Focal psychodynamic therapy: what it is and how is it used

There are many therapies which, based on the psychoanalysis closest to Sigmund Freud, have attempted to deal in various ways with the suffering of patients and how to improve their psychological state.

Among these currents, always included in the psychoanalytic approach, there is focal psychodynamic therapy, Characterized by being a brief therapeutic alternative and by focusing on the patient’s priority problems.

Although it has a clear relationship with other psychodynamic therapies, it also exhibits nuances that differentiate it from more classical psychoanalysis, giving it advantages and limitations. Below, we will see what this special therapy consists of.

    Focal psychodynamic therapy: what is it?

    Focal psychodynamic therapy, also called brief psychodynamic therapy, is a form of treatment in which an objective, called focus, is visualized and worked on the rest of the sessions that make up the therapy. Having very specific goals, the scope of therapy is limited to solving the same.

    this psychotherapy was produced by the group of Michael Balint, Paul H. Orstein and Enid Balint. Techniques such as selective forgetfulness and selective attention are used in interpreting the patient’s problems.

    In this way, and according to the authors, it is possible to give the patient a better understanding of the real cause of his suffering. Thus, once the patient understands the source of their discomfort, it is possible to generate more lasting therapeutic changes.

    Therapy, as we said, focuses on solving a single problem or conflict in the patient, trying to achieve its resolution quickly. We could therefore say that this psychotherapy takes into account the saying “who kiss a lot, do not kiss a lot”, that is to say prefers to focus on a single problem and make sure that it solves it. before trying to change everyone. nobody.

    Within this therapy, which is part of the psychoanalytic current, it is understood by focusing on a specific problem, On which the efforts and attention of the patient and the therapist will be concentrated during the sessions. This objective must be specific, unambiguous and clearly defined. Brief therapies are not aimed at reshaping the broad personality of the patient, but at solving one or a set of problems from which the patient is suffering, in a short period of time.

    Each patient’s inner world can be very large, which is why trying to resolve anything dysfunctional can be a daunting task. A treatment that aims to repair anything that causes discomfort to the patient must necessarily be long. Outraged, changes will happen slowly, Which may mean that the patient does not have a real perception of improvement and ends up dropping out of therapy, frustrated at not seeing the desired changes.

    In the same vein as the authors mentioned above, many people point out the advisability of concentrating or concentrating the therapeutic task on a particular area, symptom or problem of the patient, giving it the highest priority during treatment. This is why this type of therapy is called focal.

    The psychotherapist, at the start of therapy, has a great responsibility to decide which goal requires the highest priority, so that this is properly addressed throughout the treatment. However, it is the job of the patient-therapist tandem to accept and develop a therapeutic plan that will achieve the initially set therapeutic goal.

    Duration and application

    As the name suggests, focal or brief psychodynamic therapy is short-lived. Although there are differences between professionals, the most common is that the 25 sessions are not exceededAlthough the ideal would be a total of 14 sessions during which the therapy will be carried out. The first session would include the interview with the patient, being from the second at number 13 the treatment itself and, at number 14, the closing session. These sessions would take place once a week.

    This therapy is highly recommended for patients who suffer from some type of discomfort, but who are also functioning well both socially and professionally / academically and in life in general. It is used to show the person what caused them to have a series of symptoms and to relate them to their emotionality.

    So this therapy it is not possible to apply it to severe personality disorders or psychiatric problems. The reason is mainly because the object of focal psychodynamic therapy is very limited and brief, which is not practical for the treatment of this type of disorder, as they can become chronic and require a lot of deep and extensive changes. in the person.

    However, there are several studies that have applied this therapy in eating disorders, such as anorexia nervosa. By using this therapy, problems regarding their relation to food can be solved, especially aspects related to calorie control.

    Also, and above all linked to their emotionality, briefly works on this therapy on aspects such as their feelings about how they believe others see them, Had a childhood and thoughts while looking at himself in a mirror or putting on clothes.

