Continuing the previous Posts, from a psychodynamic perspective, clinical strategies for a psychotherapy that considers neurosis should be based upon two pillars: 1) Working on neurotic conflicts-the ones at the root of symptoms- psychosomatic diseases, dysfunctions, psychopathological patterns, etc-, which demands deeper psychotherapeutic processes. 2) Helping individuals to develop internal contention/self-restraint, that is not only a result of lack of limits, but also a result of living in a world that is constantly changing. The work as therapists today, most of the times, is not on “decompressing” over-compressed egos. It is of helping them to develop self-contention. This is what Dias calls Contour Psychotherapy. Finally, it is not entirely true that we have weakened superegos nowadays. Alongside with the old sexually repressed ones, new superegos present themselves on other terms. According to Dunker[1][2], there are new social inclusion and exclusion parameters that work as “prescriptive superegos”. They show themselves as permanent demands of renewal of work and loving/sexual relationships. This is how social expectations may be felt as “social pressure” nowadays. And neurosis lies, many times, in the process in which external pressures/expectations turn into internal ones. Regarding this aspect, Freud is still updated. The nature of relationships has become unstable. This is the new social psychological ground, and it brings a great deal of anguish, especially in what concerns more lasting directions in life, and it is this aspect that constitutes today’s subjects in comparison with the ones from Freudian times. Anyway, our interest is to think of emotional suffering today, and of how these changes and the new Zeitgeist have impacted individuals. This is the theme of the next essay. In our view, clinical strategies for todays’ teenagers and adults are: 1) apart from working on neurosis, helping them find genuine references within their flexible internal worlds, as well as helping them find authentic paths. In what concerns neurosis, once hidden conflicts emerge and models are unblocked, it is pertinent and more likely that strategies will have more long-lasting results, without the reoccurrence of symptoms.[3] Of course, every person has a pace, but mapping hidden conflicts usually helps them free themselves of sabotage patterns and feeling they have the control of their lives again. Now it would be the time for them to make decisions more aligned with their desires and values. 2) On the other pillar, our work is to help them navigate through instability in a way that it doesn’t happen at the expense of finding more lasting directions in their lives, even if they are not fixed ones. Because directions bring meaning and purpose, and not finding them bring about other kinds of anxieties- existential ones. In our opinion, the key to emotional growth and balance lies in the integration of the Self.[4][5].
[1] Dunker, C.S. Is life a suffering? Em:https://www.uol.com.br/tilt/colunas/blog-do-dunker/2021/01/08/ identidades-fluidas-e-formas-de-sofrimento-no-brasil-digital.htm.
[3]Behavioral strategies are always welcomed tools in psychotherapy, especially when applied to relational conflicts or during crisis, in which we understand therapies should follow a more oriented approach (helping patients in regards to circumstantial/real anxieties). Our consideration is directed to neurotic anxieties/ anguishes, in which there is higher probability that behavioral strategies do not work or have a limited result, reinforcing patients’ feeling of failure. [4] This topic will be discussed on the next Essay. [5] Dias, V.S, in: Todays’ patient profile (P.158-185). In: Conjugal Bond in Psychodramatic Analysis (2000). p.158-185
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