# What the hell is Psychodynamic Therapy?



## SoulAssasins (Nov 2, 2005)

Its kinda annoying because before I was taking cognitive behavorial Therapy and now im taking this. I really dont know what this therapy is and how it works. I really dont feel anything at all. Its kinda frustrating that the psychiatrist just sits there and listens to me and thats it. Im not learning anything new that I havent learned before. He said he sees improvement....I dont certainly feel it.


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## yeah_yeah_yeah (Mar 27, 2007)

Hi Soul

Why did you change?

In my experience you are right to be annoyed. CBT is the recommended (because it WORKS) therapy for SA. Psychodynamic therapy, which is very similar to Freudian or psychoanalytical therapy, is a different beast altogether. It will look into your past and seems to run on the idea of 'catharsis' - that when you realise your past events that made you uhappy, they all come flooding out and you can heal.

Unfortunately I don't think it works at all well. I did it for 6 months and just got steadily worse. You end up knowing all about your past, you can blame your parents and then learn to forgive them. But its all a distraction from actually DEALING with your SA.

Don't get me wrong - if your therapist is able to make you view situations and people in different ways, this may be slightly helpful, as is getting to unload your problems every now and then. But in my view psychodynamic therapy misses the point with SA, because my view is based on a neurological model of learned response and association. This is the angle that CBT takes and I feel, why it works. The method fits the theory.

Can you argue to get back on CBT? If not, and the CBT was working for yu, then I would say bite the bullet and find a private therapist. Are you in the States or the UK?

Ross


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## SoulAssasins (Nov 2, 2005)

Im in the US and I want CBT back thing is my therapist said there is a set limit for CBT which the only "good" thing about Psychodynamic Therapy is that it can go on longer for years.


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## yeah_yeah_yeah (Mar 27, 2007)

It sounds like the situation in the UK - there are too few qualified therapists practising CBT. Well thats not strictly true - there are therapists, they are just not generally available through the National Health Service (our free medical system).

Its not hard to see why. If therapy takes years to complete, the cost to the NHS is huge per patient - and therapies can be very hit and miss. Then there are a lot of people who need it... So it costs a lot. That is why I realised I had to find a private therapist a few years ago. You will get the treatment you need straight away. I have been on a waiting list for over a year for CBT - thankfully I retained my first therapist who I speak to by phone (although phone contact is not considered as good as face to face)

The point they may be missing though is that CBT can be very short compared with psychodynamic therapy.

If you remember some of the CBT you did, carry on with it. Mood diaires are always helpful and provide emotional relief and learning. You might also get yourself a book to learn / recall some of the exercises that are important in this approach, such as pleasure predicting, conflict methods, shame attacking, feared fantasy, vertical arrow technique etc.

Ross


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## arthur56 (Jul 31, 2005)

IMO a psych who just sits there and listens is a waste of time and money, regardless of what method or theories he is supposedly using

IMO and from my long experience, a lot of them dont actually bother to listen to the words the patient is saying, just to the sound of the voice

get back to CBT, I agree that if done by someone who is fairly good, it works


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## User (Mar 20, 2004)

I'm in psychodynamic therapy. It seems to be helping me (I've been in for nearly a year). Granted, my official diagnosis is depression, but I'm also being treated for SA. I'm actually not sure if I have social phobia like most people on this board. I think I might be AvPD, so maybe psychodynamic is better suited for that?

It's fine for me, and I'm not planning on switching therapists. The essential thing with any therapy program is finding a therapist that you're compatible with. I don't know what to make of a therapist who just sits there and says nothing? Why don't you ask him/her why they're silent?


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## yeah_yeah_yeah (Mar 27, 2007)

The archetypal Freudian approach to this therapy involves the therapist being silent.

In my view, prescribing PDT for anxiety disorders is a bit like using manipulative physiotherapy on a freshly broken leg. Its the wrong approach and the method just aggravates the very nature of the injury. 

Its commonly prescribed because there are not enough qualified CBT therapists to go round ... they are mostly private - where the money is ...

Ross


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## yeah_yeah_yeah (Mar 27, 2007)

Just saw this and knew where I needed to post it ....


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## Danu (Aug 13, 2006)

I don't know what the situation is in the UK, but in the US, it is actually CBT that is becoming the major prescribed therapy, at least with regards to public policy. A lot of people are only offered CBT and only for a certain number of weeks. And CBT is certainly more popular and available than the traditional psychoanalytic approaches or humanistic approaches. In terms of cost, they are more expensive as they take longer. Different therapies work for different people. Influenced by a world obsessed with "results" I first sought out CBT but found it shallow and inhumane. different strokes for different folks. Thankfully, the therapist I see is committed to a range of approaches based on the situation. Here's an interesting article about this stuff, that speaks from my perspective, that I was reading the other day: http://writhesafely.wordpress.com/180/
I must also say that I have a history of abuse and more problems than just SA. This probably influences which therapies people find effective.


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## yeah_yeah_yeah (Mar 27, 2007)

> I first sought out CBT but found it shallow and inhumane


Woah did they give you electric shocks?? Leeches??

I think a lot of the experience has to do with the therapist themself, but hey as you say, if it aint for you, it aint for you. Its a shame because it is usually so effective, but I hope you find something else thats right for you. I see it as a shame when someone loses the opportunity for overcoming their struggles.

Ross


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## Danu (Aug 13, 2006)

Woah, there! I lost no "opportunity for overcoming my struggles". Me and my supportive homies (certain family members, my excellent therapist) are doing just great. CBT just "ain't for me," like you said. And the inhumane comment, well, that's a more philosophical description than physical. No, CBT was not a physically inhumane experience for me, lol.


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## jenkydora (Nov 11, 2003)

Psychodynamic therapy is just a fancy word for
'client blathering to a dude with a clip board who occasionally will nod and pout sympathetically, but really doesn't give a toss'.

Sorry, but that's the truth in my experience.

jenky


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## TreeFrog (Oct 17, 2007)

My most recent experience with therapy was with psychodynamic therapy, and I found it to be incredibly frustrating. And I wasn't even addressing my SA (didn't really acknowledge/understand at the time). There were no suggestions, no insights, no techniques to try, no opinions, etc. Just him repeating back to me what I was saying in different words.


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## Tristram (Feb 9, 2008)

Just bumping this to see if there are more people willing to share their opinion. I went to my first shrink's appointment just a week ago, and she said she specializes in psychodynamic therapy. After reading the comments here I'm...well, in doubt. It makes perfect sense to me how this kind of tharepy would not work for SA and how something like CBT would. Of course this therapist just has to be the only option I have, because she's working for the place I'm studying in (read: cheap as dirt). Do you think this is worth a try or would I be just wasting my time, especially as I'll be relocating in just over a year?


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## yeah_yeah_yeah (Mar 27, 2007)

If you have a deep history of trauma then PDT will be useful in unearthing some of the deeper roots of it. Elements of PDT have been combined with Gestalt, attachment theory and CBT into 'Schema Therapy' which is an excellent form of therapy suitable for very intractable depressions and anxieties, often due to personality based problems or pre-verbal trauma.

If its cheap, go for it and go in with an open mind. Social Anxiety symtpoms are just one of a number of psychosocial symtpoms associated with trauma and there are very often a number of collected issues alongside it which can support the symptoms.

If you want more detail on CBT or Schema, try these books:

Overcoming Social Anxiety and Shyness - Gillian Butler
Reinventing Your Life - Klosko and Young


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