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A client will arrive with depression, anxiety, phobias and/or compulsive behaviors, relational problems even psychosis.  While we listen to the client’s diagnosis in psychodynamic therapy we look behind the here and now.  The aim of psychodynamic therapy is the removal of these symptoms through the correction of their underlying patterns.  The negative patterns are likely to have begun at an early age and have thwarted development of a healthy personality.


It is important for both the client and the therapist to understand that change is not linear, it will involve reversals, regressions, plateau and sudden breakthroughs bringing him to a different level of understanding his problem which will enable flexibility and a less rigid stance by the client.  Of course therapy can run smoothly, exploration and self discovery rewarding, clients understand and cope better even when some symptoms don’t disappear altogether but are managed better.


Clients will experience some unpleasant emotional states, and traumatic memories may be uncovered thereby dealing with very difficult and painful memories. Some disappointments might ensue however the client has to realize that therapy cannot remove the real difficulties and uncertainties of everyday living but will enable to handle these with composure and confidence.


Emotional suffering is often connected in ways the person perceives a situation and to aspects in the way he lives.  So there will be change on the horizon and many people have fear of change.  When a client comes in after a number of sessions finding their disorder is loosening its grip they might say ‘I don’t want to change’. They have become habituated to their neurosis, compulsive behaviors and phobias.  However, much of the ambivalence and resistance to change will not be in their awareness but unconscious, these contradictions will inevitably be brought into therapy.


The psychodynamic approach is somewhat more directive than psychoanalysis but less so than other therapies, more reflective with a deep respect for the client’s autonomy.  To effect lasting change the ends can rarely be approached directly hence we are not advice givers but guides.


Importantly it is the nature of the therapist’s relationship with the client that enables change. 


Goals can vary during the course of therapy and different individuals require different techniques and/or co-joint techniques to achieve change so the therapist’s posture will adjust depending on a whole range of factors.


Some clients might leave during the first feeling of well-being and some might even maintain the improvement, but no underlying change will have taken place.  If the client sticks with therapy at this point real work begins.  The client then enlarges the experience in a way to understand and master his emotions, widening choices to give up old securities and the fringe benefits of the ‘illness’, thereby experiencing new forms of relating to himself and others. 


It is expected there is an improved capacity for emotional regulation, self-management, increased self-knowledge and self-acceptance.

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