How does depth psychology work

Deborah C. Escalante

Initially the unconscious was conceived in structural terms with much attention to the content, especially symbolic meanings; in the contemporary world this notion has been expanded to include the study of processes which operate outside conscious awareness. In general these psychologies see the human being as often divided against him or herself, with some thoughts, feelings, wishes, and memories accessible to awareness, and others hidden beneath the surface. By focusing on the unconscious, C. G.Jung, Sigmund Freud, and their followers worked to chart and delineate what lies outside of conscious awareness, and to illumine the dynamics between consciousness and what is extruded or not admitted to it, including collective aspects with cultural and archetypal dimensions.

What Depth Psychology Is

Through the study of dreams, images, symptoms, slips of the tongue, spontaneous humor, meaningful coincidences as well as interpersonal engagements, depth psychologists attempt to understand the language and the dynamics of the unconscious as it manifests in their work with clients and in the world. Depth psychological approaches to psychological suffering attempt to help individuals become aware of what has been cast out of consciousness or not yet able to be known. Healing is associated with allowing what has been repressed, rejected, denied or ignored to come forward so that the person can understand, explore its significance and integrate it, allowing for a transformation in consciousness. Depth Psychology also attends to the way unconscious processes express themselves in society and culture, and how culture affects the psyche.

Depth Psychology is an interdisciplinary endeavor, drawing on literature, philosophy, mythology, the arts, and critical studies. Concepts and practices at the core of depth psychology are central to Pacifica’s degree programs and each graduate degree’s curriculum is enlivened and deepened by the integration of its ideas.

“Depth psychologists…love to look for signs that ‘psyche’ is speaking to us, and one way we hear her voice is through the presence of synchronicities.”

“…this long marriage between myself and depth psychology has been possible because I found in depth psychology a basic orientation to being that seeks to allow what is to be present in its animation and its difference. It is a desire for the liberation of being.”

Efficacy of Depth Psychology

Evidence for the efficacy of depth psychological approaches to psychotherapy is growing as studies show that depth psychology has a longer-lasting and more profound impact than cognitive or behavioral psychologies alone. Depth psychological approaches to psychotherapy are now joined by depth psychological approaches to community, cultural, and ecological issues. Pacifica students and graduates help the field evolve through their scholarship, creative work, and actions in the world.

Contemporary Evidence-Based Research for Depth Psychology

The following list is of some selected, peer reviewed scholarly articles and summaries from the mainstream media (e.g., New York Times, the Guardian). This is offered in the spirit of supporting diversity through contemporary research validating the noble traditions of depth psychology. It highlights the clinical and scholarly affirmation of depth psychological approaches that attend to unconscious processes, relational aspects of treatment, psychic complexity, and embodied experiences.

Abbass, A. A., Hancock, J. T., Henderson, J., & Kisely, S. R. (2006). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews. Retrieved from http://www.cochrane.org/CD004687/DEPRESSN_short-term-psychodynamic-psychotherapies-for-common-mental-disorders

American Psychological Association. (2013). Recognition of psychotherapy effectiveness. Psychotherapy, 50(1), 102–109. Available at: http://www.apa.org/about/policy/resolution-psychotherapy.aspx

Anton, B. (2015, October 14). Talk Therapy Works. The New York Times. Retrieved from http://www.nytimes.com/2015/10/14/opinion/talk-therapy-works.html

Burkeman, O. (2016, January 7). Therapy wars: The revenge of Freud. The Guardian. Retrieved from http://www.theguardian.com/science/2016/jan/07/therapy-wars-revenge-of-freud-cognitive-behavioural-therapy?CMP=share_btn_link

Chiesa, M. (2010). Research and psychoanalysis: Still time to bridge the great divide? Psychoanalytic Psychology, 27(2), 99–114. http://doi.org/10.1037/a0019413

Cohler, B. J., & Galatzer-Levy, R. (2007). What kind of science is psychoanalysis? Psychoanalytic Inquiry, 27(5), 547–582. Available from: https://www.researchgate.net/publication/247527419_What_Kind_of_Science_Is_Psychoanalysis

Cornelius, J. T. (2014, Oct. 7th). The Case for Psychoanalysis (Version 4). Retrieved from https://youtu.be/IQBx5TONHac

Evidence base of psychoanalytic psychotherapy. Institute of Psychoanalysis. Retrieved from http://psychoanalysis.org.uk/resources/evidence-base-of-psychoanalytic-psychotherapy.

