What is brief dynamic therapy?

Brief dynamic therapy has been in existence for quite some time, but it was first practiced and properly established as a discipline by Michael Balint and David Malan in the 1950’s at the Tavistock Institute, London.

Brief and time-limited work has become increasingly more popular and as we know it is often a treatment of choice for counselling agencies and health services. But it can be also very helpful in private practice, especially for clients who are completely new to counselling and who are making a first attempt to engage with counselling.

In this context brief dynamic therapy can be like a stepping stone. By participating in a brief piece of therapeutic work, where the ending is agreed upon at the beginning, the client may learn to understand themselves better and hopefully make some inner changes without being required to enter into a longer term, open ended commitment in the first instance. This may feel more manageable and less daunting for the client.

If the experience of short-term counselling has been satisfactory, the client may feel much more confident to engage in another time-limited contract in the future or to engage in open ended work, if this feels what is required.

An important requirement for brief dynamic therapy is that the counsellor, who is chosen, is a well experienced practitioner who has undergone specialist training in this approach.

The counsellor also requires very good assessment skills, to confirm that the client is suitable for this counselling method and that the client can manage the intensity and demand of it. In order for the client to make progress, the counsellor adopts a more directive style as time is of an essence.

The counsellor will need to make sure that the focus that has been agreed upon is kept to, which means painful issues will be addressed and can’t be avoided. Obviously the hope is that as a result of the brief therapeutic intervention, the client may achieve a deeper understanding of the issue they brought to the counselling and experience a sense of change.

Case example to illustrate how brief dynamic therapy works

Ms A comes for 6 sessions of brief dynamic therapy. She has already had an assessment session, where we talked about her request for counselling and we discussed her life and family history.

Ms A has recently experienced a life changing event, which is having many implications on her present life. Since then Ms A has had an experience of an angry outburst with another person, which is unusual for her. These angry feelings have remained with her and cause her concern.

Session 1

Ms A tells me that she would like to focus in our session on the angry outburst and understand its meaning. We talk about the incident in more detail and try to make sense of her feelings. We also explore the emotional implications for Ms A in relation to the life changing event.

Session 2

In between the sessions Ms A has become aware, that some of the anger she experienced during the outburst may be linked to the major changes she has recently had to face. She is now experiencing restricted choices and some loss of control. Ms A is able to link these feelings with an experience in childhood, where she felt she had to go along and accept a situation, which she was unhappy about and where she suffered.

Session 3

Ms A talks to me about a difficult family situation in the distant past which was never talked about openly. We explore how this affected her then and now and how it may relate to her experience of feeling angry.

Session 4

I introduce a link between anger and emotional pain. Ms A finds this helpful and reports on a recent incident, where she became angry, because she didn’t know how to express her deeper feelings and she didn’t feel understood by those around her. I use an upcoming break in our sessions as an example of Ms A again not having a choice.

Session 5

Ms A tells me, how she coped during the break and shares with me another difficult incident that occurred for her, while I was away. We try to uncover how Ms A may have felt about my absence on a deeper level. We then acknowledge that our work is coming to an end and explore what further support Ms A might need.

Session 6

Ms A feels much more comfortable with allowing herself to be angry and to express anger. She says that she now has a much clearer understanding of the link between her childhood experiences and how she responds to difficult feelings in the present. She also tells me that she really valued having a regular space, where only she mattered. I point out to Ms A that after our sessions have finished she may experience feelings of loss grief and anger.

At first she doesn’t understand what I mean, but then she refers to having experienced strong feelings after a special holiday. I know that she has understood me. I present Ms A with a number of options, if she wants to engage in further counselling.

It is very important that at the end of the sessions a good amount of time is spent finding the best way forward for the client after the counselling contract has ended.

Addressing the feelings of loss and sadness about the ending of the work and the ending of that particular therapeutic relationship is essential.

If you are interested in undergoing brief dynamic therapy with me please contact me.