My approach to psychotherapy with adults depends on many factors. Each individual is different in personality and background and brings with him or her a number of specific challenges, opportunities and intentions. In early sessions, we’ll work together to identify your priorities, formulate plans and look at practical matters, including whether brief therapy or longer-term depth approaches are best for your situation. It’s likely I’ll ask you to read up on some of these options (if you’d like, I’ll give you reading material or suggest internet links to explore). Our initial discussions about the many methods (or combination of methods) from which we can choose opens up the creative space we’ll need to effectively address your needs. The difference between brief therapies and depth therapies can be significant. To briefly summarize distinctions:
Brief therapy is solution and coping skills focused. Techniques are based on an understanding that change occurs in the ‘here and now’ present moment. Mindful skills are learned and immediately put into practice in order to be effective. With initial support and guidance from a therapist, most brief therapies (CBT, DBT, etc.) require clients to identify old unproductive patterns and then consciously replace them with new and more effective thoughts and behaviors. The underlying principles behind brief therapies derive from neurobiology. Synaptic patterns in the brain become structurally ingrained but new ones can be formed with changes in thinking and behavior. Consciously catching yourself the moment you’re about to fall into an old unhealthy habit or pattern and then quickly re-directing your thinking and actions towards more beneficial responses builds new synaptic routes (neurotransmitter connections) that become easier to engage with practice. The result is a more pliable brain that has access to an ever wider-range of options and solutions.
Longer-term psychodynamic/depth approaches tend to be more “discovery” oriented. For example, as one nears mid-life and many of the routines and responsibilities of daily life hold less satisfaction and meaning, finding ways to access those parts of oneself that are hidden in the unconscious becomes a primary task. Edward Edinger writes, “The young ego is obliged to establish itself as something definite and therefore it must say, ‘I am this and I am not that.’” Many sacrifices are made during early life identity formation as a great number of invaluable personal interests and qualities are repressed in the service of securing an acceptable place in society. By mid-life, we are often weighed down by doubts and worry (depressions and anxiety) as we sense our full potentials slip away. However, if we are willing to search beneath the surface of the familiar, we can discover many unlived potentials that can be reawakened and restored to consciousness. This process takes time and must be done with care, but once released these dynamic personal and collective discoveries can generate a stream of new insights and energy. The work of integrating known with unknown, inner with outer, and past with present and future can restore our sense of vitality and purpose. In my practice, brief therapy coping skills are often folded into depth psychological approaches so we can address immediate specific issues along with longer-term needs. For adults, these needs include: