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In the initial phase of depression-focused psychodynamic psychotherapy, the patient’s symptoms begin to recede with the development of a hopeful, affectively connected treatment relationship and the beginnings of an understanding that depressive symptoms have meaning. The early, central formulations create a sense of being understood by the therapist, with whose stance toward the depression the patient begins to identify. The patient sees that the depressive symptoms are connected to current and past experience, and hence the symptoms feel less “out of the blue” and more within his or her control.
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