Chapter 4: Psychoanalytic & Psychodynamic Counseling & Psychotherapy Flashcards
Psychoanalytic & Psychodynamic Theories as Depth Psychologies
Explore the unconscious mind which is conceptualized as deeper than conscious mind
Freudian Psychoanalysis
Root of all psychodynamic approaches, with ego psychology, object relations, self psychology, relational , and intersubjectivity theories being the most direct descendants
Psychoanalysis
Analyst is more likely to use a blank-slate approach, often uses a couch, and typically does not engage clients with warmth
Psychodynamic Therapy
Refers to a more standard, shorter-term (but still typically long), one session per week outpatient counseling approach that addresses a specific presenting problem rather than the project of personality analysis
Psychoanalytic and Psychodynamic Major schools
Freudian Drive Theory Ego Psychology Object Relations Self-Psychology Relational analysis
Psychoanalysis
Based on Freud’s original theories, classic psycoanalysis is a relatively rare but still practiced approach that focuses on analysis of innate drives and transference issues
Ego Psychology
Similar to Freudian Theory in terms of the working relationship, focuses on analysis of how the ego uses defense mechanisms to manage innate drives
Object Relations Theories
Using a more emphatetic and warmer counseling relationship, object relations theorists focus on repairing the client’s early object and relational patterns, often by promotive corrective emotional experiences in the counseling relationship; divided into Integrative Drive Theory and purely relational
Interpersonal Analysis
Related to object relations, Sullivan’s interpersonal analysis is unique in that the analysis process relies heavily on observable data and focuses almost exclusively on interpersonal interactions rather than unconscious processes
Self-Psychology
Based on the work of Kohut, involves empathic immersion in the client’s inner world, analysis of self objects, and a focus on building self esteem
Relational and Intersubjectivity Theories
Recent approaches that emphasize the intersubjective nature of reality and employ a more collaborative counseling relationship, including the co-construction of interpretations with clients
Jungian Analysis
Jung’s distinct approach posits a collective unconscious that shapes our personalities on the basis of universal, archetypical patterns and aims to help people self-actualize, living up to their full potential
Brief Psychodynamic Theories
Time-limited, evidence-based approaches that have been demonstrated effective with depression and substance abuse
Basic Psychodynamic Assumptions
A person’s history affects present behaviors and relationships
There is an unconscious mind that exerts significant influence over present behavior
The personality is structured into various substructures, such as ego, id, and superego.
A person’s personality is significantly impacted by early relationships in life, especially with one’s mother or primary caretaker.
Insight into one’s personality and internaly dynamics can help resolve various psychopathologies
Clients project onto the counselor interrelational patterns from earlier unresolved issues, most often with the clients’ parents; the transference of these patterns can be analyzed and used to promote change in the counseling relationship
Transference
Refers to when a client projects on the counselor attributes from unresolved issues with primary caregives; therapists use these interactions to promote client insight and work through these conflicts; process reveals unconscious templates that clients bring to relationships over and over again
Drive Theorists and Ego Psychologists’ Encouragement of Transference
By maintaining a neutral stance that encourages clients to project unresolved issues on to the counselor, the analyst can then interpret these for the client
Transference Patterns of Client in Object relations, Self Psychology and Relational Approaches
Counselor discusses the transference patterns with the client and explains how it emerged in the current relationship
Countertransference
Refers to when counselors project back into clients, losing their therapeutic neutrality and having strong emotions to the client.
