Psychodynamic intervention in brief psychotherapy

Abstract

This paper will describe a framework for an intensive psychotherapeutic intervention useful in consultation and its extension in brief psychotherapy. The approach is designed to address symptomatic expressions of distress that arise as the expression of unconscious conflict provoked by situations of crisis. It may also be a model for selected patients in longer therapies that address ongoing problems. This therapeutic approach has elements familiar to any experienced therapist, but is specific in its conceptualization. What distinguishes this therapy from others is the induction and utilization of a special positive quality in the therapeutic relationship as a therapeutic aim and curative factor in its own right beyond its role as the substrate for a trusting relationship that underlies all successful psychotherapeutic elements. This involves a specific strategy and technique designed to develop a benevolent transference to effect change, sometimes to achieve symptom relief, sometimes as a precursor to meaningful insight. In this respect the relationship, considered to be a central feature of the therapy, compliments understanding as a vehicle for change. A variety of interventions are described to facilitate this process and are illustrated in case presentations. This presentation is a synthesis of a number of papers on active engagement of the patient in psychodynamic psychotherapy. Two DVDs that illustrate this approach in consultations with patients are available for presentation. One is a three-session psychotherapy with an eight-month follow-up. The patient interviews are edited and may be the focus of separate sessions.