Steering through storms to safe havens: Playing and reality in Brief Dynamic Therapy

The author outlines the contribution and relevance of Winnicott's thinking to the practice of Brief Dynamic Therapy. Specifically he notes three transitions that can be employed to deepen the therapeutic engagement with the patient and enhance effectiveness. The transitions involve acknowledging the let-down, facing the patient's destructiveness and reaching back to what had been good enough in their early experience. The importance of play and spontaneity in the transitional space of brief therapy are also noted as well as their relationship to particular therapeutic techniques. The augmentation that Gustafson has provided to Winnicott's ideas which map the notion of changing a reiterating pattern onto the terrain of the patient's current external world as well as in dreams is described. These themes are then illustrated by two case studies.