In this essay I mainly discuss the theory and concepts behind psychodynamic counselling, followed by brief discussions of the practice and skills involved in working as a psychodynamic counsellor, and the client’s experience of counselling.
Psychodynamic counselling is mainly concerned with unconscious processes; it takes for granted that humans possess a largely unconscious inner world. Freud argued that while the conscious mind is governed by logic, the unconscious mind is not, and functions in a very literal way, motivated only to experience pleasure, unable to delay gratification. Although Psychodynamic counselling works with the conscious mind, it mainly focuses on unconscious processes.
We have key figures in our lives – e.g. parents, carers, and partners – are referred to as ‘objects’, and relationships with them termed ‘object relationships’. The phrase ‘object’ refers to the Freudian concept of the target, or object of the instinct. Object relationships embody not only actual relationships but also the ways that the conscious mind distorts them. The unconscious is viewed as dynamic and purposeful, having huge impact on emotions and behaviour. Psychodynamic theory posits that humans are driven by a need to remain unaware of uncomfortable truths that emerge from the unconscious, experiencing many conflicting needs and demands, e.g. between one’s own wishes and those of others.
To deal with conflicts people develop ‘defences’, these include ‘repression’, a form of forgetting, ‘denial’, claiming that something is not upsetting when really it is, and ‘rationalisation’, where a story is created to account for that which feels uncomfortable. ‘Projection’ involves attributing to others characteristics unacceptable to the self, making assumptions about them based on the need to avoid threat. Psychodynamic counselling encourages the client to recognise and accept the troubling attribute, a process called ‘reintrojection’.
To engage in projection a defence mechanism called, ‘splitting’, is used when one is finding it too threatening to accept two opposing traits, such as being capable of both love and hate. It is natural to develop defences, but problems come with their overuse, e.g. using denial so often that problems are not faced. Applying defences too rigidly causes difficulties, and it’s when they start to disintegrate that individuals might seek counselling. Psychodynamic counselling holds that psychological symptoms emerge from the inner world. e.g., developmental problems or conflict may lead to anxiety or self-harm. The psychodynamic approach seeks to address these issues at their roots, as well as alleviating symptoms.
Psychodynamic counselling is based on developmental theory, and asserts that childhood experiences affect adult personality. It is understood that episodic memory is physically unavailable to children under three, but that implicit memory and body memory function from an earlier age. Neuroscience now supports the concept that early emotional experiences influence brain development; the psychodynamic approach posits that the client-counsellor relationship is crucial to the process of change.
This is considered in terms of three concepts, the first being transference: “All those impulses experienced by the patient in relation with the analyst which are not newly created by the objective analytic situation but have their source in early – indeed, the very earliest – object relations…”. The counsellor may become aware of feelings in him/herself indicating issues that the client is unable to express; this is ‘counter transference’. The ‘real relationship’ is that which is free of the previous two dynamics. Within the client-counsellor relationship, elements of the client’s inner world can be revealed and become available for healing (Howard, 2011, p.22-25)
Psychodynamic counselling employs a number of basic skills that are common to other approaches. It shares the core values of the Rogerian approach: empathy, congruence and unconditional positive regard. The ability to listen is of course crucial. Summarising and reflecting back to the client what s/he has said are necessary skills, as well as being able to say things that the client will find difficult to hear.
The following are skills specific to Psychodynamic counselling;
Gaining informed consent involves informing the client of the nature, risks and benefits of counselling at the appropriate time; not so soon as to scare him/her away, but in good time. For this purpose it is advisable for the counsellor to be aware of when the assessment phase is concluding, as this is the best time to invite informed consent.
The counsellor’s attention to the client is one element that facilitates change. The counsellor must alternate between close listening to the client and attention to how s/he will respond, alert to transference and counter transference. To be aware of both the conscious and unconscious elements of the client’s communication, the counsellor must practice ‘evenly suspended attention’.
The counsellor must listen to unconscious communication as well as the explicit information the client is presenting. This includes being able to consider why the client is behaving and speaking as they are, linking this to issues arising in transference, and being able to raise such issues with the client. The counsellor will also make interpretations based on ‘extra transference’ – grasping connections between events, thoughts and behaviour unrelated to the client-counsellor relationship.
The client’s experience
Initially a client experiences the formal behaviour of the counsellor, sessions have boundaries of time, space, and confidentiality and these factors contribute to a sense of safety and predictability. The client should come to feel ‘held’ by the counselling experience, enabling him/her to feel able to explore painful issues and memories: “a safe space to lower one’s defences, be vulnerable and be held together.” Receiving a counsellor’s undivided attention contributes to this; Dibs In Search of Self illustrates an emotionally deprived child’s first experiences of undivided and non-judgemental attention, enabling him to blossom in self-discovery.
A client goes through a process of developing informed consent, the transference relationship begins once enough trust is established, as it may be experienced as threatening. The client develops an attachment to the counsellor as someone who can help and care for them, and thus may become fearful both of their own needs and of being let down .The ending of the relationship can be painful for the client, and the counsellor should allow plenty of time to deal with issues around this.
In conclusion, psychodynamic counselling functions to bring to awareness of the unconscious processes that govern the client’s inner life. A variety of practices are employed in order to supply a client with a sense of security as well as a source of challenge in order to facilitate positive change.
AXLINE, V. M., 1990. Dibs, In Search of Self. London: Penguin
FREUD, A., 1937. The Ego and the Mechanisms of Defence. London: Hogarth
HOWARD, S., 2011. Psychodynamic Counselling in a Nutshell. 2nd edition. London: Sage.
HOWE, D., 1993. On Being a Client. London: Sage