(Re)discovering the Basics of Therapy: A Continuing Process for the Psychodynamic Therapist [online presentation]

Activity: Academic talk or presentation typesInvited talk


Dr. Adam Polnay states, "In the course of writing a new textbook on psychotherapy, I was struck by the joy and value in re-visiting the so-called ‘basic’ concepts and practices of therapy. From discussion with colleagues, I think I am not alone in observing how we as therapists may, over time, come to take the basics for granted, and even ‘forget’ them." In the introduction section of his talk, he explores possible explanations for this. These include the role of interpersonal dynamics inherent in working closely with people in therapy; as well as a familiarity that may creep in that diminishes the fresh shock of clinical encounters present earlier in one’s career. Furthermore, there is the tendency for any activity we practice repeatedly to become automatic – whilst adaptive in some ways, this is not necessarily without detriment.

Borrowing ideas from a different discipline to therapy, a key technique book for experienced violinists is titled ‘Basics.’ This title is deceptively simple as the book is over 200 pages; it is not intended for beginners but for experienced violinists to use as part of their daily practice. Adam suggests that aspects of how some musicians practice may be helpful for us therapists – including a recognition of the importance of the continuing need to attend to the ‘basics,’ the foundations, of one’s craft.

With this background in mind, he goes on to highlight – with a contemporary lens – some of the basics of therapeutic work. These include:

- How an understanding of memory systems can provide a grounding for the therapist
- The importance of observation to infer a patient’s underlying ways of being
- ‘Listening in’ as a plain language approach to countertransference work, drawing on the work of Michael Parsons
- The potential for the patient to discover, within the therapeutic relationship, ‘something new from something old’ (Mitchell, 1997, as cited in Gabbard and Westen 2003)
- A contemporary approach to transference work
- To conclude, the process of writing a book has, in a good way, led Adam to feel less experienced, more ‘on the edges of knowing and not-knowing’ (French and Simpson 2000, drawing on Bion 1980). Bion argues that this is a helpful disposition for the therapist, although it is not necessarily easy. As French and Simpson (2000) put it:

“Just at the moment when working at the edges between knowing and not-knowing can allow space for a new thought, it can also let in the anxiety of one's nakedness.”
Period20 Jan 2023
Held atAusten Riggs Center, Massachusetts, United States