Fonagy, P., Rost, F., Carlyle, J., McPherson, S., Thomas, R., Pasco Fearon, R. M., … Taylor, D. (2015). Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry, 14 (3), 312–321.

Gaskin, Cadeyrn (2014). The effectiveness of psychoanalysis and psychoanalytic psychotherapy: A literature review of recent international and Australian research. PACFA. Retrieved from http://www.pacfa.org.au/wp-content/uploads/2012/10/Psychoanalytic-Review-V2-Ready-to-design-Final.pdf.

Gerber, A. J., Kocsis, J. H., Milrod, B. L., Roose, S. P., Barber, J. P., Thase, M. E., … Leon, A. C. (2011). A quality-based review of randomized controlled trials of psychodynamic psychotherapy. The American Journal of Psychiatry, 168(1), 19–28. Available from: http://academiccommons.columbia.edu/download/fedora_content/download/ac:145066/CONTENT/appi.ajp.2010.08060843.pdf

Keller, W., Westhoff, G., Dilg, R., Rohner, R., & Studt, H. H. (2002). Efficacy and cost effectiveness aspects of outpatient (Jungian) psychoanalysis and psychotherapy–A catamnestic study. In M. Leuzinger-Bohleber, M. Target, M. (Ed) Leuzinger-Bohleber, & M. (Ed) Target (Eds.), Outcomes of psychoanalytic treatment: Perspectives for therapists and researchers. (pp. 186–197). Philadelphia, PA: Whurr Publishers.

Lazar, S. G. (2010). Psychotherapy is worth it: A comprehensive review of its cost-effectiveness. Washington, DC: American Psychiatric Publications.

Leichsenring, F., Leweke, F., Klein, S., & Steinert, C. (2015). The empirical status of psychodynamic psychotherapy—An update: Bambi’s alive and kicking. Psychotherapy and Psychosomatics, 84(3), 129–148. Available from: http://www.eegym.com/wp-content/uploads/2015/03/Leichsenring2015ESTreview.pdf

Leichsenring, F., & Klein, S. (2014). Evidence for psychodynamic psychotherapy in specific mental disorders: A systematic review. Psychoanalytic Psychotherapy, 28(1), 4–32. http://doi.org/10.1080/02668734.2013.865428

Leichsenring, F., & Leibing, E. (2007). Psychodynamic psychotherapy: A systematic review of techniques, indications and empirical evidence. Psychology and Psychotherapy: Theory, Research and Practice, 80(2), 217–228. http://doi.org/10.1348/147608306X117394

Levy, R. A., Ablon, J. S., & Kächele, H. (2012). Psychodynamic psychotherapy research: Evidence-based practice and practice-based evidence. New York, NY: Humana press.

McGowan, K. (2014, April). The second coming of Sigmund Freud. Discover Magazine. Retrieved from http://discovermagazine.com/2014/april/14-the-second-coming-of-sigmund-freud

Mishna, F., Van Wert, M., & Asakura, K. (2013). The best kept secret in social work: Empirical support for contemporary psychodynamic social work practice. Journal of Social Work Practice, 27(3), 289–303. http://doi.org/10.1080/02650533.2013.818944

Richards, G. (2008). Jung’s social psychological meanings. Journal of Community & Applied Social Psychology, 18(2), 108–118. http://doi.org/10.1002/casp.967

Roesler, C. (2013). Evidence for the effectiveness of Jungian psychotherapy: A review of empirical studies. Behavioral Sciences, 3(4), 562–575. Available from: http://www.mdpi.com/2076-328X/3/4/562/htm

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. Available from: http://jonathanshedler.com/PDFs/Shedler%20%282010%29%20Efficacy%20of%20Psychodynamic%20Psychotherapy.pdf

Shedler, J. (2015). Where is the Evidence for “Evidence-Based” Therapy? The Journal of Psychological Therapies in Primary Care, 4(1), 47–59. Available from: http://jonathanshedler.com/wp-content/uploads/2015/07/Shedler-2015-Where-is-the-evidence-for-evidence-based-therapy-R.pdf

Where the power lies in the therapist-client relationship. (2016, January 12). The Guardian. Retrieved from https://www.theguardian.com/science/2016/jan/12/where-the-power-lies-in-the-therapist-client-relationship

Whether to pick sides in psychology today. (2016, January 12). The Guardian. Retrieved from https://www.theguardian.com/science/2016/jan/12/whether-to-pick-sides-in-psychology-today

Related Bibliographies:

American Psychoanalytic Association:

American Psychoanalytic Association:

CORE Research Bibliography.

