WHAT IS PSYCHODYNAMIC PSYCHOTHERAPY?

The basic set-up of psychodynamic psychotherapy is a once-weekly session (sometimes more frequently), established over a medium- to long-term timeframe. This can range from as brief as several months to a few years in duration. An important consideration is that it can be open-ended.

What this form of psychotherapy is like to undertake and how it can help, however, are more complicated matters to convey. This is because psychodynamic psychotherapy is perhaps less about intellectual learning and more about an experience – an experience of being given time, of being “held” and held in mind, of being understood deeply, and of being able to grow and develop as person.

The main “instruction” in a psychodynamic psychotherapy session is for spontaneity – for you to tune into what you are experiencing in the present moment, even if it is something unexpected or difficult to talk about. It is different from bringing a prepared story and might take some getting used to as you settle into the therapy process. So, a typical therapy session might involve talking about your life, your problems, your personality, relationships, your upbringing, your fantasies and wishes; but moment-to-moment it is led by what occurs to you, what pops into your head. With this method we see that certain themes tend to keep coming up, which we can become familiar with and start to understand. I pay attention to the shifting dynamics affecting your relationships, including present-day difficulties in significant relationships and the here-and-now relationship with me in the therapy, and how these can both be influenced by formative relationships from the past. I also try to understand what may be out of your conscious awareness, in order to help you appreciate the unconscious influences on your present-day life.

CAN IT HELP?

Psychodynamic psychotherapy can help people experiencing a range of different difficulties but it is of most help if you are motivated to understand yourself better and are prepared to dedicate time to this. It can be challenging and painful along the way, but ultimately rewarding, as you gain relief from being able to share more of yourself with another, and start to feel more self-aware and in charge of your life. It is not a one-size-fits-all approach, however, and isn’t suited to everybody. If you are seeking more of a quick-fix or specific advice and guidance, you might find the style of therapy frustrating. There are also particular circumstances and conditions where psychodynamic psychotherapy would not be advisable. However, for people seeking to really make sense of recurring problems and the narrative of their life, it can be very helpful.

PROFESSIONAL BACKGROUND

I am a medical doctor by training – I have a medical degree and the postgraduate qualification of Member of the Royal College of Psychiatrists. I have speciality registration with the General Medical Council as a medical psychotherapist and maintain clinical registration with the British Psychoanalytic Council, which means I adhere to their standards and requirements for continuing professional development.

I have 10 years of experience working as a doctor in NHS mental health settings in England and Scotland, and six years of psychoanalytic training experience with the Scottish Training in Psychoanalytic Psychotherapy. I have several years’ experience leading Balint groups for junior doctors, teaching and supervising both medical undergraduates and postgraduates, supervising other professionals such as psychologists, and offering psychodynamically-informed consultation to medical colleagues.

ASSESSMENT

Before any treatment arrangement is agreed an assessment is undertaken in order to establish: (a) if psychodynamic psychotherapy is likely to be helpful for you; (b) if remote online therapy is appropriate and do-able; and (c) if you feel you would like to work with me longer-term.

It is important that the assessment is carried out over a number of sessions in order for a process to develop between us and to see what happens in the time in between the appointments. With this approach we will get more of a sense of what longer-term therapy would be like for you.

WORKING ONLINE

In remote therapy work, there is greater reliance on the patient to set up and maintain a setting for therapy – essentially, between the two of us and the two separate spaces occupied, we are trying to recreate the atmosphere and privacy of a consulting room.

You need to be somewhere where you will not be interrupted or overhead for the duration of the session, and seated or reclined in a way that is comfortable, so you can relax a bit. It can also help to leave some time for yourself both before and after each session, so that there is some transition between therapy and your life outside, mimicking a journey to and from an appointment.

TECHNOLOGY ASPECTS

The internet can never be relied on 100%. That said, the technology now available does allow for a remarkably good human connection across geographical distance. I use Zoom for the video sessions and set up secure joining instructions unique to each patient.

It is fine to experiment a bit with set-ups until something works well and feels right, but the following pointers might help:

– Use a modern device with adequate RAM and processor clock speeds (upwards of 2GHz is often mentioned);

– Use an Ethernet cable for a faster and more stable internet connection (a powerline adapter can be used if your broadband router is situated elsewhere);

– Minimise other broadband traffic for the duration of your session;

– Station your device on a stable surface;

– Position light sources in front of you as opposed to behind; and

– Use headphones slightly off on one side, as this can help you hear my voice privately but still have a sense of your voice and its natural acoustics within the space you are in.

FEES

Sessions last 50 minutes. For weekly psychodynamic psychotherapy the fee is £50 per session, with invoices sent monthly by e-mail. All offered sessions are billable unless a minimum of one week’s notice is given for absences. Assessments are run for a minimum of three consecutive sessions. Irrespective of the number of sessions used, there is one-off charge for an assessment of £250, payable ahead of the first session. Written correspondence can be produced as part of the assessment if required.

FOR OTHER PROFESSIONALS

I am able to offer psychodynamically-informed supervision and/or consultation to other professionals upon arrangement. This could be about applying a psychodynamic focus to other types of psychotherapeutic practice, or assistance with understanding the relational dynamics and unconscious processes in any healthcare work.