Time and again: Intermittent Brief Dynamic Therapy

Abstract

The author notes that in many of the settings in which Brief Therapy takes place that a client may return after the ending for a further series of sessions. Time-limited therapy has placed an emphasis upon the termination phase of the therapy and linked this to the process of individuation and separation. Such an approach, as articulated by Mann (1973), which draws conceptually from the work of Winnicott (1965) and the notion that the infant achieves unit status from the original undifferentiated merger with the mother, is not easily compatible with Intermittent Brief Dynamic Therapy. The work of attachment theorists and Stern (1985) provide an alternative basis upon which to conceive of the development of the infant. While emphasizing the importance of attending to affects at points of separation and ending, as is evidenced in the work of Della Selva (2004), such a framework is more readily compatible with the development of Intermittent Therapy, and with the realities of the settings in which much brief work takes place. The author also comments upon the flexibility inherent in Winnicott's own practice of brief consultations, and the implications of this for the development of Intermittent Brief Dynamic Therapy. The paper includes a case study that illustrates this debate and which provides evidence for the therapeutic potency of a form of Brief Dynamic Intermittent Therapy where a dynamic focus maintains a structuring pattern to the narrative over a sequence of several periods of Brief Therapy, spread over a number of years.