Therapy
Most of us face psychological problems at some point in our lives. Common psychological problems include stress, anxiety, worry, difficulty making life choices, mood swings and recurring problems in (intimate) relationships.
We all experience these difficulties to some degree. Occasionally they are only short-lived, but in other cases suffering and pain can become too intense and long-lasting, making it too difficult to cope and understand on one’s own.
If you are experiencing psychological distress and need help, I am here to support you. There is no reason to deal with suffering alone, and seeking professional help is nothing to be ashamed of. Moreover, psychological problems often do not disappear on their own if left untreated.
My therapy aims to support you in learning to relate to yourself with greater clarity. In doing so, gaining insights for meaningful change and promoting healthier relationships and fulfillment is central. I listen and guide you empathically through your process. I help you gain greater insight and awareness into the causes of your pain and how to process and change them.
I also support you in finding effective ways to cope and relieve your symptoms. In therapy, I integrate different approaches to best suit your specific personal needs. If you’re not sure if you need or want to start therapy, don’t hesitate to contact me for an initial (free) consultation.
Types of therapy
Integrative psychotherapy
Integrative psychotherapy combines various therapeutic methods to match what you need at the time. It focuses on your unique situation and uses techniques from multiple streams to help most effectively.
Integrative psychotherapy is my specialization and forms the basis of my way of working. It is not about combining separate methods, but about working from one coherent therapeutic vision in which different approaches complement and deepen each other.
Therapy is tailored to your unique situation and evolves over time. My basic approach is usually psychodynamic and experiential, with a strong focus on emotional processes, relational patterns and recurring themes. Depending on what is needed, this approach may take a more structured form, such as schema therapy, or be supplemented with cognitive-behavioral elements that support that changes are integrated into everyday life.
When traumatic experiences affect functioning, I may suggest adding a phase or component of trauma treatment within the therapeutic pathway. This is carefully embedded in the broader process and tailored to what is appropriate and bearable at the time (see also trauma treatment below).
With some clients, I work primarily from a clearly structured schematherapeutic framework. With others, an integrative approach is central, connecting different perspectives in a coherent and purposeful way.
Psychodynamic psychotherapy
Psychodynamic psychotherapy has its origins in Freud’s psychoanalytic tradition and has continued to develop in various directions. Within contemporary psychodynamic approaches, in addition to attention to insight and meaning-making, there is more emphasis on relational, intersubjective and experiential aspects. Central is the idea that feelings, desires and inner conflicts are not always fully conscious, but do strongly influence how a person feels, thinks and behaves, and the emergence and persistence of complaints and symptoms.
In therapy, we explore these inner conflicts and tensions and gradually bring them into greater awareness. They can express themselves in symptoms and in ways of dealing with feelings, relationships and difficult situations that eventually become problematic. These dynamics are expressed in relationships in everyday life as well as within the therapeutic relationship. Concepts such as transference and enactments refer to ways in which old expectations, fears and protective mechanisms continually manifest themselves in contact with others as well as in relationship to oneself. By also examining how this plays out in therapy itself, their meaning and function can become clearer and room for change is created.
An important psychodynamic movement that I work with is Affect Phobia Therapy (AFT). This approach assumes that emotions are healthy and guiding forces, but that people can become afraid of their own feelings. When emotions have previously been unwelcome or experienced as overwhelming, a fear of feelings can develop, leading to avoidance, inner tension and relationship problems.
Within AFT, we work to reduce this fear of feelings so that emotions can again be better felt, tolerated and utilized. This can contribute to more vitality, a stronger sense of self and more freedom in relationships and life choices.
Schematherapy
Schematherapy is a well-researched and widely supported form of psychotherapy. This form of treatment is particularly appropriate for people with long-term or recurrent symptoms, such as chronic depression, problems with self-image and sense of identity, difficulties in emotion regulation, or persistent problems in relationships.
The term schema refers to deep-seated themes or sensitivities in how a person experiences himself, deals with emotions, has expectations of others and looks to the future. Schemas usually form in childhood, often when important basic emotional needs such as safety, care, recognition or autonomy have been inadequately met or violated. Once formed, schemas often remain in the background and can strongly influence how situations are perceived and interpreted, and how a person responds to them.
Examples of common schemas include Abandonment, the expectation that significant others will leave or reject you; Failure, the deep-seated idea of being fundamentally flawed or doomed to failure; and Shame and Inferiority, a deep sense of inner inadequacy or inferiority. These schemas are often, but not always, related to experiences of emotional neglect, excessive criticism, or a lack of sufficient empathy, warmth and appreciation, as well as other painful relational experiences with parents, caregivers, peers or other significant people, such as bullying, exclusion or abuse.
Schemas can be understood in several ways. A common metaphor is that of a dormant virus in the body: usually it remains relatively inactive, but under certain circumstances or in specific interactions it can be activated and evoke strong emotional reactions and behaviors. Another metaphor is that of a pair of glasses through which a person perceives himself and others. When these glasses are active, situations are filtered in a specific way, often in a way that confirms the schema and maintains it, along with the patterns that emerge from it. Schemas can be seen in this regard as sensitive strings that are easily struck.
