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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 home. Either by plan or by emergence of a problem, we decide we need to improve our
home structure (be it a wall, a room, or something more extensive). So we initiate a process to estimate the nature
of our problem and of what is required to improve things. As those of us who have undergone this process know, only
after we commence the job, can we better appreciate what the problem actually has been and what the options are for the best
solution. Not infrequently, our end
goal becomes significantly modified from the result we initially anticipated; we even may better grasp our own needs!
The target of psychodynamic treatment similarly evolves as insight accrues. All this proceeds best when a sense of trust
exists between homeowner and contractor, to optimally deal with what is discovered. Such collaboration (at its best)
is analogous to the alliance that forms between patient and psychoanalyst. The psychodynamic process evolves, as the
more fundamental aspects of problematic feelings, motivations and behaviors become revealed within the psychotherapy process:
re-experienced between patient and psychotherapist, as they gain deeper appreciation for the essence of the underlying issues
and most adaptive choices.
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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. anxieties, inhibitions, self-sabotage). It is based on 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 in the course of which a patient becomes aware of the underlying sources of his/her difficulties,
not simply intellectually but emotionally and relationally -- via re-experiencing them with the analyst. Over time this
partnership provides the impetus for deep and abiding changes in a person’s life: behavior, relationships, sense of
self, decisions, balance in perspective.
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