Marianne Hughes offers psychodynamic psychotherapy.

Psychodynamic Psychotherapy

Psychodynamic psychotherapy is an insight oriented, collaborative process to help with expressing emotion, developing tolerance of painful experiences, working through trauma, understanding a person’s role in shaping events and relationships, and improving interpersonal functioning. It is recommended when problems include depression, confusion of identity, troubled relationships, the experience of loss, addiction, and/or unresolved feelings or conflicts with one’s family.

Psychodynamic psychotherapy, often referred to more simply as psychotherapy, is distinguishable from other forms of psychotherapy by shedding light on the unconscious content of a person’s internal landscape to guide change. Although a bit of a cumbersome label, psychodynamic psychotherapy like its parent, psychoanalysis, seeks to reveal the unconscious content of a person’s psyche that not only causes tension but also interferes with one’s functioning through the manifesting symptoms such as detrimental ways of relating to one’s partner or children, work performance, and the fragmentation or dis-integration between what one wants (desire) and what one does (behavior).

Psychoanalysis

Psychoanalysis is the mother of psychodynamic and other psychotherapies. Psychoanalysis takes a closer look at unconscious thoughts and feelings that directly impact behavior and various mood states that can be elusive to even the most self-aware, developed person. This psychoanalytic practice is based on the theory and observation that these gaps in our ability to see ourselves are what make change so difficult.

The psychoanalytic framework stresses the importance of understanding:

• that each individual is unique
• that there are factors outside of a person’s awareness (unconscious thoughts, feelings, and experiences) which influence his or her thoughts and actions
• that the past shapes the present
• that human beings are always engaged in the process of development throughout their lives

Psychoanalysis is based on the observation that individuals are often unaware of the factors that determine their emotions and behavior. Because these factors are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts will often fall short of providing the kind of relief that self-discovery and the development of a unique identity offer.

Perhaps the most apparent quality that sets psychoanalysis apart from other psychotherapies is the structure of meeting multiple times a week. For some individuals, the increase in frequency is something that develops gradually and thoughtfully, as they become ready for a more comprehensive understanding of the self. Although this rigor may be demanding or daunting for those new to this and the benefits are often hard won, it is this very format that offers support, regulates the stress created by daily events, facilitates fluidity of thought, and offers more accessibility to emotional experience.

Psychoanalytic treatment explores how these unconscious factors affect current relationships and patterns of thought, emotion, and behavior. Treatment traces these patterns back to their historical origins, considers how they have changed and developed over time, and helps the individual to work through complex, recurring troubles in their life more fully, and to cope better with the realities of their current life situation.

Long-standing issues that never reach a comfortable resolution are often best addressed in psychodynamic psychotherapy and psychoanalysis. A psychoanalytic approach is preferable when the problems one is experiencing are long-standing, repetitive, and significantly interfere with life. Examples of these would include getting into one unsatisfying relationship after another, a long history of vague anxiety and depression, chronic failure to achieve goals and reach one’s potential, or a feeling that one cannot “be oneself” or act spontaneously.

Analysis can be viewed as an intimate partnership, in the course of which the person becomes aware of the underlying sources of his or her difficulties, not simply intellectually but emotionally and physically as well – in part by re-experiencing them with the analyst. From the beginning of therapy, patient and analyst work together to build up a safe and trusting relationship that enables the patient to experience aspects of inner life that have been hidden because they are painful, embarrassing, or guilt-provoking. Current research supports outcomes purported by patients, indicating intensive treatment may make it more likely that a person will undergo lasting change and resolve problems in self-esteem, relationships, sexuality, and mood.

While there are many types of therapy that address specific behavior problems, crises, or trauma, psychoanalysis is often better able to alter more pervasive general dissatisfaction, or a better fit for people who wish for a more expansive experience of their psychic life.

The Relational Approach

Relational therapy is a further development of what Sigmund Freud already believed and practiced – that the relationship is central to change. Relational therapy explores the impact of early and current relationships on a person’s sense of self and well-being and uses the intersection between patient/client and therapist to help the patient understand patterns in all of their relationships. Engaging in relational therapy acknowledges and addresses the here and now by offering a window into active feelings and palpable conflict, elucidating aspects of the self, and affording a deeper awareness and integration of desires, fears, anger, and other powerful emotions.

Equally important to the old feelings that are re-awakened in therapy is the chance to have new feelings with your therapist and to discover new ways of being in a close relationship. Over time, the patient and therapist will get to know each other well, facilitating the sharing of intimate experiences. The therapist, at different times, may feel like a parent, a lover, a sibling, or a close friend to you. One’s therapist, by becoming an important part of the patient’s life, can help to let go of patterns based in the past and to learn that there are new and better ways to be oneself.

Creative Arts Therapy

Creative Arts Therapy is a psychotherapy that encompasses and builds upon the capacities of the historical model while having access to misunderstood or previously inaccessable aspects of self. It can but does not have to deviate from the traditional model of laying on a couch or sitting and talking in a chair; by using other activities that expand and integrate the psyche/mind and soma/body.

This approach developed out of the observation of the creative practice as an active process that:

• Offers separation of the individual from the problem
• Allows more fluid access to valuable aspects of the self that were once too threatening, fragmented, or inaccessible
• Models tolerance of overwhelming or dysregulated emotion
• Practices action and the experience of change

Creativity is a preverbal, somatic, and sensorial language that also allows access to vulnerable aspects of the self from early, crucial phases of development. The creative act is a process that supports the vitality of the individual while working through difficult material such as trauma, shame, and false or maladaptive self-identifications.

Play Therapy

Play therapy is a structured, theory-based approach to psychotherapy that builds on the normal communicative and learning processes of children. (Carmichael, 2006; Landreth, 2002; O’Connor & Schaefer, 1983). The curative powers inherent in play are used in many ways. Therapists strategically utilize play therapy to help children express what is troubling them when they do not have the verbal language to express their thoughts and feelings (Gil, 1991). In play therapy, toys are like the child’s words and play is the child’s language (Landreth, 2002). Through play, therapists may help children learn more adaptive behaviors when there are emotional or social skills deficits (Pedro-Carroll & Reddy, 2005). The positive relationship that develops between therapist and child during play therapy sessions can provide a corrective emotional experience necessary for healing (Moustakas, 1997). Play therapy may also be used to promote cognitive development and provide insight about and resolution of inner conflicts or dysfunctional thinking in the child (O’Connor & Schaefer, 1983; Reddy, Files-Hall, & Schaefer, 2005).