Fluidity and transformation in time-limited psychotherapy

As mentioned earlier, the therapeutic technique in time-limited psychodynamic psychotherapy involves a degree of intensity in working towards a positive outcome. This, together with the fact that we may for the first time have all the key players available, creates an impetus for what may be described as transformative occurrences in the therapy. When we recognise the essential fluidity of the child/ adolescent/parent interaction, it is often brought home to us how the child or adolescent’s presenting problem represents as Winnicott described it, ‘a latent displaced expression of parental states’. In other words, we may (without denying the reality of the challenges experienced) view the child’s or adolescent’s problems as a kind of figment of the parents’ imagination. Our job as psychotherapists is not to get bogged down in this presenting symptomatology, but to help bring the real child and adolescent into focus, through perceiving their symptoms as the opportunity. A striking outcome of this process is that the focus of concern almost invariably shifts onto either both the parents, or one individual parent. It is not unusual for this to occur, bringing to the fore long-standing conflicts, unresolved mourning, trauma and unhappiness that reside in one or both parents.

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