Dynamic Interpersonal Therapy (DIT)

DIT is just one example of the therapies I offer.

What is DIT?

DIT is a time-limited (16 sessions) psychodynamic therapy that can help people with emotional and relationship problems. It has been specifically developed for  depression and anxiety.

One of the main ideas in psychodynamic therapy is that when something is very painful we can find ourselves trying to ignore it. Most of the time we know when we’re doing this, but sometimes we can bury something so successfully that we lose sight of it completely. This is why difficult experiences in the past can continue to affect the way we feel and behave in the present. DIT provides people with a safe place to talk openly about how they feel and to understand what might be causing their difficulties.

An example shows how this might work. Someone who was repeatedly rejected by their parents may stop themselves thinking about how painful this is. As an adult they might become depressed, withdraw from relationships, feeling that it is safer to be alone and not having to depend on anyone. Although not getting close to anyone helps them to feel safer, they might also feel lonely and get depressed as a result.

How would a DIT therapist help such a person? By helping them to talk freely about themselves it might become clear that whenever someone tries to get to know them, they fear the worst and push them away, just to make sure that no-one ever gets close enough to hurt or disappoint them again. By drawing their attention to this pattern, therapy would help them to understand themselves better and change the way they respond. In practice this means that the therapist will often draw your attention to what you are currently feeling in the session. The idea is also that by exploring the relationship between you and your therapist, you can get a better understanding of what is troubling you.

What does therapy involve?

Starting off

Talking openly about yourself for the first time to a new person can feel difficult and you may be worried about what your therapist thinks about you. Your therapist will be interested in how you experience them and will help you to make sense of any worries you may have about starting therapy. It is important that you feel comfortable and respected by your therapist and that you can come to trust them.

Getting a picture of what you need (“Assessment”)

Your therapist will need to get as good a picture as they can of what you are finding difficult in your life and how this is affecting you and people close to you. They will ask some questions, but they should also make it clear that you only need to give as much information as you feel comfortable with. Many people find that as therapy gets going they are able to talk more openly, and in the early stages you shouldn’t find yourself under pressure to say more than you want.

Although your therapist will need to gather some basic information about you and your life, and your relationships in particular, some of the time they will wait for you to talk. This is because they are interested in hearing about what is on your mind rather than asking you lots of questions. Sometimes your therapist may remain silent, waiting for you to speak. This may well feel a bit uncomfortable – for example, you may feel unsure what to say. However if this gets too uncomfortable, your therapist will help you talk.

At the start of therapy your therapist will ask you to complete some questionnaires. These will give them a better idea of the sorts of problems you have (by asking about the sort of difficulties you have), as well as how badly these affect you (by asking how much each problem affects you). Your therapist will discuss the results of these questionnaires with you. They may ask you to complete the questionnaires again every session because this helps you and your therapist see what progress you are making. If the questionnaires show that you are not benefiting from therapy it gives you and your therapist a chance to think about why this might be.

Explaining how DIT might work for you

Early on, your therapist should explain how DIT works, and help you to think through how the approach makes sense of what you are finding difficult in your life. The main thing is that the therapist needs to help you see the ways in which ideas from DIT could be relevant to you and what you want help with. That does not mean you need to be 100% convinced at this stage – it’s more that the idea of DIT needs to make some sense to you if you are going to get the best out of it. One important feature of DIT is that it uses what happens in the relationship between therapist and patient to help think about the problems in your life.

Sharing ideas about what you want to achieve

When your therapist has enough information they will begin thinking with you about what it would be most helpful for you to focus on over the 16 sessions. This is also an opportunity to agree with your therapist about what you want out of the therapy.

Length and frequency of treatment

Your therapist will talk with you about the fixed number of sessions you can expect to have. This will typically be sixteen sessions. The therapy usually takes place once a week. Your therapist will discuss with you any planned breaks and what happens if you cancel sessions.

What can you expect from your therapist

Your therapist is responsible for ensuring that your meetings take place at a regular time, in a setting where you can be sure of confidentiality. Wherever possible they should let you know if they expect to be away or need to change the time of your therapy. Sometimes people find breaks from the therapy hard to manage. When this happens your therapist should discuss this with you and help you to understand why this may feel particularly difficult.

Final stage of therapy

Many people find that ending the therapy can stir up a range of difficult feelings. Your therapist will know and understand this and you should expect them to help you to explore your feelings, including any worries you might have about how you will cope in the future. They should help you think about how you would manage if things became difficult again. After all, the aim of DIT is not to remove your problems – everyone has problems that they need to deal with. The hope is that you will have learned how to manage better, and so avoid problems becoming major difficulties again.