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Psychodynamic Psychotherapy > Assessment > Flashcards

Assessment Flashcards

1
Q

What is Assessment

A

Includes assessing the acute problems and ongoing patters, constructing an initial forumula and making a recommendation for treatment.

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2
Q

Holding Environment

A

establishing a connection that helps patients feel secure, safe and trusting

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3
Q

What does history include

A

history of present illness (when was the last time the person was at their baseline), history of symptoms, development/personal history

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4
Q

ego functions

A

patient’s characteristic ways of thinking, feeling, and behaving

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5
Q

ethical judgement/super-ego function

A

patient’s capacity to distinguish right from wrong

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6
Q

reflective capacity

A

ability to step outside their immediate thoughts to look at them critically. Two aspects include Psychological Mindness and reality testing

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7
Q

psychological mindedness

A

the way in which patients think about their mind, is there a unconscious? Can childhood events effect the present?

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8
Q

id

A

wishes, desires

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9
Q

super-ego

A

conscience and personal ideals

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10
Q

ego

A

person’s inner mental life and relationship to the world

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11
Q

self-perception

A

how we see ourselves relates to both our identity and our self appraisal

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12
Q

identity

A

sense of who we are. Likes, dislikes, talents, limitation, often consolidated in teen years

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13
Q

self-appraisal

A

how well our subjective sense of our self matches up with what we are actually able to do. Relates to both setting yourself up for failure and low self esteem

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14
Q

ideals/ego-ideal

A

inner images, fantasies, who we wish to be.

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15
Q

self-esteem regulation

A

ability to bounce back fro self esteem blows

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16
Q

empathize

A

ability to appreciate the way others see the world

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17
Q

mentalization

A

ability to think about others as having thoughts and feelings distinct from ones own

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18
Q

internal/external stress

A

internal stress thoughts and fantasies, feelings and anxiety, pain and other physical sensations. External stress includes relationships, economic/work pressures, trauma etc

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19
Q

defenses

A

unconscious and automatic ways he mind responds to internal and external stress/emotional conflict. Some are adaptive and some are less adaptive

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20
Q

object constancy

A

knowing that bad and good can exist in the same person

21
Q

object permanence

A

knowing something out of sight is still there.

22
Q

splitting

A

experiencing feelings as if they are coming from outside the self. Normal in children, but problematic when they need to protect their good image of an abusive parent or care giver

23
Q

types of less adaptive defenses (tend to be based on splitting)

A
  • Splitting
  • Projection
  • Projective identification
  • Pathological idealization & devaluing
  • Denial
  • Dissociation
  • Acting Out
  • Regression
24
Q

adaptive defenses (based on repression)

A
  • Isolation of Effect
  • Intellectualization
  • rationalization
  • Displacement
  • Somatization
  • Undoing
  • Reaction Formation
  • Identification
  • Excessive Emotionality
  • Externalization
  • Sexualization
  • Repression
  • Turning against the self
25
Q

Isolation of Affect

A

the mind represses the affect but the thoughts remain concicous. Person seems devoid of feeling

26
Q

Intellectualization

A

uses substitution of excessive thinking to take the place of painful or uncomfortable feelings

27
Q

Rationalization

A

Deals with unacceptable feelings by coming up with good reasons for the problematic situation/feeling

28
Q

Displacement

A

exchanges the object of a wish or feeling for one that feels more acceptable
EX Nate is afraid of his father, but instead feels afraid of the school principal.

29
Q

Somatization

A

causes thoughts or feelings to be experienced as bodily sensations (headache, diarrhea, chest pain etc)

30
Q

Undoing

A

Minds do-over, reverses something that feels unacceptable or uncomfortable
EX: She cheated people all day long at work then gave a dollar to a bigger on the street

31
Q

Reaction formation

A

turns unacceptable feelings into their opposite EX Ms Q is overprotective of her infant son in an effort to protect herself from rage at not being able to sleep at night

32
Q

Identification

A

If you can’t bet them, join them. Feelings of jealousy are dealt with by pulling in characteristics of the other person

33
Q

Excessive Emotionality

A

Represses thoughts while affect remains conscious. Not feeling emotional that a divorce is final but exploding that grocery order is delayed

34
Q

Externalization

A

leads people to perceive internal conflicts as if they were external conflicts. Note that this is not a splitting-based defense mechanism, because the feelings are still perceived as coming from within the self
EX Ms U consulted a therapist to talk about whether she should stay with her fiancé or begin to date an old boyfriend who had contacted her. Months into therapy, she realized that she was ambivalent about getting married at all.

35
Q

Sexualization

A

Takes issues that are not sexual and makes them so in order to avoid deeper feelings

36
Q

Repression

A

hiding thoughts, feelings and fantasies leading to forgetting, denial and inhibited sexuality

37
Q

Turning Against the Self

A

Substitutes the self for the object
EX Mr X was angry with his father for buying a new house rather than paying for a year of his college education; however, he experienced this rage as self-criticism for not doing as well as he could have during his first semester.

38
Q

Most Adaptive Defenses (can be problematic if used persistently and inflexibly)

A
  • Humor
  • Alturism
  • Sublimation
  • Supression
39
Q

Sublimation

A

when an uncomfortable thought goes straight from the unconscious to the conscious in a useful form. Like discharging anger by writing poetry or going to the gym

40
Q

Supression

A

Differs from repression as it is conscious. Scarlet O’hara “I won’t think of that now”

41
Q

Projective Identification

A

On person projects a thought/feeling onto another person and behaves in a way that makes the second person feel that way
EXMr C is passed over for a promotion by his boss. Although he says that this is fine with him, his unconscious rage is so overwhelming that he comes in two hours late for a week until his boss is so enraged that he fires him.

42
Q

Pathological Idealization/devaluation

A

the person who is idealized today may easily be devalued tomorrow:

43
Q

General Cognitive Function

A

persons built in cognitive apparatus (intelligence, memory, speech, language, linear thinking). Gross impairments make it difficult to benefit from psychotherapy

44
Q

Reality Testing

A

can differentiate reality from fantasy

45
Q

Judgment/Impulse Control

A

aware of appropriateness and consequences of intended behavior and acts in a way that reflects this awareness

46
Q

Sensory Stimulus Regulation

A

ability to tune out insignificant stimuli (like traffic noise)

47
Q

Five Domains of Function

A

Self, relationships, adapting, cognition, work/play

48
Q

supportive stance

A

Supporting the patient’s thoughts and feelings instead of uncovering the problem or challenging

49
Q

uncovering stance

A

challenging the patient to uncover what is below the surface problem,

Psychodynamic Psychotherapy (2 decks)

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