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Psychodynamic Psychotherapy Flashcards

1
Q

There are many Psychodynamic school, all of which are derived from

A

Freudian psychoanalytic theory

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2
Q

Give the broad overarching aim and goal of all PD schools

A

Aim: achieve insight, make meaning and transform experience of self in the world

Goal: generalize experience of therapy to other relationships and experiences

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3
Q

Later theorists of PDT are more oriented towards….

A

social and relationship approaches

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4
Q

Freud developed the technique of ….. where …often emerge

A

free association

strong emotions and deeply buried memories/trauma

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5
Q

The three main areas of Freuds Psychoanalytic theory are

A
  1. The models of the mind (topographical and structural)
  2. Drive theory
  3. Psychosexual stages of development
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6
Q

What peaked Feud’s interest in Psychoanalytics

A

Patients presenting with medically in-explicable symptoms (glove anaesthesia)

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7
Q

Topographical Model of the mind has 3 levels. What are they?

A
  1. Conscious (what we’re aware of)
  2. Preconscious (what we can bring into our con)
  3. Unconscious (unavailable to us)
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8
Q

The Structural model of the mind has 3 parts. What are they?

A
  1. The ego (some con/some subcon/a little uncon)
  2. The superego (mostly uncon/some precon/some con)
  3. The id (completely uncon)
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9
Q

Freud wasn’t a fan of hypnosis, which accessed the subconscious directly. He preferred to…

A

bring the subconscious into the conscious by working with defenses (free-association aka “talking therapy”)

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10
Q

Freud sees our defenses as presiding in our…

A

unconscious

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11
Q

Defenses are….

A

NOT pathological, they are necessary to protect one from past hurt, trauma and vulnerabilities

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12
Q

Two examples of defences are Repression and Supression. What is the different between the two?

A

Repression - unconscious forgetting of painful memories

Supression - conscious pushing down of upsetting things

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13
Q

Dreams and Freudian slips are examples of when the…

A

subcon slips past the defences

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14
Q

Describe the role on the three parts in the structural model of the mind

A
  1. ID - all hidden dark mess, tensions, desires, hunger
  2. Ego - tries to mitigate and control ID. Aims to create healthy balance between ID and SE
  3. SE - moral compass, values, beliefs, whats
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15
Q

What are the principles of the three parts of the structural?

A

ID - desire principle
Ego - reality principle
SE - morality principle

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16
Q

Drive theory is the match up between:

A

Life and Death
Eros and Thanatos
Libido and Aggression

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17
Q

Name the 5 psychosexual stages of development

A
  1. Oral
  2. Anal (about control, potty training etc)
  3. Phallic
  4. Latency
  5. Genital
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18
Q

Where does psychopathology come from and what does treatment look like in PsychoD

A

Pathology = repressed forbidden wishes and conflicts

Treatment = making the unconscious conscious

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19
Q

Why didn’t Freud like hypnosis?

A

During hypnosis, meaning of symptoms emerges and issues
can be resolved ( as defences are down)
But
After hypnosis ends, no longer have access to these, therefore issue returns

20
Q

Describe PDTs Focus on Affect in a few points

A
  • feelings are valid and NB
  • emphasis on having patients explore their own emotional worlds as emotional insight > intellectual insight
  • own experiences/understandings far more impactful that just hearing the therapist’s insight
21
Q

Describe PDTs “Understanding and exploring defences” in a few points

A
  • Defences = (generally) uncon attempts to protect yourself from troubling/painful feelings/experiences
  • How and what is being avoided is key to the therapeutic process
  • Some schools see defences as part of the process, some see them as evidence that patient is feeling unsafe
22
Q

Give some examples of defences in PDT

A
  • Denial
  • Deflection (conscious/deliberate projection)
  • Reaction formation (do opposite of an impulse that is unacceptable)
  • Regression (return to childish behaviour, seeking care one use to get when young)
  • Sublimation (playing rugby instead of beating people up)
  • Projection

(DDRRSP)

Don’t Do Really Really Small Poos

23
Q

Describe PDTs “Identifying patterns” in a few points

A
  • patient look for things that will confirm their sense of meaning/understanding of them selves to maintain sense of stability
  • the way in which they do this recurs/repeats
  • these patterns give insight into the patients fears/longings (must be understood in context of patients history/experiences
24
Q

Describe PDTs “Understanding the influence of the past on the present” in a few points

