What i gained from therapy
Hi guys, welcome or welcome back! If you don't know me, I'm Lauren. I am a software engineer in Toronto.
Today, I'm going to be writing about the type of new therapy that I started a couple months ago, which is psychodynamic or insight-oriented therapy. I want to explain a little bit of this because I think sometimes with psychodynamic therapy, in particular, it can be kind of difficult for people to help prospective clients understand what it actually entails. It's something that often seems very diffuse, not very tangible, and hard to sort of put your finger on. So I wanted to give a very direct, concrete explanation of the kinds of interventions that are used and what you can expect out of this type of therapy.
My Psychodynamic Epiphany
A little bit of an introduction to how I started psychodynamic therapy: ironically, for the vast majority, I was a CBT focused client. I was very solution-focused, directive, hands-on, and concrete. I had been in this type of therapy for many, many years. At the start of the new year, two things sort of happened at the same time.
First, I was getting really, really bored with the approach I had toward therapy. I was noticing that it wasn't as enriching to me. I myself decided I no longer wanted to be in CBT therapy. I told myself that if I was going to continue with therapy, it would be for something more psychodynamic. The reason for that was because, although I did find some use in more directive types of therapy, it felt like the problem was kind of just hopping around from one thing to the next. I wanted something to really get at the root, the origin of the problem, rather than just attack sort of surface-level symptoms.
So, I showed up to psychodynamic therapy for the first time with my therapist, who is absolutely wonderful and brilliant. I basically told her I only wanted maybe 10 to 20 sessions. I just wanted to get rid of my anxiety, and I wanted to meet every other week. She said to me, "We cannot meet every other week. We meet weekly for this kind of therapy. I can't promise you that your anxiety is going to go away, and I don't know how long it's going to take. It could take six months; it could take a year; it could take years. The goal of therapy should not be to just fix a problem."
When I heard that, at first, I was kind of like, "Oh, okay." A part of me wanted to run away, but I decided to stick with it. I said, "You know what, let's just give this a try." Ironically, I met my original treatment goals within six months of being in psychodynamic therapy for the first time. I actually got at the root of what the problem was. This was after I shifted away from trying to just solve the problem. I decided, "You know what, I'm just going to explore, gain insight. I'm not going to try to get rid of my anxiety anymore." As I did that, indirectly, my anxiety alleviated. It ironically resulted in stronger progress than when I had been just trying to put out fires in my life.
Even now, having met that original treatment goal, I'm still in psychodynamic therapy because I like the support when I'm going through transitions or stresses in my life. I want to continue to gain insight into my relationships and my patterns. I find it to be interesting and enriching. I've kind of graduated to more higher-order goals now. Now, it's less about wanting to get rid of this emotion, and more about wanting to deepen my relationships and learn to trust others and myself more.
What I’ve Gained from It
First, I'm going to tell you what I gained from my own psychodynamic therapy. Then, I'm going to explain how that actually looks in the therapy room, how these things unfold.
The big takeaways that I had from my own psychodynamic therapy were:
Reconceptualizing the Problem: Going into therapy, I felt like I was telling my therapist, "I have this, this, and this. I have this problem, this symptom." She refused to see me as all these different symptoms or all these different disorders. She instead reconceptualized the problem as not symptoms or labels that make me who I am, that define me, but rather reactions to adversity. This really helped me stop identifying with certain labels.
Shifting from Solution-Focused to Exploratory: Psychodynamic therapy has really helped me move from a very solution-focused mindset, where I felt like I needed to fix everything, to more of an exploratory, insight-gathering approach. This has been very liberating because, to tell you the truth, you cannot control your emotions, your thoughts, your physical sensations, or the things that happen to you. A lot of those things are outside your realm of control. The better you get at practicing acceptance of that, the better you can get at acknowledging what is within your control. Instead of trying to find solutions for every problem, it might be more helpful to just explore the problem, dive deep, and see if that might be more helpful.
Asking for Support: I also got a lot better at asking for support instead of needing to do everything on my own. Historically, I've struggled with asking people to help me out. I kind of take on the burden to do everything myself.
