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Psychotherapy can be brief, focusing upon a particular symptom or conflict
or crisis, or it can be an exploration that aims at a more sweeping modification of maladaptive personality characteristics
or at an increase in self-awareness. A psychotherapist may act as a behavior modifier or desensitizer, as a supportive
person during a time of crisis, or as a kind of guide to help a person gain the type of self-knowledge and insight that can
result in psychological change. Frequently a therapist acts in all three capacities. The type and duration of
psychotherapy is determined by a patient’s diagnosis and goals. Psychotherapy may be sensitively combined with
appropriate medication, during part or all of a treatment course. Selection of antidepressant or mood stabilizing medication,
when appropriate, depends on multiple biological & other factors. The process of psychodynamic psychotherapy may be compared to the process many of us experience when we remodel our
house. Either by plan or by emergence of a problem, we decide our home structure needs improvements (be it to a wall, a room,
or something more extensive). So we initiate a process that estimates the nature of our problem and what's needed to remedy
it. Often, it's only after we commence the job that we can better appreciate the nature of the problem and the best options.
Not infrequently, our end goal becomes significantly reconceptualized from what we initially anticipated; we may even better
come to grasp the nature of our own needs. Psychodynamic treatment similarly evolves as insight accrues. The process proceeds
best when a sense of trust is established. Collaboration between patient and psychoanalyst permits the treatment process
to evolve, as the more fundamental aspects of problematic patterns, feelings and motives are revealed within the psychotherapy:
re-experienced between patient and psychoanalyst as they together gain a deeper appreciation for the essence of underlying
issues and most adaptive solutions.
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Psychiatric Evaluation
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Psychoanalysis is a highly individualized treatment for people who
have been hampered by long-standing symptoms (e.g. anxiety, inhibitions, self-sabotoge, self-doubt). It is based upon the
observation that people are often unaware of many of the emotional factors that determine their reactions and choices. Psychoanalytic
treatment demonstrates how these patterns affect current relationships and tasks, tracing the trajectory during a person's
life. Analysis is an intimate partnership wherein a person becomes aware of the underlying sources of his/her difficulties,
not simply intellectually but emotionally and relationally -- via experiencing them with the analyst. Over time, this partnership
provides impetus for deep and abiding life changes: changes in behaviors, relationships, sense of self, decision-making, capacity
for intimacy, balance in perspective.
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