Cognitive Hypnotherapy and EMDR: Two Effective Psychodynamic Therapies for the Rapid Reduction of Cognitive Anxiety

In the main research into cognitive anxiety has focused on the conscious mind. The aim of this chapter is to review two psychodynamic psychotherapies, cognitive hypnotherapy (CH) and eye movement desensitisation and reprocessing (EMDR). Both therapies focus on implicit or unconscious processes for the rapid relief of cognitive anxiety. The objective is to give credence to CH and EMDR both in the scientific and medical domains. The philosophy is concerned with changing negative cognitions and dysfunctional feelings through a process of desensitisation and reprocessing, utilising positive imagery. CH and EMDR were investigated in an intervention study with advanced pianists (n = 46). Participants were of mixed gender aged 18–26 and were randomly assigned to a therapy or control group. The therapy groups received two therapies of either CH or EMDR during a two week period between two concerts. Quantitative data were collected through the Spielberger State-Trait Anxiety Inventory. Results showed that both therapy groups (but not the control) experienced a significant reduction in state anxiety post-therapy and trait anxiety decreased significantly below baseline levels in the EMDR group. This chapter further reviews research into CH and EMDR documented through a case study allowing for qualitative assessment of the therapies where two sessions only were required to effect positive change.

When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners’ tacit knowledge

Guided imagery psychotherapy (GIP) is an established therapeutic method using creative mental imagery within a psychodynamic frame of reference. Although there is evidence for the method’s general effectiveness, it is yet unclear under which conditions and for which patients it should be used. The aim of this study was therefore to empirically identify indication criteria for the use of guided affective imagery (GAI) as part of psychodynamic therapies. We conducted semi-structured interviews with N=15 psychodynamic therapists also qualified as GAI training therapists. We asked them to recollect cases in which they had decided either for or against the use of imagery. The therapists described a complex interplay of different factors. Using grounded theory coding supplemented by elements of Consensual Qualitative Research we reconstructed from their accounts a sequential model of their indicative decisions. First, there is a consideration of clear contraindications related to reality testing and destructiveness. Second, there are aspects requiring a modified application of GAI such as emotional instability and post-traumatic stress disorder symptoms. In a final step, there are a number of characteristics of the patient, the therapist, the therapeutic relationship, the patients’ initial imagery and different therapeutic goals and foci which are weighed relatively to each other in order for therapists to reach an indication decision. We end by discussing ways in which the indicative decision model may be used to improve GAI training as well as the method’s differential efficacy and effectiveness.

What Does Our Body Tell Us in Therapy?

Verbal interaction seems to be the main instrument of treatment. In this article the the unconscious language of the body interaction will be looked at, as it seems to be not only an important transmitter of an emotional therapeutic atmosphere, but also valid to find out the conflict contents, relation pattern, and helps to work with structural problems. Results about early parent-child interaction show like a mirror the specific needs of a successful therapy relation especially in personality disorder treatment. Counter transference is based mainly on the awareness for the own body reactions and feelings, mirroring the unconscious themes of the client. To look as a therapist how the own body reacts with specific impulses, feelings and emotions can help to discover the associated psychodynamic terms of conflict contents and structural needs. The interpretation of the own body sensations can be helpful in the application of positive and psychodynamic therapies as well as in cognitive approaches to see the body interaction like an instrument to understand the hidden agenda.

Psychodynamic therapy with children and young people – where’s the evidence?

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence base. Partly this has been due to a degree of reluctance among psychodynamic practitioners to support the kind of empirical research that would help to establish such an evidence base.

An Exploration of ADHD and Comorbidity With Substance Abuse and Brain Development

Methylphenidate (MPH) is the most commonly used drug to treat attention deficit/hyperactivity disorder (ADHD) in children effectively and safely. However, in spite of its widespread application throughout what is considered one of the most plastic and sensitive phases of brain development in children, very little is known to date about its long-term effects on brain structure and function leading well into later adolescence and adulthood. Additionally, there is scant information available to parents, clinicians, and clients with ADD/ADHD about the influence of MPH on brain development. More importantly, recent human and animal studies suggest that MPH alters the dopaminergic system with long-term effects beyond the termination of treatment. As such, a multimodal treatment with psychodynamic therapies can assist the treatment team to support the development of the client's pro-social skills in addition to medication treatment, thus reducing full reliance on MPH as the primary treatment for ADD/ADHD.

Evidence-Based Psychodynamic Therapies for the Treatment of Patients With Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a serious health issue associated with a high burden for the individual and society. Among the “Big Four” of evidence-based treatments for patients with BPD are two psychodynamic therapies that have evolved from classic psychoanalytic treatment with a change of setting and change of focus: Transference-Focused Psychotherapy (TFP) and Mentalization-Based Treatment (MBT). This overview provides a comparison of the two treatments in terms of stance, clinical concepts, costs and key interventions. Furthermore, the current literature on the efficacy of both treatments is reviewed. While TFP focuses on the content of disintegrated representations of self and other, MBT focuses on the processing of mental states. Both treatments diverge in their clinical concepts and interventions for the treatment of BPD. Although both treatments are regarded as effective in treating BPD, no direct comparison of both treatments has been made so far. Future studies are needed to investigate mechanisms of change and derive recommendations for a differential indication. Specialized therapies for BPD have favorable drop-out rates and outcome compared to non-specialized ones. MBT and TFP have very diverse clinical concepts and interventions for the treatment of BPD. Both, MBT and TFP show efficacy in RCTs. No trial has directly compared MBT and TFP; there is no evidence base for differential indication. Specialized therapies for BPD have favorable drop-out rates and outcome compared to non-specialized ones. MBT and TFP have very diverse clinical concepts and interventions for the treatment of BPD. Both, MBT and TFP show efficacy in RCTs. No trial has directly compared MBT and TFP; there is no evidence base for differential indication.

Relationally based psychodynamic psychotherapy in prison: processes of control, shame, and dissociation

The scant literature relative to the application of relationally based and psycho-dynamic therapies within correctional settings clearly illustrates the contextually driven challenges to employing such approaches (Haley, 2010; Huffman, 2006; Kita, 2011; Stein, 2007, 2009). Stein (2001, 2004, 2007, 2009) in particular has written extensively about the psychotherapeutic needs of the high concentration of severely developmentally traumatised and dissociative individuals in our prisons, who are unlikely to receive psychodynamic therapies due to resource constraints. Such acute treatment needs can be exacerbated by the operational design of correctional settings—which are predicated on the maintenance of safety and security through the exercise of behaviour management and controlled access to personnel and resources. The over-representation of relationally traumatised individuals within prison populations is confounded by the structural parallels of the controlled environment that inadvertently trigger these inmates. The counterproductive results are not necessarily unexpected given how trauma is routinely re-enacted (Chefetz, 2015; Kupers, 1996; Van der Kolk, 1989, 2014; Van der Kolk & McFarlane, 1996). Nonetheless, this reactive cycle represents an unfortunate re-enactment of relational control both intrapsychically and environmentally. Discussion of the dynamics of control inherent within correctional settings, followed by a case study of an inmate suffering from traumatic exposure to an austerely narcissistic and abusive father, is illustrative of this cycle. The isomorphism of coercive internal object relations and institutional control is striking and will be illustrated.