Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-18T21:09:12.008Z Has data issue: false hasContentIssue false

Chapter 8 - The Overall Structure of Psychodynamic Therapy

from Part 2: - The Model of Psychodynamic Psychotherapy into Practice

Published online by Cambridge University Press:  25 August 2023

Adam Polnay ,
Rhiannon Pugh ,
Victoria Barker ,
David Bell ,
Allan Beveridge ,
Adam Burley ,
Allyson Lumsden ,
C. Susan Mizen  and
Lauren Wilson
Foreword by
Nancy McWilliams
Adam Polnay
Affiliation:
The State Hospital, Carstairs and Royal Edinburgh Hospital, Edinburgh
Victoria Barker
Affiliation:
East London NHS Foundation Trust, London
David Bell
Affiliation:
British Psychoanalytic Society
Allan Beveridge
Affiliation:
Royal College of Psychiatrists, London
Adam Burley
Affiliation:
Rivers Centre, Edinburgh
Allyson Lumsden
Affiliation:
NHS Greater Glasgow and Clyde
C. Susan Mizen
Affiliation:
Devon and Exeter NHS Foundation Trust, Exeter
Lauren Wilson
Affiliation:
Royal Edinburgh Hospital, Edinburgh
Get access

Summary

It is one of the remarkable but also unsettling characteristics of psychodynamic psychotherapy that its course is not rigidly predetermined; this allows things to emerge in therapy that neither the therapist nor patient could have anticipated. What focus the work takes and what therapeutic approaches are most useful for each patient need to be found out along the way. This does not however mean it is impossible to give direction or that there is no structure to therapy. In this chapter, we aim to provide orientation to clinicians who are embarking on their first courses of therapy. We integrate theory and technique to offer a longitudinal perspective on how matters can play out over a course of therapy. Firstly, we discuss the formation of the therapeutic alliance and the development of a psychodynamic formulation. The central part of this chapter looks at the therapeutic relationship as a vehicle for change. Finally, we discuss the late phase of therapy and the dynamics of separation from the therapist, and how this can be both a challenging but productive period.

Keywords

psychodynamic psychotherapystructure of therapytherapy phasestherapeutic allianceformulationtransference workworking throughmourningending therapy.
Type
Chapter
Information
Cambridge Guide to Psychodynamic Psychotherapy , pp. 128 - 150
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

O’Neill, S. Process Facilitation in Psychoanalysis, Psychotherapy and Social Work. 1st ed. London; New York: Routledge; 2018.CrossRefGoogle Scholar
Leiper, R, Maltby, M. The Psychodynamic Approach to Therapeutic Change. London: Sage Publications Ltd; 2004.CrossRefGoogle Scholar
Wolberg, LR. The Technique of Psychotherapy. 3rd ed. New York: Grune & Stratton; 1977.Google Scholar
Zetzel, ER. Current concepts of transference. Int J Psychoanal 1956;37(4–5):369–76.Google ScholarPubMed
Gabbard, GO. Long-term psychodynamic psychotherapy: a basic text. In Long-Term Psychodynamic Psychotherapy: A Basic Text. Washington, DC: American Psychiatric Pub.; 2010.Google Scholar
McWilliams, N. Psychoanalytic Diagnosis, Second Edition: Understanding Personality Structure in the Clinical Process. 2nd ed. New York: The Guilford Press; 2011.Google Scholar
Høglend, P, Hersoug, AG, Bøgwald, KP et al. Effects of transference work in the context of therapeutic alliance and quality of object relations. J Consult Clin Psychol 2011;79(5):697–706.Google Scholar
Høglend, P. Exploration of the patient-therapist relationship in psychotherapy. AJP 2014;171(10):1056–66.Google Scholar
Lucas, R. The Psychotic Wavelength: A Psychoanalytic Perspective for Psychiatry. New York, NY: Routledge/Taylor & Francis Group; 2009.Google Scholar
Ackerman, SJ, Hilsenroth, MJ. A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy: Theory, Research, Practice, Training 2001;38(2):171–85.CrossRefGoogle Scholar
Suttie, I. The Origins of Love and Hate. Harmondsworth, Middlesex: Peregrine Books; 1963.Google Scholar
Ogden, TH. Comments on transference and countertransference in the initial analytic meeting. Psychoanalytic Inquiry 1992;12(2):225–47.CrossRefGoogle Scholar
Parsons, M. Raiding the inarticulate: the internal analytic setting and listening beyond countertransference. Int J Psychoanal 2007;88(Pt 6):1441–56.CrossRefGoogle ScholarPubMed
Solms, M. The scientific standing of psychoanalysis. BJPsych Int 2018;15(1):5–8.Google Scholar
Lemma, A. Introduction to the Practice of Psychoanalytic Psychotherapy, 2nd ed. West Sussex: Wiley Blackwell; 2016.Google Scholar
Gabbard, GO, Westen, D. Rethinking therapeutic action. The International Journal of Psychoanalysis 2003;84(4):823–41.Google Scholar
Mitchell, SA. Influence and Autonomy in Psychoanalysis. New York: Routledge; 1997.Google Scholar
Freud, S, Strachey, J, Freud, A et al. The dynamics of transference. In The Standard Edition of the Complete Psychological Works of Sigmund Freud: Early Psycho-Analytic Publications. Vol. 12, 1911–1913. London: Vintage; 2001.Google Scholar
Raphael-Leff, J. Pregnancy: The Inside Story. London: Routledge; 2019.Google Scholar
Steiner, J. The equilibrium between the paranoid-schizoid and the depressive positions. In Clinical Lectures on Klein and Bion, Eds Anderson, R, Segal, H. London: Routledge; 1991.Google Scholar
Holmes, J. ‘Too early, Too late’: endings in psychotherapy – an attachment perspective. British Journal of Psychotherapy 1997;14(2):159–71.CrossRefGoogle Scholar
Pedder, JR. Termination reconsidered. Int J Psychoanal 1988;69 (Pt 4):495–505.Google ScholarPubMed
McWilliams, N. Psychotherapy in a Pandemic [Internet]. 2020; http://web.tiscali.it/cispp/mcwilliamsPANDEMIC.htmGoogle Scholar
Hinshelwood, RD. A Dictionary of Kleinian Thought. Oxford, England: Free Association Books; 1989.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×