Counselling Oxted – Dr Kimberley Carter

Many people will be new to the terms ‘psychodynamic counselling’ and ‘psychoanalytic psychotherapy’. Before we move on let’s define and demystify them.

Psychodynamic counselling is similar to psychoanalytic psychotherapy in that it is a form of talking therapy based on the theories and principles of psychoanalysis. But psychodynamic counselling is less focused on the client-therapist relationship, because it is equally focused on the client’s relationship with his or her external world. Psychodynamic counselling is usually shorter than psychoanalytic psychotherapy with respect to the frequency and number of sessions.

Psychoanalytic psychotherapy takes the counselling process further. The therapist will be actively listening to the client with a view to making connections between past and present, particularly with reference to experiences of loss and trauma very early in life. There will be a focus on the relationship between the client and therapist, as feelings about past relationships will most likely be re-enacted within the therapeutic relationship. This most likely goes on at a very unconscious level, and it is the job of the therapist to help the client become aware of what is going on, both within the therapeutic relationship and externally.

Psychoanalytic therapy seeks to facilitate deep and lasting change within, and to contribute to overall psychological well-being. Its focus is on the conflicts that prevent clients from succeeding rather than on advising on how to succeed, and to help clients understand and resolve the underlying dynamics which cause anxiety rather than giving techniques to control anxiety. The discovery of new and positive ways of dealing with long-standing emotional difficulties often leads to desired breakthroughs in behavioural change.

Counsellors are usually referred to as ‘counsellor’, and psychotherapists as ‘psychotherapist’ or ‘therapist’. The titles reflect the depth of, and length of, training. Some counsellors also refer to themselves as a psychotherapist, although they have not undertaken the additional training. At this point in time this misuse of title is not illegal, so when searching for professional help it is advisable to check out qualifications, with the necessary professional body.

Counsellors are qualified to work with clients only once a week; however, an accredited psychoanalytic psychotherapist can usually work with clients more frequently.

Therapists make an agreement to keep a certain time, or series of times, free for the client at regular intervals. This usually includes once or more in every week, except for weeks when the therapist is on holiday or there is an emergency such as the therapist becoming ill. Some clients prefer to make a contract for a certain length of time, to be reviewed at regular intervals.

It is standard professional practice to charge clients for missed sessions including the client’s holidays if the client cannot attend when the therapist is working. Therapists are expected to give clients reasonable (more than two months) notice of their own holidays so that clients can make arrangements accordingly.

A month’s notice of the ending of therapy is usually expected on both sides.

The overall emphasis in ongoing therapy is on the professionalism and reliability of the therapist, who will do all that is humanly possible to be consistently available to the client at the agreed times.

There is no set time frame. Each client comes to therapy in a unique personal circumstance and leaves the process when an individual form of successful outcome is achieved. Clients have a wide variety of goals; as they go through the process these goals can sometimes change, leading to the continuation of therapy for longer than originally expected, or an increase in frequency of sessions.

Quite simply: the greater and deeper behavioural change hoped for, the longer it will take. Before therapy, many people are unrealistic about the enormous difficulties in change progression and the patience and trust required to make it happen. Complete commitment and belief in the process are crucial for significant changes to be sustained over the long term.

Along with no set time frames, there are no shortcuts and no quick fixes. If a therapist promises you any of these, they will not have your best interests in mind.

As is standard across the profession worldwide, therapy costs in the local area are based on a therapist’s experience and qualifications.

In general, newly qualified counsellors and supervisors charge less than experienced clinicians.

Psychodynamic therapy is useful for a range of problems. These may be problems of behaviour, such as eating disorders or drug/alcohol abuse, but may also include problems with feelings such as anxiety, excessive anger and low self esteem. They may also involve problems from the past, such as abuse in childhood or the early loss of a parent or other family member.

It is not uncommon that psychodynamic therapy unveils multiple issues, some of which were totally unconscious at the beginning of the therapy. People who wish to understand why they behave or feel in certain ways and who wish to change themselves find that the process of learning about themselves, through talking with a psychodynamic therapist, can help bring about such change.