difficult to trust – perhaps a weakness if you will. It would be remiss of me to ensure that you work with a well-trained and accredited professional who knows the benefits of this successful approach to make the terms relevant to your needs. 

I will take one term to help explain why it is that you may be feeling unwell in your mental, emotional and physical health. Transference is the presenting difficulties which your life has had. It is a part of the therapeutic alliance which forms in a safe, non-judgmental and confidential space between you and me. I hear and listen to what you feel is taking place in the world you live in. It will most likely be that you share a history which goes as far back as you can remember. Or, it may even be that you disclose memories from the past generations of your family which make up how your childhood, adolescence and adulthood has been formed. All this information is relevant and offers support to the psychodynamic approach. 

Freud’s thinking influences theories today. As a neurologist, he experimented with hypnosis, abreaction and catharsis until discovering the ‘talking cure’ in Vienna. He believed that talking neuroses could be cured by relieving the ‘damming up’ of childhood emotions. His work started with dreams to discover what had taken place for the client. For him, neurotic symptoms and the repression of sexual desires were meaningful. His work discovered that childhood conflict in unconscious phantasies was a cause of neurotic behaviour. The work done by Freud was ahead of its time and created a great many followers who also wanted to understand the mind in greater depth. His work features in education, social science, literary theory, philosophy and in the media for over a century later making it relevant today. 

Why is it called a psychodynamic approach? 

It has evolved from the earlier routes of the psychoanalytic approach. This is where it could be argued that it has some weaknesses as talk therapy. Since Freud and the subsequent people discovered the psychoanalytical approach, there have been studies and research which show it has had some evidence-based success as a theory. Over time, talk therapy has evolved to over 400 different types of approaches by many different practitioners from cultures all over the world. 

In short, psychodynamic counselling has elements of other professional people who have added to it. A professional will use an analytical element and moves it to a dynamic approach to observe and record what is taking place for both of you. There could be factors which are in awareness; there could be a preference to talk openly with a male practitioner as you had a better relationship with men in life. Or, it could be that you like discussing your presenting problems with a female practitioner as they represent a safe and nurturing space based upon what care you received from women. This strength-based idea of the approach allows the unconscious aspect of how relationships are formed to highlight difficulties you may be facing today. 

I like using this approach because it has tools which enable a well-trained practitioner to support you through open discussion and enquiry. It also acknowledges that over our development as people we change. These changes can have a negative effect; some can be your inner strengths which have been lost as you try to cope in life. We work together to learn as much as we can to help support you in knowing how to manage in a more healthy way going forward. 

 

Would you suggest this approach is better suited to face-to-face psychodynamic counselling or online psychodynamic counselling? 

I’ve written about the benefits and disadvantages of face-to-face and online before, why not head over and give that a read? I think there are pros and cons for both using this approach online more than there is face-to-face. 

As an example, if you were to have poor signal strength, or not overly good sound quality then there are disadvantages to needing to hear what you have to say. Likewise, if there are time delays in the conversation then important psychodynamic techniques could be missed. Similarly, only being able to see the head and shoulders of most removes the chance to use non-verbal communication for the conscious and unconscious processes taking place. These could be thought of as weaknesses of the approach.

However, the strength of the approach is that you can broadcast from a space which feels safe to you. As a practitioner, I am a keen advocate for self-care. Being at home or in your office you may feel safer in the space to be more open and gain greater benefits. That said, some people would prefer to leave these spaces and they are a part of what stress, discomfort and sadness is happening in your life. Therefore, a face-to-face space is better suited for you. 

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