Committee on Research Education Bibliography 2015.

British Psychoanalytic Council:

Research and Evidence.

Contemporary Freudian Society:

Effectiveness of Psychoanalytic Psychotherapies.

Surreal artistic portrait of silhouette inside swirling lightDepth psychotherapy describes a range of approaches to therapy that take the unconscious into account, rather than one specific modality. This interdisciplinary approach to treatment is based on the idea that all people possess traits or elements of nature that may influence, often unconsciously, their natural processes.

These processes—such as the ability to feel, choose, work, love, or think freely—may be affected negatively by certain of these elements, and people may seek treatment in order to resolve distress experienced as a result of any unbalanced processes. Depth therapies may help individuals explore and consciously realize those forces having an effect and study them in order to better understand their present situation. 

Development and Theory of Depth Therapy

The term “depth psychology” was first used at the end of the 19th century by Eugen Bleuler, director of Zurich’s Burghölzli Asylum (at which Carl Jung later practiced psychiatry). Pioneers in the field such as Carl Jung, Pierre Janet, and Otto Rank contributed to current usage of the term, which is to broadly describe those therapy and research approaches attempting to explore the depths of the unconscious mind. These approaches combine elements of psychoanalysis and Jungian psychology, with transpersonal psychology and existentialism among the other notable influences. 

Depth therapy can describe several models of therapy, but it is divided into three main schools: psychoanalysis, individual psychology, and analytical psychology. Psychoanalysis is based on Sigmund Freud’s ideas, individual psychology on Alfred Adler’s, and analytical psychology, Carl Jung’s. 

Find a Therapist

Advanced Searchpsyche is a partially conscious and partially unconscious process that stores experiences that have been repressed and personal concerns as well as collective and archetypal “forces.” Depth psychology considers what is referred to as the soul, or the point of interaction between the psyche’s transpersonal and personal aspects, to be an essential part of the discussion in a therapy session. Engaging and incorporating the unconscious psyche into treatment is an essential tenet of depth therapy, as uncovering the layers of the psyche is believed by depth psychologists to be an important component of increased emotional well-being, self-discovery, and growth. 

How Does Depth Therapy Work? 

Depth therapy sessions are conducted individually. The bond between the therapist and person in treatment is particularly emphasized in depth therapy approaches, as the exploration of the unconscious may necessitate high levels of trust and acceptance. A session may involve the exploration of current life events as well as past experiences; in either case, the therapist supports the person in treatment through the process of self-awareness and inner wisdom of the client.

Therapists may help those in treatment through the exploration of any unconscious conditions, offering support and guidance as the individual examines and ponders them in order to understand them fully. The new information may then be used as a tool for the development of more positive traits and elements that can be integrated first on the conscious level and eventually on the unconscious level. 

Techniques used in depth therapy to facilitate growth and change include:

  • Socratic questioning, which involves the therapist asking the person in treatment a series of warm and gentle, but also challenging, questions. These questions are used to help people develop an increased awareness of their unconscious motivations and early experiences. Later in therapy, Socratic questioning may be used to help people identify alternative and more rational plans for actions, when actions may otherwise be overly influenced by unconscious factors.
  • Guided and eidetic imagery, which is used by the therapist to guide an individual through exploration of the full sensory experience of early memories. Through detailed exploration of any experiences that led to feelings of inferiority or discouragement, the therapist can help elicit awareness and offer support and encouragement as the person in therapy remembers early images.
  • Role playing future scenarios, which can provide a safe place for those in therapy to practice alternative and rational plans for action. Role playing can include practice with progressively more challenging scenarios, so individuals can have the opportunity to practice new behaviors and ways of thinking with the support and acceptance of the therapist. 

What Issues Can Depth Therapy Help With?

