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You retrained to become a counsellor, why did you take an interest in psychodynamic therapy?

Having learnt about a variety of different styles of therapy, I felt that psychodynamic was the most effective therapy for getting to the root of a problem and achieving long-term sustainable relief. I was also interested in the depth and breadth of the theory behind this type of therapy which goes back over 100 years and provides a rich foundation for my practice.

What are the goals of psychodynamic therapy?

The goals of psychodynamic therapy align well with the definition for good mental health from the World Health Organisation: “to achieve a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

Essentially the benefits are about being able to have healthy relationships with others, achieving a fulfilled life and being freed from ‘haunting spectres’ of the past. Ideally, once therapy is complete the pain, shame, embarrassment, fear, of past experiences is significantly reduced and they can become part of the client’s controlled conscious life story.

How does psychodynamic therapy differ from other, more behavioural, therapies?

Psychodynamic therapy is based on the idea that we have unconscious mental processes and patterns that are learned in childhood. These can influence our emotions, attitudes, and behaviours throughout our lives in many ways and they are difficult to overcome without bringing the unconscious into awareness and resolving them.

Other therapies that work with only the conscious thought by challenging unwanted and negative behaviours can help in the short term. But, unless you uncover the root of the problem in the unconscious, your symptoms may recur in other behaviours.

Why do childhood experiences affect us so much?

This is where there is some overlap with psychology and behavioural therapies. A lot of what we learn in childhood can be considered as ‘conditioning’. Up until the age of 5 or 6 children are essentially sponges and are conditioned without any conscious control. In this period of a person’s life, they learn how to engage well with others and learn to trust or fear others. These patterns are programmed deeply into our unconscious and tend to repeat through our lives.

Do past experiences affect everyone adversely?

There is no doubt that past experiences have a major impact on the present, but this counts for positive as well as negative traits. Extreme experiences, such as child sexual, emotional, or physical abuse invariably have negative consequences. However, sometimes these can be developed into great motivators and strengths. It depends on many factors. People only need to seek help if an aspect of their lives is causing dissatisfaction.

Are memories reliable?

The brain memory system that we usually talk about is episodic or explicit memory. This controls things that we can remember from the past and easily recall and talk about. Memories, however, are reconstructed during the recall process, and this can introduce an element of unreliability. In terms of therapy, it is not necessarily what actually happened that is causing the problem but how we perceive it and how it affects us. Part of the process of therapy is reframing these memories of negative emotional experiences so that when they are recalled they no longer carry such a high charge of emotion.

How does psychodynamic therapy work? What methods do you engage with when someone visits your clinic?

In a typical session, I will let you do most of the talking. I make sure that I understand what people are telling me by asking questions and asking them to elaborate. Whilst doing so, I look for repeated patterns and core issues that continue to present themselves. Talking to another person and allowing emotions to be expressed is an important basic component of therapy and it is beneficial in its own right. 

Over time I work with clients to build a bigger picture of their life, bringing the unconscious into awareness and dealing with emotions as they arise. I liken the process to working on a jigsaw together. The pieces are yours, but I help you to find them and we assemble the picture.

Are there any ways that people can safely bring the unconscious into the consciousness themselves? 

Dreams are seen as a message from the unconscious and paying attention to them can sometimes identify important themes – although it is often difficult to interpret these on your own. Writing a journal of thoughts and feelings stops these unconscious thoughts from swirling in your head and gives space for new thoughts to emerge.

Taking note of how you relate to others is also useful. Can you discern any patterns in your behaviour? Are there particular things that ‘trigger’ you? Can you relate them to past events? The problem here is that without an understanding of psychodynamic theory, it can sometimes be more confusing than helpful. There are lots of self-help books that give a lot of insight and can be useful but, again, they can often cause more anxiety than they relieve.

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