Psychoanalytic Psychotherapies Flashcards
mechanisms of change
making the unconscious conscious
emotional insight
creating meaning and historical reconstruction
increasing and appreciating limits of agency
appropriate candidates
motivated
openly disclosing
willing to self-scrutinize
not in need of immediate crisis intervention
“problems in living” reflected in stress
personality disorders
short term dynamic psychotherapy
less than 40 sessions
often uncontrolled or lack rigorous active control groups; many limited by small sample sizes
long term psychoanalytic therapy
not rigorously studied
cultural considerations
developed for educated, middle-class western europeans
therapists must:
- be aware of their own bias, society attitudes, more judgement
- utilize a range of techniques
BEGINNING
psychoanalytic pluralism
no types/just one psychoanalytic theory
order of freud developments:
1) develops structural model of id, ego, and superego
2) coins term “psychoanalyse”
3) works with patient anna o.
order: 3, 2, 1
Anna O.
young women doing well in life but develops odd symptoms while aiding sick father
- paralysis of extremities
- weak neck
- suddenly cannot hear or speak
diagnosed with hysteria
tried talk therapy (release trauma psychologically rather than physically)
used experimental approach
freud concluded that hysteria resulted from _____
trauma
freud leans away from ______ and more towards _____ ____________ to help achieve catharsis (release of negative emotion and experiences)
hypnosis; free association
freud emphasized _______ ______ (carefully observing what’s taking place without influencing)
scientific rigor
free association
patient says “whatever comes to mind”
therapist interprets manifest and latent content
manifest vs. latent content
m - surface material, exactly what person said
l - deeper level, underlying meaning of manifest content
drive theory
libido produces state of tension that needs to be released!
pleasure principle
shows pattern of how we as people repeat our experiences over and over
pleasure principle
we are driven to repeat experiences that release tension
stages of psychosexual development
how to achieve release of libido
1) oral phase
- younger age
- everything goes in the mouth to achieve oral gratification
2) anal phase
- toddler
- control of bowels/choice of retaining or passing feces
- important to not instill shame in child for this
3) phallic phase
- shifting to genitals
4) latency period
- socializing through and into puberty
- what is or isn’t accepted in society
- disconnect b/t mentally vs. societal acceptions
5) genital phase
- adult
- through sexuality
id
instinctual/entirely unconscious
where drive lives
primal wishes, fantasies, desires, etc.
ego
gradually emerge as we develop
concerns of reality/navigating conflicts b/t id + superego
- ex) delaying gratification
look for ways to channel expressions
apart of both unconscious and conscious
superego
develops as we internalize norms of society
- “right things to do”
- can become overly harsh and demanding
will change as societal norms do
some conscious (expectations of society), some unconscious
ego psychology
fixed structure of personality with 3 components: id, ego, superego
primary and secondary processes (ego’s job to satisfy them)
primary process of ego psychology
begin at birth and operate unconsciously
raw/primitive functioning
cannot distinguish b/t past, present, future, just is
look for latent content to understand these processes
secondary process of ego psychology
functioning associated with consciousness
logical, sequential, orderly, rational
Jung
initially studied under Freud
drawn to experimental studies of the unconscious
broke from freud to develop his own school known as analytical or Jungian psychology
complexes
- repressed ideas that an emotionally difficult to experience consciously
- observed through reaction time
Jung’s differences from Freud
collective unconscious
- vast, hidden unconscious resource shared understanding/experiences b/t humans
unconscious has creative and growth-oriented components
- freud: all down side
- jung: not all bad
understand unconscious through observing complexes
- delayed reaction time
less emphasis on sexuality’s role in motivation
- not all drive stemming from this
is there a difference between the british and united states system of psychoanalytic pluralism
yes!
common principles of psychoanalytic perspectives
humans are motivated by wishes and fantasies that are unconscious
humans are ambivalent about changing
- want to but don’t want to change @ the same time, comes with resistance to change
therapy should help clients understand how their own construction of the past and present plays a role in perpetuating patterns
- role: identify how to achieve tension release and relationship with therapist can bring patterns to light
conflict theory
childhood neurosis common and expressed through anxiety
in adulthood, neurosis occurs due to conflict between unconscious wishes and defenses = intrapsychic conflict (what is or isn’t ok to act on)
object relations theory
internal representations guide perceptions and actions
very early attachment experiences (infant and caregiver) build internal working models
attachment theory
attachment theory
humans build internal working models of caregivers that allow them to maintain proximity
- “what do I need to do to keep this person near me so I can survive?”
