Taking the road to the unconscious together with a patient: red and green traffic lights.
Turning red traffic lights into green: Falling into the void after the murder
Davanloo´s ISTDP, psychoneurosis, and the importance of attachment trauma
Davanloo´s Intensive Short-Term Dynamic Psychotherapy is theoretically based on the psychoanalytic approach. However it´s method and techniques are structured. In therapies of a more structured nature, the therapist takes an active role in directing the structure of the therapy sessions and of the therapy. This means that the therapist, with his interventions is constantly active in focusing the patient´s attention to a well-circumscribed aspect of the problem under scrutiny.
According to Davanloo, neurotic disturbances arise as a result of a variety of possible traumatic experiences, involving damage to or disruption of the affectionate bond between the child and caretakers. The child unconsciously reacts to this damage/disruption with a sadistic, murderous rage. It is this sadistic, murderous rage and the consequent loss (of the beloved murderous person(s)), which leads to guilt and grief as well as to punitive, sadistic reactions of the superego towards the child´s ego. The traumatic experience(s), murderous rage and its result(s), guilt and grief are repressed into the unconscious. Various symptom patterns and character pathology develop as the ego of the developing child attempts to keep functioning under the mandate of the punitive/sadistic superego in such a way that it will not be overwhelmed by the impulses and feelings themselves, by anxiety, nor by the defenses.
Davanloo´s therapeutical interventions and techniques are aimed at helping the patient to take the shortest possible road to unlock his unconscious and to get direct access to his core neurotic conflicts in order to work them through and to (ideally) resolve them. Of course this road to the unconscious is within the patient and the obstacles on this road are determined by the nature and degree of the patient´s problems and character pathology (the patient variables).
No psychotherapy can be successful without a conscious/unconscious working alliance with the patient . Very often, the restricted success (or even absence of success) of a psychotherapy is due to a failure of establishing and/or maintaining a working alliance with our patients. Failure of establishing and/or maintaining a working alliance is often because the therapist underestimated nature and degree of the patient´s superego pathology and overestimated nature and degree of the patient´s ego adaptive capacity.
During the IVth Podlasie Psychotherapeutic Conference the focus will be on:
- a short introduction of ISTDP and Davanloo´s spectrum of structural neurosis
- a short introduction of psychotrauma
- the road to the patient´s unconscious and the particular patient variables that determine timing, duration and sequence of the therapist´s interventions
- the working alliance with the patient
- green and red traffic lights on this road to the patient´s unconscious
- audiovisual vignettes of ISTDP with a patient, illustrating the steps that had been necessary
- in order for the patient to get full and healthy access to her impulses and feelings that were linked to several traumata, buried in her unconscious
- questions, discussion and role play