Countertransference as unconscious projection
Represents an unconscious projection on the part of the analyst that needs to be explored in supervision, and it is often inappropriate to discuss with clients
Countertransference as conscious experiencing of the other
Can be used to help counselor and client better understand how others experience the client and the reactions the client may trigger in others, may be used to promote insight
Corrective Emotional Experience
Analyst responds differently than the client experienced in childhood to facilitate resolution of an inner conflict
Sigmund Freud
Father of Psychoanalysis
Anna Freud
Added analysis of ego functioning and defense mechanisms known as ego psychology; Recognized that motivation can come frome xternal sources, not just internal drives
Eric Erickson
Contributed Eight Stage model of Psychosocial Development
Karen Horney
Female Pioneer of psychoanalysis
Otto Kernberg
Integrated drive theory and object relations theory and focused his work on borderline personality disorder
Melanie Klein
Developed a unique form of object relations therapy that incorporates both Freud’s drive theory and object relations theory and is considered to be the most influential person in the field since Freud; pioneer in child and play therapy
Margaret Mahler
Developed a theory of separation and individuation that deals with the process of psychological birth by which an infant becomes psychologically separate from its caregivers in the first 3 years
William Ronald Dodds Fairbairn
Developed a pure object relations model; understood ego in terms of the ego striving for a relationship with an object, not merely seeking satisfaction
Donald Winnicot
Ideas have had more influence ont he understanding of the common, significant issues met by psychoanalysts and psychotherapists in their everyday practice than anyone since Freud
Henry Stack Sullivan
Approach emphasized a drive for relatedness as the primary drive rather than sex or aggression, referred to as interpersonal theory; work first to consider the impact of culture and relationships in understanding mental illness
Heinz Kohut
Developed psychoanalytic approach of self psychology, which he developed primarily with narcissistic patiens for whom traditional analysis did not work; structure
Jay Greenberg
Divided Psychoanalysis into two theoretically irreconcilable approaches: Freud’s drive model and the relational model
Stephen Mitchell
Detailed a relational model for psychoanalysis that focuses on the internal structures that are developed from the individual’s interpersonal experiences
Robert Stolorow
Leader in bringing the intersubjectivity perspective to psychodynamic work, a perspective that challenges the prevailing belief in a discrete, individual mind and instead posits that emotional experience occurs within interconnecting psychological systems or fields created by two or more people in a relationship
Phases of Psychodynamic Counseling
Listening with empathy to reduce defensiveness and increase willingness to hear interpretations
Interpretation to promote insight
Working through insight to promote new action
Listening and Empathy
Primary tool of psychoanalytic therapists; listening objectively to the client’s story without offering advice, reassurance, validation, and confrontation; Empathy may be used to help the client open to nondefensively hearing the therapist’s interpretation of unconscious dynamics
Interpretation and Promoting Insight
Focus is to encourage into personal and interpersonal dynamics, which the counselor promotes by offering interpretations to the client using various case conceptualization approaches; the form of case conceptualization is the most distinguishing feature between the various schools
Working Through
Refers to the process of repeatedly getting in touch with repressed strivings and defense responses so that the unconscious can be made conscious; facilitated by providing a realistic ego to help the client tolerate delay and anxiety as the client revisits, explores, and struggles to accept and understand drives, urges, and patterns that have been unrecognized; involves translating these into action
Psychoanalysis
Refers to an intensive approach designed to create significant and sustainable personality change
Psychodynamic Counseling and Psychotherapy
Brief forms developed to last 12 to 16 sessions; goals are narrower, creating clear criterion for termination
General types of Human Intersubjective Approach
One Person Psychology
Two Person Psychology
One Person Psychology
Entire focus and process of analysis is on one person, the client; increasingly rare and only used in formal analysis that emphasizes drive theory and ego psychology
Two-Person Psychology
Includes two people, the counselor and the client; counselors are keenly aware of their impact on clients;
Neutrality
Allows clients to be provided with a blank slate on which clients can project unconscious material that the analyst can use to promote insight; also referred to as abstinence; allows analyst to be more of a recipient, observe client’s to study their internal and unconscious processes, and allow for transference
Holding Environment
Refers to the nurturing environment provided by the mother that enables the child to move from an unintegrated state to having a structured, integrated self; reduces overwhelming stimuli that the child cannot yet manage, thus requiring skills and empathy ont he part of the mother/caregiver; when applied to counseling process, refers to providing structure, consistency, and routing to filter out overwhelming stimuli and enable the client to develop the ego strength to do the work of psychoanalysis; structure of counseling process takes care of ego maintenance functions so the client has freed energy to work through and resolve conflicts and developmental crises
Empathy
The ability to grasp another’s internal reality; involves first grasping then sharing aloud this understanding; broadened to include emphathizing with that which the client cannot tolerate in himself, projections, and other forms of dissociation from self
Mirroring
Refers to the counselor confirming the client’s sense of self, both verbally and nonverbally
Assumptions of Relational Psychoanalysts
Analyst has a deep, personal influence ont he client and has more influence than is typically acknowledged
The impact of the analyst’s behavior can never be understood while it is happening, if ever
The analyst cannot adopt any posture, including neutrality or empathy, that guarantees a predictable atmosphere and relationship; instead, each relationship must be uniquely negotiated to suit both client and counselor
