relational psychodynamic therapy

Until you make the unconscious conscious, it will direct your life and you will call it fate.

C. G. Jung

Psychodynamic therapy can be simply (perhaps too simply) summarized as an attempt to make the unconscious conscious. While most psychologists, psychotherapists, and other mental health professionals will agree that there is a part of the mind that is unconscious, the psychoanalytic and psychodynamic therapies emphatically proclaim that there is dynamic processes at play beneath our awareness. It is not just that we are thinking and feeling things that we don’t know we are thinking and feeling (although that is also assumed). Rather, we have various drives, needs, desires, fantasies, images, memories, and beliefs that are in tension with each other, or even battle each other. And the numerous battles are waged outside of our conscious expereince.

These battles create all sorts of symptoms and neuroses, both directly (anxiety about two unconscious desires in tension) or indirectly (a rigid defensive structure to keep the tension out of awareness). A lot of therapeutic approaches will focus on aleviating these symptoms, and this is an honorable desire. The psychodynamic contention is that if we do not bring into our awareness the conflicts within us, then the same or similar neurotic symptoms will emerge. The symptoms are not the problem; they are guiding us to the problem.

We are born in relationship, we are wounded in relationship, and we are healed in relationship

Harville Hendrix

Symptoms are often guiding us to a problem of relationship. In Western culture, we tend to downplay the importance of relationship. That is not to say they are not seen as important, but they are often treated as facets or aspects of human life, rather than as a condition for human life. Human life is seen as atomistic and individual. I as an individual opt to engage or not engage in human relationships.

Neuroscience and attachment science, as well as an increased influence of non-Western cultures in Western society, have challenged this approach. We know from neuroscience that we are born with an enormous amount of undifferentiated neurons (brain cells), and that starting at age 2 and continuing into early adulthood, the brain removes the unused neurons and reinforces the used ones (a process called synaptic pruning).

The idea here is that we are born with far more neurons than we need, and that our early childhood experiences, specifically before age 2, have a significant impact on our how our neural networks (the conneciton of various neurons to each other) develop. The environment of the first two years of life largely determines which neurons are used, and which are pruned. Once we are about 2 years old, these neurons are fairly set in place.

Attachment science has revealed this process in relationship. The way that our primary caregivers relate to us during the crucial first 2 years of life dramatically affects the way we connect, perceive our self and the world, and experience and regulate our emotions. Few things in the human experience has as significant an impact on our mental health and wellbeing as our attachment relationships early in life. And when we are wounded in our attachment, those wounds are carried throuhgout our lives until they can be repaired.

If we do not transform our pain, we will most assuredly transmit it

Fr. Richard Rohr

Our attachment wounds may go underground, but they don’t go away. Every relationship we form is colored by those essential first relationships. If our parents are “good enough” caregivers, we will enter into the world with a strong sense of self and the world, an ability to regulate our emotions, and self-esteem in our work. If our parents are inconsistent caregivers, we may develop an axious connection with them, and every ensuing relationship that follows. We cannot trust that our needs will be met consistently, and we cling and clutch to our loved ones for fear that they will not be there for us when we need them. Or, we may learn that our needs won’t be met adequately, and become dismissive about our own needs and emotions in order to protect ourselves from inadequate caregivers. If the pain is significant enough, we may struggle to organize our minds about relationships in a meaningful way, and vascilate between different strategies of protection.

This means that our struggle invaribly becomes relational. We find the people in our lives that we think can finally meet our needs. We try to build relationships with them. But we’re unable to form a secure enough bond to be healed, and the original wound is reinforced instead of repaired.

We repeat what we don’t repair

Christine Langley-Obaugh, MD

The assumption of relational psychodynamic therapy is that the past will be repeated in the therapy relationship, as it does in every other relationship. Freud refers to this as the Repetition Compulsion. Our unconscious is directing our life to repeat what has happened in the past in the hope of correcting or healing the original wound. The problem is that we often are defended against the wound, and our relationships are defended against their own woundedness as well, so that the repetition does not reach the intended goal, but rather simply repeats the wounding experience.

Transformation comes when the therapist and patient can “catch” themselves in this sort of enactment. Far from being an expert, the relational therapist expects that they will be “caught up” in the repetition with the patient. But when we catch ourselves, we become conscious of what has been happening below our conscious level of awareness. We can then embody a new way of being together, where the woundedness is not repeated, but repaired.

Neuroscience calls this neuroplasticity: the ability of established neural networks to give way to new ones. In attachment science, we are able to internalize a new relational object that is a “good enough” caregiver. Psychodynamic therapy claims that the unconscious repetition that we play out in all of our relationships produces a new, redeeming experience in therapy. As this repetition continues to produce a corrective experience in therapy, new neural networks emerge and new attachment figures are internalized leading to a greater level of integration, the ability to create meaning, and a healtheir experience of our self and the world.

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