Integrating Psychodynamic Therapy with CBT?

Typically, you get the two camps.  But erm...what if these issues can be bridged.  We could well be shot for saying this, but why not consider some interesting issues.

Psychological splitting?

Either you get psychotherapists who believe strongly in either Psychodynamic (Psychoanalytic) Psychotherapy or Cognitive Behavioural Therapy.  Isn't it interesting how reminiscent the internal splitting process is demonstrated in the field of psychotherapy? Both methods are backed by strong research and historical following, in the ways therapists work through with their clients debilitating issues on the couch.  There has to be some way to get us all united around assisting clients to make sense of their difficulties.

Different strokes for different folks?

Look, whilst we are proponents of the former, we have the view that there are different needs for different individuals who present for psychotherapy.  So we'll have to meet those needs based on our different levels of experience and training.  Therapist preferences and clients preferences are probably important too.

Different scope and mechanism of change?

These two different methods work very different, most might argue.  Being trained in these two broad methods, we can see how similar and different they work.  But one might have to consider the need to be flexible and utilise helpful elements from psychodynamic therapy to bolster CBT work, otherwise, a therapist may miss important issues in the therapy process, and fail to manage glaring clinical issues.  For e.g., personality problems impacting an ability to maintain meaningful relationships.

Expert Opinion

Let's hear it from Aaron Beck himself, the creator of CBT.  In the video, he points out the importance of being informed by Transference issues, Childhood Issues, and the clinical use of Dreams - all three of which would be typically dismissed in CBT, but are characteristical cornerstones in psychoanalysis.  

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck describes clinical scenarios in which incorporating certain aspects of psychodynamic theory in cognitive behavior therapy (CBT) can be helpful in treatment. For CBT resources, visit http://www.beckinstitute.org

If you're a junior psychotherapist, consider the value of being well-informed, as opposed to being under-informed, when working with all sorts of clients.

As a classically trained psychoanalyst himself, Aaron Beck's version of CBT is, in our opinion, very different from what is the rigid practice you might hear of being practiced or taught in many postgraduate programmes or courses around the world.  So, ask yourself today, as a therapist, what is your stance?  And reflect on how you've been practicing whether you're a novice or seasoned hand.


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