Frequently Asked Questions
What is psychotherapy?
Psychotherapy is a talking treatment that
aims to resolve emotional distress. There are many different types of
Some, such as cognitive behavior therapy,
are more structured and based on developing rational strategies to change
thinking and behavior. Others, such as psychodynamic psychotherapy, are usually
longer-term and are seemingly less structured to enable a deeper level of
exploration of emotions, identity, issues from the past, and relationships.
What problems can psychotherapy address?
Psychotherapy can help many emotional
- emotional distress
- trauma syndromes
- personality disorders
- eating disorders
- self-harm behaviours
- complex grief
- sexuality issues
- problems with self-esteem and
sense of identity
- problems being in relationships
- resolving difficult or
traumatic experiences from the past
How does psychodynamic psychotherapy work?
Psychotherapy involves talking about
problems and working with the therapist to increase insight and understanding
about oneself, and resolve distress. Importantly, what is covered in therapy
should translate into life changes in the outside world too.
In psychodynamic therapy, over time, as
patient and therapist settle into treatment together, there can be a powerful
unfolding of an emotional developmental process. One analogy is that the
therapist is like a jungle guide – but the jungle represents the patient’s
emotional issues. The therapist and patient aim to carry a light together to
walk through the jungle.
What happens in a psychodynamic therapy session?
A therapy session is the patient’s time and
space to say whatever is on their mind. For many people, coming to therapy may
be the first time they’ve actually stopped to reflect on what they think and
feel, or to have an experience where someone else is interested in their
The patient and therapist work towards
having a collaborative, open and trusting relationship.
The therapist listens in a very careful
way, picking up on verbal and non-verbal emotional queues, and will try to help
the patient reflect on their experience. The therapist and patient may find
links with significant issues from the patient’s past. They may explore the
emotion and how it is experienced and responded to. They may discuss how some
of the feelings or tensions within the therapeutic relationship can represent problems
troubling the patient in other relationships too.
What can therapy achieve?
A successful therapy can help someone:
- establish a realistic and
grounded sense of self-identity and self-esteem
- participate more healthily in
- understand and reflect on the
emotions they are experiencing
- respond to emotions in a helpful
rather than a destructive way
- work through traumas from the
past so they do not have a consuming impact on their life
- find their values, passions,
and creative interests
- improve their physical health as
their emotional distress settles
Are there risks?
There are potential risks involved with
every treatment. One of the main risks of psychotherapy is increased distress.
Your therapist will work to avoid this by aiming to establish a collaborative
relationship with you, and having therapy sessions at regular times so there is
a sense of consistency and emotional security. Another risk is that you might not get what
you imagined out of the process. The therapist does not necessarily have all
the ‘answers’ and the outcome of therapy will be the unique creation of how you
and your therapist interact and find a way to work together. It is important to
be realistic about what can change, and one’s responsibilities in life and in
Isn't therapy self-indulgent?
A lot of people who come into therapy have been struggling for a long time, and once they are in treatment, they often wish they had started therapy sooner. Although therapy requires an investment of time and money, the emotional payoffs can be immense and can have ripple effects into one's personal, family, professional, and social lives.
Isn't therapy just for really desperate people, or the 'worried well'?
Therapy can help a range of people with a range of problems. Often the 'worried well' are really the 'walking wounded'.
Do I have to lie on a couch if I have therapy?
No. Some psychoanalysts still use a couch
for treatment because it can help someone say more freely what is on their mind
without the inhibition that can arise from seeing someone sitting across from
What is the difference between psychodynamic therapy
There is no strict difference because
psychodynamic therapy is based on principles of psychoanalytic theory.
However, pragmatically, psychoanalysis is considered to be a more intense
treatment that would usually be conducted at three or more sessions per week. Psychodynamic
therapy is usually conducted 1-2 times per week (3 at most).
Is therapy all about Freud’s theories?
Freud and his contemporaries opened up the
field of psychotherapy but there have been many developments since his day. Some
of Freud’s work is still seen as highly relevant, but his theories are also
tempered with contributions from the vast professional field that has developed
over the past 100 years.
There are a lot of stereotypes of therapy,
mainly seen in TV shows or movies. The therapist is often portrayed as a
mysterious figure who does not say much, if anything at all. The patient usually
wonders what they are getting out of the session as they are lying on the
couch, talking and feeling anxious! The reality is that contemporary therapists
aim to work collaboratively with their patient and foster a sense of warmth,
openness and empathy.
I’d like to have therapy. What is the first step?
The first step is an assessment for
psychotherapy. This usually involves meeting for about three sessions. You will
need a referral from your GP or another medical specialist.
The aims of an assessment are to:
- talk about the problems that
have led someone to seek psychotherapy
- take a background history of
the person’s life – family, experiences and relationships
- come up with some preliminary
ideas to explain how the distress has arisen and formulate together what might
be some goals for treatment
- consider whether psychodynamic
psychotherapy is likely to be an appropriate treatment for that
- for the therapist and patient
to consider together how they would feel about the prospect of working together
- provide information about
psychotherapy and what a treatment contract would involve e.g. policy regarding
fees and missed sessions and planning for breaks in treatment such as holiday
How much does treatment cost?
Each doctor at Mindscape Health sets their own fees and will discuss them with you. Medicare provides a rebate for
therapy so once the Medicare Safety Net is reached, the average cost per session is
How long does therapy take?
It is difficult to estimate but a brief
psychodynamic psychotherapy that focuses on one or two key issues may take
between 10-20 sessions. Longer-term treatment can continue for a number of
years. There is usually a beginning phase of settling in to treatment, a middle
phase of working through issues, and an ending phase of consolidating, reflecting,
and saying goodbye. For people with significant emotional issues, it can take a
long time to settle into treatment, and being able to settle in can actually
represent important emotional changes.
What is the difference between a psychiatrist and a
There is considerable overlap in these
professions because they both deal with mental health and emotional problems.
A psychiatrist is a medical doctor who has undergone
at least 5 years of extra training in mental illness. Like many medical
specialties, there are subspecialties within psychiatry, such as psychotherapy
(to become a psychiatrist psychotherapist). Psychiatrists can prescribe
medications and Medicare rebates apply for their services.
A psychologist has a degree in psychology
and their training may involve different treatment approaches. There are
different levels of psychology training and a clinical psychologist has usually
completed at least a Masters level degree. Psychologists are unable to
prescribe medications but can work in conjunction with a GP or a psychiatrist.
Medicare rebates apply for some psychologists.