psychodynamic Flashcards
1
Q
The Theory of Templates
A
In our earliest relationships we establish templates, patterns into which we fit all subsequent relationships.
2
Q
Repetition compulsion
A
Repetition compulsion is a need to create for ourselves repeated replays of situations and relationships that were particularly difficult or troubling.
3
Q
Freud considered himself
A
Freud considered himself an archaeologist of the mind, uncovering and reconstructing the stories of a person’s life
4
Q
“Working Through”
A
“Working Through” describes the process through which new insights become so well integrated in the personality, that old patterns and beliefs are abandoned. Freud realized that it takes clients more than simply knowing their unconscious feelings
5
Q
Two key Freudian points to keep in mind:
A
1) Therapy is effected by remembering past experiences and how it’s influenced present behavior and 2) that he saw transference as a distortion and by bringing this to light for the client will help to see distortions throughout their life
6
Q
agape love
A
Believed a therapist should convey agape love.
Agape - to Rogers/khan, is a “strengthening love, a love that by definition does not burden or obligate the loved one
7
Q
empathy
A
The therapist continual attempt to understand the client’s experience from the client’s point of view
8
Q
Unconditional positive regard
A
We have to view clients as “prized”
9
Q
Implications of Roger’s Theory
A
- “No special intellectual or professional knowledge is required of therapists or will do them the the slightest good” – Meaning, it is more important to be an “encounter therapist,” learning in person and practicing in session (while training)
- No therapeutic value in a diagnosis”
- “People are neither valuable nor unvaluable; they are simply interesting to figure out.”
- Understand your client - then help your client understand him or herself, while helping the client to not implement self destructing behaviors along the way
10
Q
excessive repression leads to
A
- takes too much energy to keep impulse repressed = no energy for living life
- Repressed material is by definition unconscious and therefore not under the control of the conscious, rational faculties; that is, it’s not under the control of ego which causes all sort of issues
- Repressed material acts as a magnet, drawing other impulses into the unconscious
11
Q
remembering & insight is necessary but not sufficient
A
need re-experiencing: must have an opportunity to relive emotionally the impulses, the anxieties, and the conflicts of their past to relive them under certain specified conditions
12
Q
Conditions for Re-experiencing
A
- experienced presently toward person
- must be expressed toward person
- new object of old feelings must discuss
- client must learn source of re-experienced impulses
13
Q
resistance is inevitable
A
true
14
Q
Therapist’s most important and delicate job is to
A
help clients through this resistance
15
Q
transference might be seen as having to do with
A
- relationship with other
- another situation
- concern fo hwo another feels about client
16
Q
Intersubjectivists
A
- Therapist exert significant unconscious influence on the interaction, influence they can learn about only from the client
- They must learn to be gently skeptical about their own objectivity and their own view of the client’s reality
17
Q
Gill does not follow Freud in thinking transference as a distortion
A
We are not distorting the client’s world but trying to arrive at the most plausible construction of it given the ambiguities and our own history: most important aspect of the intersubjective position
Major Goal: help clients learn the ancient roots of their unconscious attitudes
18
Q
gill believes in
A
the importance of remembering and transference as royal road to remembering
19
Q
Three ways to interpret resistance:
A
- Here and now interpretation
- Contemporary life interpretation
- Genetic interpretation
20
Q
Here-and-now Interpretation -
A
uses aspects of the therapy situation to help the client see that a particular response to the therapist is not as inevitable as it seems.
21
Q
Contemporary Life Interpretation
A
- helps the client see that a particular attitude toward the analyst is similar to his attitudes toward other people he deals with. If the client can see that their feelings about the therapist are similar to feelings they often have towards other people, they will come to see that those feelings toward the therapist are in part transference.
22
Q
Genetic Interpretation -
A
helps the client see the similarity between feelings toward the therapist and feelings toward people in the client’s past.
23
Q
primary goal
A
The patient’s experience of the relationship
24
Q
the most accurately demonstrable pattern of interpersonal interaction is that being enacted between the patient and therapist
A
Therapeutic relationship
25
Remembering is not enough.
It must be accompanied by an opportunity for the client to re-experience the old feelings and expectations in the presence of the new object of those feelings, the therapist.
26
Therapist’s nondefensive support and encouragement will be a unique experience for the client because...
1. The clinical relationship is where therapuetic re-experiencing is possible
2. Talk about other relationships and childhood events are helpful but might be more fascinating than useful.
3. Encourage client to discuss relationship with therapist.
27
2 hidden dramas
client’s psyche and therapist’s.
28
Countertransference .
- Freud saw as obstacle. All Therapist’s feelings and attitudes towards client. Process taught something about the client’s problems that they could not have learned otherwise
29
Intersubjective theory (2 values)
two unconscious dramas playing out.
Two values of intersubjective perspective:
1 - emphasis on therapist’s contributions. 2- demand for skepticism of therapist’s view of situation.
30
4 forms of countertransference:
1- realistic responses - realistic, some people tend to evoke similar responses from a wide variety of others.
