Psychodynamic Psychotherapy and Enduring Change

Article excerpt

After working with patients at the Chicago Institute for Psychoanalysis for many years, I have become more and more convinced that psychodynamic psychotherapy can lead to change that is both effective and lasting. In fact, we've got solid data that back up this contention.

In follow-up studies at the institute, my colleagues and I looked at 40 patients 2 or more years after they had completed psychoanalysis by mutual agreement with the treating psychoanalyst.

We were very careful to use safety and consent procedures aimed at avoiding disruptive effects on the patients. For example, the interviewing analysts reviewed process notes of the original analysts so that they would not inadvertently inquire into traumatic areas. This goal was balanced against the concern about the analyst having too much information about resultant biases.

Our findings should be particularly rewarding to those of us who have dedicated our lives doing this work: The change that our patients experienced proved enduring. Furthermore, we found two key elements that correlated with that enduring change.

The first, which occurred as the treatment reached its concluding phase, is characterized by a capacity to self-analyze and recognize the disruptive patterns that led the patients to treatment and to modify those patterns using the self-analytic capacity.

An essential component of this is a process of cycling between a character style that early in life had been adaptive and later became dysfunctional and the painful tensions of needs that had led to the character style.

The second element involved a period of mourning the loss of the psychoanalysis and the psychoanalyst. …