Harmony SeekerPsychodynamic therapy is blowing my mind a bit. The complexity of unconscious processes, transference, and early relational patterns makes me pause and really reflect. Every class leaves me contemplative, with more questions than answers. I love that. These ideas feel alive, like something I can sense and feel in myself and others. I am finding lectures so inspirational. They are changing how I think about people, pain, and connection. I received some good feedback after a exercise where I hat to reflect back emotions. #PsychodynamicTherapy #CounsellingStudent #MentalHealth #TherapyTraining #Reflections #StudentLife #Psychotherapy
Tech Singer@HarmonthSeeker Like everything on social media, you can completely ignore this if you like. I ask because I'd appreciate hearing your views, I'm just curious. You have no duty to share your views, obviously. Having said that, is the lack of evidence and the replication issue not a problem for you? Having read some of this stuff, frankly, it just seems to be based on somebody's opinion, not something I can verify for myself, or even verify in principle. Indeed, sometimes I can't seem to see the basis for an opinion, I keep wanting to ask "what makes you think that" or "how do you know that"?
@techsinger I really appreciate the way you’ve asked this. These questions matter and I’ve been thinking about them a lot too.
I think the lack of replication and evidence is a valid concern, especially from a scientific or empirical standpoint. For me, psychodynamic approaches try to make sense of something more fluid and less measurable. Our inner lives, our relationships, what we repeat without knowing, what we defend against feeling.
I've had moments where I’ve asked those same questions. What’s shifted for me is how much those questions are part of the process rather than something to be solved. The value is in the questions themselves.
#Psychotherapy #Psychodynamic #CriticalThinking #Reflections #StudentLife
@HarmonthSeeker Granted. Having said that, though, the problem for me here is that it is authoritative, or supposed to be authoritative. The basis, though, is a bit more shaky than I would like. Other things are authoritative, but though I may not be able to verify every part of them, I can verify a good deal myself and can verify even more by talking to other people who can provide reasons for what they think. I bring to mind that people really did think phrenology was a science in the late 1800s :) Thanks for letting me know about your opinions on this, I have never studied it but have done a good deal of reading and it's interesting to hear from someone who is actually studying it systematically.
@techsinger Thanks, I really value this exchange.
Contemporary psychodynamic theory has shifted quite a lot from the classical model. It’s no longer focused on instinct theory or claims about drives. Modern developments draw more from attachment theory, relational perspectives, and neuroscience. Much of the theory now focuses on how early relationships shape emotional development, how unconscious patterns form, and how these play out in therapy and in daily life.
Some approaches influenced by psychodynamic thought, like mentalisation-based therapy or affect regulation theory, are being studied with more empirical rigour. They’re not perfect, and they’re still developing, but they aim to connect with current research in developmental psychology and trauma studies.
So while the roots are tangled and historical, what has grown from them is often grounded in present-day relational and developmental understanding. Thanks again for the thoughtful critique.
@HarmonthSeeker Again, it's a pleasure to talk with someone who is actually studying this practically. I agree that there has been an attempt to push towards a bit more rigor than the historical texts, there's no comparison between, say, what was published in the 30s and what's being published now, I was amazed at how conclusory and anecdotal the older stuff is, honestly. There's quite a bit of it on archive.org, if you want to have a quick look to see how things have changed. Having said that, the new stuff is a good deal more wordy, but is it really more based on what you might call solid fact? I am often reminded of what the universities here teach as "political science", I'm not sure what name they give it in your area, I know English speaking countries differ on the wording. Basically, it tries to understand patterns in politics. Let's just say it's not terribly successful :) It's a good deal more successful when considering policy, but if you look at the record on higher level and more general understanding of the political process, it's obvious that people are just guessing really hard and hoping for the best. Is the whole psychodynamic project exactly like that? I don't think so. Is it very far off from that? Honestly, I don't know. I'm tempted to say no. There is still far too much guessing, unfortunately, which is fine I suppose, people need to make money somehow. The difficulty I have isn't so much with the guessing but the guessing dressed up as something that can help a significant number of people. Basically, the theory wouldn't be hurt by a massive dose of humility. On the other hand, you could very reasonably tell me "who cares?". Nobody is forced to speak to a therapist, let alone buy into it, nobody is saying that astrology should either become more rigorous or be outlawed, after all. If people find it helpful, why not? This is leaving aside, of course, what I've heard when some people express their emotions where "you should go to therapy", is code for "I don't want to hear about this, shut up and go to someone who is paid to listen". That has nothing to do with psychodynamic theory, or any theory of therapy, it's just people dressing up their disinterest so that they don't have to acknowledge that they don't care about the person who's talking. No blame rests on the theory there except, maybe, the blame of claiming too much. Again, though, nobody is forced to believe the claims.
