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What is Depth Psychology?

 

Depth Psychology: Stronger than the Thinking Mind

By Tracy Sidesinger, PsyD

 

If you’ve landed on this page, you’re probably wondering what “Depth Psychology” is. The name is pretty straightforward, but in this article you’ll learn a little more about how and why it works, as well as when it is an appropriate type of therapy to pursue or recommend.

In the simplest of terms, Depth Psychology is therapy that engages with what lies under the surface in the vibrant, immense depths of the psyche. To understand this we have to make a distinction between the conscious and unconscious mind. The conscious mind contains that which we are aware of and can understand with reason, whereas the unconscious mind contains everything else, including that which we do not yet have words for.

As you may already sense, there are many things for which we don’t have words. For example, why does someone feel depressed, even though their life looks perfectly fine? Why can’t you find a loving relationship even when all of your friends can? What are you supposed to do with the anger you feel at the injustices around you? Why did you seem to be saved from a worse fate that was headed your way? These unknowns can occur at many registers including thought, emotion, or relationships and other circumstances. They evidence the working of the unconscious that is stronger than our thinking minds. Depth Psychology, accordingly, is the theory and practice of anyone who works with the unconscious.

 

Why Depth Psychology?

The 2021 Mental Health America report showed that almost a quarter of adults (24.7%) with known mental illnesses in the United States who received care, did not receive adequate care. Some of the reasons this report cites are “lack of available treatment types” and insufficient funding such as time-limited coverage through insurance and Medicaid. These findings are based on self-reports, suggesting that most individuals know they need longer-term care including Depth Psychology, regardless of differences in class, race, and symptom severity. However, there are barriers to receiving this care that need addressed at the community and political levels to make it more accessible.

What many don’t realize is that Depth Psychology is also an evidence-based treatment. In public perception, there has been a semantic emphasis on brief, cognitive-focused treatments equating them as “evidence based.” However, there is also a body of research on Depth Psychology demonstrating that its effectiveness continues to grow over time, even after therapy ends. In contrast, many who receive short-term therapies return to treatment again after twelve months for the same condition. When longer lasting change occurs, we may attribute it to the internal processes set in motion uniquely through Depth Psychology. 

In a review of research on both brief and depth treatments, Linda Michaels noted that psychodynamic psychotherapy fared well in the short-term. When measured nine months later, after treatment ended, improvement was more notable still. This is significant because most of the research studies on ‘evidence-based treatments’ assess short-term protocols that typically last 8-10 weeks.” Furthermore, in a meta-analysis of this research, Jonathan Shedler found that a “consistent trend toward larger effect sizes at follow-up suggests that psychodynamic therapy sets in motion psychological processes that lead to ongoing change, even after therapy has ended.” Depth Psychology, in short, affords patients with lasting change from the inside out.

 

What is Depth Psychology?

The symptoms that bring people into therapy are often a misalignment between externalities and the internal psyche. External pressures like future planning and the expectations others have for one’s career and identity can leave little space for internal reflection. Depth psychology sees symptoms as manifesting as a means of realigning oneself, forcing time for reflection, even if this means a disruption from daily life for a time. 

An old trope about psychotherapy comes to mind: Things often get worse before they get better. Brief and goal-directed therapies may offer relief from feeling bad in the short term. Sometimes this is necessary, such as when therapies teach communication strategies and coping skills to get through distress, and harm reduction to help people stay safe. But, as my own patients remind me, the immediate feeling of relief won’t be effective if it is a means of avoiding reality or removing someone from the wisdom inherent in their distress. Having an experienced therapist sit with you through difficult feelings and experiences can be essential to embracing reality, and finding your own way of navigating life.

