Short-term psychodynamic therapy as a form of desensitization: Treating affect phobias

Abstract

This article presents an “anxiety-regulating” model of short-term dynamic psychotherapy that uses the behavioral principles of desensitization to treat psychodynamic conflict. In this model, psychodynamic conflict is reinterpreted as an “affect phobia.” In contrast to phobic stimuli that are external (bridges, snakes), intrapsychic phobias occur within us; the phobic stimuli are feelings. Within this framework, behavioral methods of exposure and the prevention of avoidance can be applied to avoided feelings to resolve the psychodynamic conflict. Clients who are afraid of anger, grief, or closeness are exposed to these feelings in imagery in doses they can bear. Defensive avoidance is prevented and the client experiences the conflicted feeling while learning to regulate the associated anxiety, guilt, shame, or pain. A case example with transcripted segments of sessions is presented to illustrate these principles. © 1999 John Wiley & Sons, Inc.