Psychodynamic And Psychotherapy Flashcards
Psychodynamic therapy
Broader perspective than psychoanalytic
Include interpersonal, both internal and social world
Internal representations are built up over time reflecting dispositions that arise from innate vulnerability and early childhood experience
Dynamic nature of both the internal and external worlds- representation shift and change in the context of social relationship and group setting experienced over a life time
Psychoanalytic principles
Unconscious
All behaviour is goal directed, motivated and meaningful
Psychological adaptation, defence, conflict
Developmental or historical approach
Oedipus complex
Transference, resistance, countertransference
Specific psychodynamic therapy (evidence based)
Interpersonal therapy (IPT)
Psychodynamic interpersonal therapy (PIT)
Cognitive analytic therapy (CAT)
Mentalization-based therapy (MBT)
Transference focused therapy (TFP)
Dynamic interpersonal therapy (DIT)
Defence mechanism -primitive
- Denial
- Projection (attributing one’s unwanted thoughts and emotions to another)
- Splitting
- Projective identification (the objects of projection invokes in that person precisely the thoughts, feeling, or behaviour projected)
- Dissociation (temporary drastic change in personality or identity to avoid emotional distress)
- Idealization (tending to perceive others to have better quality)
- Somatization (transformation of uncomfortable feeling toward others into toward self. Ie self harm)
- Regression (子供帰り)
Defence mechanism -neurotic
Identification (modelling/copying of other)
Displacement (mom yell at child because she is pissed with husband)
-Intellectualization (concentrating on intellectual aspects rather than emotional )
Isolation of affect (separation of feeling.ie describing murder scene with graphic)
Rationalization
Sexualization
Reaction formation (doing the opposite to your desire cause it cause anxiety)
Repression
Undoing
Defence mechanism -mature
Humour
Suppression (conscious decision to delay paying attention to an emotion or need in order to cope with the present reality)
Asceticism (禁欲)
Altruism
Anticipation (realistic planning for future)
Sublimation (playing sports when u get upset)
Freud developmental stage
Oral stage: projection, incorporation, denial, displacement, reversal and turning against the self
Anal stage: identification, undoing, reaction-formation, isolation and regression
Phallic stage: Intellectualization, repression
Genital stage: symbolization and sublimation
Paranoid schizoid position
Malaria Klein
Early stage of development in the infant (-6 month) when immature defence mechanism such as splitting and projection preliminary and defend against persecutors anxiety
Depressive position
Melanie Klein
A later stage of development in the infant (6-1yo) in which conflicted feeling can become more integrated and directed toward the same object, there is tolerance of ambivalence and loss, concern and guilt for the object
Projective identification
Unconscious 3 step process in which aspects of the self are disavowed and attributed to someone else
1) project a self or object representation into the therapist or others
2) the therapist unconsciously identifies with what is projected and begin to feel or behave like the projected self or object representation in response to interpersonal pressure exerted by the patient
3) the projected material is “psychologically processed” and modified by the treater and returned to the patient through reintrojection. The modification of the projected material modify the corresponding self or object representation and the patten of interpersonal relatedness
Bion -containment
Baby communicates via projective identification with mother
Baby project it’s unbearable distress into mother who “contains” it and responds by modifying he baby’s anxieties by her “reverie”
Reverie
Mother’s capacity to understand through empathic identification with her baby, bear the intolerable anxieties, moderate them and feed them back to her baby in a form in which he can tolerate them, thus promoting healthy mental and physical development
Psychosis -Freud
extreme form of regression
Primary process thinking supervenes
Loss of ego functions
Instinctual desire can’t be handled by fragile ego
Narcissistic neurosis
delusion and hallucination attempt to repair fragmentary world
Kernberg’s level of personality organization
Neurotic level of personality organization
-people function well in many domains, with maladaptive personality traits interfering in focal areas of functioning and /or causing subjective distress
Borderline level of personality organization
-severely maladaptive personality rigidity with clinically significant identity pathology, lower level splitting based defence, variable reality testing
Psychoanalytic approach
Free association Resistance Reconstruction Interpretations Transference Counter transference Working through
Psychodynamic technic
Focus on affect and expression of emotion
Exploring attempts to avoid distressing thoughts and feelings (defence and resistance)
Identifying recurring themes and patterns
Discussion of past experience (developmental process)
Focus on interpersonal relationship
Focus on the therapy relationship (including transference )
Exploration of wishes and fantasies
Transference interpretation
Explicit reference to patient-therapist relationship, in which the patient’s current feelings and behaviour toward the therapist point to conflicts from past re-enacted in the transference situation
Focus on “here and now” of what is currently happening in therapeutic interchange, esp the “affective focus” or most emotionally charged moment in the therapy session
Where a patient’s feelings and behaviour from an important past relationship shape their feelings and behaviour toward the therapist
Counter transference
Unconscious Emotional reaction that the therapist has toward the patient
Result of both unresolved conflict in the therapist, as well as contributions from the patient
Psychodynamic formulation
Hypothesis about the way a person thinks, feels, and behaves, which considers the impact and development of unconscious thoughts and feelings. Consider;
- the developmental origin
- why has the patient come for treatment now/ current life situation ? (Maintaining factor)
- the relationship between the patient and the assessor -transference and counter transference
Psychodynamic psychotherapy
Encompasses broader perspective than psychoanalytic
Include the relational (ie the interpersonal, intersubjective and embodied experience of both the social world and the internal world)
Internal representation are built up over time reflecting dispositions that arise from innate vulnerability and early childhood experience
Dynamic nature of both the internal and external worlds- representation shift and change in the context of social relationships and groups settings experienced over a life time
Freud-mental illness and defence mechanism
Hysteria- denial, projection, and identification
Obsessional condition- isolation, magic undoing, reaction formation
Phobia-displacement of affect
Depression-aggression turned against the self
Paranoia- projection and splitting
British object relations school
Klein, Bion, Winnicott
Focus on internal object relations and interests in the pre-Oedipal period, very early development
Tended to treat more ill patients (personality disorder)
Emphasis on primitive defence mechanism (splitting, idealization)
Attachment theory
Normal secure attachment are necessary for the development of affect regulation, impulse control, empathy, and the capacity to reflect or mentalize
Spectrum of intervention
Empathic comments
Clarification
Confrontation- therapist will point out inconsistency in the patient’s account or draw his attention to subjects he may be avoiding
Interpretation
Working through
Interpretation
Verbal intervention which makes something unconscious conscious and offer new formulation of meaning and motivation
- dream interpretation
- reconstructive interpretation: link patients current thought or behaviour to past especially childhood experience
- extra transference interpretation: exploration and interpretation about the patient’s current external life
Transference interpretation
