How to be brief
when you were
trained to be deep
and vice versa...

Psychotherapy's Unrecognized
Dilemma
Deep versus brief: A false dichotomy
The unchallenged assumption that deep therapy cannot be brief therapy has dominated the field for a century.
 
The progressive, nonpathologizing brief therapies that emerged since the 1960s achieve speed by purposefully avoiding any focus on the unconscious emotional basis of clients' problems--the depth dimension, often the seat of major life themes.
 
This failure to deal with the actual complexity of people has been a serious loss, even a crisis of avocation, for many practitioners forced by managed care to do brief therapy. They experience the depth-avoidant brief methods as a superficial and often artificial engineering of symptom relief that leaves the heart of the problem unchanged.
 
Yet so ingrained is the assumption that depth must be sacrificed for brevity, that the real dilemma goes largely unrecognized: What threatens the quality of therapy services is not so much managed care's demand to be brief, but rather the failure of brief therapies to be deep.
 
Depth was a casualty in the struggle to break away from psychoanalytic orthodoxy.
 
The longstanding Freudian/psychiatric monopoly on in-depth therapy had created a backlash. To the creative new breed of nonpathologizing clinicians it seemed that working with unconscious, intrapsychic process necessarily entailed unverifiable interpretation, an authoritarian, pathologizing attitude for the therapist, preoccupation with causes in the past, monumental goals, a snail's pace of change, and dubious effectiveness.
 
The progressive movements therefore shunned "the unconscious" with anti-orthodox zeal and abandoned it to the pathologizing schools. It was not yet apparent that the deplored features of mainstream psychoanalysis were not intrinsic in working with the unconscious, and were limitations of that particular model and methodology.
 
"Only recently has the term unconscious begun to be liberated from exclusively psychoanalytic connotations," observed theorist and clinician Michael J. Mahoney in his 1991 Human Change Processes.
Depth oriented brief therapy (DOBT) is a qualitatively new development, combining "brief" and "deep" in a comprehensive methodology and conceptual framework.
 
It is, like many other progressive brief approaches, a postmodern, constructivist therapy, but with a significant difference: It heads straight into the unconscious and emotional domain where many of the most meaningful, passionate, and governing themes are found. Yet it is as focused, optimistic, nonpathologizing, noninterpreting, collaborative and transparent as any other postmodern therapy.
 
A wide range of symptoms presented by individuals, couples and families can be alleviated by DOBT time-effectively along with the less visible, often lifelong emotional wounds associated with them.

A "cross-platform" therapy

TOP
To which school of psychotherapy does depth-oriented brief therapy belong?
 
DOBT properly understood is a new synthesis that does not fit into the assumptive framework of any of the major schools of therapy. It is a "cross-platform" therapy in that adherents of a wide range of orientations find comfortable common ground with it:
 
Its central attention to emotional and unconscious process makes it relevant to psychodynamic therapists.
 
Its focus on current constructions and internal representations created in the course of development gives it much common ground with the object relations school, cognitive therapists and, of course, constructivists. DOBT is certainly a form of "personal construct therapy," and it resides in the same constructivist paradigm as the Personal Construct Therapy originated by George Kelly, but it differs greatly from Kelly's approach.
 
Its insistence on experiential, phenomenological and empathic methods is shared by humanistic and existential therapists as well as practitioners of self psychology.
 
Its systemic dimension with couples and families makes it thoroughly compatible with family systems approaches.
 
Its constant focus on swiftly dispelling the concrete presenting symptoms makes it relevant to brief therapists of all types.
 
DOBT is not another "miracle cure" brief therapy. Its essence, once grasped, has great simplicity. However, for many therapists DOBT requires a new way of thinking that challenges prevailing assumptions about the mind, the nature of symptom production, the process of change, and how rapidly deep change can occur.

Copyright © 2001 Bruce Ecker & Laurel Hulley
Email:  website@dobt.com