Psychoanalysis - one psychological therapy for depression (A02)

Question 1

PSYCHOANALYSIS TAKES A LONG TIME TO BE EFFECTIVE - justify and elaborate this criticism.

Answer 1

…because the ‘cause’ of depression is hidden deep in the unconscious and is not easily accessible. Sessions usually span at least ten to twelve weeks, and can often take years to reach completion. This means that some clients may ‘drop out’ early - because they don’t have the time, money, or emotional energy to devote to it. Hence this may be a barrier to effectiveness.

Question 2

 PSYCHOANALYSIS TREATS THE CAUSE OF DEPRESSION, NOT JUST THE SYMPTOMS - justify and elaborate this criticism.

Answer 2

…because the aim of psychoanalysis to uncover the hidden conflicts in the unconscious mind which are thought to be the root problem for people suffering with depression. Once this root cause has been uncovered, the conflict can be resolved and so the therapy should, in theory, provide a permanent resolution.

Question 3

PSYCHOANALYSIS DEMANDS A GREAT DEAL OF INVESTMENT FROM THE CLIENT - IN TERMS OF TIME AND EMOTIONAL ENERGY - justify and elaborate this criticism.

Answer 3

…because the aim of psychoanalysis to uncover the hidden conflicts in the unconscious mind which are thought to be the root problem for people suffering with depression. As the root of the problem is hidden, it takes a great deal of time to uncover. Emotional investment is required because the client may need to face up to painful, anxiety provoking memories which have been repressed exactly because of their anxiety provoking nature.

Question 4

IT IS DIFFICULT TO KNOW WHETHER PSYCHOANALYSIS IS EFFECTIVE FOR THE INDIVIDUAL WITH DEPRESSION - justify and elaborate this criticism.

Answer 4

…for two reasons: (1) it is difficult to measure the severity of depression in the first place, so assessing whether there has been any improvement is difficult; (2) even if the client does appear to improve in terms of their mood and everyday functioning, we can’t be certain this is a result of the psychoanalysis uncovering and resolving hidden conflicts - it could be the result of just ‘talking through’ one’s feelings, or even more simply, just the passage of time that has led to an apparent reduction in symptoms.

Question 5

IT IS DIFFICULT TO KNOW WHETHER PSYCHOANALYSIS IS EFFECTIVE AS A TREATMENT FOR DEPRESSION IN GENERAL - justify and elaborate this criticism.

Answer 5

…because to truly test its effectiveness, we would need to compare the change over time in the symptoms of depression of a group of people under-going psychoanalysis with a separate group of people under-going some other form of therapy. Even if we were able to devise a valid and reliable way of operationalising ‘improvement in symptoms of depression; to be certain that any apparent advantage of psychoanalysis over the other therapy was genuine, we would need to control a host of extraneous variables, such as lifestyle factors, severity of depression at the start of therapy, other life events, etc. This would be impossible on a practical level, not to say unethical.

Question 6

THE ‘CAUSE’ OF DEPRESSION UNCOVERED BY THE THERAPIST DURING PSYCHOANALYSIS MAY NOT BE VALID - justify and elaborate this criticism.

Answer 6

…because what seems to be the emergence of a ‘theme’ may actually be the result of the therapist’s own biases and subjective experience. This means that there is the risk that the client ‘blames’ a parent for their depression, when in fact they may have nothing to do with it at all. In this sense, psychoanalysis may not be effective, or appropriate.

Question 7

PSYCHOANALYSIS CAN BE EXTREMELY STRESSFUL FOR THE CLIENT - justify and elaborate this criticism.

Answer 7

…because the aim of psychoanalysis is to uncover the hidden conflicts in the unconscious mind which are thought to be the root problem for people suffering with depression. The very memories that the therapist is trying to help the client access have been repressed because they cause anxiety - hence it is inevitable, for the therapy to be effective, that the client will need to face up to painful, anxiety provoking repressed memories. For this reason, psychoanalysis may not be appropriate for all people suffering with depression - suicidal clients, for example, because the extra stress may actually increase the severity of their depression.

Question 8

PSYCHOANALYSIS MAY NOT BE APPROPRIATE FOR ALL INDIVIDUALS SUFFERING WITH DEPRESSION - justify and elaborate this criticism.

Answer 8

…for a number of reasons: (1) because it is very time consuming and the time investment may cause added stress to some people, especially if the apparent trigger for their depression is a stressful job, for example; (2) psychoanalysis is not appropriate for children - they may not be emotionally developed enough to cope with the stress of catharsis; (3) there are different types of depression - Freud’s views about melancholia really only related to major depression, rather than, say, bipolar disorder - therefore psychoanalysis is not appropriate for bipolar disorder.

Question 9

PSYCHOANALYSIS IS NOT EASILY ACCESSIBLE BY EVERYONE - justify and elaborate this criticism.

Answer 9

…because the practical issues such as time and cost may be barriers to access. Availability of psychoanalysis may vary from area to area too - as it is often not funded by the NHS, provision is not evenly distributed.