developmental arrest definition
as child develops, gets “stuck” in one of these places
developmental arrest components
psychological problems are due to caregivers’ failure to provide “good enough” environment
- should NOT be perfect, providing some adversity to understand how to defend themselves
infants believe they are omnipotent and wishes are fulfilled by mother
- no development of ego/delayed gratification
optimal disillusionment
- goal of “good enough”
- learning to accept limitations of others and develop healthy ego boundary
- failing to attend to need but an attempt was made, gradual and balanced
false self
- needs not met @ all or rarely
- infant learns to overall adjust to others, learn wishes and needs don’t matter
- lose touch with your own needs but instead needs of others
defense mechanisms
sit primarily in ego and happen unconsciously
defense styles
- process that helps avoid emotional pain, helps short term but hurts long term
- impact our physical and mental health
- have implications for treatment
sublimation
conflicted emotions –> productive outlet
hurts: ruining other areas of life when outlet overtakes life
repression
forgetting something negative or unwanted
no memory or awareness
displacement
transfer feelings from one source to another
ex) get yelled at at work, yell at family when you get home
regression
revert to childlike state
ego doesn’t attempt to control emotions
denial
refusal to accept truth/reality
feels good short term, not long term
different than repression (which has no memory of event)
splitting
attempt to avoid negative feelings about person, split them into either all good or all bad
inability to reconcile people have good and bad qualities
ex) someone does one bad thing = they are a bad person
projection
feeling and motive about self towards another person
ex) hearing laughing and then thinking it is about you
reaction formation
negative belief unwilling to admit to self = proclaim the opposite
ex) attraction toward same sex = proclaiming homophobia
intellectualization
talking about something while keeping emotional distance
very matter-of-fact
can recognize they played role but without emotions
ex) stroke patient describing their own experience as not their own or giving details about accident but not about their feelings
rationalization
attempt to explain something away/coming up with an excuse (taking away responsibility)
ex) I failed because my teacher hates me
theory of psychotherapy basic theory
intrapsychic conflict and maladaptive use of defense mechanisms
one-person vs. two-person
one: patient is considered a person and the therapist is a blank observer
two: relationship b/t 2 people, therapist is a person too
intersubjectivity
therapy is complicated/debate b/t therapist and patient
goal = come to consensus
enactment
same patterns are going to happen in therapy as they do outside (which is mostly why they go to therapy)
create false self: over adapt to others, meet others’ needs
we don’t see the world as it is. we see the world as ___ _____
we are
transference
what takes place from patient to therapist
patient’s schemas shape relationship with therapist as one they had with a past person
countertransference
therapist’s reaction to totality of patients transference
therapeutic alliance is how well …
patient and therapist are aligned in treatment plans and trust
key to withstand tough tines in treatment
resistance in therapy
people have a tendency to resist change
working through, not an obstacle but an opportunity
methods of psychotherapy (interaction)
empathy
- emphasis on emotion
- empathetic conjectures: “I can imagine…”, “I can see..”
- hypothesize what person was experiencing
clarification
- interpret what patient is saying
- making unconscious conscious
- hypothesizing latent content
interpretation
- hypothesis for what may be happening
- often in form of questions to ease information on patient
- skill in determining when interpretation should be shared with client/beneficial to hear
support/advise
- part of relationship, can help build alliance
methods of psychotherapy (process)
opening
- beginning to reveal information at their own pace
- looking for themes, patterns, conflicts, defense mechanisms, and evidence of resistance
development of transference
- patients reaction to therapist
working through
- to develop insight
- interpretations of how past influences present
- patterns that play out all the time for patient/what unconscious behavior is causing this
termination
- ending treatment, patient-led
- therapist needs to be aware of countertransference (if they don’t want patient to leave)
- goal: for patient to see own role in patterns and role in driving own change, they are in control
review notes on annie’s therapy sessions!
got it :)