The analyst is a subjective participant in the analysis process; objective neutrality is impossible
Relational Psychoanalysis
Analyst’s role is to provide useful ideas and explore their relational interactions to help clients reach their goals; strive to create an intersubjective relationship with clients in which obth the analyst and client mutually influence each other, cocreating interpretations and better understandings of self and other
Personal Analysis
Requires that analysts go through analysis themselves in order to be helpful to clients
Areas for Potential Assessment for Psychoanalysts
Levels of Consciousness
Structures of the Self: Id, Ego, & Superego
Drive Theory
Psychosexual Stages of Development and Oedipal Comples
Defense Mechanisms
Good Enough Mothering and the True Self
Stages of Separation and Individuation
Narcissism and Self-Objects
Relational Matrix
Unconscious Organizaing Principles and Culture
Levels of Consciousness
Preconscious
Conscious
Unconscious
Preconscious
Holds memories and experiences that a person can easily retrieve at will
Conscious
Includes sensations and experiences that the person is aware of, such as awareness of exhaustion, hunger,
Unconscious
Holds memorable thoughts, and desires that the conscious mind cannot tolerate and is the source of his work drives; largest level of consciounsness
Self
Organization and integration of all psychic structures that make up the individual
Id
Part of the personality motivated by instinctual drives
Ego
Operates according to the reality principle; part of the personality that involves intellect, cognition, defense mechanisms, and other executinve functions and serves as a mediator between the id and the superego
Superego
Represents ego and social ideals and generally prohibits the id’s drives and fantasies that are not socially acceptable
Freudian Conceptualization of Client Problems
Examining how the ego manages the ongoing conflicts between the id’s drives and the superego’s prohibitions; ego manages these tensions using defense mechanism
Libido
Energy from inner workings of the instinctual drive that cannot be discharged; it must be managed and/or channeled by denying or redirecting it
Death Drive
Source of aggressive energy; must be managed as well
Psychosexual Developmental Model
Descrives the development and maturation of libidinal energy
Psychosexual stages of Development
Oral Stage (Birth to 18 months) Anal Stage (!8 months to 3 years) Phallic Stage (3 to 6 years) Latency Stage (6 to 12 years) Genital Stage (12 or more years)
Psychosexual Stages
Provide a template for understanding how sexuality and aggressive drives may shape the personality and, more important, shape the development of the superego and morality
Fixation at Anal Stage
Leads to one becoming anally retentive or anally expulsive
Intrapsychic Conflict
Metaphor for emotions that cannot otherwise bo consciously acknowledged and /or expressed
Primary Gains
Primary benefit of the symptom
Secondary Gains
Benefits that are not immediately related but a natural consequence
Defense Mechanisms
Automatic responses to perceived psychological threats and are often activated on an unconscious level; used to manage seemingly irreconcilable conflict when the ego is unable to reconcile tensions between the id and the superego and/or manage unacceptable drives
Types of Defense Mechanisms
Denial Introjection Splitting Projection Projective Identification Repression Suppression
Denial
Refusal to accept an external reality or fact because it is too threatening and may involve the reversal of facts
Introjection
Describes when one takes in whole behaviors, believes, and attitudes of another; can have positive or negative emotional valence; when used by adults, swallowing whole the opinions, style, and characteristics of others in order to identify with them or gain their approval
Splitting
Refers to the inability to see an individual as an integrated whole that has both positive and negative abilities; person switches from seeing people as all-good or all-bad: Idealizing and then villainizing;
Projection
Refers to falsely attributing one’s own unacceptable feelings, impulses, or wishes onto another, typically without being aware of what one is doing
Projective Identification
Involves falsely attributing to another one’s own unacceptable feelings; continued unconscious identification that maintains a typically strong and animated connection and control;
Repression
Describes the process that occurs when the superego seeks to repress the id’s innate impulses and drives; cause of a wide range of neurotic symptoms such as obsessions, compulsions, hallucination, psychosomatic complaints; because it happens outside of awareness, repression is considered more pathological than suppression
Suppression
Intentional avoidance of inner thoughts, feelings, and desires
EriK Erickson’s Psychosocial Stages of Development
Trust Vs. Mistrust (Infant Stage)
Autonomy Vs Shame and Doubt (Toddler Stage)
Initiative Vs Guilt (Preschool and Kindergarten Age)
Industry Vs Inferiority (School Age)
Indenity vs Indentity Confusion (Adolescence)
Intimacy Vs Isolation (Young Adulthood)
Generativity Vs Stagnation (Adulthood)
Integrity Vs Despair (Late Adulthood)
Erik Erickson’s Psychosocial Stages of Development Theory
Describes crises that must be negotiated at eight significant points in life. If these crises are not mastered, difficulties are encountered in subsequent stages
Object
In psychodynamic theory refers to the object of a person’s desire, attention or drive; often refers to a person, most often one’s mother; can be internal or external
Internal Object
Operating in one’s internal world
External Object
Existing in the “real world.”
Object Relations Theory
Explores introjection of external patterns with objects, primarily, caregivers; concerned with how the infant internalizes relationships in the first 3 years of life and analyze how this affects adult personality development
Freudian Drive Theory Views on Objects
Relates to external and internal objects to understand personality
Good Enough Mothering
Involves being able to respond to their infants’ communication and needs while allowing them to move toard independence, allowing the child to develop a true self
True Self
A person can spontaneously express needs and desires while maintaining a clear distinction between self and other
False Self
Overly anxious to comply with others, feels unreal and struggles in relationships, Goal is to repair parenting damage and restore sense of true self