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Psychodynamic Therapy: My Experience


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I spent two years in an intensive treatment program for people with treatment-resistant mental illness, and one of the cornerstones of this program was intensive individual psychodynamic psychotherapy four times a week.

At first, I hated it. My therapist didn't say much in the beginning, and I perceived her as distant, cold, and emotionally detached. I never felt like I had permission to start a conversation, so there were many long silences, during which I stared intensely at her Oriental rug while frantically trying to come up with "the right thing" to say.

After a little while of this, my therapist realized that I needed help being invited into a conversation. She began to talk more, and I felt safer talking. We got more comfortable with each other, though I still spent a lot of time staring at her carpet. (I have major problems with eye contact.)

The approach was totally foreign to me. Everything I did was some symbolic communication of some subconscious process or something I was conscious of but unable to communicate verbally. My therapist drew parallels between reactions to present situations (which often seemed out of proportion) to past situations and events from my past. Sometimes I thought she went overboard interpreting supposed symbols, but most of the time her parallels made sense but weren't connections I was aware of.

As I divulged more about my past (I have and extensive trauma history) and saw that my therapist could be trusted with it, I became more comfortable with her. I perceived her as being more caring and compassionate. I'm not sure if she actually changed or my perception of her changed as I was able to open up more and accept care, help, and kindness. She was very astute at figuring out what I needed and wanted, and she tried to give me what she could.

As the therapeutic relationship stabilized and strengthened, I began to let go of self-destructive behaviors. I didn't need them as much, though they'd often crop back up when I was dealing with trauma stuff. My therapist talked a lot about creating "a holding environment," and the therapy was a major part in that. I knew I could trust my therapist with all the horrible things in my past and in my mind, and she wouldn't hate me or get angry or abandon me. If I started to fall, there were people who would catch me before I hit the ground--all I had to do was ask.

For the first time in years of treatment, I was getting better. I really believe that psychodynamic therapy (and my relationship with that therapist) let me save my life.

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  • 3 weeks later...

Wow.

Your therapy story is an amazing testament to the power of relationship... and the ability of a "safe container" to allow people to heal themselves.

How did you find this amazing resource?

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Short version is I was too sick to be outpatient, but inpatient psych has never helped. My OP therapist strongly recommended I go to a program for people with treatment-resistant MI. The centerpiece of that program is intensive individual therapy, which is good because I now know that I need therapy, not just meds.

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  • 2 weeks later...

I likewise see a psychodynamic therapist (he's also my psychiatrist) and struggle somewhat because, as you point out, he has a tendency towards seeming "distant and emotionally detached". There are exceptions to the rule, of course, i.e. times where he'll mirror my experience with a kind of cheerful understanding.

But during the moments where I'm speaking, he'll often just sit there in silence. There are no prompts on his part .. I'll simply use the silence as a cue to nervously keep talking, until finally, he ends up tying together my various, rambling threads into some coherent set of insights. In that regard, he's completely unparalled (in terms of therapists I've seen to date) and scarily attuned to my inner experience.

But I still find myself stricken by this residual discomfort. I sometimes try to rationalize my fear by telling myself that I'm transferring feelings towards my father (who I'm extremely uncomforable around), but I don't believe that's the entire picture. I just never feel completely comfortable, or "loved" by my therapist. When I call up to report medication side-effects, I'm terrified of 'displeasing' him and will often downplay my negative experiences, for fear of reproach/abandonment. I've expressed these issues before, and he's emphasized the fact that he's here to "help", not "judge" me. I just find it strange that after one year of working together weekly, I never feel entirely safe or comfortable or contained in him. Maybe the analytically-informed psychodynamic school just isn't for me - is there an emphasis placed on detachment? - or maybe I'm incapable of feeling truly safe/loved, because this has also been a recurring issue in relationships recently.

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I kind of doubt that your ability to feel safe/truly loved is completely damaged.

Some people would say that if you now have a conscious awareness of it, that therapy is helping... because once you get to conscious awareness of your thoughts/feelings/behaviors is when you can start to make changes based on the new sets of choices that emerge.

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