Tag Archives: coping strategies

Psychodynamic Psychotherapy in Brief

Therapy is a method for:

  • improving self-esteem and self-understanding
  • changing unhealthy coping mechanisms
  • decreasing feelings of guilt and shame
  • resolving conflicts with others
  • developing/improving emotional regulation
  • confronting the existential negatives: pain, illness, ageing, freedom, responsibility, death, and loss
  • managing anxiety, compulsive thoughts, disordered eating and other issues
  • increasing empathy and emotional sensitivity
  • healing old wounds
  • mental/emotional hygiene and “preventative maintenance”
  • understanding confusing emotions and inexplicable reactions in both self and others

Therapy works by:

  • providing a “pressure valve”
  • increasing emotional tolerance
  • decreasing vigilance and defensiveness
  • increasing trust in self, others, and life itself
  • increasing tolerance for ambiguity and unpredictability
  • re-organizing and re-routing thought processes
  • regulating emotional processes through empathic interaction
  • integrating perception with reality
  • establishing control over “automatic” responses
  • increasing overall self-awareness
  • increasing understanding of what motivates other people
  • frank and honest discussion of difficult topics

Ego-Strength

Everyone struggles with low ego-strength at some point in their lives. Things don’t always go our way, and negative experiences great and small can come as a major blow to our self-confidence and our self-esteem. On top of this, the stress and strain of our fast-paced, high-pressure lives make it difficult to manage even the “simplest” of life’s demands, often leaving us feeling drained and weak and incapable. In general, though, we expect that with a bit of rest and relaxation, we’ll soon be up and ready to go.

However, for a lot of people, this doesn’t happen. They get knocked down and they stay down, and they begin to wonder if they were ever really standing in the first place. Even without any specifically negative event, a great many people seem to drift through life on a tide of stress, anxiety and depression, low self-esteem and absent self-confidence. They put others’ needs before their own, to their own detriment; they speak of being invisible and unlovable, being somehow intrinsically flawed, basically bad; they feel inferior and worthless, empty, lonely, and afraid; they make resolutions and try to set boundaries, but continually find that their efforts at self-assertion fall through; they struggle endlessly with addictions and addiction-like behaviours, especially with food, sex and/or pornography, alcohol, cigarettes, and bingeing on movies and/or TV.

If you’re reading this, chances are that at least one of the above applies to you in some way. Whatever your personal struggle might be, there is no shame in finding life difficult, especially when it comes to relationships with other people. When we look from the right angle, however, it becomes surprisingly simple to understand the feelings that trouble us. Once we understand the what and why of the way we feel about ourselves and other people, we then start to believe that we can resolve the emotional conflicts which cause us so much suffering. It is never easy and rarely quick, but it is possible and worth the effort it costs and the turmoil the process often causes.

Ability vs. Attribute

Unfortunately, the way we talk about psychological experience tends to confuse and disorientate us. Ego-strength is not something you “have” in the sense of ownership (e.g. “I have a TV”), it isn’t really a thing at all. Rather, “having” ego strength means being able to assert yourself and feeling comfortable in your own skin. High ego-strength means you can establish and maintain healthy boundaries with others, and tolerate those inevitable occasions on which your boundaries are crossed. You are able to receive criticism (constructive or otherwise) without feeling guilty, ugly, dumb, or worthless. And when you look back upon your misdeeds and stupidities, you feel embarrassed, perhaps, but you don’t feel ashamed.

So ego-strength is not an attribute like height or hair-colour that you do or don’t have — it is an ability and a skill which can be built up through deliberate effort and practice. It is an emotional muscle which allows us to bear the burdens of life without being weighed down or crushed by them. You are able to say yes to the unexpected, and to say no to the unwanted, and mean it. You can bend with the wind and shelter yourself from the rain. When the power goes out you light a candle and visit a neighbour instead of sitting alone in the dark.

