My Approach to Psychotherapy

 


IN THE THERAPY ROOM, THERE IS NO SUCH THING AS “UNSPEAKABLE” OR “SHAMEFUL”. MY AIM IS TO HELP PATIENTS REORGANISE OLD WAYS OF NEGATIVE THINKING SO THAT THEY DO NOT FEEL A NEED TO REPRESS, WITHHOLD, FEEL ASHAMED, OR SHUT DOWN THEIR FEELINGS.

[COMFORT SHIELDS]


My approach is psychodynamic and humanistic, and existential philosophy informs all of my practice. In addition to traditional talk therapy, I also offer intensive PTSD treatments: EMDR and Narrative Exposure Therapy (NET).

Psychodynamic Psychotherapy

Psychodynamic therapy is a highly effective approach that stems from the work of analytical psychology and psychoanalysis. My approach is a modern form of psychoanalytic psychotherapy. It is relational. It focuses on allowing patients to increase awareness of their inner world and its influence over relationships—and vice versa—both from childhood and in the present. Dreams and fantasies are also an important part of psychodynamic therapy, making the psychodynamic approach uniquely focused on all three aspects of time—past, present, and future. From a psychodynamic intersubjective perspective, personalities develop within the context of relationships with others, including the therapeutic relationship between a therapist and client.

Is Psychodynamic Psychotherapy Evidence Based?
In one of the world’s top peer-reviewed psychology journals, The American Psychologist, Jonathan Shedler, Ph.D. challenges prevailing thinking about psychotherapy by using multiple meta-analyses of psychodynamic therapy compared to other psychological and pharmacological treatments. In “The Efficacy of Psychodynamic Psychotherapy,” Shedler argues “Empirical evidence supports the efficacy of psychodynamic psychotherapy. Effect sizes for psychodynamic psychotherapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” Additionally, unlike in other forms of ‘non-depth’ therapy, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve long after treatment ends, making psychodynamic psychotherapy a particularly effective therapy long-term.

Relational Psychotherapy
Relational Psychotherapy Relational psychoanalysis began in the 1980s as an exploration of interpersonal interactions with British object relations theory’s ideas about the psychological importance of relationships that individuals internalise with other people. Relational therapists believe that personality emerges from the formative pattern of early relationships with parents and other figures. Stephen Mitchell is often thought to be the most important relational psychoanalyst.

I base much of my relational work on Robert Stolorow’s theories of emotional trauma and intersubjective-systems theory. I also find Stolorow’s work on therapeutic comportment very useful. The crux of this approach is that therapists take a highly active role in empathising with the client. In this approach, the therapist is much more than a listener and a guider. He or she actually “dwells” in the emotional pain and invests his or her own emotions into it. The emotional pain is not skirted or understated. In so doing, the emotions are granted a dignity rather than shame. The old organising principles of repressing painful or embarrassing emotions are reorganised. This approach has had enduring success in treating soldiers with PTSD in active combat (Carr, 2011) and is also useful in most therapeutic treatments.

 

Humanistic Psychotherapy

UNCONDITIONAL POSITIVE REGARD IS AT THE HEART OF THE THERAPEUTIC RELATIONSHIP. I APPROACH THERAPY WITH THE INHERENT UNDERSTANDING AND BELIEF THAT MY PATIENTS HAVE THE ABILITY TO DIRECT THEIR OWN LIVES AND THE POTENTIAL TO ACHIEVE THEIR OWN GOALS.

[COMFORT SHIELDS]


Much like Stolorow’s therapeutic comportment model, Rogers’ approach is nonjudgmental and empathic. Active listening, warmth, acceptance, and the client-therapist relationship are all paramount to the success of humanistic therapy. A main goal of humanistic therapy is to allow patients to develop a stronger and healthier sense of self and to “self-actualise” or “become” one’s potentialities.

Humanistic psychotherapy is less based on the medical model or pathology and focuses instead on the healthy aspects of a person’s life. It is a science of human experience, valuing the actual lived experience of the client rather than any goals that a therapist may bring to the work. The therapist’s role, instead, is to provide empathy and a relationship based on respect and trust through active listening and support for the client to steer the therapy work.

Existential Philosophy

Existentialism is not so much a therapeutic approach, but rather it is a philosophy that informs all of my practice. It focuses on free will, self-determination, living authentically, and the search for meaning. My therapy work is most closely informed by Robert Stolorow’s psychoanalytic approach to existentialism, which is developmental in nature. According to Stolorow, people only exist authentically if they are able to dwell in the emotional pain that is part of the finitude of human existence. This non-evasive emotional dwelling, according to Stolorow, requires patterns in one’s life of healthy relationships so that individuals can develop the capacity to incorporate the painful emotions that are part of human existence into their lives. Without healthy relationships, people are more likely to experience what Stolorow calls traumatic temporality, or an inability to integrate the past, present, and future, and instead a feeling of being ‘stuck’ in time.

The full realisation of the truth of our existence creates unbearable existential anxiety, and can make us feel overcome by nothingness. We feel that all of our choices are final. Since time is finite, every choice we make destroys all of the options we did not realise. Individuals cannot possibly live with the existential anxiety that goes along with the full consciousness of the deep-structure of our existence, at least when we do not have a safe place to “hold” the feelings that coincide with this reality.

Therefore, to survive emotionally and psychologically, we live in what Heidegger calls a state of inauthenticity; we cling to the system of everyday significance that provides us with structure, meaning and safety. Our culture is enamoured with quick-fix methods that promise overnight relief. Facing the tragic dimension of human existence is no longer popular in our culture that perpetuates the myth of immortality, and repeats the mantra that happiness is a birthright. The problem is that without acknowledging that our existence is limited–that we have limitations that cannot be overcome,  that we can only realise freedom when we face our personal and existential limitations–psychopathology ensues, as we are living inauthentically, or in a delusional version of reality.

Thus, an important part of my work with clients is to accept that there will always be an inability to control all aspects of their lives. Additionally, strengthening relationships is key to managing existential anxiety.

 

 

 

Psychodynamic and Humanistic therapy in Harley Street Central London | Psychodynamic Humanistic Existential Therapy Aviva, Bupa International, Cigna, Cigna International GBG, Aetna.