Irvin Yalom on what's wrong with psychodynamic psychotherapy

Early in 2003, it occurred to me that the most likely outcome of psychodynamic psychotherapy was that the therapist would feel clever. Although cynical in tone, I believe the statement contained a core of truth. I was pleased, therefore, to read in Irvin Yalom's The Gift of Therapy, the following paragraphs.

In an experiment I described earlier, in which a patient and I each recorded our views of each therapy session, I learned that we remembered and valued very different aspects of the process. I valued my intellectual interpretations whereas these made little impact on the patient, who valued instead the small personal acts relevant to our relationship. Most published firsthand accounts of psychotherapy point to the same discrepancy: Therapists place a far higher value than patients on interpretation and insight. We therapists grossly overvalue the content of the intellectual treasure hunt; it has been this way from the very beginning, when Freud got us off to a bad start with two of his enticing by misguided metaphors.

The first was the image of the therapist-cum-archaeologist painstakingly brushing the dust off buried memories to uncover the truth—what really happened in the patent's early years: the original trauma, the primal scene, the primordial events. The second metaphor was that of the jigsaw puzzle. Find only the last missing piece, Freud suggested, and the entire puzzle will be solved. Many of his case histories read like mysteries, and readers eagerly push ahead, anticipating a juicy denouement in which all riddles will find their solution.(pp174-5).

Author: Steven Bagley

Date: 2017-05-28 Sun