PSY343 - 2. Psychoanalysis and Psychodynamic Therapies Flashcards
Sigmund Freud
Influenced by: Jean Charcot believed bodily
symptoms result of psychological disturbances
Pierre Janet: connections betw the past traumatic events
of a person’s life + present day symptom
Sigmund Freud
hypothesized psychopathology must arise from repression of sexual needs + feelings.
Background
pleasure principle – drive for pleasurable sensation instinctual + normal part of human development
personality shaped by biological drives expressed early in life through preoccupation with specific parts of the body
Background
Each stage involves gratification associated with function of that part of the body + child’s developmental stage
Psychopathology result of fixation at a developmental stage
Background
psychoanalysis – focused on accessing unconscious mind
Neo-Freudians – psychoanalysts who broke from Freud
Background
Psychodynamic therapy is umbrella category includes psychoanalysis + ones emerged out of psychoanalytic context (object relations, self-psychology)
Theory of Personality
Psychoanalysis emphasizes influence of biology + early childhood experiences on personality development
Personality is influenced by both conscious + unconscious motivational forces, which can sometomes conflict
Personality Structure
Id: biological component
Ego: psychological component
Superego: social component
Theory of Personality
“conflict model”: continuous conflict betw Ego + other 2 structures (Id + Superego)
deal with conflict, Ego develops defense mechanisms to keep conflict from surfacing (becoming conscious)
Defense Mechanisms
automatic ways of responding to situations that arouse unconscious threats/fears
Theory of Personality
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Defense Mechanisms
Repression – removing painful memory or feeling from consciousness
Projection – unacceptable impulses or feelings to another person
Defense Mechanisms
Displacement – unacceptable thoughts, feelings, wishes, urges + impulses from real target to less threatening object
Denial – refusal to accept external reality when it is too threatening
Defense Mechanisms
Avoidance – withdrawing from experience of pain or anxiety
Splitting – seeing some people as all good + others as all bad, or idealizing + devaluing same person
Sublimation – channelling one’s impulses into positive, culturally desirable activities
Theory of Personality
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Theory of Personality
pathological personalities determined by way moves through the stages of development
moves through each stage without getting stuck will develop a “normal” personality
fixated on a stage, pathology may develop
How does fixation occur?
Biology: Some more naturally susceptible to getting stuck
Trauma: traumatic events at particular stage might result in gelng stuck
Freud’s Psychosexual Stages of Development
When libidinal energy becomes fixated at particular stage, person will manifest personality style that reflects focus of stage: Oral Stage (0-1 yr) – ability to trust, to love + form close relationships + development of self-esteem
Theory of Personality
Anal Stage (1-3 yrs) – inability to recognize + express anger, leading to denial of own power as person + low sense of autonomy Phallic Stage (3-6 yrs) – inability to fully accept sexuality + sexual feelings
Theory of Personality
Latency Stage (6 yrs-puberty) – No psychosexual development takes place during this stage Genital Stage (puberty – adulthood) – Successful resolution of previous stages
Goal of Psychoanalysis
Long term, intensive process: typically 2-5x per week for 3-5 years
uncover sources of past pain causing problems in present
Goal of Psychoanalysis
discover obstacles for acting in line with goals, wants, desires
Reworking old patterns so indiv is more free to respond in new ways
Therapy Process: Transference
transfer of feelings originally experienced in early significant relationship to other ppl in the present environment
transference reactions analyzed + interpreted
Therapy Process
origins of transference understood + resolved, ego strengthened, + client able to relate to others in healthier way
Neo-Freudians challenged + broadened transference
Therapeutic Stance: Neutrality
therapist as “blank screen”
Listening with ‘third ear: Attuned to underlying meanings, symbols, contradictions + important omission that may help analyst unlock the unconscious
Therapeutic Stance
Evenly hovering attention: Listening to all the levels of communication at once
Therapy Techniques
Interpretation: shares understanding of central theme, often facet of transference
Free association: Exploring unconscious through spontaneous associations (words, dreams, fantasies, memories), unedited streams of consciousness