EX: client is friendly and attractive - therapist feels positive towards her.
2- responses to transference - countertransference is response to transference.
EX: client is seductive, therapist feels excited or frightened.
3- responses to material troubling to the therapist- when area is particularly troubling to the therapist.
EX: I am going through a divorce, when hearing about client’s happy marriage, I feel envious.
4- characteristic responses of the therapist - some countertransference feelings I take everywhere with me, no matter what the client does. EX: some people need to be liked by everyone they meet, some of them are therapists.
31
realistic responses
responses to transference
responses to material troubling therapist
characteristic responses of therapist
4 forms of countertransference
32
Obstructive countertransference
- interferes with the therapist’s clarity and empathy, expose us to dangers.
33
Use countertransference
feelings and attitudes are those that an alert therapist succeeds in employing to the client’s advantage by continuing to observe and ponder them until they become empathic insights.
34
*important point- at every moment our deep characterological, habitual responses lie in wait for us, looking for opportunity to express as countertransference.
(repetition compulsion)-history that wants to make itself known.
35
2 main forms of projective identification
1. The client may want to project onto the therapist feelings too difficult for the client to own. The client will then attempt to induce the therapist to experience these feelings. If the projective identification is successful, the therapist then feels the way he imagines the client feels; that is, he identifies with that aspect of the client.
2. A client wants to cast the therapist in the role of a significant other person and uncover an internal relationship too difficult to access in any other way. The client attempts to induce in the therapist the feelings of the significant other.
36
all empathy begins with
a countertransference response
37
The Necessary Conditions for the Production of Empathy:
1. The only countertransference that is a potential generator of empathy is the countertransference stimulated by the client
2. it becomes therapeutic empathy when the therapist can maintain or achieve an optimal distance from the feeling
38
For the therapist, ________is often the most difficult task of all
remaining aware of the countertransference
39
goal of countertransference
The goal is to shorten the time it takes to recognize and resolve a countertransference attitude or impulse.
Countertransference is the source of empath
40
The purpose of increasing one's awareness of countertransference forces is not to eliminate countertransference.
TRUE
41
We learn the most about clients by allowing ourselves to feel what they are feeling, to enter their world as if it were our own.
empathy is not a technique its an attitude
42
psychodynamic = 2 person theory
characteristics....
1. affect/expression (words to feelings)
2. themes/patterns
3. connect past to current
4. therapy relationship counter/transference
43
psychodynamic goal
be close to ct experience so ct can live more honestlys & increaed sense of choice
44
similarities of psychodynamic & psychoanalytic
relationship + empthy + meanign of sx
45
therapists failure or miss
observe reaction & admit miss
46
transference
conscious and unconscious repeat of relationships
47
replacement of earlier person with therapist
displacement
48
3 steps of transference
1. make it conscious
2. impedes treatment
3. find origin
49
countransference
previously seen as obstacle
now = useful info about ct
begins before first meeting
50
working alliance based on 2 things
1. ct experience of therapist as supportive
| 2. working together
51
defenses
= resistance; all forces opposing process of therapy
can be conscious and unconscious
52
denial
keep out of awareness
53
intellectualization
stays in head out of feelings
54
reaction formation
opposite of real feelings
55
goal of 1st session
ct comfortable
56
interpretations
understanding of thoughts/behaviors ; save for later
57
free assocation
client descrives exact thought in moment with censorship
58
psychodynamic = anything unconscious is
GOLDEN
59
dreams
window to unconscious
dont interrupt, form of communication, can be defensive function, recurring = anxiety
60
1st step in transference = discuss current feelings...this teaches client
treatment can be object of displacement
61
Behavior:
seen as a product of conflicting parts of self (structural models of mind: id, ego, superego: all moving against each other in different and this produces behavior)
62
ID
"i want it now"
Exists at birth (born with desires & they remain) & allows need to be met
○ Irrational/emotional - based on pleasure principle as it wants whatever feels good at the time and wants it now -
○ "full of seeding expectations"
○ Doenst care about reality or needs of anyone else just own satisfaction
If id is unregulated by the ego, impulses and self gratification takes over a persons life
63
ego
○ Rational part of personality
○ Develops out of awareness that you can't always get what you want
Regulatory funciton of self, keeps impulses of id and rigidity of superego in control
64
In a healthy person, the ___ is the strongest of the 3, allowing it to balance needs of id with needs of superego
ego
65
Ego strength =
Ego strength = refers to how well ego copes with conflicted desires, morality, and fulfill desires appropriately that takes others into account without distorting reality
66
superego
(the "above-I" = "I shouldn't, you can't its not right")
Moral values, self critical values, internalized parental or or over- I
Conscious "shoulds" and "oughts"
Develops due to moral and ethical restraints placed on us by our caregivers and by society
If it becomes too strong, the person is driven by rigid morals, is judgmental and unbending
Strives for perfection, unrealistic expectation, feel guilty for what you’ve been punished for
