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CBT and Psychodynamic Psychotherapy

CBT, Cognitive Behavioural Therapy, works on the premise that if the pattern of thinking and behaviour can be changed then feelings will also change.

In a lot of cases, this is clearly true and at times all our therapists make use of CBT methods, working on understandings and cognitions as self management tools. However, there are limitations in the usefulness of CBT.

CBT assumes that the rational mind is able to manage or overcome all aspects of who we are [self]. But not all aspects of self and behaviour are accessible to language and logic, which is why often some issues are difficult to resolve and to work through.

Our earliest experiences [the mother/baby dyad] are pre-verbal. The events and experiences of this time are embedded deep within [semantic memory] and are known or felt as ‘facts’. Until these are able to be brought into consciousness, they are not accessible to language or logic and we are therefore not able to process them. Similarly, the experience of trauma can temporarily knock out or restrict the ability to reflect on the traumatic event, and as such the trauma becomes ‘stuck’, either dissociated and not available to conscious memory, or else replaying a fixed and unchanging scenario [flashback]. Both of these possibilities impact on current life as patterns of behaviour and ways of relating to accommodate the distress. Aliveness and spontaneity can be restricted in an attempt to avoid the risk of repetition of some aspect of the trauma or there can be acting out of the trauma by [unconsciously] recreating some aspect of it.

Often underlying themes or repeating patterns of behaviour are noticed and a desire for change comes to mind. In the therapeutic relationship, thoughts feelings and actions are able to be brought into conscious awareness, identified and integrated into a more robust and healthy sense of self.

Psychodynamic psychotherapy such as the ‘Conversational Model’ practised by the therapists at Talking Therapy is important in accessing these subconscious patterns of behaviour that methods such as CBT are generally ineffective in working with.