Depth-Oriented Therapy for Meaningful Change

“Short Term” or “Brief" Therapy refers to 12 sessions or less.  

Any of the above therapies can be done in a short term way, including psychoanalytic therapy. Brief therapy is usually highly structured and has specified target goals.   Goals usually involve reduction of some symptom such as panic attacks, sleep disturbance, fear of flying, or something of that nature. When the symptom resolves or becomes less acute, the therapy is ended.

“Long Term” or “Open-Ended" Therapy refers to 12 sessions or more.  

The length depends on the individual person's issues and desires. It could be 6 months or it could be some years. Therapy might last longer because the problems are more complex and require a longer time to get resolved. Or it might last longer because there are profound positive life changes going on and the person wants to continue to improve.

There are some issues for which short term, structured therapies are very helpful and some for which they are not. For example, if a person has just been diagnosed with a serious medical problem, they might best be helped by structured techniques to manage fear, or guided imagery to boost immune functioning, or techniques to reframe panic-inducing perceptions. These are short term goals.

On the other hand, if that same person wants to reevaluate how they've lived their life so far, or if unresolved feelings from the loss of a parent have been opened up, or if they want to grieve the losses of health and safety and future that they might be feeling, a short-term therapy that targets surface thoughts or behaviors is not well suited for those goals. Goals like this involve self exploration, and self exploration requires a longer and more organic (less structured) inner process.

Longer term psychoanalytic therapy offers a context in which complicated or lifelong difficulties can be addressed in a deep enough way to create meaningful changes. It offers a chance to deal with things that, in my view, short term therapy cannot be very effective for. Some difficulties are complex enough that they cannot be resolved in a few sessions of therapy. Some examples:

• Inability to find or keep a committed relationship

• Fear of anger

• Mild to extreme self destructiveness

• Fears of closeness to others

• Intense emotional reactions that cause problems either internally or in relating to others

• Not living up to one’s potential

• Fear of conflict

• Anger problems

• Abusive childhood history

• A life that feels lacking in meaning

• Sexual problems

• Problems that remain despite working on them in other forms of therapy

A major appeal of longer term therapy is that it offers a depth of change that nothing else can. For people who feel ready to deal with things they haven't been able to overcome themselves or in other ways, psychoanalytic therapy offers them a chance to do that.

Psychoanalytic therapy can be done in a short term way and frequently is done in a short term way. Couples therapy, for example, is often shorter term. If the relationship is basically solid and the two people love each other and wish to stay together, areas of difficulty can often be worked through in a relatively brief time. 

Similarly if an individual is pretty satisfied in their lives overall but has one area that trips them up or causes pain, a brief psychoanalytic approach is often sufficient.

In short term psychoanalytic therapy, there is a more narrow focus on one or two specific goals. If the therapist believes the surface problems are connected to other issues that must be addressed as well, they can explain this to you. You can then decide for yourself.

In my view, of all the therapy approaches, the psychoanalytic approach is the most powerful for dealing with human complexities and contradictions. It can be a very meaningful and life changing experience to find someone who is interested in and trained in helping you get into sealed off areas of your psyche and helping you to understand them.  

• A good psychoanalytic psychotherapy experience can change your life in ways you might think unimaginable or impossible. You can become freer to flourish in all areas of your life. Love, family, friendships, physical health, financial security, occupational satisfaction, and all areas of living can become more fulfilling.

• A longer term analytic therapy is not so different in some ways from getting a college degree. They both require time, effort, and expense to get something that can change the course of the rest of your life.  

Empirical research over the years has show that psychoanalytically oriented therapies (psychodynamic, psychoanalytic, and psychoanalysis proper) are all effective for treating a range of problems and syndromes, from acute anxiety and depression, to personality disorder, manic-depression, and psychotic disorders.

Here are a few resources to better inform yourself:

1. The Neurobiological Underpinnings of Psychoanalytic Theory and Therapy

2. The Efficacy of Psychodynamic Psychotherapy

3. What Evidence is There to Support the Usefulness of Psychodynamic/ Psychoanalytic Treatment?

4. Tavistock Adult Chronic Depression Study

5. The Mechanisms of Change in the Treatment of Borderline Personality Disorder With Transference Focused Psychotherapy

6. Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study