Dialogue Concerning Contemporary Psychodynamic Therapy

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As practicing psychotherapists know well, the application of theory to this lived reality is no simple matter. We strive to connect abstract principles e. What is required for this kind of work, in short, is a "middle discourse"—that is, a practice-oriented conceptual system that bridges the gap between philosophical principles and clinical intervention. Our faculty believes that psychodynamic psychotherapy is ideally suited to meet this need. We emphasize the radical roots of this discipline, as well as its unparalleled emphasis on the therapeutic relationship as a catalyst for change.

The Clinical Psychology Doctoral Program students receive specialized and advanced training through sequenced coursework in the philosophical foundations of psychoanalytic thought, psychodynamic perspectives on the therapeutic relationship, personal and social dimensions of the unconscious, and radical and critical approaches in psychodynamic psychotherapy. These courses are taken simultaneously with professional seminars in which students are taught to link theory and practice through in-depth discussion of clinical cases.

Is articulate; can express self well in words. Has an active and satisfying sex life. Appears comfortable and at ease in social situations.


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Tends to express affect appropriate in quality and intensity to the situation at hand. Has the capacity to recognize alternative viewpoints, even in matters that stir up strong feelings.

Has moral and ethical standards and strives to live up to them. Is creative; is able to see things or approach problems in novel ways. Tends to be conscientious and responsible. Tends to be energetic and outgoing. Is psychologically insightful; is able to understand self and others in subtle and sophisticated ways. Is able to find meaning and satisfaction in the pursuit of long-term goals and ambitions. Is able to form close and lasting friendships characterized by mutual support and sharing of experiences.

Just when you thought psychoanalysis had breathed its last, research resurrects and even validates certain core Freudian beliefs. Forget penis envy. Think conflicting motives and what talking to a shrink four days a week can do for you.

Pdf Dialogue Concerning Contemporary Psychodynamic Therapy

Gary Shteyngart has written three best-selling novels and been hailed by critics as one of today's most gifted young authors. But ask Shteyngart about his life a decade ago and he sums it up in two words: "major dysfunction. Petersburg to New York City. Theirs was the ever-better immigrant experience. Gary's was not. Quiet, frail, frequently bedridden with asthma, Shteyngart was sent to a Hebrew school where he was incessantly teased about his wardrobe he had two shirts , his heavy accent, and his preference for Russian food.

He had few friends, frequently worried about dying, and felt neither Russian nor American. The isolation and alienation followed him to college in the midwest and back to New York, where he worked for tiny nonprofit organizations. Although Shteyngart was spending hours a day writing, he had a paralyzing fear of sharing his work with publishers. His wildly comic first novel, The Russian Debutante's Handbook, was published only after he sent a portion of the manuscript to a fellow immigrant, who ran an MFA program in writing in New York; Shteyngart thought he was applying to the program, but his bowled-over friend sent the manuscript to his own publisher.

A series of "disastrous relationships" with women only fed his feelings of being a "second-class citizen. Although he was often depressed, there were no specific symptoms he sought to address. It is time-intensive and prohibitively expensive. Its benefits are not easy to measure, particularly compared with those promised by more popular, contemporary methods of treatment like cognitive behavioral therapy CBT. As a result, psychoanalysis has been dropped from the curriculum of many medical schools and is rarely covered by insurance plans. When it is taught and practiced, experts say, modern psychoanalysis, also called psychodynamic psychotherapy, often bears little resemblance to the treatment put forward by its founding father, Sigmund Freud.

But psychoanalysis is a profound exploration of human subjectivity—our inner world with all its memories and desires and impulses—and its relation to the external, objective world. And it is much more than a treatment. It's also a set of theories about the nature of human experience, its depth and complexity.

At its center is the belief that subjectivity matters, that regardless of how many millions of circuits science shows are carrying out the work of the brain without our awareness, we still experience a unified sense of self that gives our lives coherence and meaning. In this regard, experts argue, psychoanalysis, which celebrates its hundredth anniversary in America this year, is very much alive. In this sense, I think psychoanalysis is in the best shape it's ever been in.

For most of the 20th century, psychoanalysis became a guru science, driven by cults of personality around Freud and other dominant figures rather than by scientific investigation. Many analysts were spinning out theories about the mind without gathering evidence to support them—say, the idea that all our thoughts and actions are driven by only two basic motives, sex and aggression—and doing little to disseminate them outside their own exclusive circles.

One result was the creation of factions and intense infighting within them over details that had no currency in the wider world of psychiatry. So when other sciences were advancing with research, psychoanalysis didn't. They essentially shut their eyes and said 'we don't do that. The shift of mainstream psychiatry to psychotropic medication and the development of short-term therapies—beginning in the late s and accelerating through the s—eventually jolted psychoanalysts into the realization that they had to subject their grand theories to rigorous testing.

Today, scientists are working to build a body of empirical research to support the efficacy of psychoanalysis, a tough task for a treatment that often takes years and hundreds of sessions. Unlike its therapeutic rival CBT, psychoanalysis does not lend itself to easy-to-measure evidence like the speedy elimination of symptoms. But a growing body of research—including neuroscientific interest in the nature of consciousness—has helped bring psychoanalysis to a new place at the psychiatric table.

Jonathan Shedler, an associate professor of psychiatry at the University of Colorado School of Science, has examined the efficacy of psychodynamic therapy—a term describing treatment based on psychoanalytic theory and methods but briefer and less intensive—for everything from depression and anxiety to panic disorders, personality disorders, and substance abuse. He has found that the benefits of psychodynamic therapy extend well beyond symptom relief.

What's more, they display continued improvement. Among patients with borderline personality disorder—a condition notoriously resistant to treatment—only 13 percent still met the diagnostic criteria for the disorder five years after completing psycho-dynamic therapy compared with 87 percent who underwent other forms of treatment. To those familiar with traditional psychoanalysis, there's no small irony in the idea that it has lacked the science to support it.