Later-Life Learning

Ego-strength, like learning to walk and talk, is easiest to develop as we ourselves are developing. Given the right circumstances of healthy attachment and emotional support, ego-strength grows naturally and “builds itself into” the child’s basic experience of the world and view of themselves. The rare and lucky person who grows up in this optimal environment will be able to believe in and trust their emotions and perceptions, to have faith in their own abilities and intentions, to trust others, and create deep, intimate emotional bonds.

Sadly, very few of us grow up under these ideal circumstances. Many kids get barely enough care and support to develop into adults who are reasonably able to manage the demands of life — and a great many don’t get even that much. To be frank, many, if not most of us find ourselves barely holding on by a thread.

However, there is no reason to think that just because we didn’t get it in childhood, ego-strength is somehow impossible to develop later on. Some people compare it to learning a new language, or exercising and getting psychically fit, or learning how to paint or play an instrument — but the essential thing is that ego-strength can be developed later in life and it is never too late. There is no question that it is more difficult to do as an adult, and more painful, but there is also no question that it can be done, or that you can do it too.

Psychotherapy & Ego-Strength Building

This, fundamentally, is what psychotherapy is: Building up your emotional muscles, your ego-strength, so that eventually you no longer have to worry about not being “strong” enough to handle the stress, confusion, and anxiety of adult life.

The “work” in therapy is first to understand how you have come to be how you are. Often, people find themselves talking about how they grew up, what their early life was like, how well their parents/caregivers got along, and their relationships with all of the people who helped raised them. This doesn’t mean “going back there” or “re-living” your most painful experiences, rather, it means acknowledging and accepting the full truth of who you are. This, of course, brings up strong feelings, but this is what your therapist is for, to help you learn the skill of managing and regulating the feelings that arise out of past experiences and present emotional conflict.

And as these muscles grow, as their ego-strength increases, most people find that they become less and less dependent on their coping mechanisms, their “bad habits.” They feel less guilty for taking time for themselves and less ashamed of making mistakes. They can walk down the street without fearing the judgement of others and can assert their needs and wants without feeling selfish or greedy or rude. Lifelong depressions lift, anxieties fade into the background, and day-to-day living gradually becomes more fluid, and put simply, easier.

Patience Will Out

Learning a new ability takes time, there’s no way around it. Real understanding and meaningful change come from assimilation and integration, re-shaping yourself to make room for new ideas, thoughts, and feelings. You can’t build up your ego-strength in a month, any more than you can learn to speak French, or Russian, or Farsi in a month. It takes time for your mind to displace old patterns and trace lasting connections between new and existing meanings and beliefs. Some people learn faster, and some slower, to be sure, but regardless — it takes as long as it takes.

And, ironically, if you start from the idea that building up your ego-strength will take longer than you’d like it to, you’ll have a much easier time and the process itself will go much faster than you expect.

What is Psychodynamic Psychotherapy?

introduction: therapies and modalities

All forms of psychotherapy start from the belief that meaningful human contact is intrinsically healing. There are many approaches to establishing and maintaining this “therapeutic” contact, and you have likely heard of a number of them: older therapies like Freudian, Jungian, or Adlerian, for example, or newer ones like narrative therapy, bibliotherapy, or motivational interviewing.

Each “modality” is generally represented by its creators and practitioners as being utterly separate from all of the rest, with its own unique techniques and methods for psychological and emotional healing. Some of this is, frankly, ego-driven on the part of the modality’s “inventor,” and some it is marketing designed to catch the eye of potential new clients, and some of this representation is for the purpose of secure grants and funding for research. That said, however, there are in fact real differences between psychotherapeutic approaches.

These differences begin as emotional and philosophical intuitions and ideas about what motivates human beings and how to alleviate suffering. While these initial intuitions and ideas usually begin with only one or two therapists or theorists, over time they are gradually elaborated into larger constructs, concepts, and methods by the many therapists and clients who contribute thoughts and observations and experiences to the larger body of understanding.