Over time, schemas can lead to dominant parts or states of the self. In schema therapy, these states or parts are called modes. Some modes attempt to handle emotional pain or avoid threat, often in unhelpful ways, while other modes reflect vulnerable or child states shaped by past experiences. Examples include the Willless Indulgent mode, which tries to avoid (perceived) rejection, the Demanding Parent mode as a critical and dismissive inner voice, and the Vulnerable Child mode, which feels easily hurt, embarrassed or overwhelmed. These modes can be activated in relation to oneself and in contact with others, often automatically and without awareness.
In schema therapy, we work together to recognize the schemas and modes that are most central to your particular symptoms and relational difficulties, and to understand how they arose and how they continue to affect daily functioning. At the same time, the work is highly experiential and emotional in nature. Through various experiential techniques, and by paying attention to emotions in the here-and-now and within the therapeutic relationship itself, new and corrective emotional experiences can emerge. Early experiences are explored and emotionally processed, while current situations are considered and gradually challenged, with the goal of breaking the repetition of schemas in the present.
A central goal is to strengthen what in schema therapy is called the Healthy Adult: the part of the self that can reflect, set boundaries, show compassion for vulnerable feelings, and respond in a more flexible and nuanced way.
Schematherapy is a structured form of treatment that proceeds in several phases and, in most phases, requires the therapist to be more directive and supportive. Between sessions, clients are often invited to notice activated schemas and modes, explore new perspectives and experiment with expressing emotions and other behaviors in everyday life.
Trauma treatment
Trauma refers to experiences that are beyond the ability to cope in the moment. This can be a one-time, well-defined event, such as a traffic accident, medical procedure or incident of violence, but also repeated or long-term experiences, such as emotional neglect, abuse or a chronic sense of insecurity in relationships. What makes an experience traumatic is determined not only by what happened, but also by how it was experienced and whether adequate support and coping was possible.
When traumatic experiences are inadequately processed, they can leave lasting traces in the nervous system and in the way a person experiences himself and others. This can lead to post-traumatic symptoms such as re-experiences, nightmares, startle reactions, emotional flattening, avoidance and a persistent sense of threat. In some cases, post-traumatic stress disorder (PTSD) is present. Trauma can also contribute to the development of phobias, such as when a person begins to avoid driving after a serious traffic accident.
In some situations, trauma treatment by itself is the primary and sufficient focus of therapy. This is often the case with single trauma or with specific phobias, where targeted trauma-focused interventions can lead to marked relief in a relatively short period of time.
In many other cases, however, trauma is part of a broader psychological picture. This is especially true when there has been repeated traumatization, neglect or abuse over an extended period of time, also called complex trauma. Such experiences can deeply affect personality development, emotion regulation, self-image and recurrent problems in relationships. In such situations, trauma treatment is usually offered as a phase or component within a broader integrative psychotherapy, carefully tailored to the client’s pace and ability to cope.
Processing trauma is not limited to specific techniques. Being able to talk about traumatic experiences gradually and safely within an attuned therapeutic relationship is itself an important part of trauma processing. Sometimes, however, more structured methods are needed to support processing in a more focused way. Within my work, when appropriate, I may suggest the use of Imaginal Rescripting and or EMDR, as part of a broader treatment or, if indicated, as a more targeted intervention.
Imaginary rescripting
Imaginal rescripting is a therapeutic method in which burdensome memories are revisited in the imagination and then actively modified or supplemented. The goal is not to deny what happened, but to create a new emotional experience in relation to the memory. This may include adding protection, care or freedom to act that was lacking at the time.
Imaginal rescripting is a core component of schema therapy, but can also be used independently as a trauma-focused treatment. The method is particularly helpful when traumatic memories are associated with feelings of shame, fear, powerlessness or unmet emotional needs. By working experientially with images, the emotional meaning of the memory can shift and become less upsetting.
EMDR
EMDR, in full Eye Movement Desensitization and Reprocessing, is a treatment method for people who continue to suffer from the effects of shocking or traumatic experiences, such as accidents, violence or other upsetting events. EMDR was developed in 1989 by American psychologist Francine Shapiro and has since been extensively researched and further developed into an effective trauma treatment.
Many people are able to process profound experiences on their own, but in others symptoms persist. These often include re-experiences, nightmares, heightened startle reactions and avoidance behaviors, which may indicate post-traumatic stress disorder (PTSD).
At the beginning of EMDR treatment, the nature of the symptoms, the background of the trauma and the client’s capacity and stability are carefully considered. Based on this, it is assessed whether EMDR is appropriate at that time and how it can be applied safely. Preparation is an important part of the process because EMDR can be intensive.
During EMDR, the client is asked to recall the traumatic event, including associated images, thoughts and feelings, while simultaneously performing an attention-loading task, usually following the therapist’s hand movements with the eyes. This combination seems to activate the brain’s natural processing system. Gradually, the memory often loses its emotional intensity, images may change and new insights may emerge. The experience thus acquires a more integrated and less threatening place in the life story.
