Psychodynamic psychotherapy

In psychodynamic or psychoanalytic psychotherapy, the focus is on how people develop over the course of their lives. Thoughts, feelings, desires, motives and behaviors are considered in conjunction with past experiences. This assumes that people are often not fully aware of all their desires and intentions as well as needs, thoughts or feelings that impede their psychological functioning. Patterns formed in the early years of life usually continue, unconsciously, to repeat themselves in adult life. This involves both how you deal with your own feelings, desires and thoughts as well as how you form relationships with others. Psychological symptoms arise when these unconscious patterns do not help you but “sabotage” your life. In psychodynamic psychotherapy, issues such as unconscious drivers of behavior, past and present relational experiences play a central role. Reflection on this makes it possible to better understand psychological problems, process them and develop other ways of dealing with stressful situations. A good therapeutic relationship is a prerequisite for achieving this, and the psychodynamic psychotherapist has learned to connect optimally with the patient’s thinking-and-living (inner) world. To this end, the psychotherapist takes an active exploratory stance. Psychodynamic psychotherapy may be appropriate when someone suffers from severe psychological symptoms, keeps running into the same patterns and wants to change them. Psychodynamic psychotherapy is indicated when these symptoms and problems cause suffering and undermine social and/or occupational functioning. In addition, it is important that the patient himself is curious to better understand himself and has a need to develop himself as a person.

Group therapy

Ithaca offers several group therapy options. Group psychotherapy is group psychotherapy, where learning from and with each other, interacting with other participants and the psychotherapists, is central. The therapy group consists of a limited number of participants and two group psychotherapists who meet weekly. All participants work on their own psychological symptoms and problems. During the sessions, group members explore their problems with each other under the guidance of the psychotherapists. For this reason, some ability to empathize and to be able to listen and make space for others is required of participants.

Group psychotherapy is suitable for a wide range of people with mental and psychiatric problems and proven effective for anxiety disorders, mood disorders and personality problems, among others. Therapeutic factors include interpersonal feedback (cognitive, affective and behavioral), mutual recognition, empathy and support, recognizing and changing role patterns and learning to practice new behaviors, learning exemplary behavior and learning mutual advice. Group therapy provides an opportunity for new positive experiences in exciting moments in how you experience yourself in relation to others. These new experiences can translate into one’s own life.

Group therapy options within Ithaca:

Within Ithaca there are several psychodynamic therapy groups for both Dutch-speaking and English-speaking adults.
A psychodynamic therapy group will soon start for Hebrew-speaking adults.
The intention is mid-2023 to start a psychodynamic therapy group specifically for adolescents/young adults, age 18 – 24, Dutch-speaking.

Schema therapy

Schema-focused therapy is a form of therapy that integrates elements of cognitive behavioral therapy, Gestalt therapy and attachment theory, among others. Schema therapy assumes that symptoms and problems people come to treatment for have their basis in maladjusted schemas that involve obstructive emotional and cognitive patterns that begin early in our development and repeat throughout our lives.

Unadjusted schemas can arise from past traumas or unpleasant experiences from not getting basic needs met in our lives, mainly in childhood. These basic needs include; secure attachment to others, autonomy, expression of needs and emotions, spontaneity, realistic boundaries. Dysfunctional behavior arises as a response to the inappropriate schemas and produces a particular coping behavior or response that may vary from moment to moment; this is called a schema mode.

EMDR

This form of therapy is for people who continue to suffer from consequences of a shocking, traumatic experience manifesting themselves, among other things, in having nightmares, re-experiences or flashbacks. The beginning of EMDR therapy focuses on the cause and background of the symptoms. In addition, an appraisal is made of a number of individual characteristics, including personal bearing capacity and the burden of one’s symptoms. The therapist will work with the client to identify and gather more information about the traumatic events and to determine which images to work with. Then the coping process is started where you are asked to think back to the event, including the associated images, thoughts and feelings. This is done in conjunction with a distracting stimulus, such as a sound or light pulse. After such a “set,” rest is taken and reflect on thoughts, feelings and bodily sensations that have arisen and a new set is started.

By repeating this process and working through the various identified images/memories, the intense anxious charge of the memories is reduced and the symptoms may subside. The traumatic memory does remain a memory but it is no longer so overwhelming to think about this: it can have a place within yourself. It is also expected that situations in the here and now that previously evoked the trauma response are less triggering. This can also create space, through follow-up treatment, to work on possible underlying patterns or difficulties that may still be present. Examples include depressive symptoms, self-image problems and difficulties in relationships.

Note: Should there be complex trauma or multiple trauma, we may decide to refer to more trauma-specialized settings.

Cognitive behavioral therapy

So the basic premise of CBT is that thoughts affect a person’s feelings and behavior, and vice versa. CBT is an umbrella term for various forms of treatment in which patients learn how to better manage their negative thoughts and feelings about themselves and their environment, get a better grip on their emotional lives and, if applicable, better align their behavior with what they want to achieve. This is based on the premise that symptoms and problems, in addition to environmental influences, can be explained and maintained to a large extent by systematic dysfunctional thoughts. The influence of these thoughts is reflected, among other things, in the way one thinks, feels and acts, and these thoughts can lead to mental health problems and dysfunctional behaviors.

One of the principles of CBT is that the evaluation and possible adjustment of cognitions leads to reduction of symptoms and prevention of relapse. In therapy, therefore, the emphasis is on influencing these thoughts insofar as they play a role in the origin and persistence of the symptoms and problems. This is done through conversations with a practitioner and by doing assignments and targeted exercises both during therapy sessions and between sessions in an environment relevant to the symptoms. The intention is that by actively working with these assignments and targeted exercises, the patient can gradually evaluate and, if necessary, adjust his or her own thoughts, thereby gaining more control over his or her emotional life and, if applicable, also try out other behaviors. CBT is indicated when symptoms are confined to one domain of life and do not appear to stem from personality development. It is also important that the client enjoys working practically with his or her symptoms.

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