As modalities grow, they are slowly codified into specific theories of how the mind works, often accompanied by a “toolbox” of specific “interventions” and techniques that are accepted as useful ways of helping people understand themselves and resolve their emotional distress: Talk therapy, guided meditation, dream journals, expressive dancing, hitting mattresses with tennis racquets, free association, body work, and even just sitting together in silence.

There are hundreds of these interventions, and within each modality there is continual discussion back and forth about which techniques work best for whom and how best to apply them. However, for someone approaching therapy for (perhaps) the first time, the most important thing to remember is that each theory and corresponding “modality” is basically just a set of rules and expectations about how the therapist is supposed to behave—and the kinds of things the client is supposed to talk about, pay attention to, and do.

And the goal of all of this is to relieve psychological suffering through effective, meaningful human contact.

With that in mind, let’s now turn to the question in hand: What is “psychodynamic” psychotherapy?

Psychodynamic Psychotherapy

Psychodynamic psychotherapy (which is what I practise) focuses on internal experience and making sense of the things that happen to us; what we feel and why we feel it. In other words, it tries to understand the movement and relationships (the dynamics) of and between the thoughts we think and the feelings we feel (our personal psychology).

In our day-to-day lives, most of the time anyway, we do the things we do without realising what we’re doing or why. When these things cause us problems, it then leads to the common feeling of being out of control and of being unable to change—of being in thrall to “bad habits” we hate, depression we cannot shake, being “triggered” by trivial events, and overcome by anxieties that won’t go away no matter how “rational” we try to be.

The psychodynamic view is that the thoughts and actions which cause us so much trouble are actually ways of escaping from uncomfortable emotions, or forgetting about the things that make us feel them. Denial and repression; escapism through food, drugs, sex, and entertainment; obsessive work, or cleanliness, or exercise; rigid and dogmatic rationality that ridicules “silly and stupid” feelings—effectively, these are all simplistic ways of hiding from strong emotions, bad thoughts, and difficult memories.

You are not broken

Contrary to a more mechanistic view of mind and emotion, the psychodynamic approach does not assume that these so-called “maladaptive behaviours” (this term is inaccurate and misleading on a number of levels) are the result of faulty cognition, or a “chemical imbalance, or a broken brain. Quite the opposite: they are active, intentional adaptations we make in order to manage difficult circumstances and unresolved traumas.

To put it another way: We choose to act in these ways because it makes us feel better, it makes us feel safe, like we have some kind of control over the world. Even if we don’t know why, even if it’s only for the briefest moment, and even if it brings serious side-effects with it—it works, and until now that’s all that has mattered.

However, while our respective coping/survival/protection strategies were effective in the past and have gotten us this far, they probably aren’t as effective as they used to be, and today probably cause more problems than they solve.

Understanding our Personal History

This is largely because we each chose our preferred coping mechanisms at a time when we were too young to really understand what we were doing or what the consequences would be. As children, with a limited range of options, we found a strategy that worked and so we used it.

In order to develop a mature and balanced approach to difficult events and emotions, we need to understand what makes the childlike ones so powerfully attractive. A large part of this is understanding what we were feeling at the time that made us need to reach for a coping mechanism in the first place—because often, the more intensely we rely on an unhealthy/unhelpful strategy in adulthood, the more intense the childhood aversion/fear/trauma was. And the tighter we cling to it, and the harder it is to shake and re-shape.

Very often this is reflected in the form of the coping strategy we use. The most problematic ones are always the most childlike:

  • stealing (I want it!)
  • denial and lying (I don’t want it to be true!)
  • cheating (I want to win!)
  • directly seeking comfort in foods we know are bad for us (Feed me!)
  • escapism, drugs, alcohol (Make me feel safe and strong!)
  • neediness and disruptive attention-seeking (Love me!)
  • distrust and avoidance (I hate this, and I hate you!)
  • throwing a temper tantrum (Give me what I want!).