EMDR is considered a short-term treatment, especially for single trauma, often showing marked improvement within a limited number of sessions. Processing may continue for some time after a session, which is part of the therapeutic effect.
Text adapted in response to: Text adapted in response to: Handbook of EMDR, 7th edition, by Ad de Jongh and Erik ten Broeke.
Psychodynamic group therapy
Psychodynamic group therapy offers a special therapeutic experience involving not just one client and one therapist, but a group of people who together form a shared therapeutic space. Within this setting, the group itself becomes an active part of the therapeutic process. The interactions between group members form a rich context in which emotional reactions, relational tendencies and underlying personal themes naturally emerge.
One way to understand the group process is through the metaphor of the hall of mirrors, a concept introduced by S. H. Foulkes, one of the founders of group therapy. In the group, people reflect each other in different ways. Resonance occurs: feelings, reactions and relational patterns evoke something in others and are reflected back. Aspects of yourself that sometimes remain less visible in individual therapy can emerge more clearly in the group because of how others respond, are touched or express themselves. Thus, the group provides multiple mirrors that give insight into how a person comes across, how he or she influences others and is influenced himself or herself.
At the same time, the group functions as a living organism with its own dynamics, themes and stages of development. The group can also be seen as a social laboratory, in which participants can explore personal questions and difficulties in direct contact with others. One person may want to put words to a deep-seated sense of shame for the first time; another wants to experience what it is like to set boundaries or express anger; yet another notices that unresolved feelings toward parents or siblings return symbolically in interactions with group members. These experiences make it possible to explore not only individual themes, but also how they take shape within relationships.
The group process is guided and facilitated by the therapist, who supports safety, reflection and dialogue. As time progresses, the group becomes increasingly adept at carrying its own process. Group members respond to each other with increasing openness and awareness, and interactions gain depth and meaning.
An important aspect of psychodynamic group therapy is that what is experienced and learned within the group can be gradually transferred to relationships outside the group. Participants gain insight into how they position themselves in groups and in relationships in general. It is almost inevitable that familiar patterns and tendencies will surface in the group. That very fact provides a unique opportunity to explore these patterns explicitly and collaboratively-an opportunity rarely available so clearly and safely in everyday life.
Psychodynamic group therapy aligns with the insights of Irvin Yalom, who described several therapeutic working factors in groups. These include experiencing that you are not alone in your struggles, drawing hope from the growth of others, giving and receiving support, learning about yourself through feedback, expressing emotions, and developing more open and flexible ways of interacting with others. Together, these elements contribute to a sense of belonging, meaning and personal development within the group.
In practical terms, psychodynamic groups usually consist of about eight to 10 participants, often with both similarities and differences in symptoms and reasons for seeking therapy. The group is led by one therapist or by two co-therapists. Group therapy requires commitment and involvement: meetings usually take place weekly and are most effective when participants commit for a longer period of time, often about a year. Breaks and vacations are usually arranged in consultation with the group. This continuity provides the space needed for trust, depth and meaningful therapeutic work.
Schema group therapy
Schema group therapy builds on the power of group therapy and works explicitly within the framework of schemas and modes (see the section on Schematherapy). The group provides a direct and, more importantly, experiential (experiential) context in which schemas and modes activate in real time and become visible in interaction with other group members. This makes it possible to work with these in real time with fellow group members, not just in dialogue with a therapist.
Schema group therapy is essentially experiential, primarily because schemas and modes activate themselves in real time in contact with other people. Being emotionally and relationally involved with multiple others in the here-and-now evokes feelings, expectations, resonance and compassion that are central to working with schemas and healing persistent patterns.
To illustrate, an example:
A group member who struggles with a strong sense of failure or shame in daily life may suddenly feel criticized, exposed or inadequate in response to a question, comment or reaction from another group member. In that moment, the inner critical mode may be activated, coloring the perception of the situation and reinforcing self-judgment. As a result, the vulnerable child mode may then be activated, with feelings of shame or self-doubt not necessarily commensurate with the current situation. In response, a person may withdraw or make himself smaller (an accommodating mode), or respond with anger that may be perceived as disproportionate by other group members, as an attempt to ward off these painful feelings and the perceived threat.
With support from the therapist and group members, underlying vulnerable feelings and their origins in previous experiences can be explored, understood and validated (seeing and nurturing the vulnerable child mode). At the same time, critical and punitive parts can be addressed and maladaptive coping modes can be challenged in a gentle and empathetic way. Where possible, this creates space to experience and reinforce responses from the healthy adult mode. This process offers a unique, remedial and experiential learning experience rarely available in everyday life.
In addition, schema group therapy uses experiential methods that are also central to individual schema therapy, such as imagination exercises, chair techniques and role plays. In the group, these methods are carried out with the active involvement of other group members, who support each other in the process.
Schema group therapy typically takes place in groups of about eight to 10 participants and is led by one or two therapists. The group can be offered as stand-alone treatment or in conjunction with individual schema therapy. For many people, schema group therapy provides a powerful experiential and relational context that supports and deepens individual treatment.