Individuals with deep-rooted emotional concerns, trauma, or issues they do not fully understand may find depth therapy to be a beneficial mode of therapy. Those who experience depression, anxiety, relationship issues, sexual concerns, compulsions, or a variety of life challenges may be able to explore and understand the roots of these difficulties through depth therapy. Generally, depth therapies do not focus on a specific problem or issue, instead seeking to address the entire scope of an individual’s conscious and unconscious emotions.

Individuals wishing to spend time more deeply exploring the things that led them to seek treatment may find depth therapy a useful approach. Studies have shown depth therapy may have long-lasting, significant results. It is typically a lengthier approach than solution-focused therapies, and individuals wishing to spend time more deeply exploring the things that led them to seek treatment may find depth therapy a useful approach. One outcome that may often result from depth therapy is an increase in self-awareness and a deeper understanding of the self. Those who are experiencing difficulty understanding their life purpose or are searching for a sort of higher calling may seek out some form of depth therapy to gain insight into their unconscious conditioning. As a result, they may feel a greater sense of authentic self and an increased sense of liberation from the concerns affecting them and may find themselves with an increased capacity to maintain strong, healthy inter- and intrapersonal relationships. 

Depth therapy requires individuals to engage in abstract thinking. The techniques used call for those in therapy to consider multiple meanings of concepts, explore patterns in their behavior, and consider non-literal meanings. Sometimes people are unwilling, unable, or would simply prefer not to engage in abstract thinking, and depth therapy may not be ideal for those who prefer a more concrete approach to therapy. 

Training for Depth Therapy

Depth therapy is typically offered by mental health practitioners called psychotherapists. Depth therapy is just one type of treatment a therapist may offer. The American Psychoanalytic Association regulates training programs through which practitioners can become certified in the practice of depth therapy. Certification in psychoanalysis typically takes at least four years of extensive study. 

In order to participate in a program accredited by the American Psychoanalytic Association, an individual must hold one of the following degrees:

  • Doctor of Medicine (MD)
  • Doctor of Osteopathic Medicine (DO)
  • A PhD in psychology, social work, or another mental health discipline 
  • A master’s degree in a related field in which the master’s degree is the highest clinical degree, such as marriage and family therapy or psychiatric nursing

Concerns and Limitations of Depth Therapy

Depth therapy is typically a lengthy and relatively expensive form of therapy. Before starting depth therapy, the therapist should share information about the potential costs associated with the treatment. Individuals seeking therapy should also be aware that other forms of treatment may address the issues prompting them to seek treatment in a shorter period of time. Due to a desire to decrease the cost of health care, many insurance companies require providers of therapy to conduct planned and time-limited therapy. Depth therapy is not well-suited to the constraints of many health insurance companies, and people seeking treatment should be aware their treatment may not be covered by insurance. 

Historically, the various forms of depth therapy were used to treat a number of mental health conditions, but according to recent studies, as well as anecdotal evidence from mental health practitioners, depth therapy may be better suited to some individuals than others. These approaches typically involve intense emotional work and require a high level of motivation on the part of the individual participating in treatment. Some individuals may prefer a briefer, more solution-focused treatment approach. Depth therapy also requires people to confront feelings and memories that may be painful, and those participating in depth therapy should understand the approach will likely elicit strong, potentially negative emotions and that they may feel worse before they begin to feel better. 

References: 

  1. American Psychoanalytic Association (n.d.). Careers in psychoanalysis. Retrieved from http://www.apsa.org/content/careers-psychoanalysis-0
  2. Gundry, M. (2014, January 10). Exploring depth psychotherapy. Retrieved from http://markgundry.com/2014/01/exploring-depth-psychotherapy
  3. Depth psychology. (2013, August 14). In New World Encyclopedia. Retrieved from http://www.newworldencyclopedia.org/entry/Depth_psychology 
  4. Hoffman, L. (2004). Depth psychotherapy. Retrieved from http://www.existential-therapy.com/topics-in-existential-thera/depth-psychotherapy.html
  5. Perry, W. (2008). Basic counseling techniques: A beginning therapist’s tool kit. Bloomington, IN: AuthorHouse.
  6. Stein, H. T. (1997). Stages of classical Adlerian psychotherapy. Alfred Adler Institutes of San Francisco & Northwestern Washington. Retrieved from: http://www.adlerian.us/stages2.htm
  7. What is depth psychology? (n.d.). Retrieved from http://www.pacifica.edu/about-pacifica/what-is-depth-psychology

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