This is one of the reasons why psychodynamic therapists seem so obsessed with their clients’ childhoods, particularly their family relationships. Because human beings learn primarily by example (monkey-see, monkey-do), and the coping strategies we choose are often the same as (or the exact opposite of!) the ones our parents used. And if we didn’t learn them from our parents, we almost certainly learned them because of our parents.

More generally, however, it is our earliest experiences of support or criticism, love or neglect, success and failure which lay the foundation for our entire future self. These experiences can have been with anyone we ever encountered in our youth, and everything that has come after is built upon and interpreted in terms of them.

Talk therapy

The psychodyamic model is built on the finding of thousands of therapists and clients that “working through” our personal histories—taking the time to remember, talk about, and reflect upon our childhood experiences—is psychologically healing. It does so (in part) by creating a coherent sense of your own story and the people and events who have made you who you are. It also helps you put the past into the past, and to recognise when it is interfering with the present. This lets you build and maintain a sense of solid structure within yourself: who, what, where, why, when, and how.

Most importantly, however, it helps you tolerate the “stupid” or “irrational” feelings you have been trying to escape from. Talking openly about emotions lets you see that the opposite is true, everything we do is emotional, and we have feelings about everything. Verbalising them therefore helps you understand that having strong emotions does not make you a monster, or selfish, or childish, or irrational, or immature, or any of the ideas we use to punish ourselves for being “bad.”

Simply put, there is something magically liberating about allowing yourself to remember events you have banished to the back of your mind, and hearing yourself say out loud the things you have so long been terrified of letting out. Doing this over and over again without being punished, or judged, or criticised, or ridiculed, or rejected—being instead praised and encouraged—is a major part of the healing process.

Re-Learning, Re-Adapting

However, your present life is just as important as your childhood. Because it is in the present that you have to actually make the changes you want to make. You will inevitably encounter situations which stir you up and you will then have decide not to react in your old-established ways.

By talking about your present life and how it relates to your past, you create intelligible chains of cause and effect which allow you to see things differently, to understand what is happening and why, and then to behave in a way that is consistent with who you want to be.

This is by nature a process of trial-and-error, and exploring your day-to-day successes and failures in your therapy sessions helps to reinforce the new patterns and integrate them into your self-image.

In other words, you are re-learning how to be in relationship with the people around you, and re-adapting to the circumstances of your life as they really are. Psychodynamic therapy sees this re-adaptation process as having three basic, interrelated elements.

  1. Our coping strategies and defence mechanisms are activated and strongly influenced by thoughts and emotions that happen outside of our immediate awareness. Because we can’t see them, we can’t understand them, and therefore can’t yet change them.
  2. The patterns which give rise to these hidden thoughts and emotions don’t spring up from nowhere; they have grown over time and have been continually refined and reinforced through experience. To change them we need new experiences, and those experiences must also be reinforced over time.
  3. By talking about the past we are looking at old events with new eyes, and we can learn to see what was previously invisible. By talking about the present, we get a clear view of what is really happening. And by talking about the future we direct our development towards what we actually want.

In other words, becoming aware of our unconscious motivations allows us to break old habits, to then have new experiences and cope in a new way, and to gradually, but intentionally reinforce new patterns so that they continue on into the future.

Moopidoo

Each session is a chance to step out of the normal form and flow of space and time and see and experience things in a new way. The focus is on you and only you, because that is also the point. The psychodynamic therapist keeps their needs and automatic reactions out of the conversation so that you can see, feel, and understand those parts of your memory and perception which are normally hidden from view. They do it gladly because they know the value of it, and that it can work no other way.

And as you discover more things about yourself than you ever though you could know, and see yourself becoming the person you always knew you should have been, you’ll (hopefully!) understand and be glad of this somewhat strange arrangement. Because above all, psychodynamic therapy has as its goal to see you, know you, and respect you for exactly who you actually are. It is a feeling that everyone craves, and which everyone ought to experience at least once in their life.