Психодинамикалық және психоаналитикалық психотерапия түрлері

Form of psychoanalysis and/or depth psychology

Psychodynamic psychotherapy (or psychodynamic therapy) and psychoanalytic psychotherapy (or psychoanalytic therapy) are two categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies. Psychodynamic psychotherapy is evidence based; the effectiveness of psychoanalysis and its relationship to facts is disputed. Psychodynamic psychotherapy relies on the interpersonal relationship between client and therapist more than other forms of depth psychology. They must have a strong relationship built heavily on trust. In terms of approach, this form of therapy uses psychoanalysis adapted to a less intensive style of working, usually at a frequency of once or twice per week, often the same frequency as many other therapies. The techniques draw on the theories of Freud, Klein, and the object relations movement, e. g., Winnicott, Guntrip, and Bion. Some psychodynamic therapists also draw on Jung, Lacan, or Langs. It is a focus that has been used in individual psychotherapy, group psychotherapy, family therapy, and to understand and work with institutional and organizational contexts. In psychiatry, it has been used for adjustment disorders as well as post traumatic stress disorder (PTSD), but more often for personality related disorders.

The principles of psychodynamics were introduced in the 1874 publication Lectures on Physiology by German physician and physiologist Ernst Wilhelm von Brücke. Von Brücke, taking a cue from thermodynamics, suggested all living organisms are energy systems, governed by the principle of energy conservation. During the same year, von Brücke was supervisor to first year medical student Sigmund Freud at the University of Vienna. Freud later adopted this new construct of "dynamic" physiology to aid in his own conceptualization of the human psyche. Later, both the concept and application of psychodynamics were further developed by the likes of Carl Jung, Alfred Adler, Otto Rank, and Melanie Klein. Psychodynamic therapy has evolved from psychoanalytic theory, with some later modifications in the therapeutic practice experienced since the mid 20th century.

Psychodynamic psychotherapy is an evidence based therapy. but these arguments have also been subjected to various criticisms. For example, meta analyses in 2012 and 2013 came to the conclusion that there is little support or evidence for the efficacy of psychoanalytic therapy, thus further research is needed. A systematic review of Long Term Psychodynamic Psychotherapy (LTPP) in 2009 found an overall effect size of 0.33. Others have found effect sizes of 0.44–0.68. Other reviews have found an effect size of 0.78–0.91 for somatic disorders compared to no treatment and 0.69 for treating depression. A 2012 meta analysis by the Harvard Review of Psychiatry of Intensive Short Term Dynamic Psychotherapy (ISTDP) found effect sizes ranging from 0.84 for interpersonal problems to 1.51 for depression. Overall ISTDP had an effect size of 1.18 compared to no treatment. In 2011, a study published in the American Journal of Psychiatry made 103 comparisons between psychodynamic treatment and a non dynamic competitor and found that 6 were superior, 5 were inferior, 28 had no difference and 63 were adequate. The study found that this could be used as a basis "to make psychodynamic psychotherapy an "empirically validated" treatment." In 2017, a meta analysis of randomized controlled trials found psychodynamic therapy to be as efficacious as other therapies, including cognitive behavioral therapy.

Because of the subjectivity of each patient's potential psychological ailments, there is rarely a clear cut treatment approach.