Concurrent Therapies When Therapists Don't Concur

This paper reports on my experience with a common but little studied phenomenon in the field of psychoanalytic psychotherapy: the simultaneous treatment of a patient by more than one therapist and in more than one modality. Although I have found no research and very little clinical writing about concurrent therapies, when informally polling psychoanalytic colleagues, everyone I spoke with was treating patients who were simultaneously in treatment with someone else in a different therapeutic modality. The most difficult combinations appear to be individual psychotherapy or analysis along with couple or family psychotherapy, while group therapy or psychopharmacology are less problematic.

Everyone does it, but no one has been trained to work in this way, leaving experienced therapists at sea, with many questions, including the following: Should we do concurrent therapies at all? How do concurrent psychotherapies affect one another, positively and negatively? If there are interaction effects how must we adapt our psychological theories and treatment models to address the mutual impact of multiple therapies and multiple therapist systems? For example, must we rethink a central concept like transference if we accept that our patients look quite different in interactions with different therapists or with family members?

Schooled in both psychoanalytic and family systems theories and treatment paradigms, I have encountered multiple arguments from