Posted by violette on June 9, 2010, at 8:37:27 [reposted on June 11, 2010, at 13:45:10 | original URL]
In reply to Re: Brainstorming alternate treatment options » violette, posted by lpslpslpslpslpslps on June 7, 2010, at 19:19:23
Hi lps,
Psychodynamic therapy is a form of psychoanalysis--and from what you have written, I am fairly certain that you are already in that type of therapy with your PDoc. If you weren't, you probably wouldn't meet with him weekly for 50 minutes or so or have the reactions you describe.
"The Efficacy of Psychodynamic Psychotherapy" is a pretty good summary of the process:
https://portfolio.du.edu/pc/port?
(full text)That type of therapy is influenced by oject relations, attachment theory, self-psychology, etc., usually focusing on the actual relationship between you and your therapist, the transference, unconscious motivations.
Patients were once treated for the psychological aspects of mental disorders until pharma/insurance companies overpowered how most psychiatrists currently practice.It's really sad reading how people spend years going from drug to drug while most psychiatrist never addresses the psychological causes of the symptoms. I think for many who have had depression and anxiety for an extended period of time, or treatment-resistant for many years, such issues have become a part of personality/self. I'd like to see psychiatrists go back to therapy and meds, but that will likely never happen.
Shame is at the core of many chronic illnesses, influencing how we feel from day to day. Using medications, although I believe they should be used for most of us in therapy because we need them to function better, rarely address these underlying issues. Meds prolongs the symptoms, keeping them buried inside. This article describes the effects of toxic shame:
http://www.soulselfhelp.on.ca/tshame.html
(It mentions spirituality, which I'm not trying to promote (am not religious anyway), but it is a good synthesis of how shame effects us and the article has influences of self-psychology.)
Your PDoc sounds so much like mine. Like most therapists, it sounds like he is a bit eclectic, but mainly psychodynamic and maybe even somewhat psychoanalytically oriented. For people harder to reach/ego-syntonic, straight psychoanalysis is more effective, I believe, because it encourages more transference and feeling that some need to come out of denial. One who practices orthodox psychoanalysis would not be so chatty with you and likely would not discuss all the academic research. You seem ego-dystonic. Many who are ego-syntonic don't end up in therapy until their life is falling apart, are coerced by family, or are court ordered.
"I do notice two things though: 1) I generally feel better after our appointments than I did before the appointment, even if he hasn't said hardly anything, and 2) often when I am by myself, I start talking to myself mentally as if I were talking to him -- several hours a week of this, in fact, and it feels as effective as the actual therapy. And I never did anything like that before, so who knows."
That's the effect I get from psychodynamic therapy too. It works all week! I also have conversations with him in my mind-that's actually very comon. The transference and our discussion of my unconscious motivations and associations leads to insights and feeling states that I had repressed for so many years. It can be painful, but after each time, I feel a sense of grief-then feel a bit better each time. Sometimes I get a release of emotional tension after sessions. It's really intense because I feel those emotions physically. The tension release is a physical feeling, yet its not the same as taking a xanax and feeling anxiet relief-it feels as if some long-time buried anxiety actually has physically left my body. I think some of this is due to having childhood problems before I could talk-so I have a lot of emotions that manifest somatically.
The relationship between you and your PDoc sounds great, and that is so very important for effective therapy. I think you are doing just what you should be doing and defintely stay with this guy...I'd be interested to hear if you 2 discuss the intensive research you do, exploring whether or not you are using an intellectualizing defense to resist addressing deep, painful emotions.
You might not be doing this, but when I read your messsage, it sounded so similar to what I was doing, which is why I responded to your post. First, reading about all the medications to get better. That wasn't working so well after a few years. Then in psychodynamic therapy for the first time, and feeling amazing insights after sessions, I realized I never processed all my childhood stuff, and that medications were not going to "cure" me and were only prolonging my conditions. So, I started researching all about psychodynamic therapy, object relations, attachment theory...I am slowly weaning myself off doing this-its gotta stop. It's sort of like an OCD thing-intellectualizing everything defends the psyche against feeling painful emotions and blocks anxiety from surfacing.
I just suspected you were doing this to keep the unconscious feelings from emerging--that's what we do-we have defense mechanisms to avoid feeling pain. We do it this in several different ways and sometimes one, such as intellectualization, becomes our dominant defense mechanism.
You really do seem to be just where you need to be. It might be helpful to ask your PDoc about intellectualizing hindering your progress for the possible reasons I stated. (I'm curious, too!) I also think the lack of motivation and procrastination are oftent he result of unconscious mental conficts. It can be difficult to treat and to discover the underlying cause.
Some possible causes of lack of motivation (doesn't really get at all of them though):
http://www.psychologytoday.com/articles/200308/procrastination-ten-things-know
It just takes time. I expect to be in therapy for a few more years...but I am getting better one day at a time and have even progressed since I cut down on all the researching!
But...since you are a research person:
http://www.apa.org/news/press/releases/2010/01/psychodynamic-therapy.aspx
http://jama.ama-assn.org/cgi/content/abstract/300/13/1551
Even though the obsessive researching had adverse affects of my progress for quite some time, I do admit that understanding the therapy process and concepts in great detail has been very beneficial to my therapy results. It's time to quit, though, and let my doctor take over-he is a wonderful therapist. Your therapist sounds awesome too. I hope this information is helpful to you. Good luck with the meds too, and take good care!
Best,
Violette
poster:violette
thread:950715
URL: http://www.dr-bob.org/babble/psycho/20100529/msgs/950718.html