Book Review: Long-Term Psychodynamic Psychotherapy

First – I’m really curious to see if ANYONE reads this review.  I mean really – with a title like that – how many people are really going to find this on a google search?  This isn’t exactly a popular topic. Hunger Games and Honey Boo Boo it ain’t.

But – I read it – it helped me, and here’s what I thought.

The author did a good job writing about a topic that few would read past the first page. 

The first topic?  MISCONCEPTIONS.

They explain that it isn’t about the stone faced therapist, sitting mostly in silence and only speaking to say “mmm-hmm” or to ask about the patient’s sexuality.

It’s about the relationship between the therapist and the patient.  They’re both real people – both have backgrounds and upbringings and biases and conversation styles and patterns and soft spots and rough edges etc…

The author explained Klein, Freud, Kohut, Bolwby, Stern and others.  But none of them are God; none should be followed precisely.  They are people who had theories, and their theories taught us something.

This book helped me the most by teaching me what NOT to do.  Don’t over analyze, don’t interpret too quickly.  If the patient says I remind them of their father, just leave it alone.  If they mention a past experience, just listen.  Once they mention the same subject 3 or 4 times, once a pattern is readily apparent - then bring it up.  Don't assume to know what it means - just bring it up.  Sure I'll have idea and theories, but not push them on the patient or they'll pull back.

If they mention a dream - don't try to interpret it.  If they give an interpretation - fine.  If it reminds me of a recurring thing they've brought up many times - ask if there might be a connection.

I learned to slow down and avoid jumping to conclusions.

This book teaches how to do psychotherapy, how to deal with resistance, when to interpret and when to just listen.  It taught the good and the bad of transference and countertransference - when to bring it up and when to just acknowledge it and move on.

It explained the goals, the purpose, the meaning behind it all.  It gave me another useful tool to use with patients.  I think that's the point, if you learn lots of medications, lots of therapies, and lots of ways to help - you'll have a better chance of picking the right one.  "If all you have is a hammer, everything becomes a nail."

Here are a few of my favorite quotes:

"When in doubt, be human." - p. 57

"The young therapist - fearing spontaneity, human engagement, and a naturalness of response - is overly rigid and formal." - p. 71

"Therapists are privately passing judgments on the patient all the time." - p. 72

"We might regard resistance as a way that patients show us who they are...resistance is not 'bad' behavior on the part of the patient." - p. 117

"Patients are boring for different reasons...the art of therapy includes making the boring patient a fascinating subject of study." - p. 161