Therapy Techniques
Dream interpretation: investigation of repressed feelings expressed through dreams, hidden motives, wishes, fears
Defense analysis: Focuses on what patient is resisting, how s/he is resisting, and why s/he is resisting
Therapeutic Alliance
necessity of good rapport betw the analyst + patient
Ruptures in alliance can lead to a temp deterioration of mutual agreements concerning tasks + goals of treatment + heightened resistance + increase in negative transference
Countertransference
reactions towards transference due to own unconscious
conflict
Originally considered serious obstacle to effective treatment
Countertransference
Current definition broadened to include all
analyst’s reactions to patient conscious + unconscious
Criticisms of Psychoanalysis
Eurocentric approach: Rooted in secular values
Heavily influenced by gender and sexual
politics of late 19th + 20th century
Difficult to study scientifically
Psychodynamic Approaches
Maintain structural theory of id, ego,superego
Focus on how paKent experiences self in context of interpersonal relationships
Psychodynamic Approaches
Transference – countertransference enactments
important source of info about interpersonal + intrapsychic dynamics of both members
interpreting transference still key to elucidating patient’s intrapsychic life
Divergence from Psychoanalysis
Degree transference major focus of treatment main distinction
Rejection/deemphasis of drive theory + psychosexual stages
Divergence from Psychoanalysis
Focus on attachment: interpersonal relationships
Frequency of sessions, use of a couch
Relational Psychoanalysis
emphasize relationship betw self + others as major organizing principle in lives
Reject Freud’s idea initial pull toward objects based primarily on object’s role in serving instinctual discharge
Relational Psychoanalysis
importance of early mother-infant relationship + in facilitating or arresting personality development
Relational Psychoanalysis
Psychopathology from environmental failures leading to faulty internalization of early interpersonal relationships
patient-analyst dyad interactive + reciprocally influential
Interpretation deemphasized for providing corrective emotional experience
Relational Psychoanalysis
Active Ingredients: Increasingly coherent, plausible narratives co-constructed by patient + therapist
holding environment provided by therapist can constitute corrective emotional experience that allows patient to risk new ways of relating to others
Relational Psychoanalysis
patient can experience diff aspects of self + learn various self-states influenced by interpersonal contexts
patient emerges with more balanced integrated view of
self + other
Adlerian Therapy
Human behaviour is goal-oriented + socially embedded
family serves as first social group; people are influenced by their unique positions in their family constellation
Adlerian Therapy
Pathological personalities emerge from family atmosphere of competition, mistrust, neglect, domination, abuse or pampering
Social interest: willingness to participate in life +
cooperate with others opposite of self-interest
Adlerian Therapy
Time-limited treatment
Collaboration betw client + therapist necessary for change to take place
Therapy helps patients become aware of mistaken goals + change behaviour
Brief Dynamic Therapy
Incorporates presence of resistance. value of interpretation, working alliance central
Length treatment decreased
Targets focal interpersonal problem within first few sessions
Brief Dynamic Therapy
Goals determined early
Therapist less neutral, more active
Transference interpretations happen earlier
Research on Psychoanalysis
No RCTs
difficult to study
process long term + unstructured
Research on Psychoanalysis
case study basis for developing clinical + theoretical views
Empirical research considered less useful given idiographic nature of psychoanalysis
Research on Psychoanalysis
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Research on Psychodynamic Therapies
efforts to establish stronger empirical base for effectiveness of psychodynamic therapies
more effective than placebo, supportive therapy, or TAU; no difference between psychodynamic + other bona fide treatments
Research on Psychodynamic Therapies
Efficacious for common mental disorders(depression,
anxiety, personality disorders, PTSD, etc.)
5 year follow up 87% (of patients who received TAU continued borderline personality disorder vs. 13% of psychodynamic patients
Video of Psychodynamic Therapy
checking back with the client whether he agrees with her interpretation
discourse rather than blank space
contemporary
Video of Psychodynamic Therapy
bring to consciousness unconsciously reenacting old patterns
losing father - respond to loss by numbing himself when there’s a threat
