403 – Deepening Treatment:   Moving to Intensive Psychotherapy or Psychoanalysis 

Description: Most patients and therapists assume that meeting once weekly is the standard “dosage” for psychotherapy. However, for many people, including those who have painful symptoms, longstanding difficulties in relationships or work, disturbances in self-image or mood, a highly punitive conscience, self-defeating behavior patterns, rigid defenses, a history of relational trauma, difficulty with affect regulation, or borderline object relations, once weekly therapy may be ineffective.   

Some people opt for increased frequency, not only because they are in pain but because they desire deeper self-understanding as a pathway to a richer and more creative life. The decision to undertake more intensive psychotherapy is often made after an initial crisis has been resolved in therapy. Because many patients are unaware of the benefits of intensive psychodynamic therapy, the therapist must raise the issue and make a recommendation. 

Working at higher frequencies sets the stage for a different quality of experience in therapy. Rather than focusing on symptoms or “the events of the week,” frequent sessions allow time to explore the patient’s thoughts, feelings, dreams, and relationships and to identify conscious and unconscious factors contributing to painful symptoms. Increased frequency allows time to identify patterns of behavior, thought, and feeling that lead to self-defeating behavior.  Finally, greater frequency allows a more intensely experienced relationship to develop between patient and therapist, providing a rich laboratory for examining and healing painful relational patterns that were forged during the vulnerable years of early childhood. This kind of work may become playful and deeply fulfilling for both patient and therapist. 

This course is for therapists who work with adult patients and wish to understand how and when to recommend therapy at a frequency of two or more times per week. Reality issues such as time, money, and insurance will be addressed in a way that does not inhibit the therapist’s thinking about what is optimal for the patient. We will also consider when increasing frequency may be part of the solution for a treatment that is stagnant or locked in struggle.  

Target Audience: The class is intended for intermediate to advanced-level clinicians.

Prerequisite:  Priority will be given to matriculated students in the Adult and Adult/Child Psychoanalysis Programs, as this is a required course. Psychoanalytic Psychotherapy students who have completed the Core Curriculum may request permission from the instructor to take this class. If space permits, graduates of the psychoanalytic psychotherapy program, or equivalent, may register with the consent of the instructor.