Many people seek psychotherapy as a way of getting help with a wide range of psychological problems. A multitude of therapeutic modalities currently exist, including those that focus narrowly on concrete behavior change (e.g., cognitive-behavior therapy) versus those that open up a broader range of interwoven themes affecting general psychological well-being (e.g., psychodynamic therapy).

Psychoanalytically oriented approaches to treatment include psychodynamic psychotherapy (a term largely used interchangeably with “psychoanalytic psychotherapy”) and formal psychoanalysis. These approaches can be particularly effective for addressing maladaptive or constricted engagement in one’s life (e.g.: insecure attachment, depressive withdrawal, anxious avoidance, low self-esteem, problematic relationship patterns, feeling stuck in motivation and work, unresolved grief, addictive tendencies, and feelings of meaninglessness).

In general, psychodynamic/psychoanalytic approaches transform painful feelings, thoughts, and behaviors by getting “underneath” the overt symptoms themselves and trying to understand the meaning, original cause, and current relational patterning of the symptoms. Psychodynamic theories share a core assumption that our ways of being in the world are guided by unconscious motivations, feelings, beliefs, conflicts, and compromises.

As people grow, even relatively benign, “normal” developmental pathways have experiences of emotional pain (e.g., jealousy at the arrival of a younger sibling, feelings of exclusion from the parents’ relationship, feelings of loss of a parent’s intimate affection as the child grows up, fears of being disappointing to others, humiliation of unrequited love). Every person finds ways of managing both these subtle emotional hurts, as well as more egregious traumas and abandonments through psychological avenues. A person’s “character” or personality includes those ways in which he/she manages or defends against painful emotions. Sometimes, the ways people manage feelings are inflexible and maladaptive to current circumstances, even though they may have been adaptive as a child.

The psychoanalytic treatment approach seeks to identify and understand our evolved manners of emotional self-protection, and then gradually open up alternative more adaptive means of affect regulation. Thus, one of the paramount aims of an analytic process is to loosen compulsive, rigid ways of responding to one’s interpersonal world, opening up freedom of choice and free will.

About the author:

Licensed psychologist Dr. Abigail McNally maintains a private practice in Harvard Square (Cambridge, Massachusetts) where she conducts psychoanalysis, psychodynamic therapy, and integrative therapy. In addition to a general focus on anxiety and depression, Dr. McNally maintains particular expertise in the treatment of personality disorders, eating disorders, and trauma. A graduate of the doctoral program in Psychology at Boston University, she has completed a post-graduate fellowship at the Massachusetts Institute for Psychoanalysis (MIP), where she is currently a fourth-year candidate in the General Psychoanalytic Training Program.

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