Psychodynamic therapy is less planful but more dramatic than Cognitive Behavioural Therapy (CBT). It’s focused on returning to “the scene of the crime” or to the point of greatest pain in your life. So each week in therapy a psychodynamic therapist will allow you start and wander where you want, but they’ll be always subtly steering you to return to the painful issue. That point may be back in the past, covered by the sands of time, or deliberately buried by you if you’re ashamed of it.
If Psychodynamic therapists are guides, they’re more trackers than surveyors. Their training has probably been in something more literary than scientific. They’re relying on their intuition, following their noses, and they’re looking for signs that something out of sight is buried and needs to come out. Something may be sticking out to them in what you say, or emotion may be welling up like oil seeping from an underground deposit. They think that if you uncover what’s buried that will be enough to start the process of recovery. You may recover an insight, or renewed emotional energy may start to flow out of you like oil from a wellhead, or you may excavate the connections between events in your life like uncovering a lost road.
Like CBT, Psychodynamic therapy has developed many tools, schools and specialisms. There’s Psychodrama, whose therapists probably wouldn’t want to be thought psychodynamic. When treating individuals they get the person to define the different parts they play in the drama of their life, or ask the person to take on the roles of important others in their life. There’s EMDR, where you’re parachuted back into a past trauma to relive it whilst a part of you remains in the here and now as an observer, looking for new perspectives on the problem. And there’s Lifespan Integration, where you’re repeatedly taken on the journey from birth to present, looking at all the important events on the way, until the story of your life begins to come together and you realise how far you are from your old troubles. I use all those techniques as necessary.
Psychodynamic therapy is useful particularly for problems involving inner conflict between different parts of ourselves, and for people who want the journey of therapy to be more a quest or an exploration than a disciplined trek to an agreed destination. However, one limitation of psychodynamic therapy is that all that wandering about takes time, which most people can’t afford these days. So I use tools from Brief Focused Psychodynamic Therapy to get to the issue quicker. Another limitation is that it’s often not enough to uncover the problem or release the emotion. People need practical knowledge and skills about to do next. Lastly, at the end of psychodynamic therapy although you can find your way better around the landscape of your life, you don’t have a map you can pull out and refer to if you’re in trouble.
What we need is therapy which can integrate different approaches seamlessly, so that all sorts of different techniques can be used where appropriate to help all sorts of people in all sorts of situations. And that therapy needs to be something people can understand so that they can follow what’s going on in therapy and remember what to do when therapy is over.
That is the approach I have developed: Journeybuilding™