A
  • most NB feature of PDTs
  • early experiences (especially with caregivers) shape our experiences of the present
  • patterns of relating, experiences of self etc are formed in the past
25
Describe PDTs "Focus on relationships" in a few points
- Relationships = primary site of both injury and healing - Meaning-making not done alone - relationships and patterns of relating NB - Problems often seen as a rooted in unmet relational needs
26
Describe PDTs "Centrality of the therapeutic relationship" in a few points
- T relationship used to bring relational healing and patterns of relating - Transference = emergence of relational patterns shaped by fears and hopes from past experiences (client towards therapist) - Counter-Tr = therapist's response to patient's feelings/behav (now called co-trans, a recognition that therapist isn't a blank slate) - T relationship = fertile ground for processing
27
Describe PDTs "exploring symbols and fantasy life" in a few points
-fantasies/symbols that are NB to hidden fears and wishes - session is unstructured and has no agenda patient encouraged to talk freely -> allows emergence of F and S - exploring dreams one way to do this
28
PDT is all Freuds work PDT is no grounded in evidence These are both...
myths
29
4 key understandings of PDT
1. Unmet relational needs/injuries = root of many problems 2. Response to these injuries = uncon defences 3. These defences become pattern of relating 4. Therapy develops emotional insight to transform the way the patient see themselves. This transforms their pattern of relating
30
How are symptoms understood in PDT?
- Symptoms serve a purpose - they are a means to re-establishing equilibrium/sense of self - symptoms can be symbols or areas of stuckness
31
What is the goal of PDT?
- Main goal is NOT symptom reduction, but to transfrom the patients experience of themselves in the context of their relationships - improving psych capacity/functioning are main goals (especially healthy ways of relating) - this leads to symptom remission
32
Freud saw behaviour as motivated by drives and instincts while moderns theorists see the motivators as ...
affect and relatedness
33
What are 4 of the tool that modern PDT uses?
1. Use of therapeutic relationship (transference) 2. Free association 3. Dreams and fantasies 4. Interpreting defences
34
Modern PDT uses .... to bring about a ....
what ever the patient brings to the space collaborative meaning-making process
35
How does the therapeutic process use transference?
Feelings client has towards therapist will be similar to those towards significant others in past - this allows therapist to observe early childhood relationships as they are re-enacted in the consulting room. The aim is to let client become aware of projections
36
How does PD use free association?
- Free talking means client is less likely to be influenced be defence mechanisms - Allows the truth to "slip out" - Patient sets the agenda and the therapist follows the lead
37
How does PDT use dreams and fantasies?
- Dreams are considered the "royal road to the subconscious" - sees dreams as processing experiences and fears - not all dreams meaningful/symbolic, but all are processing something - symbolism is NOT universal
38
How does PDT use "interpreting defences"
- Other tools used to generate material for interpreting defences - Awareness and understanding of root of defences help clients understand origins of problems - Goal is not to GET RID of defences (as they protect us and are necessary), but we ought be careful of overusing any of them
39
In revealing defences to clients, therapists need to conscious of 2 things:
1. timing 2. resonance for patient
40
Three main areas of criticism of PDT
1. Gender and sexuality 2. Context 3. Evidence
41
Explain the "gender and sexuality" critique of PDT
- Freudian theory pathologised women (penis envy) - alternative sexuality seen as pathological/deviant - much Freudian research only on boys/men
42
Explain the "context" critique of PDT
- traditional psychoanalysis disregarded context and saw the mind as isolated - v little attention given to culture or social issues - long terms, unaffordable approach for many
43
Explain the 'evidence' critique of
- see PDT as unscientific - not "evidence based" - very hard to measure, so not "proof" *this has been the most damaging critique
44
Response to critiques of PDT
- mounting evidence for PDT (neuro-imaging proving uncon etc) - lots of evidence to PDT is effective - larger effect sizes (incubator effect)
45
Biggest changes from Freudian practice to modern-day
- recognize affect and relationships as primary motivators (not drives) - no longer see therapist as "blank slate" - therapist responsible for what they bring to the process - each therapist-patient relationship unique - Unconscious is not "discovered" but meaning is co-created
46
Key elements of PDT
Focus on Affect Defences Patterns Past on present Relationships Therapeutic relationship Symbols and Fantasies
47

Clinical Psychology (6 decks)

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