Psychoanalytic therapy - Psychodynamic Approaches

Question 1

Founder:

Answer 1

Sigmund Freud

Question 2

Theory

Answer 2

A theory of personality development, a philosophy of human nature, and a method of psychotherapy that focuses on unconscious factors that motivate behavior. Attention is given to the events of the first six years of life as determinants of the later development of personality.

Question 3

Basic Philosophies

Answer 3

Human beings are basically determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in present behavior. Early development is of critical importance because later personality problems have their roots in repressed childhood conflicts.

Question 4

Key Concepts

Answer 4

Normal personality development is based on successful resolution and integration of psychosexual stages of development. Faulty personality development is the result of inadequate resolution of some specific stage. Anxiety is a result of repression of basic conflicts. Unconscious processes are centrally related to current behavior.

Question 5

Goals of Therapy

Answer 5

To make the unconscious conscious. To reconstruct the basic personality. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.

Question 6

Therapeutic Relationship

Answer 6

The classical analyst remains anonymous, and clients develop projections toward him or her. The focus is on reducing the resistances that develop in working with transference and on establishing more rational control. Clients undergo long-term analysis, engage in free association to uncover conflicts, and gain insight by talking. The analyst makes interpretations to teach clients the meaning of current behavior as it relates to the past. In contemporary relational psychoanalytic therapy, the relationship is central and emphasis is given to here-and-now dimensions of this relationship.

Question 7

Techniques

Answer 7

The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference, and countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and eventual assimilation of new material by the ego.

Question 8

Application of Approaches

Answer 8

Candidates for analytic therapy include professionals who want to become therapists, people who have had intensive therapy and want to go further, and those who are in psychological pain. Analytic therapy is not recommended for self-centered and impulsive individuals or for people with psychotic disorders. Techniques can be applied to individual and group therapy.

Question 9

Contributions Multicultural Counselling

Answer 9

Its focus on family dynamics is appropriate for working with many cultural groups. The therapist’s formality appeals to clients who expect professional distance. Notion of ego defense is helpful in understanding inner dynamics and dealing with environmental stresses.

Question 10

Limitations in Multicultural Counselling

Answer 10

Its focus on insight, intrapsychic dynamics, and long-term treatment is often not valued by clients who prefer to learn coping skills for dealing with pressing daily concerns. Internal focus is often in conflict with cultural values that stress an interpersonal and environmental focus.

Question 11

Contributions of the Approach

Answer 11

More than any other system, this approach has generated controversy as well as exploration and has stimulated further thinking and development of therapy. It has provided a detailed and comprehensive description of personality structure and functioning. It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first six years of life. It has developed several techniques for tapping the unconscious and shed light on the dynamics of transference and countertransference, resistance, anxiety, and the mechanisms of ego defense.

Question 12

Free association

Answer 12

A primary technique, consisting of spontaneous and uncensored verbalization by the client, which gives clues to the nature of the client’s unconscious conflicts

Clients are encouraged to say the first thing that comes to mind regardless of its essence to uncover unconscious wishes, conflicts, motivations, or fantasies. The counsellor then uses this process to help uncover any repressed material locked away in the unconscious.

Question 13

Anxiety Types

Answer 13

• Anxiety - feeling of dread that results from repressed feelings, memories, desires and experiences that emerge to the surface of awareness
• Reality Anxiety - the fear of danger from the external world and the level of such anxiety is proportionate to the degree of real threat
• Neurotic Anxiety - the fear that the instincts will get out of hand and cause the person to do something for which she or he will be punished
  Moral Anxiety - the fear of ones own conscience

Question 14

Structure of Personality

Answer 14

Id - ruled by the pleasure principle
Superego - ruled by the judicial branch
Ego - ruled by the reality principle

Question 15

Libido

Answer 15

The instinctual drives of the id and the source of psychic energy; Freudian notion of the life instincts.

Question 16

Life instincts

Answer 16

Instincts oriented toward growth, development, and creativity that serve the purpose of the survival of the individual and the human race.

Question 17

Death instincts

Answer 17

A Freudian concept that refers to a tendency of individuals to harbor an unconscious wish to die or hurt themselves or others; accounts for the aggressive drive.

Question 18

Psychosexual Stages

Answer 18

Oral stage (1st year)—issues of trust in oneself and others; left unresolved can result in low self-esteem, and a fear of loving and forming close relationships

Anal stage (ages 1–3)—issues of recognising and expressing anger; left unresolved can result in the denial of power and sense of autonomy

Phallic stage (ages 3–6)—issues of sexuality and sexual feelings; left unresolved can result in difficulty accepting oneself as a man or woman

Latency stage (ages 6–12)—increased focus on socialisation and forming relationships with others

Genital stage (ages 12–60)—sexual energy transformed into socially acceptable activities, such as making friends, playing sport, being creative, etc.

