HC.5 psychodynamic therapy

Question 1

Name the 7 basic principles that are commonly accepted over time:

Answer 1

1. humans are partly motivated by unconscious wishes, fanatsies, or knowledge
2. Increasing awarness of unconscious motivations can enhance personal choice
3. it’s crucial to explore how people avoid painful, or threatening feelings and thoughts
4. there is ambivalence
5. the therapeutic relationship is essential for exploring self-defeating psychological processes
6. the therapeutic relationship is also a vital vehicle for change
7. helping clients understand how they construct their past and present can aid in overcoming self-defeating patterns

Question 2

What does Freud mean with: ‘we are not masters of our own houses’?

Answer 2

Humans are not fully aware of the factors driving their actions

Question 3

How does Freud describe ‘the unconscious’?

Answer 3

a domain of the psyche where impulses, wishes, and certain memories are hidden from conscious awareness because they are too threatening or culturally unacceptable.

Question 4

What is meant by ‘fantasy’ in the earlier days (mainly by Freud)?

Answer 4

1. Instinctual wishes for sexuality or aggression > wish fulfilments
2. Fantasies play a role in the self-esteem regulation, safety, trauma mastery
   Fantasies can be conscious and unconscious

Question 5

Explain what primary processes mean

Answer 5

A prmitive form of psychic functioning present from birth and operating unconsciously throughout life
- lack of distinction between past, present and future

Question 6

Explain what secondary processes mean

Answer 6

conscious thought, being logical > forming the basis for rational, reflective thinking

Question 7

What are defenses?

Answer 7

Intrapsychic processes that help avoid emotional pain by pushing distressing thoughts etc. out of awareness

Question 8

Name 3 forms of defenses:

Answer 8

1. Intellectualization: discussing something threatening while maintaining an emotional distance
2. projection: attributing one’s own threatening feelings or motives to another person
3. reaction formation: denying a threatening feeling and proclaiming the opposite

Question 9

Describe the Kleinian theory about defenses

Answer 9

splitting: an individu separates their perception of others into all-good and all-bad to avoid the conflict of ambivalent feelings.

Question 10

What is transference?

Answer 10

a patient projects feelings and attitudes from a past relationship onto the therapist

Question 11

How did Freud see transference first and now?

Answer 11

• first: as a resistance to recalling traumatic experiences
• now: essential for psychoanalytic process > it helps the therapist understand how the past experiences influences the present behavior

Question 12

Why did the popularity of psychoanalysis decrease?

Answer 12

• psychiatry’s biological shift
• rise of CBT
• negative perceptions of psychoanalytic arrogance and insularity

Question 13

Describe the conflict theory of the theory of personality

Answer 13

intrapsychic conflict: internal psychological struggles (opposing desires, impulses etc.)
- conflict between id and superego: conflict between id’s desires and superego’s moral standards
- conflict within ego: balancing between id en superego creates also tension
- unconscious conflict
Internal conflicts play a role in the development of personality styles

Question 14

Name 4 character styles

Answer 14

1. obsessive personality: manages conflict between obedience and defiance through intellectualization
2. hysterical personality: desires emotional intimacy but defends against it
3. phobic personality: displaces internal conflict onto external objects and situations
4. Narcissistic personality: defends against dependency and fear of abandonment

Question 15

What is the view of psychoanalysis on the personality styles?

Answer 15

they arise from the interplay of underlying desires and the defences used to manage them

Question 16

Describe the object relations theory

Answer 16

internal representations shape how people perceive others, choose relationship partners, and interact within these relationships. the internal representations are formed through a process called internalization and are influenced by experiences, unconscious wishes, fantasies.

Question 17

Describe the attachment theory

Answer 17

Humans have an instinctual need to maintain proximity to primary caregivers for survival.

Question 18

How do the attachment theory and object relations theory differ from eachother?

Answer 18

they differ in their views on internalization:
AT: internal working models are based on actual interactions with caregivers
ORT: internal models are shaped by real experiences and unconscious fantasies

Question 19

What are developmental arrest models and give 2 examples:

Answer 19

psychological issues arise when caregivers fail to provide an adequately supportive environment, leading to a halt in normal development.
1. Winnicott’s developmental theory
2. Kohut’s Self Psychology

Question 20

Explain Winnicott’s developmental theory

Answer 20

• subjective omnipotence: infants initially believe their wishes can make things happen and that their needs will always be met by their mothers
• Gradual disillusionment: over time, inevitable maternal failures help infants distinguish between their fantasies and reality
• False self: if maternal responses are overly unresponsive or intrusive, infants may adapt to other’s needs
• optimal disillusionment: if maternal failures are gradual, infants can accept limitations without trauma

Question 21

Explain Kohut’s Self psychology

Answer 21

• Cohesive Sense of self: children need caregivers who provide adequate mirroring or attunement to their needs
• empathic failures: inevitably, caregivers fail in attunement or empathy, but working through these failures with parents is critical for developing a cohesive sense of self
• therapeutic relationship: Both theories emphasize that therapy involves forming a new kind of relationship with the therapist, which helps resume the natural developmental process that had been arrested

Question 22

What is psychoanalytic therapy?

Answer 22

• longterm treatment
• frequent sessions
• open-ended approach without fixed termination dates
• helping clients become aware of their unconscious motivations
• not giving advice
• avoiding the imposition of the therapist’s beliefs
• maintaining a certain level of anonymity
• adopting a neutral observer role

Question 23

What is countertransference?

Answer 23

the therapist’s emotional entanglement with the patient
- The therapist’s total reactions to the client)
- First seen by Freud as a hinder
- now: a valuable source of info about the client’s unconscious experiences
-

Question 24

What is resistance?

Answer 24

The client’s tendency to hinder/ oppose therapeutic progress, often rooted in unconscious motivations to avoid emotional discomfort or change.
- now seen as an intrinsic aspect of the client’s psyche that requires exploration and understanding

Question 25

What is intersubjectivity?

Answer 25

The relational dynamics between therapist and client, focussing on how their mutual influence and shared experiences contribute to the therapeutic progress

Question 26

What is enactment?

Answer 26

the unconscious and complementary roles that both client and therapist play in rlational schemas of both parties

Question 27

What is empathy?

Answer 27

Therapist’s identifying with client’s experiences, aiding in alliance formation and facilitating change

Question 28

Describe the role of interpretation

Answer 28

aims to bring unconscious aspects of client’s experience into awareness. the quality, timing, depth and empathic nature determine its usefulness, not accuracy

Question 29

Describe the mechanism ‘making the unconscious conscious’ in psychotherapy

Answer 29

through therapy clients explore their unconscious, revealing hidden motivations and defences, thus gaining greater control over their behaviors and decisions

Question 30

Describe the mechanism ‘emotional insight’ in psychotherapy

Answer 30

integrating conceptual understanding with affective experiences

Question 31

Describe the mechanism ‘creating meaning and historical reconstruction’ in psychotherapy

Answer 31

Assisting in constructing meaningful narratives about their lives, addressing both the absence of coherent narratives and the presence of maladaptive ones.

Question 32

Describe the mechanism ‘increasing and appreciating the limits of agency’ in psychotherapy