There is such an interesting core difference to two major approaches to psychological therapy.

In the psychodynamic approach, the idea is that a person will develop ‘insight’ into what is holding them back psychologically. This becomes an agent of change. Where a person can not ‘unsee’ what they have learned.

The other approach is behavioural therapy, such as ACT, where a person will change their behaviour, by deciding about ways that they want to show up in life, and all the underlying psychobabble, or stuck feelings and emotions can be defused, acknowledged and managed, so that the person keeps moving forward to their values, despite the issues.

What does the research say?

Some people suggest that while behavioural therapy has a lot of evidence for its efficacy, there is less clear evidence on long term change.

Is there evidence for long term change with psychodynamic therapy? I don’t know. And I should endeavour to find out.

Can I change?

The question ‘can I change?’ springs to my mind a lot lately.

The problem seems to be that therapists are usually in either one camp or the other. (Or at least exert a preference). An ACT psychiatrist would sneer at psychodynamic approaches to therapy, I think. And a psychodynamic therapist would question if the cognitive behavioural therapies are just a bandaid for deeper wounds that need to be expressed and understood to be healed.

Some therapists sit in the middle, saying ‘this type of therapy is not exclusive’.

Anecdotally

I am curious about both. In my experience, some kind of wound from earlier in life, has grown and developed into insight that is so obvious that all the difficult parts of my psychological world can suddenly be explained.

(But have I been living my best life lately?)

(And where was ACT when I was at my most vulnerable? My psychiatrist might be right that we can’t ‘delete thoughts’, but my underlying wounds have become worse, not better in all the years I have been doing ACT. . . (and why?) – if not due to an insecure faux relationship, then what?)

The choice at that point needs to be, am I going to concentrate on consistently showing up in life as the person I want to be, defusing all these psychological burrs that I have recently joined the dots on? Or am I going to go deep into therapy that aims to soothe my nervous system, to try to heal these attachment wounds?

Or maybe both!