Melding Psychotherapy Approaches

This letter is in response to the article in the July 6 issue by Dr. Frederic Busch titled “Psychodynamic Approaches to Behavioral Change.”

Dr. Busch’s article is very relevant and timely. While various psychotherapy modalities have been developed over the past few decades, one point that we need to keep in mind is that each modality has something to gain from the other.

Sadly, psychotherapists tend to restrict themselves to a certain approach, at times to the point of dismissing the value of a psychotherapy modality that is different from what they believe in or have been trained in.

This can be detrimental to patient care as well as to the future generations of psychotherapy practitioners. Dr. Busch’s article beautifully delineates examples of how psychodynamic therapy may benefit from behavioral approaches and vice versa.

Due partly to more research supporting behavioral approaches, psychodynamic psychotherapy has been relegated somewhat to the background in recent years, such that many newer psychiatrists and psychologists are not fully aware of what psychodynamic psychotherapy has to offer. Certain factors may be contributing to this situation, but Dr. Busch aptly suggests that the psychodynamic approach may also benefit from incorporating elements from the behavioral one. I’ve even encountered many therapists holding a negative bias toward certain major forms of psychotherapy.

The same way in which just a biological approach or a purely psychological approach would not provide a patient with the most optimal or comprehensive treatment, a psychotherapy approach that is purely of one type runs the risk of missing important elements of treatment, treatment resistance, and, eventually, understanding the patient as a whole.

Richa Bhatia, M.D.

San Mateo, Calif. ■