Let the Evidence Show: Psychodynamic Therapy Provides Effective and Lasting Benefits
Psychodynamic therapy offers substantial and lasting mental health benefits
Posted Feb 01, 2010
For too long, psychodynamic therapists have been treated like the redheaded stepchildren of the mental health field.
Over the years, alternative psychotherapy models developed by charismatic personalities have sold their treatment packages with flashy marketing and media appearances. Each new form of therapy purported to be a panacea for all the mental health woes of the nation and marched under the banner "scientifically-based" while waiving a couple of clinical research trials demonstrating that their particular mode of therapy works better than a do-nothing control group.
Now to sell a product, it's not enough to say that the product is good. It needs to be newer, fresher, more cutting edge, and better than something else. After Coke, Pepsi was the fresh taste of a new generation. Or there's the young, hip Mac standing next to some old and inept PC.
Therapeutic innovators built virtual empires on peddling their new "state-of-the-art" wares in professional settings, in university classrooms, in bookstores, and in the popular media. Forget that antiquated Freudian stuff where you lie on the couch five days a week and endlessly spout about your childhood woes, they said, all that is "unscientific", "outmoded", and "ineffective".
The fact is that all forms of psychotherapy have the same roots: two people sitting down and working together to explore and find effective ways of coping with mental anguish, troubled lives, broken relationships, and physical effects of emotional ailments.
Time and again, it has been found that factors common to different types of psychotherapy are usually the most effective elements of change. Despite this, the world has largely bought into the business model that very specific therapies are needed to treat very specific disorders. Psychotherapy isn't the only field like this: just to go to your local pharmacy and see how many different types of cold medication there are in an entire aisle of the store.
For too long, psychoanalytic practitioners have let these problems fester. Many have remained ensconced in ivory towers, or holed up in upscale uptown offices, or walled off in selective secretive societies and psychoanalytic institutes. They felt no need to systematically study and present their work. They knew their methods worked, so why should they have to prove them to anyone? Research doesn't capture the complexity of deep psychological work, they argued. They talked in obscure jargon and psychobabble about Oedipal complexes and neuroses and penis envy. They forgot how important it was to communicate with the people that mattered, the everyday people in the world suffering with broken dreams and broken hearts.
Psychoanalysis was created over 100 years ago. Over that century, a lot of people whose names don't end with Freud have done a great body of work, development, practice, and public service. Across all this time, a new breed of psychodynamic therapy and psychodynamic therapists is emerging.
This new breed of clinicians and researchers appreciates that human beings are unique and have their own stories, but also that scientifically-informed observation and accountability is crucial for mental health care. They respect the importance of cost-effectiveness while also realizing that the real-life concerns of human beings can not nor should not be dismissed with a casual quick-fix. They realize that while deep, meaningful, and lasting change takes time, it doesn't mean that you have to be on the couch four days a week and take out a new mortgage to pay your therapy bill. They understand the importance of emotions and relationships in our lives. They recognize the need for clear communication with others in everyday language free of jargony psychobabble.
Yes, a new breed of psychodynamic therapy is emerging, and the professional community is starting to take notice. Last year, the Journal of the American Medical Association published a meta-analysis of multiple studies demonstrating that long-term psychodynamic therapy (weekly treatment lasting at least 50 sessions) is very effective for a range of complicated mental health conditions and is more effective than short-term treatments.
This month, American Psychologist, the flagship journal of the American Psychological Association, is publishing a paper titled The Efficacy of Psychodynamic Psychotherapy. "The American public has been told that only newer, symptom-focused treatments like cognitive behavior therapy or medication have scientific support," said study author Jonathan Shedler, PhD, of the University of Colorado Denver School of Medicine. "The actual scientific evidence shows that psychodynamic therapy is highly effective. The benefits are at least as large as those of other psychotherapies, and they last."
To back his claims, Shedler presents evidence from over 160 studies of psychodynamic therapy. His findings reveal that the treatment benefits of psychodynamic therapy are as large and lasting as those reported by other therapies, such as cognitive-behavioral therapy, that actively promote themselves as the only "evidence-based" options.
Effective therapists, Shedler says, are adept at psychodynamic principles such as "facilitating self-exploration, examining emotional blind spots, understanding relationship patterns". Furthermore, patients who receive psychodynamic therapy not only maintain the benefits of treatment, but also continue to improve after treatment ends.
"Accountability is crucial," said Shedler. "But now that research is putting psychodynamic therapy to the test, we are not seeing evidence that the newer therapies are more effective." Psychodynamic therapy is just one in a large family of therapy models that are designed to and are effective at alleviating emotional and interpersonal distress and improving people's lives.