Here is a short list of some things you can expect to focus on in Depth Psychology:

 

    • Symptoms – Talking at length about the symptoms you experience, including the history and context in which these occur.
    • Emotions – Symptoms often manifest when a person isn’t able to articulate what they are feeling through language. Depth Psychology focuses on identifying and naming your emotions as a basis for self-understanding and action.
  • Relationships – Talking about current relationship dynamics helps understand how and where issues are relevant in the present moment.
  • The Therapeutic Relationship – What is experienced internally often plays out in the therapeutic relationship. Talking about this relationship is a way of understanding in the moment what is happening for the patient. 
  • Sexuality – Many other aspects of life manifest strongly in sexuality and sexual fantasy (desire, impotence, aggression, fear, etc.) which makes it a useful area of focus in therapy.
  • Spirituality, Race, and Class issues – All of these are very personal but have huge implications for how a person experiences the world, and so they would be considered in therapies of depth.
  • Dream Analysis – Nighttime dreams are famously used in Depth Psychology because they are a direct link to feelings and realities that otherwise remain unconscious. 
  • Unexpected Life Experiences – Surprise is a major element of change. When ideas held in the conscious mind are confronted with the unexpected, there is access to what we didn’t know before. 
  • Symbols – Symbols that captivate a person hold multiple meanings and can be amplified to broaden psychological experience.
  • Family History – Family history can give context to how a person has developed. We need to understand a person’s foundational experiences before we can attempt to change them.
  • Patterns of Behavior – When patterns emerge – over an individual’s life or across different people in a family history – they indicate an unconscious psychological dynamic playing out. We focus on these patterns to give them attention and liberate patients from unconscious repetitions.

 

Depth Psychology in the tradition of Carl Jung

Sometimes the Depth Psychology term is used specifically to refer to therapists who work in the psychoanalytic tradition of Carl Jung. Jung was a contemporary of Freud’s and is most known for his theories of archetypes and the collective unconscious, and his use of mythology and symbols to find meaning through distress. 

I’ll break those concepts down a little bit. The collective unconscious is a theory that suggests each persons’ unconscious is more than a reservoir of what has been kept out of awareness or repressed in their individual lives. Rather, the unconscious is also a larger well into which we are all linked. It is collective. It includes that which is passed unknowingly across generations, as well as social-historical experiences of race, gender, and power. The archetypes are pre-existing patterns of expression that can be tapped in this collective unconscious well. Some examples of archetypes include the mother, orphan, hero, and sage. Sometimes archetypal patters seem to operate with a mysterious power (why does one pattern keep presenting itself, despite a person’s best efforts?) or alternately, other patterns feel totally inaccessible to a person. Dream images, symbols or cross-cultural stories that show up in an individual’s life are very often considered in Depth Psychology as a way to get deeper into the depths and access archetypal patterns of behavior. 

For example, James is a young man who identifies peripherally with the orphan archetype in that he often feels rudderless and abandoned. His parents divorced when he was a toddler and, although he maintains loving contact with all of his family members, he also routinely feels left out and abandoned. One of his major pastimes is watching documentaries about the U.K. royal family. He studies generations of their lineage, their family feuds, and public perception of the family, all with relentless focus. While James presented with bodily symptoms around eating and body image, taking into account his family history and symbols of interest has shown that the bodily symptoms were a manifestation of longer standing interpersonal anxieties. Other forms of therapy may dismiss James’s royal family pastime as irrelevant to the treatment or worse, a misuse of his time. In contrast, using a Depth Psychology orientation to consider his preoccupation with the royal family, James and I developed language for the particular ways in which he experiences himself as an orphan. We have a point of entry into his pains and longing for belonging. A specifically Jungian Depth Psychology will use archetypes like this regularly in the therapy, in the belief that whatever captivates a person through symptom or symbol is meaningful to the work in process.

Whether you go with a Jungian Depth Psychology or a more general Depth Psychology, you can expect to be in a therapy that engages the unconscious. These therapies consider the past as well as how it continues to function in the present. Simultaneously, they consider unique new possibilities for the future that come through untangling the knots of the life one is in. Depth Psychologies work with the whole person, exploring the terrains of thought, emotion, body, and relationships, to understand the context of a person’s distress and work toward long-term healing of the soul. Depth Psychology therefore fosters space to develop ones own voice through interiority, toward the reduction of symptoms as well as longstanding authenticity. 

 

References: 

 

Michaels, L. (2020). Therapy that Sticks. https://aeon.co/essays/why-depth-therapy-is-more-enduring-than-a-quick-fix-of-cbt

 

https://mhanational.org/issues/2022/mental-health-america-access-care-data#seven

 

Shedler J. (2010). The Efficacy of Psychodynamic Psychotherapy. https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf