Important psychodynamic concepts

Question 1

Psychic determinism

Answer 1

• unconscious events play a causal role in later experiences

- developmental psychopathology is the source of adult life difficulties

Question 2

Therapeutic alliance

Answer 2

-the good relationship that therapist and patient have when working on a common task

Question 3

Continuity

Answer 3

-things that may affect progress of therapy include absence, lateness, breaks, impasse

Question 4

Acting in

Answer 4

• enactment within a session
• physical contact
• persistent questions
• presents/gifts
• silence

Question 5

Acting out

Answer 5

• enactment outside the sessions
• suicide
• self-injury
• alcohol use
• drug use

Question 6

Interpretation

Answer 6

-expression of therapist’s understanding of the meaning of feelings, attitudes, defense mechanisms and behaviours currently exhibited during therapy

Question 7

Transference

Answer 7

• the feelings, thoughts and attitudes given to a person in the present (such as the therapist) that do not befit that person but actually originate from a person or figure in the patients past
• transference is bidimensional
• transference is unconscious
• only an aspect of a relationship, not the entire relationship is transferred
• it is the communication of a patient’s needs that cannot be verbally expressed

Question 8

Factors increasing transerence

Answer 8

1. vulnerable personality, especially people with borderline features- intense and early transference can occur
2. the patient’s appraisal of being in a needy or vulnerable or dependent position
3. frequent contact with the therapist or key workers

Question 9

Kohut

Answer 9

• defined three types of transferences
  1. mirroring transference
  2. idealising transference
  3. twinship transference

Question 10

Mirroring transference

Answer 10

• due to significant mirroring failures from the parental figures in childhood
• child feels inadequate and may try to compensate by being perfect
• in therapy they are in constant need of a therapist to assure their self-esteem

Question 11

Idealising transference

Answer 11

• based on the concept that poor self esteem is not troublesome as long as the person can be attached to another person with power or prestige
• through the idealisation of and identification with external objects, the process of preservation of self-esteem is maintained

Question 12

Twinship transference

Answer 12

• evolves when the patient feels comfortable only when the self-object has the same thoughts, values, and appearance
• the patient may expect the therapist to feel and act as he or she does

Question 13

Countertransference

Answer 13

-the therapist’s spontaneous feelings and emotions that are evoked when they ‘tune in’ to the patient’s unconscious communication, including the patient’s transference

Question 14

Resistance

Answer 14

• the means by which aspects of reality are repeatedly rejected by the patient
• they refuse to acknowledge them and they are kept in the unconscious

Question 15

Repression resistance

Answer 15

-refers to the patient’s difficulty in gaining access to certain ideas and emotions

Question 16

Transference resistance

Answer 16

• refers to the patient’s unconscious wish to keep therapeutic relationship similar to past relationships
• negative therapeutic reaction is also a type of resistance

Question 17

Termination reactions

Answer 17

-temporary setbacks that occur when sessions enter termination phase due to the dependence of the patient on the therapist

Question 18

Negative therapeutic reaction

Answer 18

-this is the process by which a step in the right direction may be followed by a backwards step

Question 19

Insight

Answer 19

-being aware of and acknowledging one’s mental processes including ego defence mechanisms

Question 20

Acting out

Answer 20

• refers to performing an action to express unconscious emotional conflicts
• it is the ‘return of the repressed’

Question 21

Repetition compulsion

Answer 21

• person repeats a traumatic event over and over again

- occurs during Id vs Superego conflicts

Question 22

Working through

Answer 22

-a process of unlearning prior misconceptions and learning new constructions

Question 23

Franz Alexander

Answer 23

-corrective emotional experience

Question 24

Regression

Answer 24

-activation of parts of the patient’s personality that is normally hidden may occur

Question 25

Defence mechanisms

Answer 25

-anxiety about an internal conflict over a wish or impulse can trigger the use of a defence mechanism