67
Develops by the age of 5 and is the moral part us
superego
68
countertransference bad if
remains unconscious or acted ou
69
Therapist observations as projective object help clients
gain insight into emotions/behavior
70
Establish frame & alliance respect by
Setting boundarie
71
Processes that keep (wishes/desires) from conscious awareness/expression
defenses;
| Observed during times of resistance & must be commented on
72
take back words/action that seem unacceptable
undoing
73
obtain power by identifying with person who harmed them
Identification w/aggressor
74
3 important questions to help patients become conscious of their defensive manner:
1. Think about preceeding session & content of ongoing therapy
2. Think about transference - patients reactions to you
3. Think about defensiveness in context of patients outside life
75
Therapist intervention to clarify & understand underlying causes of behavior, thoughts & actions - make unconscious conscious
interpretation
76
*distinguishing factor of psychoanalysis, _______ultimate tool of figuring things out
therapist ultimate tool of figuring things ou
77
2 dimensions of interpretation
1. observe contradiction/incongruence
| 2. hypothesize cause as linked to past or current therapy
78
Repitition of process of patients understanding of or gaining insight into problem until fully integrated into conscious awareness
working through
79
_____ is a valuable issue to explore when you are feeling stuck or unproductive
Safety is a valuable issue to explore when you are feeling stuck or unproductive
80
_______ is expectations and misunderstandings and harm from the therapist based off of painful experiences
Negative transference is expectations and misunderstandings and harm from the therapist based off of painful experiences
81
ordinary degree of confidence in the doctor, based on positive experiences with other authorities is necessary for a good treatment outcome
objectionable positive transference
82
Most of our behaviors and thoughts are not conscious.
true; People unconsciously organize experiences through the lense of their first attachment with their primary caregiver
83
the basis of psychodynamic’s purpose can be summarized as
highlighting self understanding, authenticity, valuing of one’s values, and the quest for truth.
84
psychoanalysis
Has come to be defined as an open-ended effort to understand all of the one’s central unconscious thoughts, wishes, fears, conflicts, defenses and identifications
85
7 Factors that distinguish psychodynamic from CBT type therapies
It focuses on affect
It explores defenses/avoidance/resistance
It explores patterns in client’s life (relationships, thoughts, experiences etc.)
It emphasizes past experiences
It focuses on interpersonal experiences
It puts emphasis on the therapeutic relationship
It explores wishes, dreams and fantasies
86
key aspect of psychoanalysis
Honesty in the therapeutic relationship
87
Empowering the client by
not giving advice is important.
88
Insight is not enough because our client don't always take in our interpretations
The ingredient added to insight is the relationship between therapist and client
89
Freud prior view on therapy
1.if the therapist stayed quiet then the patient would unconsciously reveal their internal struggle between desires and the superego
2. That the transference would develop better if the therapist was a blank slate
3. They believed that the process required optimal frustrations which was not directly replying but only replying in interpretations or silence. They believed that silence would still up frustration and that stirred up inner conflicts and emerged more depth
90
contemporary definition of ego
metaphor for a set of funcitons in self that defv in context of secure attachment figure & enables indiv to navigate tension btwn inner & outer reality
91
contemporary definition of superego
dictates of parents & society and also internalized experiences about what kinds of emotional responses were tolerabel to the caregiver
92
contemporary definition of ID
source of all our wants, needs & emotions, affects, emotions inherently adaptive, maladaptive feelings/behaviors come from defenses
93
Symptoms as compromise formation
Compromise solution: the sx maintains itself b/c it gives partial expression to both unconscious desire (id) and rejection of it (superego)
94
Primary gain of sx =
do away with the UNC conflict btwn desire & punishing itself
95
symptom
Implication: a sx is an attempt to express what is unconscious (desire) while at the same time to banish it from consciousness (defense) - neither of which is fully accomplished
96
treatment plan goal
make unconscious conscious
Help to own and express desire/feelings directly but appropriately
97
mahler Psychological merger:
even though you're a separate person I expect you to be emotionally I need
98
Normal infantile autistic phase & normal symbiotic
= psychotic level of personality dev stage (no separation btwn whats inside me and whats outside coming at me)
99
Differentiation:
Differentiation:
• Physical merger ends here (psychosis); understand physical separation but still psychologically separate
Indicator of beginning of internalization; can recognize caregiver; expects others to be there b/c they want them to
100
psychotic defenses
○ (alter reality)
○ Mirror presumed experience of an infant
○ Defenses lack a sense of logical thinking(magical)
○ There is NOT a sense of others as separate from the self NOR a consistent view of them as generally good
Profoundly alter perception of external reality
101
= transform reality to fit your wishes (no guilt/anxiety)
distortion
102
Simple projection (externalize)
project impulses onto other
103
introjection
Turning against self is the cathartic transformation of impulses causing intrapsychic conflict into exaggerated negative qualities and attributes tuned inward and ascribed to the self
104
Temporary substitution of internal reality(daydream) for external reality to do with threatening ideas or affec
fantasy