Stopping Self-Blame: I stopped blaming myself so much for the actions of other people in my life. I completely reconceptualized the way that I understand certain people. There are certain people in my life that I would have never possibly imagined distancing myself from. Now, having been in this type of therapy, I can recognize I do not want to engage in this pattern anymore. I've come to a place where I'm like, "No, I don't want this person in my life anymore." A year ago, it would have been impossible for me to even fathom that I could distance myself from this person.
Building Trust: I find it easier to trust people now. I find it easier to trust my own judgment now. I don't experience as much shame as I used to. I definitely don't experience as much anxiety as I used to. I got to the root of certain problems, certain symptoms that I had. For instance, I realized the reason why I wake up around 3 a.m. feeling shame sometimes. Once I actually got to that reason, once my therapist explained it to me in therapy, it hasn't happened since. It's absolutely mind-blowing.
Understanding Symbolic Anxiety: I also understood the symbolic reason why I was anxious about one specific thing, and it traced back to a relationship I had in high school.
“But I’m Already Self-Aware!”
Something that I hear sometimes from my friends when they're talking to me and they're not sure about psychodynamic therapy, they're a little bit ambivalent, is they say, "Well, I'm a very introspective, insightful person already. I don't think I need more insight."
The thing about that is you can be a very insightful person, but you only see things from your perspective. I, for instance, like to think I'm a pretty insightful person myself. I have a very strong understanding of my own psychology and my own history, but I too benefit from having a third party who is also a trained psychotherapist in giving me her perspective on things. Sometimes I'll come into therapy with a dream, for instance, and I will have kind of interpreted it all on my own, but she will have something that it's unbelievable that I didn't think of because you can only see things from your perspective. When you're only seeing things from one perspective, you're missing the other however much 180 degrees of the problem that is outside of your realm of visibility. We could all benefit from having an extra perspective and the insight of someone other than us. Let's not kid ourselves into thinking we have it all figured out by ourselves.
Also, a second thing is you could have an insight on yourself. You could say, "Oh, I logically understand that I do this thing because of this thing that happened." But if you don't really feel that insight, you're not going to transform it into something healing.
In therapy, the therapist pinpoints insights in that moment for you to be able to alchemize that into something helpful. Our emotions are really portals into our unconscious, and they're also tools to help us make progress in our lives. Without fully feeling our emotions, we can't make the most of them. So, that's another reason why, if you think, "Well, I'm already an insightful person. I already understand my whole history," it's not enough to understand yourself. You also have to hear other people's perspectives and feel those insights in the moment.
So, how do interventions in the therapy room work? How does psychodynamic therapy actually work? What happens in the room? You'll likely feel a lot more like a conversation than in other types of therapy like CBT, DBT, SFBT, and so forth. It's typically very client-driven and non-directive on the therapist's part. The therapist is not going to bring up worksheets and skills. They're not going to tell you what to talk about; that is your responsibility. It'll usually start with the client bringing up whatever they feel is pertinent or the therapist trying to help them access what is most emotionally pertinent in that moment.
Sometimes, you might leave feeling like, "What exactly did I accomplish in this session?" If you're someone who's really compulsive or productive and needs to feel like they accomplished something in a certain hour, you might be kind of confused. Like I said, there are no worksheets, there's no homework, there's no skills. But I take notes after each one of my psychotherapy sessions. I reflect on the key takeaways and insights that I gained, and I can tell, first of all, that I have a whole page of insights. Then, after weeks and months, when I look back on prior reflections, I can see how far I've come in my perspective, in my emotions, in my relationships. Massive changes are happening; you just don't realize it as much.
Now, on the therapist's end, the interventions might sound simple on paper. Things like asking a question, clarifying something, explaining something, interpreting something—these things sound very simple to do, right? You might hear a therapist saying, "You mentioned last night's date didn't go so well, and then you started tapping your foot. What do you think that is about?" Something like that is meant to gently nudge the client towards awareness of the fact that they're avoiding an emotion, likely anxiety. Or a therapist might say, "I wonder if you had this angry reaction to the professor saying that to you because it brought up memories of X, Y, and Z." Something like that might be meant to point out how current emotions are informed by triggers related to the past.
