Presence and the Present: Relationship and Time in Contemporary
Psychodynamic Therapy offers salient points learned from the author's
forty years of practice and teaching, and applies psychodynamic
psychotherapy to the contemporary practice climate. Emphasizing the
therapeutic relationship and the dimension of time, it grounds the
discussion in clinical application. Including more than fifty vignettes
and four extended case presentations, the author deconstructs successful
interchanges as well as errors. Part I sets out central themes and
components of this contemporary view of dynamic therapy while part II
examines present-day applications. Part I begins with an overview of the
core (the relationship) and the contours (characteristics) of therapy
and some of the challenges therapists face today. The ten contours
discussed are the frame, uniqueness, not knowing, different types of
knowledge, mentalization, the therapist's use of self, goals beyond
symptom relief, integration with nondynamic approaches, integration with
neuroscience and therapy outcome research, and, finally, the use of time
and space. Following a discussion of these ten contours, the book
summarizes evidence-based relationship elements in therapy and the
robust empirical research demonstrating dynamic therapy's effectiveness,
while providing a theoretical overview for therapists not familiar with
psychodynamic theory. The last two chapters of part I examine the
complex relationships among time, life, and psychotherapy and continue
the exploration of therapy duration, the present moment, transience,
unending therapy, and termination. Part II of Presence and the Present
begins with two chapters on the therapy of trauma. Chapters 8 and 9
discuss the phenomena of trauma and include practical recommendations
and frequent therapist countertransferences. Chapter 10 focuses on the
organization of self experience through bodily sensations and offers a
nuanced model to understand physical elements of transferences and
countertransferences. The final three chapters explore therapy with
couples who are struggling with disturbed adult or adolescent children,
integrate cognitive-behavioral interventions with the dynamic approach,
and examine the frequent and key affect of shame in psychotherapy.