@techsinger Thanks again for this thoughtful reply. I’m really enjoying this exchange, and I agree with much of what you’re saying. The shift from older psychodynamic writing to the current literature is definitely noticeable. Some of the early texts feel like personal reflections. The newer material is more complex and reflective, although I still find myself wondering whether the complexity adds clarity or disguises the same issues.
I also agree the field could benefit from a bit more humility. Some of the claims are ambitious, especially considering the difficulty of verifying them or measuring outcomes consistently. Personally, I prefer a more holistic approach to therapy where the whole person is respected, not only their past or their unconscious processes. I’m at the beginning of my training and my course is integrated, so we’re learning a range of theories. I also speak from lived experience, having been in therapy for several years, so I’m coming to this as a student and as someone who’s been on the other side of the process.
One issue that rarely gets addressed is access. In Australia, psychodynamic therapy can be $200 a session. Traditionally, it’s twice a week, and eventually reduces to once a week. That cost makes it inaccessible for many, no matter how helpful it might be. Your comparisonwith political science made me smile. There’s a lot of interpretation and definitely some wishful thinking involved. And like you said, there’s nothing wrong with trying to understand something complex, as long as it doesn’t get sold as certainty or truth. I also really agree with your point about “go to therapy” sometimes being code for “I don’t want to deal with you.” That has nothing to do with therapy itself, and everything to do with how people misuse it socially.
@HarmonthSeeker I had to laugh at your wondering "whether the complexity adds clarity or disguises the same issues.". That puts it very well, I think. I don't remember the author who said that, whenever he saw a restaurant which put tons of sauce on the food, he knew the food wasn't going to be cooked well. He had a point, sometimes adding more of anything just hides what was already a problem. Are the new authors just putting sauce on the badly-cooked food, or are they actually following a new recipe? I don't know, but it's worth keeping in mind that sauce is both cheaper and easier than redesigning your recipes. As for cost, all I can say is that it's not only an Australian issue, by any means. It's a problem wherever I look, and it's not really a psychodynamic problem, I think. It's a therapy problem, with either very few sessions, very long waiting lists, very high costs, or a pleasing mixture of all three. You could say "well, who cares? Therapy isn't worth much anyway, if people want to waste their time and money, it's their business and why should the government or insurance do it?". You could also say "even assuming therapy is helpful, lots of things which are helpful are available to the rich but not available to the poor. What makes therapy so special?". I do see the point of both those arguments, I'm not saying they're completely wrong, but I also see that the expense does do some harm, at least to the therapy providers themselves. When all you see are the problems of the rich, you think solving them for everyone is easier than it is, and you think most problems are like the ones you see. We have the same problem as blind people. I have never spoken to a therapist professionally, so this is from other peoples' experience which they've told me and mentioned publicly. The problems of being a blind person are sometimes so specific that when people go to therapy and want to discuss issues which are connected to blindness specifically, the therapist is obviously out of his depth. One guy said something like "I spend more time teaching my therapist than anything else". For blind people, that's not a solvable problem, there are just too few of us. I've actually read of people who say they specialize in disabilities, but that's like a store saying it specializes in "clothing". Anyhow, however that may be, the cost isn't just a problem for the users, it's a problem for the service itself. Obviously, though, there's a market, even at the high prices.
@techsinger I really appreciate everything you’ve shared here. There’s so much I agree with, especially around cost, access, and the illusion that more complexity equals more insight.
Cost is a systemic issue. It's not unique to psychodynamic therapy, and not only an Australian problem. People who need support are being left out. I think mental health shapes everything we do, and the lack of access reinforces inequality.
When therapy is only available to a narrow slice of people, it skews what therapists come to see as “normal” or “universal”. And for disabled clients that disconnect is even sharper. I’ve been in therapy for years and have absolutely had experiences where my blindness was misunderstood or dismissed. Some therapists genuinely want to understand, others are clearly uncomfortable or avoidant. And like you said, when someone ends up teaching the therapist more than receiving support, the balance of the work is lost. That kind of labour shouldn’t fall on clients, but it often does.
That’s part of why I want to offer online and phone counselling once I’m qualified. I want to work with people who can’t do in-person sessions, who need flexible options, and who might have felt shut out or misunderstood by traditional services. I’m training as a counsellor (rather than psychologist) partly for this reason. Counsellors can set lower rates and work with a wider range of clients. I also plan to offer a sliding scale.
You’re right too about the term “disability specialist” being far too broad. It’s meaningless without context. Blindness is its own world, with distinct realities, and it can’t be lumped in with every other form of disability as if it’s all the same. I don’t know the answer but I do know that we need more disabled voices in therapy.