Beyond the Supportive-Expressive Continuum: An Integrated Approach to Psychodynamic Psychotherapy in Clinical Practice

A psychotherapy that is based on psychodynamic principles uses an understanding of unconscious processes in order to help patients with problematic feelings and behaviors. This can involve making patients more aware of their unconscious thoughts and feelings (expressive goal) and supporting weakened ego functions (supportive goal). These two techniques have generally been considered either completely separate types of psychotherapy, or two ends of the “expressive/supportive continuum.” Instead, we suggest that all psychodynamic psychotherapies use both of these techniques in an oscillating way depending on the moment-to-moment needs of the patient and thus that an integrated model is the most useful for conducting this type of psychotherapy.