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Clinical Psychology > Psychodynamic Psychotherapy > Flashcards

Psychodynamic Psychotherapy Flashcards

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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
Q

Describe PDTs “Focus on relationships” in a few points

A
  • 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
Q

Describe PDTs “Centrality of the therapeutic relationship” in a few points

A
  • 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
Q

Describe PDTs “exploring symbols and fantasy life” in a few points

A

-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
Q

PDT is all Freuds work
PDT is no grounded in evidence

These are both…

A

myths

29
Q

4 key understandings of PDT

A
  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
Q

How are symptoms understood in PDT?

A
  • Symptoms serve a purpose
  • they are a means to re-establishing equilibrium/sense of self
  • symptoms can be symbols or areas of stuckness
31
Q

What is the goal of PDT?

A
  • 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
Q

Freud saw behaviour as motivated by drives and instincts while moderns theorists see the motivators as …

A

affect and relatedness

33
Q

What are 4 of the tool that modern PDT uses?

A
  1. Use of therapeutic relationship (transference)
  2. Free association
  3. Dreams and fantasies
  4. Interpreting defences
34
Q

Modern PDT uses …. to bring about a ….

A

what ever the patient brings to the space

collaborative meaning-making process

35
Q

How does the therapeutic process use transference?

A

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
Q

How does PD use free association?

A
  • 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
Q

How does PDT use dreams and fantasies?

A
  • 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
Q

How does PDT use “interpreting defences”

A
  • 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
Q

In revealing defences to clients, therapists need to conscious of 2 things:

A
  1. timing
  2. resonance for patient
40
Q

Three main areas of criticism of PDT

A
  1. Gender and sexuality
  2. Context
  3. Evidence
41
Q

Explain the “gender and sexuality” critique of PDT

A
  • Freudian theory pathologised women (penis envy)
  • alternative sexuality seen as pathological/deviant
  • much Freudian research only on boys/men
42
Q

Explain the “context” critique of PDT

A
  • 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
Q

Explain the ‘evidence’ critique of

A
  • see PDT as unscientific
  • not “evidence based”
  • very hard to measure, so not “proof”
    *this has been the most damaging critique
44
Q

Response to critiques of PDT

A
  • mounting evidence for PDT (neuro-imaging proving uncon etc)
  • lots of evidence to PDT is effective
  • larger effect sizes (incubator effect)
45
Q

Biggest changes from Freudian practice to modern-day

A
  • 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
Q

Key elements of PDT

A

Focus on Affect
Defences
Patterns
Past on present
Relationships
Therapeutic relationship
Symbols and Fantasies

47
Q
A

Clinical Psychology (6 decks)

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