Before he invented psychoanalysis, Freud was a neuroscientist, and while he didn't have available to him the technology to explore the brain, he believed his theories about the mind had to be rooted in biology.

Pdf Dialogue Concerning Contemporary Psychodynamic Therapy

Today, however, science provides technology to explore some of the most fundamental questions posed by psychoanalysis, such as the very structure of the psyche. And while there is still a large gap between what brain scans reveal and what happens in treatment, the research is proving the validity of many tenets of psychoanalysis, both theory and treatment. Through the use of functional magnetic resonance imaging, for example, neuroscientists have found that many operations of the psyche take place in widely disbursed neural circuits.

Specifically, such mental functions as passion, reason, and conscience are activated in different areas of the brain. The finding supports Freud's contention that the psyche can be differentiated into id, ego, and superego. One result is that the mind is often in conflict, and we experience contradictory motives.

When both are active, we might experience a deep visceral fear, even though we're not aware of any imminent danger. Or we might feel the desire for an intimate relationship while at the same time fearing intimacy. Neuroscience has also confirmed another fundamental tenet of psychoanalytic theory—the idea that our motivations are largely unconscious, and that our brains have active repressive mechanisms that protect us from disturbing thoughts and impulses.

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Ask a psychoanalyst which theories have proven most enduring over a century of research, science, and clinical practice, and you're likely to hear it's the theory of the unconscious. Freud put forth the idea that there are three levels of consciousness: the conscious part of the mind of which we are aware and about which we can verbalize; the preconscious, consisting of all the memories and thoughts that, with effort, can be brought into conscious awareness; and the unconscious, the part of the mind that is not accessible to us and which houses some of the most intense urges, feelings, and desires that drive us.

We're not humanly equipped to shut out the technologies of connection offering us a steady stream of distraction and providing constant feedback and reinforcement. Technology is not going away, says Essig, but it can leave us feeling distracted, overstimulated, hollowed out, and alienated. While technology compels us to live in a constant present, psychoanalysis connects us with memory, the past, and desire, what we want next.

It stretches the existential muscles that are atrophying when we spend too much time with our Blackberries. Essig points to one of his patients, a music industry hipster, who begins and ends each session by making a show of checking his iPhone for messages and offering up a report on his latest Twitter followers.

At first, Essig thought that the patient's ritual of checking was a show of importance. But by exploring the patient's need to be constantly connected, he understood the man was letting him know he was releasing himself from being trapped in the present tense of stimulation to enter a more reflective state. Dreams are another domain in which ongoing research supports many ideas that originated in psychoanalytic theory.

For sure, modern scientific studies of the brain have led to some contradictory theories about dreaming—that dreams mean little, that dreams mean something if only we could figure out what , that they represent strategies of rehearsal for events that matter, and much more. In the s and '70s, scientists learned that dreams occur involuntarily but regularly—about five or six times, of increasing duration, throughout the night—while the brain is aroused physiologically but the body is immobilized physically. The discovery of dream sleep, distinguished by the presence of rapid eye movements, contributed to the discrediting of psychoanalysis.

Dreams, it seemed clear, were the product of a revved-up brain—not, as Freud believed, a reflection of hidden or frustrated desires, especially those of a sexual or aggressive nature. But studies conducted in the s, using imaging technology to examine neural activity in the dreaming brain, corroborate some ideas Freud laid out in The Interpretation of Dreams. During dream states, certain circuits of the brain—notably those based in rational thought and reality—are inactive. The neural circuits that remain active while we dream, however, are those governing emotions, sensations, and memories.

While much remains to be discovered about the dreaming brain, the neuroscientific evidence suggests that there's a close link between the content of our dreams and our deepest instinctual drives. They ask patients to recall their dreams in detail and say whatever comes to mind as they do. Solms notes that by taking the time to recall the content of a dream, it's the patient—not the analyst—who almost always discovers the desire that underlies it.

Jones, your dream means this,'" Solms says. When you take the time to deconstruct a dream, it just makes sense. Precisely because dreams are vivid, uncensored representations of our desires and fears, they can be a window into what we really want out of life, Solms insists. Another theory that vies for a spot among the most enduring legacies of psychoanalysis concerns the importance of experiences in early childhood.

The understanding that our past influences who we are today, and especially that the first few years of childhood have a profound influence on all our development, informs almost all types of contemporary therapy. It might sound obvious, but the view that early development creates an enduring template that stamps behavior and feelings throughout life can be credited to classic psychoanalysis.

Researchers now know that early experiences of care literally shape the developing nervous system and play out in the nature and quality of emotional attachments we form decades later. Neuroscience has shown that personal experience is so powerful it even influences whether or not specific genes get expressed, including those determining responsiveness of nerve cells to various neurohormones.

Encouraging adults to talk about their early life and relationships, particularly with caregivers, can provide tremendous insight into current psychological problems, says Peter Fonagy. Finding meaning in certain behaviors which help or harm us is a valuable step in summoning the wherewithal to change them. Buy eBook. Buy Hardcover. FAQ Policy. About this book This intriguing volume presents the most contemporary views on the conceptualization and treatment of somatoform disorders and related conditions from experts in psychodynamic and cognitive behavioral approaches.

Among the topics covered: Maintaining mechanisms of health anxiety: current state of knowledge. Negative affect and medically unexplained symptoms. Alexithymia as a core trait in psychosomatic and other psychological disorders.

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Trauma and its consequences for body and mind. Embodied memories, a new pathway to the unconcious. Psychotherapy among HIV patients: a look at a psychoimmunological research study after 20 years. Health anxiety: a cognitive-behavioral framework.

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