    Requirements to work with her

    In order for focal psychodynamic therapy to be carried out as effectively as possible, the patient and the professional must meet a number of requirements. If not, it will be necessary to consider another type of treatment options or to refer to another professional, As a psychiatrist or general practitioner, if applicable.

    As part of the characteristics and requirements that the patient must meet in order to be able to apply focal psychodynamic therapy, it is necessary for him to have a good awareness of psychopathology, or suffering from a problem. He must also understand that he has responsibility and commitment in the evolution of this problem in the context of therapy. In other words, it depends on your level of motivation and your desire to want to achieve the solution of the problem.

    The patient must have adequate pulse control, Expected for his age and level of education, which is neither excessive nor rare. He must also have an adequate tolerance for frustration and exhibit a degree of anxiety at levels that do not overwhelm his behavior or sanity. In the event that your anxiety is too high, it is recommended to apply a longer therapy, focusing on various aspects of the person, whether they are experiences or personality traits.

    Finally, among the most practical characteristics that the patient must present in order to be able to carry out this therapy, there is the have an adequate intellectual level, In addition to the non-pathological symbolization and abstraction capacities. It is also desirable that you have a self-esteem that is neither too diminished nor excessive.

    From all the characteristics that the patient must exhibit, it can be understood that this type of therapy is recommended for patients with moderate discomfort. For example, a patient with a disorder as serious as schizophrenia or bipolar disorder would not be suitable candidates for this type of therapy. In addition to suffering from disorders that cause them a high degree of discomfort, these must be treated with psychopharmacology.

    On the other hand, so that the therapy can be carried out in the most appropriate way, the therapist must, of course, have a number of requirements that allow him to perform this therapy. Among them was a patient in long-term psychoanalytic therapy. With this, the therapist will be able to grow as a professional, knowing how to clearly distinguish his discomfort from that of the patients, and having a good management of the countertransference.

    Although the most appropriate patient profile for this therapy is that of a person who does not have a severe mental disorder, this does not mean that it is an easy to apply therapy. The therapist should have extensive clinical experience in prolonged psychodynamic treatments, which will serve as a preliminary basis to be able to apply the brief version thereof. it is recommended that you initially be supervised by another more experienced professional.

    The most personal attitudes, the professional must have a good detailed observationAt the same time, be organized and know how to make good therapy planning. It is only with the detailed observation of the discomfort that the patient will be able to detect which aspect of it is to be transformed into the goal of therapy. Along with this, you need to have a good tolerance for frustration because unfortunately not everyone inside the patient can always be fixed.

    Differences between classical psychoanalysis and focal psychodynamic therapy

    Although in the mainstream of psychoanalysis, focal psychodynamic therapy differs from more classical psychoanalysis for several reasons. Below we see the main differences between the two types of therapy.

    Within the framework of classical psychoanalysis, especially with regard to long-term therapies, it is intended to bring about profound changes in the personality and the degree of well-being of the person. On the other hand, in focal psychodynamic therapy, the duration is short, it is limited to changes in modifiable aspects in the short term, which can lead to an improvement in the well-being of the person and that the person can see them as soon as they begin. -se the treatment.

    too much, the two types of therapy differ in the number of weekly sessions. Classical psychoanalysis requires a couch visit about three or four times a week, while in the case of focal therapy it only needs to be done once.

    The most classic psychoanalysis chooses to maintain a careful distance from the patient’s family, to avoid possible interruptions throughout the therapy. In contrast, focal psychodynamic therapy seeks to have maximum contact with the social world of the patient, as long as it is practical and facilitates an improvement in the well-being of the person.

    Bibliographical references:

    • García-Arzeno, ME (1997). Brief or targeted psychoanalytic psychotherapy. Cuban Journal of Psychology. 14 (1), 121-126.
    • Sánchez-Barranc, A. and Sánchez-Barranc, P. (2001) Brief dynamic psychotherapy: clinical and conceptual approach. Journal of the Spanish Association of Neuropsychiatry. 21 (78). 1013-1031.

    Leave a Comment