“Talk is powerful medicine.” Renowned researcher and clinician Jonathan Shedler, Ph.D., joins us to discuss the effectiveness of psychodynamic psychotherapy. While so-called evidence-based therapies—brief treatments conducted by instruction manuals—offer benefits for some, their status as the “gold standard” of treatment for mental distress is undeserved.
Dr. Shedler’s 2010 paper, “The Efficacy of Psychodynamic Psychotherapy,” is the most widely read psychoanalytic paper of our time. It’s been downloaded more than a quarter of a million times and has been cited by thousands. He discusses this influential work with us, including the finding that those who engage in psychodynamic psychotherapy not only improve by the end of treatment but continue to make gains even years after therapy is finished. According to Shedler, “psychodynamic therapy sets in motion psychological processes that lead to ongoing change, even after therapy has ended.” Jung tells us that we don’t solve our problems so much as grow larger than them. There is good empirical evidence that psychodynamic psychotherapy does indeed help us to grow.
Here’s the dream we analyze:
“I am in a snowy place with my mom. We are leaving one chalet to go to a different one to meet up with other family members. While packing up to leave, I am preoccupied with a lost sweater. My mom is angry at me for wasting time. I love the sweater; it’s beautiful, and I wanted it for a long time before I got it. I gradually accept that the sweater is now gone, but I’m really sad about it. Then we get into the car. We are both in the back seat of the car talking to each other, and it takes a few minutes before we realize that the car is driving itself. I am not bothered by this; I seem to intuit that the car will take us to the right place, or at least that it knows where it’s going. But my mom is once again angry at me for not driving it. I cannot drive it because my leg is injured. It is this anger–as she realizes that I’m not driving the car–that seems to make the car stop, and then we are stranded in the middle of the road.”
RESOURCES:
Dr. Shedler’s https://jonathanshedler.com/
Seven Principles of Psychoanalytic Psychotherapy: https://www.youtube.com/watch?v=YNWy1ksxIDo (video)
That was then, this is now: An introduction to contemporary psychodynamic therapy: https://jonathanshedler.com/wp-content/uploads/2020/07/Shedler-That-was-then-this-is-now-R10.pdf
The tyranny of time: How long does effective therapy really take?: https://www.psychotherapynetworker.org/magazine/article/2436/the-tyranny-of-time/5d2ed7b6-3a2a-4c7c-b491-2a2742748e83/OIM
The Efficacy of Psychodynamic Psychotherapy: https://jonathanshedler.com/PDFs/Shedler%20%282010%29%20Efficacy%20of%20Psychodynamic%20Psychotherapy.pdf
Follow Dr. Shedler on Twitter: https://twitter.com/JonathanShedler
Learn to Analyze your own Dreams: https://thisjungianlife.com/enroll/
Loved thus, but where is Deborah Stewart this week?
Deb is well and was visiting with family. She’ll be back next week.
~ Joseph
Good morning Joseph, Lisa and Deb.
This was a thought provoking episode. I’m a teacher and I can draw a lot of parallels with what is happening in education today. In just asking the question, “Does analysis work?” we are forced to come up with some kind of measurement system to answer it. Of course, the measurement systems that we construct can never take into account the entire situation of the individual because so many factors which cannot be separated are always in play. I think that we have to always be aware of making systems that fundamentally cannot measure what our ego, left-brain, rational mind (whatever you want to call it) desperately desires to measure. My mother always used to say, “What’s the PERFECT flavor of ice cream?” She would always pose this question when my rational mind all too often ran away with itself. What she was saying was that not everything can be reduced to rational measurement. You circumambulated but never really touched on what it means for analysis to WORK or be successful. What does it mean for analysis to be successful? What do we mean by “successful?” The analyst, the analysand, the society in which we live all have different ways of measuring success and they may not be “rational” ways at all. Success may not fit into the box that we assign to it. It’s the same in education today. People want to have the CERTAINTY that teachers are “effective” and so there are rubrics and models that purport to measure that effectiveness. But teachers know that those rubrics do little to explain anything about teaching and learning. And often the teachers who actually teach have no input whatsoever into the creation of these rubrics so that their whole field of direct experience has no say in the matter. I remember teaching at a massage school (I’m also a Licensed Massage Therapist.) and I remember the school wanting to have rubrics for the students as to what constitutes a “great” massage!!! So, I think we always have to be aware of this tendency we have to nail down and be certain in areas where subjectivity, emotion, relationship and the importance of direct experience come into play. It’s kind of like the story you told, Lisa, about your experience with your “psychotic” patient who lived in fear of her life in her housing situation. All the doctors could see was their own idea of what “success” for her should be and that was to just take her pills. This also made me think about you presentation last night at OFJ and how you try to reduce the working of the psyche and dreams to materialistic brain function. Although, I imagine that you don’t think the psyche can totally be reduced to brain function (?). I always think about this relationship between brain function and the psyche which even Jung thought were two different things – that is, that psyche or consciousness is not an epiphenomenon of the brain. Of course, there is an interrelationship between brain function and consciousness but we’re just at the infancy stage of this kind of research which I find fascinating. I often wonder about this question because it seems to me like the rational, left brain once again wants to take the reductionist view that everything can be explained by a physical, material process (what happens “in” the brain). Let’s say that we were to find (which I don’t think we will) that consciousness is an epiphenomenon of the brain and that every thought, feeling and emotion that “happens” in the brain can be known or discovered in the end. Well, what would humans do with this information? Where does that take us? How would we USE that information and what would we do with it? Would it make our lives better or worse and how? I think anyone who had had a numinous experience (example, Jill Bolte-Taylor) that widens his/her consciousness instinctively feels that consciousness or psyche (whatever words we want to use)is beyond just the physical. Now, is this experience just due to chemicals in the brain and brain function? That’s something we’ll be studying for a long time. I find it all fascinating and thank you for your wonderful talk last night at OFJ.