The theory of Freudian psychoanalysis is a psychological stream and pseudoscience founded by Sigmund Freud, an Austrian neurologist, at the end of the 19th century. As a result, new currents and therapies have emerged. here we will learn more about one of them, supportive psychotherapy.
Supportive psychotherapy is based on psychoanalysis, although it aims to treat a wide variety of patients and clinical settings. One of its central elements is the therapeutic alliance. Let’s find out in detail what this type of intervention consists of.
Origin of supportive psychotherapy
The therapy initially proposed by Sigmund Freud was psychoanalytic care, therapy where the patient lay down in an armchair or couch and expressed mental images and ideas it crossed his mind under the guidance of the psychoanalyst. The sessions took place 4 to 5 times a week. It was therapy that lasted for several years (practically “a lifetime”).
Later, new forms of therapy emerged, the so-called psychoanalytic psychotherapies, of which there are three:
- Psychoanalytic psychotherapy proper.
- Brief dynamic psychotherapy.
- Supportive psychotherapy.
In the following lines we will see how the latter was designed.
Supportive psychotherapy, as we have seen, has its roots in psychoanalysis. Currently, however, many schools of psychotherapy, approaches and techniques use it.
Its field of intervention is wider than that of the other two psychoanalytic psychotherapies mentioned. (As well as that of psychoanalytic type care). It focuses on finding relief from the patient’s suffering and restructuring their personality.
As for its framing, the sessions take place face to face, with a variable frequency and a duration of the sessions between 30 and 60 minutes.
It is a type of intervention focused on three fundamental objectives: allow feelings to be expressed, strengthen defenses and contain anxiety. More precisely, it aims to maintain or strengthen the adaptive defenses of the patient, so that they allow him to best resist his daily life or his situation.
Supportive psychotherapy emphasizes mobilize the patient’s strengths to increase their self-esteem. Use adaptive defenses and patient coping strategies in a positive way, so that the patient can better cope with their situation or life crisis.
Regarding the indications for brief psychotherapy, the patient is not required to have special psychological qualities. This differentiates it from the other two psychoanalytic psychotherapies, as well as psychoanalytic-type care, which requires insight on the part of the patient and a good tolerance for frustration.
Supportive psychotherapy is often used in a very wide range of disorders and patient types. The indication depends on the specific clinical situation, rather than the type of psychopathology.
It is generally considered that the more severe the crisis and the greater the patient’s fragility, the more support will require the same; likewise, you will also need more support, the more your psychic structure is deteriorated or damaged.
Supportive psychotherapy techniques
Supportive psychotherapy techniques aim to create an environment that facilitates therapy. This aims to create an atmosphere in which the patient feels comfortable in freely expressing his concerns and concerns.
Thus, the techniques most used in this type of psychotherapy are: case formulation, framing, active listening and therapeutic alliance.
1. Case formulation
Once the patient has been heard in detail during several interviews, the case is formulated. The formulation of the case consists of a set of assumptions about the causes, precipitators, and influences that support the patient’s problems. It is therefore a conceptualization of his case, beyond diagnosis or psychopathology.
It is the conscious (with unconscious elements), voluntary and propositive expression of the moment, the place and the end of the therapy. The framework defines who, why or for what, when, where, how and at what cost the patient and the therapist will meet; that is to say, they would be the “conditions” of therapy.
The framing structure i it gives a feeling of reliability to the psychotherapy and the therapist.
3. Active listening
As obvious as it sounds, it’s all about listening, but doing it with quality. Respect silences, provide elements that allow the patient to know that he is being heard, Maintain eye contact, etc. In short, listen respectfully and attentively to the patient. It is an element present in any type of psychotherapy.
If appropriate active listening is performed, the patient will feel free to express their feelings, emotions, fears and conflicts in their own way.
4. Therapeutic alliance
According to Sigmund Freud, the first duty of every therapist is to “bring the patient together both in the therapy itself and in the person of the therapist”. Therapeutic alliance is the extent to which the patient experiences the relationship with the therapist as something solid and useful. to achieve their therapeutic goals.
Bordin (1979) breaks down the therapeutic alliance into three elements:
- Agreement between patient and therapist on the goals of psychotherapy.
- Agreement between the patient and the therapist on the tasks of the current psychotherapy.
- Relationship between patient and therapist i perception that there is a common commitment and mutual understanding psychotherapeutic activities.
- Avila, A; Rojí, B; Saul, LA (2004). Introduction to psychodynamic treatments. A D. Madrid.
- Alarcón, A. (2008). Technical foundations of supportive psychotherapy. Tower. Columbus. Psychiatry., 37 (1), 114-126.