What is Psychotherapy?

Psychotherapy is the treatment of psychological and interpersonal difficulties through psychological means.

Psychodynamic and psychoanalytic psychotherapy are largely open-ended, holistic approaches that explore how and why a person’s unconscious beliefs, thoughts, and feelings impact conscious ways of being. In these approaches, the therapist aims to help patients gain a clearer understanding of themselves, while reworking any underlying patterns that problematic symptoms may stem from and deconstructing psychological blocks that prevent a fulfilled life.

To do this, the psychotherapist typically encourages patients to talk freely about whatever is on their minds and how they are feeling during the session. This enables various patterns of behaviour, thoughts, beliefs, and feelings to emerge, allowing the dyad to discover how the patient organises their psyche and how this affects their interactions with their environment. In doing so, this process generally:

• Grows self-esteem,

• Fosters the ability to have more satisfying relationships

• Grows people’s capacity to build epistemic trust and securely attach

• Increases understanding of self and others.

• Grows people’s capacity to identify, regulate, and manage emotions

• Works through maladaptive psychological defence mechanisms and ways of coping and deconstructs maladaptive coping mechanisms

• Enables people to grieve and process traumatic and neglectful experiences

• Helps people to learn from experience, as well as to handle their social environment more effectively

• Builds one’s capacity to grieve and let go

Effectiveness / Research

Research into psychodynamic and psychoanalytic psychotherapy has shown that it is effective for a wide range of mental health illnesses and relationship difficulties to a similar degree as other widely used approaches.

A significant amount of trials show lasting outcomes for people struggling with mild-moderate mental health and relationship difficulties through brief engagements (roughly 36 weeks or 4-8 months).

Numerous studies show significant progress for more complex and chronic presentations (i.e., CPTSD, personality difficulties, attachment trauma, psychosis) with longer-term engagements (2-4+ years).

A significant number of these studies have also shown that improvements from psychodynamic and psychoanalytic psychotherapy persist after termination and have what some call a “sleeper affect”. In other words, the studies suggest that psychodynamic and psychoanalytic psychotherapy sets a range of psychological processes in motion that lead to ongoing change after treatment.

For more information about this research, see https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf. For a comprehensive list of randomised controlled trials of psychodynamic and psychoanalytic psychotherapy, follow this link https://www.researchgate.net/publication/317335876_Comprehensive_compilation_of_randomized_controlled_trials_RCTs_involving_psychodynamic_treatments_and_interventions

There is some recent research that suggests that psychoanalytic psychotherapy is just as, if not more, effective at treating people struggling with childhood and complex trauma. click here

Additionally, in his books "The Only Cure” and “The Hidden Spring”, Mark Solms argues that there is strong neurological and biological evidence for the model of the mind that Sigmund Freud developed through his observations in the early 1900s, and for its subsequent updates through various clinical observations over the past 120 years. (Note: the title of Mark Solms’ book, “The Only Cure”, alludes to the idea that symptom reduction is not a cure, but rather more like treating an illness with painkillers.)

Psychotherapy in Aotearoa New Zealand

In Aotearoa New Zealand, the word ‘psychotherapist’ is a legal term designated to therapists who are registered with the Psychotherapists’ Board of Aotearoa New Zealand (PBANZ). This means that registered Psychotherapists are a government-regulated profession, are bound by an ethical code of conduct, and must meet certain criteria to gain registration. This code of conduct incorporates the following principles (as defined by PBANZ):

• Mana Motuhake | Autonomy; To freely make judgements and act on decisions which are grounded in values of the profession and respect the right of each person, family or community to make decisions based on self-sufficiency and the ability to control their own destiny.

• Whakahonorētanga | Respect

• Tiaki | Duty of care: To actively regard and nurture the welfare of others, responding with compassion to their misfortune or suffering.

• Mana Tangata | Integrity: To strive to integrate expertise, care and respect in one’s professional self so as to demonstrate adherence to the values of the profession.

• Mahi Pono | Justice: To treat people fairly and appropriately in light of what is their due.

• Whānaunga | Community: To strengthen the bonds of those with a shared heritage or some shared common purpose.

• Ūkaipō | Nurture and sustenance: promoting a person’s well-being and taking full account of the people, places and traditions that nurture that person’s well-being.

• Manaakitanga | The process of showing respect

• Wairutanga | Spirituality: To respect the spiritual as well as the physical presence of people.

• Pūkenga | Expertise: To maintain and develop all aspects of psychotherapeutic expertise for the betterment of client, self and profession.

For more information about the Psychotherapist’s Board of Aotearoa New Zealand’s ethical code of conduct, click here.