You see, these interventions sound so simple. If you don't know what they're meant to accomplish, it could seem like your therapist isn't doing anything at all. In the therapist's mind, they're doing a lot of unseen work. They're noticing clues about the client's emotional state. They're using empathic attunement to better understand how the client might be experiencing this lived experience. They're noticing their own reactions as a clue to maybe how other people in this client's life might be feeling about them. They're identifying the client's defense mechanisms. They're noticing patterns. They're inferring what could be causing a current experience based on past experiences the client has had. They're considering the research on this topic. And all the while, holding these different pieces of information, they're also considering, "What's a gentle way to help the client make this insight themselves? How can I make sure my response is different from other relational patterns my client experiences in their life? How can I, at the same time, model healthy attachment, healthy communication, metallization, and other skills?"
There's a lot of work that goes on behind the scenes behind a question that feels simple. A lot of psychodynamic therapy is about increasing awareness of defense mechanisms. Defense mechanisms are the walls we put up when there's something too painful to acknowledge in the unconscious realm. So, our mind goes, "Nope, I don't want you to look at that yet. I'm going to put up this wall." A lot of psychodynamic therapy is helping clients become more aware of when they're doing this, with the intent of lowering those barriers a little bit when there's something helpful in the unconscious that they would benefit from knowing. Helping them prepare to take that information in.
So, a lot of it is becoming more aware when we're using defense mechanisms. Then, the other half of it is becoming more aware of the unconscious information past those defense mechanisms. This could be by straight-up noticing patterns or making interpretations. It could be like saying, "I wonder if you feel bad about what you said to Emma because you're afraid of conflict. You grew up in a home where expressing anger wasn't allowed." A lot of this type of therapy is also getting in touch with our emotions, using them as a portal to the unconscious, and as a way to move forward, to make progress, to heal. A lot of it is also highlighting patterns between past and present.
For instance, my therapist pointed out that I struggled to accept help or validation from other people, and she helped me see the errors in that pattern and helped me forge new patterns of moving through the world. What it did for me is what it needed to do, but what it could do for you is something wildly different. That's why psychodynamic therapy is so hard to explain because it could look wildly different from one person to the next. The therapist needs to identify a person's patterns and become kind of like a soundboard for amplifying what's not adaptive about them and teaching a new way to approach things by giving you a reaction you don't usually get.
Let's say that everyone always talks over you, and a therapist who learns and sees this pattern is going to maybe make sure to never interrupt you, to always listen to you. When you get used to that new pattern in relationships, it's going to seem very discrepant and disrespectful when people in your life start to interrupt you. It's going to feel like, "Hm, my therapist doesn't do this. I don't know why I should tolerate this." Versus if someone's coming into therapy and they are constantly interrupting the therapist, and they're used to everyone in their life always just putting up with it, a therapist's way of breaking those patterns might be to instead stand their ground, not stop talking when the client's trying to interrupt them, to continue to send the message that, "No, right now I'm talking, and what I have to say is worthwhile, and you can speak when I'm done."
That is why therapy can look so different from one client to the next because everyone needs a different kind of corrective experience. Maybe one of my favorite parts about this kind of therapy is interpreting the symbolism of psychological content. From a psychodynamic perspective, you can interpret the symbolism in works of fiction, you can interpret dreams, and you can even interpret the symbolism of your waking hours. Let me give you an example.
A few weeks ago, I was having a difficult conversation with someone that was painful for me. While I was talking to this person, I accidentally slammed my hand into a chair, and I broke my nail really deep in its nail bed. It started bleeding and stinging; it hurt really badly. In that moment, I started crying, and it wasn't because of the physical pain. It was because the physical pain I was experiencing was a symbol for the relational pain that I was experiencing. It was basically a physical embodiment of what I was feeling inside about that conversation.
If you're just going surface level with therapy, you might say, "Oh yeah, you were physically in pain, so you started crying." But if you go a little bit deeper, you realize that the physical pain was a symbol for something else. Dream interpretation is also something that I really love because the unconscious communicates to us through symbolism, and that shows up in dreams.
If all this sounds interesting to you, I would recommend that you look into psychodynamic therapy because, like I said, it really changed my life as a client. I hope that gives you a little bit of insight into how psychodynamic therapy works. Just so you know, I may have favoured certain theories within psychodynamic therapy over others just because of what I personally use. There are a lot of different theories within the field itself. At the end of the day, this is what I mostly use for myself. Hope you have a great day. See you soon!