Question 19

Psychsocial Stages

Answer 19

Crisis
Classical Psychoanalysis - id psychology
Comtemporary Psychoanalysis - ego psychology

Question 20

Transference relationship

Answer 20

The transfer of feelings originally experienced in an early relationship to other important people in a person’s present environment.

Question 21

Psychodynamic therapy

Answer 21

Psychoanalytically oriented psychotherapy involves a shortening and simplifying of the lengthy process of psychoanalysis.

Question 22

Relational analysis

Answer 22

An analytic model based on the assumption that therapy is an interactive process between client and therapist. The interpersonal analyst assumes that countertransference is a source of information about the client’s character and dynamics.

Question 23

Transference

Answer 23

The client’s unconscious shifting to the therapist of feelings and fantasies, both positive and negative, that are displacements from reactions to significant others from the client’s past.

Through adopting a psychoanalytic approach to therapy, the counsellor assumes a neutral stance and seeks to foster transference. This process is designed to elucidate unconscious reactions reflecting deep patterns of old experiences through the relationship with the counsellor. By identifying the various negative and positive reactions and feelings to the counsellor, the client is better equipped to understand and resolve past issues and their effect on current relationships or situations.

The act of transference may also provoke conscious conflicts within the counsellor, referred to as countertransference. This relationship may trigger the counsellor’s own conflicts or emotional responses to a client, leading them to respond in an irrational manner. As such, to maintain their objectivity, counsellors must be aware of their countertransference reactions and take appropriate steps to manage these reactions.

Question 24

Countertransference

Answer 24

The therapist’s unconscious emotional responses to a client that are likely to interfere with objectivity; unresolved conflicts of the therapist that are projected onto the client.

Through adopting a psychoanalytic approach to therapy, the counsellor assumes a neutral stance and seeks to foster transference. This process is designed to elucidate unconscious reactions reflecting deep patterns of old experiences through the relationship with the counsellor. By identifying the various negative and positive reactions and feelings to the counsellor, the client is better equipped to understand and resolve past issues and their effect on current relationships or situations.

Question 25

Interpretation

Answer 25

A technique used to explore the meanings of free association, dreams, resistances, and transference feelings.

The counsellor seeks to assist the client in uncovering unconscious material by teaching them about the hidden meaning of behaviour revealed through dreams, free associations, resistance and the therapeutic relationship. The client’s ego is thus encouraged to assimilate new material, allowing further identification of repressed material, and the client’s readiness for such interpretation is gauged through their reactions within the therapeutic relationship.

Question 26

Dream analysis

Answer 26

A technique for uncovering unconscious material and giving clients insight into some of their unresolved problems. Therapists participate with clients in exploring dreams and in interpreting possible meanings.

Freud believed that dreams were a window into the unconscious mind, as our defences are lowered and repressed feelings more readily come to the surface. By analysing the latent content (hidden, symbolic, and unconscious motives, wishes, and fears) and manifest content (the sexual or aggressive impulses underlying latent content transformed into acceptable content—in other words, the actual content of the dream), counsellors can uncover the disguised meanings expressed, allowing clients to obtain greater insight into their unresolved problems.

Question 27

Latent content

Answer 27

Our hidden, symbolic, and unconscious motives, wishes, and fears.

Question 28

Manifest content

Answer 28

The dream as it appears to the dreamer.

Question 29

Dream work

Answer 29

The process by which the latent content of a dream is transformed into the less threatening manifest content.

Question 30

Resistance

Answer 30

The client’s reluctance to bring to awareness threatening unconscious material that has been repressed.

A key concept to the practice of psychoanalytic therapy is that of resistance, which relates to anything that works against the progress of therapy and hinders change and reflects the client’s reluctance to make conscious previously unconscious material. Acting as a defence mechanism, resistance is utilised to avoid the pain and anxiety they may experience in becoming aware of their repressed feelings and impulses, which can then be identified to assist clients in confronting their conflicts in a realistic manner. This can be extremely valuable in the therapeutic relationship by lessening the possibility that clients will reject the interpretations of the counsellor. However, care must always be taken to ensure that resistance is handled both appropriately and respectfully.

Question 31

Analytical psychology

Answer 31

An elaborate explanation of human nature that combines ideas from history, mythology, anthropology, and religion.