My approach: What to expect… And why?

Psychodynamic (or psychoanalytic) psychotherapy is an empirically-supported (i.e., evidence-based) talk therapy rooted both in the exploration of your mind and of the relationship between the two of us, who share the goal of your desired psychological change.

Our aim, beyond minimizing your current distress, is making our way toward expansive, fulfilling, and lasting change in your life for the better.

While we might consider the ways in which your past could be important, we are equally and importantly anchored in the here-and-now. It’s my job to meet you where you are and to support your present and your future.

This will involve my open-minded and nonjudgemental listening, my active curiosity and mutual reflection, my efforts to make thoughtful observations and useful connecting-of-dots, my empathetic challenging of patterns that might contribute to your distress, my dedicated respect, and my optimism about your potential.

This will not involve skills, tools, or homework. There’s no one-size-fits-all, no manual. I can’t decide nor construct the best path forward for you on my own; this is unique to your personal goals, desires, needs, and values. We’ll work together to figure it out.

• Many people who come to see me have already tried Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), Eye Movement Desensitization and Reprocessing (EMDR), or Exposure and Response Prevention (ERP). Maybe these were helpful up to a certain point, but then plateaued—or maybe they didn’t move the dial. These are indicators that a psychodynamic approach could be worthwhile right now.

Why will our relationship matter? First of all, it’s crucial that your therapist is someone who you feel comfortable enough speaking with. This might be something in itself that takes time, and that doesn’t necessarily mean the treatment’s not going to help you; it takes a while for many of us to trust someone. And going further—unique to the psychodynamic approach—we’ll consider how therapy is a window into your life, where relevant themes and patterns are likely to emerge within the therapy experience itself. This almost always includes—in some way, shape, or form—interpersonal patterns. Addressing them together “in real time” enhances our capacity both to understand them and to figure out how to make changes in line with your goals.

Consider the following “10 Vital Signs of Mental Health,” adapted from Nancy McWilliams, PhD, ABPN, as examples of what can be achieved:

1. Greater attachment security (i.e., stronger, healthier, more trusting relationships)

2. Increased sense of personal agency (i.e., to take control of your life; to be enabled to pursue your goals and shape your path)

3. More integrated and coherent experience of self and others (which tends to involve, e.g., deeper and more nuanced perspectives)

4. Self-esteem that is realistic and reliable (e.g., accurate perceptions of your strengths and weaknesses; self-compassion and self-acceptance)

5. Increased emotional regulation and resilience (e.g., feeling more steady, peaceful, grounded; better able to adapt and recover)

6. Ability to reflect on and understand the inner experience of self and others (e.g., greater senses of self- and other-awareness)

7. Greater ease in working interdependently (i.e., comfort and capacity to both be alone and be with others)

8. Increased presence, vitality, and capacity to play (i.e., engaging intentionally and enthusiastically with what interests you and brings you joy)

9. More capacity for forgiveness, gratitude, and acceptance in whatever ways these might feel right to you

10. Adaptive and flexible defensives (i.e., effective ways of coping with and growing from stress and hardship)

For more, here’s a clearly-written piece from Jonathan Shedler, PhD: “That Was Then, This Is Now: Psychoanalytic Psychotherapy for the Rest of Us” He additionally writes a straight-forward and incisive Substack on matters relevant to this therapy.